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The first step is to find an exfoliant that best suits your skin type — One that will slough off the older, outer dead skin cells and reveal younger, healthier looking skin. Retin A, definitely the most powerful exfoliant of all, is a true “miracle in a tube” for reversal of photoaging skin. However, not everyone is a candidate for Retin A. One alternative, Kinarase, a natural plant derived gentle exfoliant, can be better tolerated by more sensitive skin types. Another alternative is Glycolic Acid, which is made from sugar cane. It not only stimulates cell renewal by holding water in the skin and increasing skin plumping collagen, but also enhances the penetration of Vitamin C Ester and Alpha Lipoic Acid which you will be hearing more about later in the article. Still another alternative, Afirm, which is a retinol that contains a “Microsponge sytem” which allows the product to be exceptionally gentle on the skin while refining the pores, evening out the skin tone, and adding new radiance. After the exfoliation process, we need to “feed” the fresh new skin with nutrients, anti oxidants, and collagen building ingredients. Topical C Serum with either Ester C or Ascorbic Acid not only prevents free radical damage, but also helps with collagen synthesis and aids the body’s natural resistance to wrinkles by boosting immunity to ultraviolet light (our biggest aging enemy). Another anti oxidant, DMAE, often referred to as “An Instant Facelift In a Bottle” helps tired, over stressed skin, and loss of elasticity and fine lines. Alpha Lipoic Acid, which we been hearing a lot about lately, helps to tighten pores while evening out the complexion and giving it a healthy glow. A combination of all three ingredients used daily can significantly address every sign of aging on your face. You may also want to add professional treatments to your skin regimen. Microdermabrasion, a process that evens out pigmentation, smooths fine lines, and removes surface sun damage, can be administered during your lunch hour with literally no down time. Each treatment ranges from $100 to $200. However, it is most effective when done in a series of six every two weeks with maintenance once a month. Botox injections can rid you of aging crow’s feet and frown lines. Nerves are temporarily weakened causing wrinkles to decrease or virtually disappear. The cost of the treatment ranges from $500 to $800 per treatment and lasts approximately 3 to 4 months. If you require a more permanent approach, then, maybe laser resurfacing might be your treatment of choice. While you are under anesthesia, the laser removes top layers of skin eliminating fine to medium lines while improving deeper ones. Effects are permanent. Down time is approximately two weeks. After that time, camouflage make up may be applied to mask the redness until final healing is reached usually 6 to 8 weeks later. Coming Soon: Our New Greatskin All in One Cream! After extensive research, product testing and collaboration with leading phytochemists, Dr. and Mrs. Van Wormer are pleased to offer what they consider to be the most technologically advanced, most potent anti-aging cream available today. We have combined effective antioxidants such as: Alpha Lipoic Acid, Vitamin E, Grape Seed Oil and Retinol, also known for great exfoliation, and powerful anti-aging ingredients: DMAE, L-Carnitine and Copper. We hope to have our new All in One Cream available to the public by December 1st, watch our website www.greatskin.com for updates!
Externally, the skin obviously will be affected, both through incisional work or thermal damage. Incisions can be made with scalpels, radiofrequency knives or laser beams. Scalpels are not particularly hemostatic (blood stopping), but radiofrequency knives and laser beams are, laser being the most hemostatic instrument. So the degree of potential hemorrhage during the procedure should be optimized. One’s coagulation system can be optimized to prevent significant bleeding and bruising through taking oral Arnica and topical Arnica for several days prior and after surgery. Arnica also has an anti-inflammatory effect and helps prevent postoperative wound infection. What about thermal damage to the skin? One can optimize the results of cutaneous laser resurfacing by minimizing thermal damage to the dermis. Actually, it is the thermal damage to the dermis, which results in the formation of collagen fibrils during the healing phase, resulting in rhytid reduction (wrinkle removal). Excessive thermal damage, however, can result in a disastrous outcome. For the last few years I have gradually decreased my dosage of Laser Energy with excellent results. Through a careful preoperative period of vigorous exfoliation using a combination of glycolic acid, tretinoins and chemical exfoliation prior to laser resurfacing, the surgeon can use much less thermal energy and achieve the same results. How? With the surface epithelium completely stripped, and only a thick vascular dermis remaining behind, the thermal energy imparted to the dermis is much more effective, and tissue heating is minimized because the layer of stratum corneum (dead epithelial cells) is not there to absorb heat and transfer it to the dermis. In practical terms, this means the surgeon can perform optimally with two or three moderate energy laser passes, rather that three or four maximal energy passes with similar cosmetic results. In fact, the reason Erbium-yag lasers became popular is that less thermal energy in a more superficial fashion was imparted to the tissues with less post-operative redness. How can the surgeon minimize “down time,” or the embarrassing appearance of postoperative redness, scaling, and crusting? Again, through the appropriate pre and postoperative care and close attention to laser settings (thermal energy) and number of skin passes used during the procedure. I find that most patients only have a mild “sun burn” appearance that actually looks healthy by about postoperative day 14. I rarely have patients use any masking makeup post operatively, because they look so healthy. The patients even appreciate the glow. However, a few years ago, the postoperative redness (erythema) encountered during laser resurfacing was often prolonged and cosmetically disfiguring. The difference is the optimization of skin health through gentle pre-operative exfoliation and use of Arnica preparations. Interoperatively, much less photo-thermal energy can be used, combined with intravenous steroid use, minimize postoperative swelling and redness. Post operatively the technique of continuous facial cooling for the first 48 hours with total occlusion of the wound using the Silon II semipermeable skin-like membrane prevents postoperative pain, swelling, and redness. Rarely, do my patients require any postoperative analgesia other than Tylenol. What about late complications such as hyperpigmentation or scarring? Again, with moderate laser settings and fewer passes through well-prepped skin, the surgeon can minimize the postoperative complication rate. For patients who are Fitzpatrick three or greater (olive to dark skin), the surgeon should provide a bleaching program using either hydroquinone or Kojic Acid daily. These compounds are tyrosinase inhibitors which prevent the formation of melanin in response to either surgical or thermal injury. In terms of wound healing, oral antioxidants such as vitamin C, Coenzyme Q-10, Vitamin E, pycnogenol, and grape seed extract with proanthocyanidins can be very helpful. L-ascorbic acid applied topically has been shown to minimize chemical and photo induced injury and diminish postoperative redness as well as promote wound repair. Topical Epidermal Growth factor promotes cellular growth for wound repair. Human growth hormone used one month prior and two months post operatively results in significant reduction in healing time. All the comments above apply to surgical face lifting, blepharoplasty, and cutaneous laser surgery. Please refer to http://www.greatskin.com/product/surgery.htm for the actual content of the pre and postoperative program for optimizing facial surgery results.
Are you planning on having facial surgery? We have put together two excellent kits for our Pre and Postop clients. Read about both of these programs -- plus the protocols that Dr. Van Wormer uses to prevent scarring, bleeding and swelling when he does laser resurfacing.
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