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Rosacea is a chronic skin condition that typically affects the face, however, can affect face, neck, chest and other areas of the body. Just about 16 million people are diagnosed annually, and that’s just the folks that go into the physician’s office for help. So I’m guessing it’s more like 18-20 million. The most common symptoms are blushing, persistent flushing, visible blood vessels in your face, typically in the t-zone of the face (nose, cheeks, chin). Symptoms can often progress into small pimples that resemble acne also known as “papulopustular rosacea”. Moderate symptoms can be a burning sensation to the affected areas then some people can have “rhinophymatous” changes like enlargement of the nose and an orange peel look to the skin. Rosacea of the eyes ,“ocular rosacea”, can cause dry, irritated, sometimes swollen eyelids. Sounds complicated! Right…. There are triggers for your rosacea that can cause flare ups: Red wine, alcoholic beverages, emotions, hot drinks, spicy foods, temperature extremes, certain drugs, exercise, some cosmetic and skin care products. These triggers are very individual and can differ from person to person. The cause is still being disputed but what we do know is that it can be hereditary, it’s not contagious or caused by poor hygiene. Research is leaning on multiple causes; possibly an overactive immune system, environmental, chronic inflammation which leads to the breakdown of the skin barrier, just to name a few as root causes. Breaking that cycle of inflammation, seems to be a key factor in improving rosacea symptoms.  This chronic Inflammation (inflammation over time ) is looking more like a key factor in the rosacea continuum. Decreasing inflammation can be crucial in reducing the overall symptoms related to rosacea. The repeated episodes of facial blushing, flushing, papules, pustules (acne rosacea) can lead, over time, to the skin barrier breakdown thus resulting in a breakdown of the skin’s microbiome. Here are some things to consider to reduce some of this inflammation.

Summer is here and the weather is hot! I would like to say, the best protection from the sun’s radiation over time is a wide brimmed hat, sun protective clothing, staying in the shade, and of course your sunscreen. Recently there has been some controversy over some sunscreens containing benzene. Benzene is a known human carcinogen for at least a hundred years. A recent article in “Dermatology Times”, highlights a recent batch testing done by a pharmacy (Valisure), that found up to 78 different sunscreens and after sun care products contained benzene. This is startling to say the least. Attached (see below) is what Valisure has posted, Attachment A, table 5, product description of various batches of sunscreen for which benzene was not detected through initial tests, of at least one sample from each batch. You can check on your own with the UPC (Universal Product Code), lot number and expiration date. I believe some sunscreens have already been recalled. Best to check yours at home or any recently purchased sunscreens, and check table 5. Things to consider when purchasing a new sunscreen; When you apply sunscreen and then go into the sun, your pores will dilate from the heat allowing the sunscreen chemicals to be absorbed into your skin and into your bloodstream. Certain chemicals can cause issues later on in life. In addition, consider staying away from sprays and aerosol type sunscreens. The reason behind that is, you can breathe in those chemical/mineral particles getting into your lungs. I do not recommend any sunscreens that are in a spray or aerosol form.  I will list a few sunscreens that are over the counter that I like and are on table 5, from Valisure (see attachment below).

Good morning all, I haven’t posted anything in over a year, I sooooo apologize. Today I’m bringing up the issue of trust. Lately I’ve been hearing of the resurgence of “Botox” parties. Usually these are at an off site location of someone’s home or place of business ( not a medical office). Alcohol and appetizers are usually served. The person injecting comes from out of town to make money on a small group of folks. I have a real issue with this for several reasons. One, I don’t think its a good idea to mix alcohol with decision making regarding your face or anything for that matter. Second, injecting Botox is considered a medical procedure and there can be complications. Let’s face it , it’s not like you are having a Tupperware Party. Injecting Botox or other injectables is a medical procedure and should be done in a medical setting by a medical professional. Another thing you should be asking yourself is, “Do you trust this person”? Can you get a hold of them if something does go awry? What if I faint? These are just examples of unforeseen medical complications, the list goes on. Rest assured if you are in a medical office any of these circumstances can be addressed, promptly. I have spent hours fixing other people’s botch jobs and sometimes it’s not an easy fix. Let’s look at the cost benefit analysis: Say your husband doesn’t want to pay a professional to trim his trees/yard. So he does the work himself and injures his back. Ends up in the hospital eventually needing surgery. What could have cost maybe $1,500 now is costing $50,000. Sometimes it’s better to put your trust in a professional who performs that service regularly and is good at it. Why put yourself at risk? Finding an injector you trust, that has the knowledge base to address your particular needs and works in a clean setting is imperative for consistently good outcomes. At our office we have a medical professional on call after hours and on the weekends for urgent situations related to procedures. I have been at the same office for the last 17 years, everyone knows where to find me. I inject everyday.  The next time you search for the cheapest botox or dermal filler, just remember this is your face! YOU CAN’T PUT A PRICE ON TRUST AND EXPERIENCE.

Your Safety Is Important To Us  Some new guidelines when visiting our office for cosmetic treatments When arriving to the parking lot please call 805-434-5563 to check in from your car. We will call you on your phone when your room is ready to be entered. A mask is required when entering the building, once you are roomed with your mask on, you will be instructed on mask removal, if necessary. Once you are roomed you will be given hand sanitizer If applicable, a pre-rinse may be given before your treatment Please do not come in to the office if you are not feeling well. Please use hand sanitizer again on your way out

Otherwise known as medical needling

There are four neurotoxins. These four neurotoxins: Botox, Dysport, Xeomin and Jeveau all work the same way. Basically it’s a protein taken from the Botulism neurotoxin and this protein is injected into certain muscles to relax them. This protein works by blocking the neurotransmitter acetylcholine (the messages being sent to the muscle) and those injected muscles relax. It is this relaxation of certain muscles that smooths the forehead or the frown lines, etc… There are four different pharmaceutical companies creating these neurotoxins, and the proteins come from four different neurotoxins. I have used all four neurotoxins on myself and they all seem to do the same thing and last pretty much the same. I feel sometimes I have to use more Xeomin to get the same result as Botox or Dysport. Jeveau is the newest of the bunch and seems to do fine so far. I’m thinking though that Allergan (Botox) has been doing it for 30 years , has a great track record, their lab has been doing this a long time and a medical team waiting to answer any of my questions or concerns. Dysport comes in at a close second. My top two products would be Botox and Dysport. Botox seems to be the more expensive out of the bunch but they also have a huge resource system in place as well. Each product has its attributes. It’s really what your injector is most comfortable injecting. When it comes to finding someone to do your injections the most important thing to consider is how well your injector knows your anatomy. Anatomy knowledge is key to seeking natural and consistent results. Your injector should get to know you and vice versa. Your injector should be very proficient in knowing your anatomy. Talking before injecting is important especially if it’s your first time. I usually do a follow up appointment at two weeks to make sure the patient is happy and there isn’t anything we need to add. Its way easier to add on but you can’t take away. Everything is documented, where, how much, how often, what product etc… It’s not a point and shoot kind of thing! I feel like some people shop around for the best price. Really? You really want cheap Botox for your face. Or a person will hop around from place to place and the injector doesn’t get to know your likes and dislikes. Your face is, well, your face. You’ll spend $200 on your hair and maybe $60 for a mani/pedi, and $400-500 on a purse but then want to spend less on your face? Do you really want a groupon for your face? What it comes down to is just finding someone you are comfortable with, and is available to you for any questions or concerns.

The Importance of Your Skin Barrier and Moisturizing (Part 1) A recent pilot study has linked keeping a proper moisture barrier may have an interconnection to a person’s health and wellbeing. Researchers at UC San Francisco found that age damaged skin in older adults could be related to a variety of conditions such as heart disease, Alzheimer’s, just to name a few. So, here’s what researchers found, as we age our skin barrier breaks down, which then leads to an increase in cytokines circulating in the body. Cytokines are proteins that signal there’s inflammation. If the cytokine level in the body is substantial, it will provoke inflammation throughout your system. This continuous inflammation over time then can lead to health issues. Researchers were trying to figure out what organ of the body is big enough that even a small portion could cause such inflammation. Bingo! The Skin. As we age, the circulating cytokines increase, our skin gets dryer, itchier, acidity changes, and so on. Our skin barrier breakdown plummets as we age causing more inflammation. Young people don’t have as many circulating cytokines and young skin is plump and intact, a safer skin barrier (less aged). The experiment went like this, they took older adults (ages 58-95) and had them moisturize their bodies twice a day for 30 days. After 30 days, these adults had cytokine levels tested again and it seems these folks had a decrease in three different cytokines to that of a 30-year-old. Wow! Let’s get back to that skin barrier. Even young skin can be compromised, people with eczema or psoriasis, for instance. These conditions break down the skin barrier at a younger age, so are these folks more susceptible to inflammation sooner then most? Is there a study linking eczema to Alzheimer’s? The sun in general will break down your skin barrier over time, including pollution, radiation, chemotherapy and the list goes on. Again, your skin is the largest organ of your body, take care of it, moisturize it, protect it, baby it. Skin Barrier (Part Deux) We now understand that moisturizing the body is important. What should you use? Which ingredients are going to be the most helpful in reducing inflammation? According to Skin Inc. magazine the July 2019 issue, Vitamin B3, also known as Niacin or Niacinamide, enhances the skin barrier. Niacin is found in meat, fish, beans, cereal, eggs, and vegetables. Our body doesn’t make this particular vitamin, so we have to ingest it through the foods we eat. Studies have shown that a topical application enhances the skin barrier lipids! Niacin also helps reduce redness and pigmentation, increase elasticity, and has a bit of anti-inflammatory effect as well. I think this will be a great ingredient. The skin barrier is SO important. The other ingredients you will look for are emollient oils and butters. Shea butter is good. Mango seed butter is good. See if you can get these ingredients in your moisturizer. What I mean by oils are, sunflower oil, or sweet almond oil. These are just examples; you can be creative. These natural oils work well and they contain fatty acids that help support your skins moisture barrier. The oils and butters are over the counter, just be sure to go organic. Another ingredient that is super important is hyaluronic acid. This stuff is a natural moisturizer and can hold in moisture 1,000 times its weight in water. It can repair your skin and lubricate! Now anything with anti-oxidants like vitamin C, vitamin E, that would be the Skin Ceuticals; C, E, Ferulic acid, just add that to your regime. You should be using that already anyways. Just e-mail me if you have any questions. I have two kids launched and only one at home. I am happy to help. Product Suggestions:

Sunscreen is important these days, but some sunscreens are better then others. This summer get yourself a good sunscreen, always have a wide brimmed hat (tightly woven one) with you. Sun protective clothing is also a good option. No matter what, you still need to put sunscreen on those parts of your body that get sun exposure. You want a sunscreen that is a mineral screen avoid the chemical screen if you can. Mineral ingredients include zinc oxide, titanium dioxide, and avobenzone. Avobenzone is good but some people are allergic to it. If you can use avobenzone as an ingredient go for it. Stay away from sunscreens with insect repellent in it. So, the reason you want a mineral sunscreen is because when you go out in the sun what happens? Heat! The sun causes heat and heat dilates, it will dilate your pores and then you absorb all those chemicals into your blood stream time and time again. So, stay away from a chemical sunscreen. A mineral sunscreen will do this a lot less and kind of sits on the skin and absorbs much less into skin. Remember the skin is the largest organ of the body it does a lot of absorbing of whatever you put on it. Ingredients to avoid: Oxybenzone Octinoxate Homosalate Retinyl palmitate Aerosol sprays Over the counter sunscreens that are good include; Blue Lizard Australian sunscreen baby SPF 30, Vanicream sunscreen SPF 30, Neutrogena Sheer Zinc Dry-touch sunscreen SPF 50. If you are looking for something with a little more oomph! try Skin Ceuticals Physical fusion UV defense sunscreen SPF 50, this has a little universal tint to it and is nice. Skin Ceuticals physical matte UV defense SPF 50 has an oil absorbing base with a matte finish perfect for oily skin types. When you are at the beach use a lot and reapply frequently.

WHAT A VITAMIN A RESURFACING SERUM CAN DO FOR YOU. What is a retinol cream or serum? A retinol cream or serum is a topical form of Vitamin A, also known as retinoids. There are many derivatives of Vitamin A, which can reduce fine lines, and wrinkles, and help even out certain skin pigmentations. Retinoids are usually prescribed by a dermatologist, retinols can be used in over the counter formulas.