Monthly Archives: October 2010

Actinic keratoses/pre-cancerous/dry scaly crusty lesions/sun damage

Actinic keratoses are potentially pre-cancerous dry-scaly lesions that usually appear on hands, face, ears, bald heads, any skin that was extensively exposed to sun during one’s life.

The condition usually becomes evident as we age – some people showing them in their 30’s but usually in the 40’s and 50’s and older. Light skin toned individuals that did not make good and effective use of sunscreen in their youth and yet spent time in the sun, are most susceptible to them. Men account for a larger percentage of actinic keratoses sufferers. Even intermittent sun exposure (and typical San Francisco foggy/cloudy weather) does not stop UVA exposure. Use of tanning beds is one of the worst ways to expose your skin to the potential of creating actinic keratoses as you age.

They present with intermittent expression, even in patients with extensive damage, according to an 11-month study presented at a Society for Investigative Dermatology meeting in 2009.

A small percent of Actinic Keratoses can become pre-cancerous (leading to squamous cell carcinoma’s according to , and dermatologists will assess them to see if they should be removed or left alone. Very often they use cryosurgery (freezing it with liquid nitrogen) and in some of us, it results in depigmented ‘white’ spots. Other options are strong chemical peels or 5-Fluoroucil (5-FU)…an easy to remember acronym

They are not attractive (hard scaly areas on the skin never are) and applying moisturizer all over them will mask them for a while, but it appears that they naturally wax and wane according to this report in Dermatology Times .

If you are concerned, go see your dermatologist. If they get burned off, use alocell gel to help the skin heal and reduce the potential for scaring. Most importantly, wear a mineral sunscreen everyday!

What I have stated here is not meant to diagnose your condition nor try and claim to cure it. Just helpful suggestions that usually create positive changes. We are all unique, and our body chemistry and genetic inheritance will often create unique skin conditions. I always hope that I can help the majority who fall in the middle between the extremes.

Skin lightening/Dealing with hyperpigmentation/brown spots/solar lentigos/sun damage

Brown spots come with age…yes…but most are due to sun damage. Not just direct sun damage – incidental sun damage too – like walking your dog in the morning, picking up food at lunch time, driving to and from anywhere (near and far) etc etc. You are NEVER truly out of UV rays from the sun – no matter how hard you wish to believe that you are. The proof is in the sun damage you develop – and then must deal with.

Pigmentation can also come from hormonal issues in women (melasma), acne (post-inflammatory pigmentation), genetic disorders, photo-sensitivity due to medications….

And then there is pigmentation from your skin not breaking down cell material properly when cells die off (or are killed off by safety mechanisms in the body). This issue has no real solution as yet. The big brown spot on my left cheek is proof of this.

According to the March/April 2010 edition of MedEsthetics, doctors invariably attack pigmentation issues with strong ingredients like Hydroquinone and retinoids (Retin-A and all similar products). Both of these product ingredients are irritating to the skin and often can not be tolerated by patients – who wants red/irritated/flaky skin?

As stated in the article “many individuals with uneven pigmentation also have sensitive skin, so it is important to ease into any treatment regimen”. Strengthening and balancing the skin is my #1 goal, so let’s do that before you embark on any expensive medical treatments.

Medical treatments for fair skin tones with light to moderate sun damage includes IPL and other stronger laser resurfacing treatments. Unfortunately doctors usually prescribe strong detergent cleansers and hydroquinone products post laser treatments so your skin will definitely be red/irritated/uncomfortable for quite some time.

Medical treatments for dark skin tones include the same harsh detergent cleansers and other barrier damaging ingredients in moisturizers, coupled with retinoids. I like glycolic acid serums  and retinaldehydes in treating darker skin – it takes longer but will not create potential hypopigmentation issues (light spots). I agree with some of the doctors that a Jessner peel is a good solution of light skin tones as well as some darker skin tones. Come in for a consultation and we can decide if you are a good candidate for a strong peel. Specialized peels are an option at Blue Turtle Spa. I prefer to consult with you on a peel first, and if your skin is suitable we can set up an appointment. You will need to review the post-peel home care regimen because a peel is a commitment that you must plan for…

The essential aspect of any pigment lightening treatment is the  repair and rejuvenation that occurs after the initial procedure. Help the skin get stronger with antioxidants (like the antioxidant vitaserum ), hydration gels (like the Hale Dermist HA ), and repair stimulating beta glucans and glycoproteins (as in the aloCell Gel ). Ongoing lightening in the home care regimen will include a nightly application of glycolic acid serums (like Glyco-A-Gel or Age Limit ) as well as a retinaldehyde (Vit A) serum (like Renew or Calm ). ALWAYS wear a mineral sunscreen (>10% minerals) EVERYDAY – otherwise your quest to lighten dark spots will all be wasted as the sun (UVA and UVB – whether direct or incidental) will always cause pigmentation issues to reappear.

Hydroquinone is approved by the FDA as a skin lightener. It does works. I can get you a high % Glycolic acid and 2% Hydroquinone mix for strong skin, and a high % Lactic acid and 2% Hydroquinone mix for less strong skin. Both have a distinctive ‘sting’ when applied to the skin. Some people may be able to use it nightly – others only 3 x per week. You have to scale back on it’s use if you are getting irritated skin (always a possibility with frequent use of products like this). Often the pigmented area will turn quite dark within a week or 2 but this will peel off and leave the area lighter – or even without the pigmentation if it is not too deep… I never recommend strong acids and hydroquinone for rosacea or weak/unbalanced skin.

Alternatives to hydroquinone are available – though they tend to work a little slower – so these are fine as long as you are not impatient about getting results. Arbutin from Bearberry extract is a natural form of Hydoquinone, Azelaic acid from almonds, Kojic acid – another natural form of Hudroquinone, Licorice and mulberry extracts also show lightening effects. Vitamin C also has skin lightening abilities (as well as being a great antioxidant) but there are many forms of Vit C, the one that penetrates the skin barrier the best is tetrahexyldecyl ascorbate – found in the Triple C E formula . Peptides are also a growing area of skin lightening ingredients.

The most important aspect of using any skin lightening ingredients is how well they can absorb into the skin. Many poorly formulated products will just sit on the skin and do not penetrate to where they will be effective. The quantity of the ingredient in the product is also critical to the level of success you can expect. Using an exfoliator like glycolic acid (in Glyco-A-Gel or Age Limit) together with any skin lightening ingredients will be the most effective.

Wrinkle erasing – the medical solutions

The primary cause of wrinkles is sun damage, but genetics and how you live your life play a substantial role as well. Teenagers and young adults can reduce their potential for severe wrinkling later on in life by wearing a mineral sunscreen everyday, and take care of their skin and body by eating well.

Age happens to everyone and everything on this planet. If you have done major damage and genetics are not on your side, either accept it or pay big bucks to make changes. The dramatic changes can only come from medical procedures.  Here are some of your potential costs based on the national average based on a Wall Street Journal report of Oct 12, 2010 on page D1…

Frown lines between eyes (Botulinum toxin A – e.g. Botox) $397
Crow’s Feet at the sides of eyes (Botulinum toxin A – e.g. Botox) $397
Smile Lines and Sunken Cheeks (Dermal fillers like Restylane, Juvederm, Radiesse, Sculptra…) $467 – $1253
Loose Jowls (facelift) $6881
Dark Sunken Eyes (fat grafting or specialized fillers) $1797
Sagging Eyelids (Blepharoplasty eyelid lift) $2717
Sagging Brow (Forehead lift) $3276
Sun Spots (laser resurfacing) $1030 – $2424. An alternative is a chemical peel. At a medical facility it is $719, at Blue Turtle Spa a chemical peel is $150 so you can get 4 of them for less than 1 a medical facility…

Dr. Gregory Nikolaidis, a dermatologist and cosmetic surgeon from Austin TX is reported in the Sep/Oct 2010 issue of MedEsthetics that filling the tear trough and sunken eye area is  one that he specializes in and avoiding the veins in the area is critical to preventing bruising that may take a while to disappear. He also feels that under-correcting is better than over-correcting the area. Excess Juvederm can last for up to a year – so over-correcting will require a further procedure using Vitrase to break it down. He feels that 1 syringe of Juvederm XTC in the periorbital region is sufficient. The patient should return 4 – 5 months after first treatment and then every year or two as needed.

FDA APPROVED = Animal Testing

When ever you see those words “FDA Approved” you know immediately, and without any doubt, that animals were tortured and killed getting to the point where a corporation can make a lot of money selling a product or equipment that has been FDA approved. Makes you wonder just how exciting all these marketing hyped up innovations are. You can spend money on looking younger and feeling better thanks to the death of over 100 million animals.

Congress must change the rules for the FDA and EPA. Check out the valiant efforts being made…

I cannot begin to think what it must be like being one of the many people whose job it is to torture, cause pain, and death to millions of animals each year. Just how humane is humanity? Genocidal warfare does not paint a pretty picture of human beings…and what does torturing animals for the purpose of making money say about us??????

Our charity donations make us feel good – we need to help others and improve our society and planet – but is it OK to do it at the expense (aka life) of defenseless and unwilling animals? Support charities that do not spend money testing on animals. Go to / and search to see if your charities are pro or anti animal testing. There are alternatives to the exact type of charity that you support so there is no need to stop supporting an area that is important to you.

This is breast cancer awareness month – so which
charities do NOT support animal testing? Avon Breast Cancer Crusade (, American Breast Cancer
Foundation (, Breast Cancer Fund ( And with
the Nike Womens Run this weekend to support Luekemia and Lymphoma here is an
organization that does NOT support animal testing – Lymphoma Foundation
of America ( AND for skin
cancer there is the Skin Cancer Foundation ( SOURCE:
personal care guide.

Sunscreens are for EVERY DAY

WEAR A MINERAL BASED SUNSCREEN EVERYDAY BECAUSE UVA radiation damages DNA in human melanocyte skin cells, causing mutations that can lead to melanoma.

A new study by researchers at NYU School of Medicine found that UVA radiation damages the DNA in human melanocyte cells, causing mutations that can lead to melanoma. Melanocytes, which contain a substance called melanin that darkens the skin to protect it from the ultraviolet rays of the sun, are more vulnerable to UVA radiation than normal skin cells because they are unable to repair themselves as efficiently. See the full article . For super mineral based sunscreens see the Blue Turtle Spa Online Shop .