Dermatology scale validates quality of life

The quality of life can supposedly be determined by a dermatology scale. There are various scales out there that can study hyperpigmentation disorders among adults, and then show the person’s quality of life from the results. Who knew so much can be told about someone just from a possible skin disorder

Can having a skin condition impact the quality of your life? Absolutely, claim Boston University School of Medicine researchers who have set out to find the best tool to measure the impact on patients.

Several dermatology and disease-specific tools have been developed to measure the impact of skin disease including the widely used Dermatology Life Quality Index (DLQI) and the non-validated Skin Discoloration Impact Evaluation Questionnaire (SDIEQ). But the question remains: is one scale superior to the other, and/or easier to use?

In this study, BUSM researchers compared the DLQI with a short questionnaire (SDIEQ) to determine the impact of dark spots on a patients’ quality of life

After analysis of 321 adults with hyperpigmentation disorders using both scales the researchers found that DLQI and SDIEQ were similarly effective in measuring quality of life, however SDIEQ was simpler to use and less time consuming.

“Knowing how a condition impacts a patients’ quality of life is essential and a helpful guide in making treatment choices,” explained corresponding author Neelam Vashi, MD, assistant professor of dermatology at BUSM and director of the Boston University Cosmetic and Laser Center at Boston Medical Center. “Measuring health related quality of life is also important in patients when it comes to allocation of resources.”

Vashi added that further studies are needed to validate the use of this tool in different patient populations and potentially other disorders of pigmentation, such as vitiligo.

These findings appear as a Research Note in the Journal of Dermatology.


Food allergy is triggered by perfect storm of genetics and skin exposure to infant wipes, dust and food

A lot of people you know may have a food allergy of some sort, as it is more common than not having any allergies. Some recent research has shown possible links between environmental factors and genetic factors coexisting to trigger this allergy. When it comes to children, this perfect storm is rather easy to concoct on it’s own:

Infant and childhood food allergy, whose cause has long been a mystery, has now been linked to a mix of environmental and genetic factors that must coexist to trigger the allergy, reports a new Northwestern Medicine study.

The factors contributing to food allergy include the genetics that alter skin absorbency, use of infant cleansing wipes that leave soap on the skin, skin exposure to allergens in dust and skin exposure to food from those providing infant care. Food allergy is triggered when these factors occur together.

“This is a recipe for developing food allergy,” said lead study author Joan Cook-Mills, a professor of allergy-immunology at Northwestern University Feinberg School of Medicine. “It’s a major advance in our understanding of how food allergy starts early in life.”

The paper will be published in the Journal of Allergy and Clinical Immunology on April 6.

Food allergies are on the rise and affect an estimated 4 to 6 percent of children in the U.S., according to the Centers for Disease Control and Prevention. The prevalence of reported food allergy increased 18 percent among children under age 18 years from 1997 to 2007. Recent data also show hospitalizations with diagnoses related to food allergies have increased among children.

Food allergy risk factors can be modified at home

The good news is factors leading to food allergy can be modified in the home environment, Cook-Mills said.

“Reduce baby’s skin exposure to the food allergens by washing your hands before handling the baby,” Cook-Mills said. “Limit use of infant wipes that leave soap on the skin. Rinse soap off with water like we used to do years ago. “

Scientist discovers the ‘perfect storm’ triggering food allergy

Cook-Mills made the discovery by using clinical evidence about food allergy in humans, the effects of food allergen and environmental allergen exposures and neonatal mice with genetic mutations that occur in humans.

Clinical evidence shows up to 35 percent of children with food allergies have atopic dermatitis and much of that is explained by at least three different gene mutations that reduce the skin barrier.

Cook-Mills used a neonatal mouse model with skin barrier mutations and tried exposing its skin to food allergens like peanuts. The peanuts alone had no effect.

“Then I thought about what are babies exposed to,” Cook-Mills recalled. “They are exposed to environmental allergens in dust in a home. They may not be eating food allergens as a newborn, but they are getting them on their skin. Say a sibling with peanut butter on her face kisses the baby. Or a parent is preparing food with peanuts and then handles the baby. “

Next, she read about skin research studies that delivered compounds through the skin by using soap. “I thought oh my gosh! That’s infant wipes!” Cook-Mills said.

The top skin layer is made of lipids (fats), and the soap in the wipes disrupts that barrier, Cook-Mills explained.

Skin problems that occur with skin barrier mutations may not be visible until long after a food allergy has already started. The neonatal mice with the mutations had normal-appearing skin, and the dry itchy skin of dermatitis did not develop until the mice were a few months old, the equivalent of a young adult in human years.

After the neonatal mice received three to four skin exposures of food and dust allergens for 40 minutes during a two-week period, they were given egg or peanut by mouth. The mice had allergic reactions at the site of skin exposure, allergic reactions in the intestine, and the severe allergic food reaction of anaphylaxis that is measured by decreased body temperature.

A skin barrier dysfunction was necessary for food allergy to develop in the mice, but there is a wide continuum of severe to mild skin dysfunction with eczema or atopic dermatitis, which in its mildest form may simply appear to be dry skin.

In patients with skin-barrier defects, there are changes in the proteins in the skin that are a result of mutations in the genes. These gene mutations in patients are primarily heterozygous, which means there is a mutation in one of the two copies of a gene.

Accordingly, in the preclinical studies, neonatal mice were also heterozygous for skin barrier mutations. The mice were co-exposed to food allergens such as egg and peanut proteins, allergens in dust (house dust mite or Alternaria alternata mold) and sodium lauryl sulfate, a soap present in infant cleansing wipes.

These novel animal studies provide a basis to test interventions that will more effectively block the development of food allergy in infants and children, Cook-Mills said.

She is currently studying molecular responses in the skin that are unique to this combination of genetics and skin exposures. The goal is to determine unique signals in the skin that occur during development of food allergy. This will lead to approaches to intervene with those skin signals and block the development of food allergy.

The study was supported by National Institutes of Health grants R01 HL124120, U01 AI131337 and R01 AI095282.


Surgery vs. Non-Invasive Procedures

The trends are shifting and more and more people are deciding to avoid plastic surgery procedures like face lifts and tummy tucks and choosing injections and laser treatments instead.  The article below talks about how the trends have shifted and gives recent statistics on popular treatments and procedures.  If you’ve been thinking about starting a career in laser and skin aesthetics, now’s the time because, as this article shows, business is booming!

Americans are ditching plastic surgery, but are still super vain

By Jeanette Settembre


People are choosing the needle instead of going under the knife.

Since 2000, the number of cosmetic plastic surgery procedures has dropped 6 percent. But it’s not that we’ve become less concerned with our looks: In fact, people are simply opting for non-surgical alternatives like injectable fillers and Botox to reduce forehead lines, crows feet and wrinkles, according to data released Thursday by The American Society of Plastic Surgeons.

The number of people choosing minimally-invasive cosmetic procedures has increased a whopping 200 percent since 2000. Since then, the number of facelifts has gone down by 6 percent; nose jobs are down 44 percent; cheek implants are down 37 percent and forehead lifts decreased by 67 percent.

“There seems to be a small decline in the surgical procedures and an uptick in the minimally invasive because we’re in a day in age where everyone is interested in what they can do with minimal downtime and good results,” Dr. Jeffrey Janis, president of the American Society of Plastic Surgeons, tells Moneyish.

Botox is the No. 1 minimally-invasive procedure with 7.2 million people getting the wrinkle reducing injections. That’s up 2 percent since last year, and 819 percent since 2000. At No. 2 on the list is soft tissue fillers for areas such as cheeks and lips, followed by chemical peels, laser hair removal, and microdermabrasion for smoother skin.

On its face, that’s decent news for our pocketbooks: While the average cost of a facelift is $7,048, according to 2016 statistics from the American Society of Plastic Surgeons, fillers cost between $500 to $1,000 depending on how much work you’d like to be done. However, you typically have to do fillers much more frequently.

What’s more, people are choosing to shape different parts of their bodies with non-surgical treatments, rather than liposuction. Non-surgical cellulite treatments that tighten skin — using ultrasound, radio frequency, infrared light, vacuum massage and injectable medication to reduce fat cells — are up nearly 20 percent since last year. And non-invasive fat-reduction procedures that use special technology to “freeze” away fat without surgery increased 7 percent, while skin tightening procedures that target fat and tighten sagging areas increased 9 percent. The cost of liposuction ranges from $2,000 to $3,500 per treatment region, not including the cost of anesthesia and other fees, while fat freezing costs typically start at around $750. Fat freezing alternatives and lipo can last a number of years, but without diet and exercise, results of both wear off eventually.

“Unwanted fat is something that affects so many Americans,” said Janis. “Plastic surgeons are able to give patients more options than ever before for fat elimination or redistribution. Patients appreciate having options, especially if they can act as maintenance steps while they decide if getting something more extensive down the line will be right for them.”

Of the surgical procedures, breast augmentations were most popular, followed by liposuction, nose jobs, eyelid surgery and tummy tucks. And one surgical procedure that is falling flat, according to Janis, is buttock implants, with a decline of 56 percent since last year.


Wearing Makeup During Laser Treatments

If you have ever wondered whether or not you can get laser treatments done with makeup on your face, Kim Kardashian just answered that question for you. The celeb recently documented a laser treatment she was getting on social media and noted that, first, the makeup on her face needed to come off. If you have been wanting to try laser treatments for your facial region, removing your makeup is just one thing you can do before your appointment to prepare.

The next time your dermatologist, plastic surgeon, or aesthetician tells you that your makeup has to come off before they perform a laser treatment or facial on you, tell them, “Well, Kim Kardashian West didn’t have to.” They may not buy it as an excuse to let you stay made-up, but it’s true: She did wear a full face of makeup during a laser treatment, and she documented the whole thing.

Kardashian West visited Skin Thesis, a medspa staffed with board-certified nurse practitioners in West Hollywood, where she kept the front-facing camera focused on herself during her appointment with the clinic’s director and co-founder, Melissa Haloossim.

“OK, guys, I am getting a Laser Facial. I have to wash all this makeup off,” Kardashian West says to viewers, at which point Haloossim starts removing the foundation, concealer, and bronzer Kim K. may have been wearing. However, she leaves on her smoky pink eye shadow, eyeliner, and dramatic lashes, as well as her pale matte lipstick and scrupulously shaped brows, intact. Yes, the Snapchat flower-crown filter the media mogul is sporting the entire time is known for adding a little glam, but there’s no denying that she’s still wearing a whole lotta actual makeup.

“We’re doing a Laser Facial, so we’re gonna plump up the skin, stimulate the collagen, work on pores, tightening everything up,” Haloossim explains, telling viewers about the $375 treatment. Skin Thesis’s online menu doesn’t indicate exactly which kind of laser is used during its Laser Facial, but its website says the laser is “gentle and non-invasive,” with no downtime.

So, is it OK that Kim K. kept her eye and lip makeup on during a laser treatment? We asked Joshua Zeichner, the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City, for the scoop. “You do not necessarily need to fully remove eye makeup and lipstick if you are not treating the skin in those areas,” he explains.

However, it’s a damn good thing that Haloossim removed everything else. “Makeup must be fully removed from the area of skin being treated with a laser because it can interfere with the laser penetrating into the skin,” explains Zeichner. But it’s not just efficacy that’s a concern. “The makeup can also potentially enter the skin through an open wound created by laser, leading to inflammation and infection.” Yikes.

Following the laser, Haloossim starts their $225 Oxygen Facial, “which I love,” Kardashian West says, lips and eyes still fully beat. The Skin Thesis menu says it “uses pressurized oxygen to infuse a serum of low molecular weight hyaluronic acid, antioxidants, and peptides into the dermis to instantly hydrate and rejuvenate the skin.”

Although Kim K. didn’t give followers an unfiltered look at the end result, we’re guessing it wasn’t long before she reapplied her KKW Creme Contour and Highlight Sticks once she was done.

More on Kim Kardashian’s beauty routine:

If you think $225 is a lot for a facial, wait until you see the million-dollar facial:


Treating Whiteheads

Let’s talk about whiteheads.  Pimples.  Zits.  Blemishes.  No matter the name, they are a nuisance to everyone from time to time.  Whiteheads are different from blackheads and are sometimes easier to get rid of/treat.  We know many people will pop whiteheads in hopes of they will go away just like that, but is that the smartest thing to do?  Learn the answer in the article below.

A Dermatologist’s Pro Tips For Getting Rid of Whiteheads

Once and for all.

It’s time to get rid of whiteheads once and for all. The pesky pimples’ white heads—that’s where the very original name comes from—are agonizingly noticeable and tend to pop up at the most inconvenient times. To figure out how to fight these blemishes, we enlisted the help of Dermatologist Dr. Nava Greenfield of Schweiger Dermatology Group. Read on to find out how to get rid of whiteheads and prevent new ones from popping back up.

What exactly is a whitehead?

“A whitehead is a buildup of keratin (substance produced by skin cells) and oil from sweat glands inside a hair follicle,” says Dr. Greenfield. Whiteheads and blackheads are both comedones, which are small bumps or blemishes on the skin usually causes by a clogged pore, but they do differ. “Whiteheads are also called closed comedones because the pore does not extend to the skin surface,” explains Greenfield. “Blackheads are open comedones because they are open, and allow the keratin and sebum to oxidize which turns it black.”

Should you extract whiteheads at home?

You can, but unless you know exactly what you’re doing, it’s not recommended. “If the technique is not sterile, you can cause an infection in the skin,” says Greenfield. “Also, pimple popping can easily lead to scarring which is hard, time consuming, and costly to treat.” Your best bet is contacting a dermatologist. They have three important things: the tools, the knowledge, and the degree. The only three things you have are your fingers, an insatiable need for instant gratification, and the free trial version of the Headspace app. “Our goal as a dermatologist is to treat the acne without leaving any scars,” says Greenfield.

What are some non-popping at home remedies for whiteheads?

It starts with prevention. “You can try a salicylic acid spot treatment when you see one developing,” says Greenfield. “Sometimes they can help prevent and acne papule from enlarging and can help them resolve.” If you see a whitehead forming, try grabbing one of the products listed below to catch the pimple in the earliest stage.

The Ordinary: Salicylic Acid 2% Solution, $4.90,

Orgins: Super Spot Remover Acne Treatment Gel, $17.00

Peace Out: Acne Healing Dots, $19.00

What products can you recommend for whiteheads?

“I recommend retinoid and glycolic acid washes and moisturizers, Retinoids balance sweat gland productions and stabilize cell turnover on the face which helps control white production,” says Greenfield. If you’re using retinoids to fight whiteheads in the winter, Dr. Greenfield urges users to pack on the moisturizer since retinoids are very drying. It’s best to ask your dermatologist for a prescription retinoid, but here are a few over-the-counter options.

Obagi: Retinol 1.0, $61.00

NeoStrata: Retinol & NAG Complex, $48.00

Jack Black: Deep Dive™ Glycolic Facial Cleanser, $22.00

Mario Badescu: Glycolic Foaming Cleanser, $16.00

So you’re going to pop your whitehead at home anyway. (We get it, no judgement.) How should you prepare?

Be clean! “Clean it [the whitehead] with an antibacterial like rubbing alcohol,” says Greenfield. “Clean your hands and sterilize any other instruments that you will use.”

What’s the process of popping a whitehead? What’s the best after care?

The process is fairly straightforward. “Opening up the skin with a needle and using a comedone extractor to remove the contents of the pore,” explains Dr. Greenfield. In regards to after care, “wipe away any debris left over and hold gentle pressure with a gauze pad for up to approximately one minute.”



What Microneedling Does

Microneedling has become a very popular treatment in aesthetician’s and dermatologist’s offices over the last couple years because of the alleged benefits to your skin that it brings. However, not many people know a lot about microneedling because other treatments sometimes overshadow this procedure. We think the future is bright for microneedling! It is a relatively simple procedure that helps fight your acne scars, large pores, and more. Learn about what it’s like to try microneedling in the article below.

Carina Jahn/Blaublut Edition/August

In movies about a woman trying to get pregnant, there?s always that scene in which the protagonist looks around and sees nothing but infants in strollers, swollen bellies, signs advertising DJ school for toddlers. I have a similar obsessive streak, but in my movie, I?d be faced with a sea of Rihannas, Cate Blanchetts, Pharrells?flawless visage after flawless visage. I?d stroke my own imperfect cheek and weep.

My skin problems began in puberty with a case of cystic acne that haunted me right up until last year, at age 25. (Aczone, my friends: Ask your doctor about it.) Even though I?ve now got my blemishes more or less under control, I?ve been left with enlarged pores and scars around my cheeks and mouth. For this, I?ve tried all manner of over-the-counter peels, exfoliants, and ?miracle? witchy cures (apple cider vinegar shots, anyone?) to no avail.

Then, via the wonderful world of Instagram, I caught wind of the microneedling craze. Microneedling is a process that?s exactly what it sounds like?tiny needles penetrating the skin hundreds of times?usually at the hands of a wand-wielding dermatologist or licensed aesthetician. Popularized in the 1990s by a Canadian plastic surgeon after he found he could fade surgical scars with an inkless tattoo gun, it?s used to treat all kinds of textural woes, from acne scars to enlarged pores. According to Mary L. Stevenson, MD, an assistant professor of dermatology at NYU Langone Health, the counterintuitive process, also known as collagen induction therapy, is thus: The needles create wounds that trigger an ?inflammation cascade,? the same natural healing process that occurs when scar tissue is formed after, say, a scraped knee?rendering skin, to crib from Ernest Hemingway, ?strong at the broken places.? But because the needles are so short (0.5 to 4 mm, tinier than a garden ant), the process is very controlled. While clinical assessments of microneedling are in their relative infancy, the results are promising: A 2015 study in the Journal of Clinical and Aesthetic Dermatology showed ?a noticeable enhancement in skin appearance, post-acne scars, and patient satisfaction? in all 10 patients after six bimonthly sessions. And while lasers are more prone to causing accidental hyperpigmentation in darker skin tones, microneedling does not.

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While microneedling isn?t exactly new, it?s only in the last couple of years that at-home devices have flooded the market. Most DIY treatments involve running a small manual device (think a spiky paint roller) over the skin. Experts agree that at-home rolling should never be done with needles exceeding 0.5 mm?the risk of infection is too high?yet those same experts will tell you that at that particular length, little damage is being done to the skin, and therefore little actual collagen-building is being triggered. Which isn?t to say that at-home rolling is useless. According to Stevenson, DIY devices might increase the effects of certain topical treatments, while Manhattan-based dermatologist Joshua Zeichner, MD, notes that if you?re looking to reduce post-acne hyperpigmentation, the exfoliation ?likely may give some effect. You?ll notice I put in three qualifiers.?

After a few weeks experimenting with a 0.3 mm at-home roller, I notice that my skin feels softer but not markedly changed. I want my pores teeny and my acne scars gone?now. And so, on the recommendation of superstar dermatologist Dendy Engelman, MD, I make my way downtown to Jeannel Astarita, the founder of Just Ageless NYC Medical Spa.

A single microneedling treatment runs between $500 and $750, and it?s rarely sold as a one-off (patients with deep scars often opt for a series of three to six treatments). But for my rosacea and acne-prone skin, traditional microneedling could spell disaster (inflammation! Exacerbated breakouts!). It turns out I?m in luck: Astarita can offer the EndyMed Intensif, a relatively new device that couples microneedling with radio frequency to treat both active acne and acne scars. Delivered via 12 highly conductive gold-plated needles, the heat kills acne-causing bacteria and lessens inflammation. (Because it?s basically two treatments in one, it?s more expensive; my treatment, which Astarita provides gratis, would normally cost $1,200.) After cleansing, exfoliating, numbing, and disinfecting my skin, Astarita starts stamping the thicker skin on my cheeks, nose, and chin, programming the needles to go to a depth of 2.5 mm, followed by my delicate undereyes and forehead at 1.5 mm. It?s no more uncomfortable than a light pinch?for the first few pulses. Then the discomfort gradually increases until tears stream down my cheeks. (Astarita explains that because the Intensif uses a slower in-out motion for its needles than straight microneedling, it?s considered marginally more painful.)

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But almost as soon as it begins, it?s over, and Astarita is applying postprocedure topicals?an antioxidant and a skin-strengthener. When she finally hands me a mirror, my face is a shocking shade of burgundy. It subsides to that of a particularly bad sunburn by the time I get home, and the pores on my chin?this isn?t for the squeamish?look like they?re purging sebum. In actuality, ?it?s a result of the inflammation,? Astarita texts me the next day during a check-in. ?The pores weep.? Per her advice, I slip two damp muslin cloths into the freezer and apply them periodically, feeling not unlike Norma Desmond in Sunset Boulevard?s gruesome makeover scene.

Everyone?s skin reacts differently to these procedures, but it?s typical to be red, dry, and flaky for a few days. I?d planned to work from home on the Friday following my treatment, and at the early-morning sight of my swollen, pink visage, I?m glad I did. I commence a weekend of extreme moisturizing, and by Monday, one colleague remarks upon my smooth skin (hallelujah!).

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By the one-month mark, my pores look definitively smaller, and the scars that have bothered me for years are far less noticeable. Time will tell as to how much collagen- induced filling and tightening I?ll experience?the effects continue to develop for up to six weeks postprocedure?but for now, I?m basking in my own glow.

Not ready to commit to an in-office treatment? Here are the tools you?ll need to baby-step your way at home.


Skimping isn?t an option when it comes to needles in your face?at-home dermarollers like the Rodan + Fields Amp MD Micro-Exfoliating Roller System (1) may help with product penetration. And while in-office post-treatment topicals include injection-grade hyaluronic acid and platelet-rich plasma (via your own blood?as in the vampire facial), there are ultraeffective over-the-counter alternatives. Astarita swears by antioxidants, like SkinBetterScience Alto Defense Serum and SkinCeuticals C E Ferulic, and peptide promoters, like DefenAge 8-in-1 BioSerum (2); Zeichner recommends simple wound-healing balms, like La Roche-Posay Cicaplast Baume B5 (3). ?You may have a fantastic micro- needling procedure,? he says, ?but if you use the wrong products afterward, you may run into problems.”

1. Rodan + Fields Amp MD Micro-Exfoliating Roller System, $220; rodanandfields.comSHOP

2. DefenAge 8-in-1 BioSerum, $220; defenage.comSHOP

3. La Roche-Posay Cicaplast Baume B5, $11; amazon.comSHOP

This article originally appears in the February 2018 issue of ELLE.



Have You Heard of Baby Botox?

The newest injectable method involves a product we already are quite fond of, Botox. The name? Baby Botox. No, babies are not the recipients of treatment. Baby refers to getting a lesser amount of Botox injected into the target area. That way the area won’t appear as stiff as it would with a higher volume used. Learn more about Baby Botox in the article below.

“Baby Botox” (which doesn’t actually involve babies ? phew!), might just be the future of injectables.

Simply put, “Baby Botox” uses a lower volume of Botox (a.k.a. botulinum toxin injections) than a traditional injection to smooth fine lines and wrinkles. “Instead of using 25 units in an area, you may use 10 units,” Melissa Doft, a board-certified plastic surgeon in New York City, tells Allure. “I have many patients who ask for half the normal dose, as they do not want to look frozen but are tired of wrinkles in photos. First-time Botox patients are perfect for this.”

Besides the volume of product used, Baby Botox is about the technique, says Doris Day, a board-certified dermatologist in New York City and author of Beyond Beautiful. “If you’re very precise in where you put the product, you can use lower doses,” she tells Allure. These super targeted micro injections deliver the more natural, tailored look Baby Botox is so coveted for.

As compared to standard-size injections, Baby Botox lowers the risk of your features appearing to be frozen. Take the forehead, for example: “The risk is that you weaken your frontalis muscle, which causes your eyebrows to drop,” Darren Smith, a board-certified plastic surgeon in New York City, tells Allure. “If you’re getting micro doses of Botox, that’s a lot less likely to happen.”

Baby Botox can be used pretty much anywhere on your face, but it’s best to create subtle changes or to erase fine lines. “Something like this is especially nice for an area like the crow’s feet, which is a very delicate area where a subtle treatment is more effective,” explains Smith. “If someone has very deep folds, micro Botox probably isn’t going to cut it. I would offer this to someone with moderate to fine lines.”

Here’s everything you need to know about Baby Botox.

1. This is not a one-size-fits-all injection.

Botox often gets a bad rep for leaving patients looking a little frozen, but that’s the fault of bad technique, not necessarily the procedure itself, explains Day. “In many places where it’s not a trained aesthetic physician doing the injection, it’s really just inject by number,” she says. The problem with this is that no two faces, or even two sides of a face, are the same. “That cookie cutter, one-size-fits-all approach is what often gives these treatments a bad name,” says Day.

Baby Botox takes the exact opposite approach. The goal of the teeny targeted injections is all about personalization. “For me, the goal of Botox is to rebalance and restore the face so you look your most beautiful best,” says Day. “I’m so over that look of sameness.”

Of course, for your most tailored look you might need a bigger dose. When considering Baby Botox, keep in mind, “The lower dose of Botox may not remove all of the lines,” says Doft. “Sometimes patients will try the lower dose first, and if in two weeks they do not see enough improvement, we will invite them back to have the full dose.”

2. It can be used to prevent lines.

The subtle nature of Baby Botox makes it perfect for those hoping to prevent lines in the first place by starting treatment in their 20s. “Baby Botox is designed for patients who are on the younger end of the spectrum of Botox users who wish to prevent the formation of wrinkles,” says Doft.

The idea is to prevent wrinkles before they form by using Botox to manipulate the way wrinkle-causing muscles move, explains Day. “My goal is to watch how you animate and how your face is aging and redirect it.” In other words, Baby Botox can help you hold onto your baby face.

3. It can be a subtler way to maintain results.

Baby Botox can also be used as an upkeep strategy. “I really think of it as small maintenance doses of Botox over time instead of standard doses given at three- to six-month intervals,” says Smith. “The other term that describes this well is ‘tweakment’ ? subtle changes done over a longer period of time using lower doses of product at each treatment.”

Instead of letting your injection totally wear off after three to six months, monthly Baby Botox injections, which use about a quarter of a standard dose, can maintain the original look. Think of it as a bangs trim between haircuts.

If making monthly injection appointments doesn’t seem feasible, you might want to forego Baby Botox in favor of a traditional dose of Botox every three to six months, says Smith.

4. It’s potentially cheaper.

Using less product should mean spending less money, right? Maybe, but not necessarily.

In some practices, the cost of the actual product determines the price, but in others, “The cost of the treatment is based on the skill set, not the product,” says Day. In other words, seeing a trained aesthetic physician, who has the time and technique to give you tailored, micro injections, might actually be more costly than larger, more formulaic doses.

Before going under the needle, it’s important to understand the pricing structure so you don’t end up spending a fortune, stresses Smith. Monthly micro doses could end up costing you more than standard-size injections every three to six months. Talk to your doc about a Baby Botox strategy before getting injected.

Related stories:

Now, watch as a dermatologist explains lip fillers:


Lasers For Your Body

Laser technology can be used on other areas of the body besides the face. There are now laser treatments for body contouring that aim to help you lose inches in certain areas. If you take courses at the Clearskin Institute of Laser Aesthetics to become a certified laser technician, you could very well be performing these procedures one day. Learn more about laser body contouring in the article below.

Putting in very little work to lose inches off your body may sound like a Christmas miracle, but that’s what Sculpsure?the latest in non-invasive, body contouring?claims can happen in just a 25 minute procedure. After passing countless bus-stop ads for body sculpting and wondering if it’d actually be possible to get peak-Britney Spears abs, I talked to Dr. Dennis Gross, a NYC-based board-certified dermatologist and dermatologic surgeon, and founder of Dr. Dennis Gross Dermatology to learn more. Here’s how it works: The 25-minute procedure uses light-based technology to eliminate fat in areas such as the abdomen, thighs, under the chin, and love handles through lasers that heat up to 120 degrees Fahrenheit and melt the fat cells under your skin. Once they?re dead, your metabolism works to get rid of them by…eliminating the waste, if you will. Is it worth it? Read on for more about the process straight from the doctor’s mouth.

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Sculpsure is a relatively quick laser treatment

Unlike liposuction, this process “lets you do work on anywhere you have fat build up that doesn’t necessarily have to be excessive,” explains Dr. Gross. “Consider it fine-tuning or tweaking to get rid of fat that’s resistant to diet and exercise.” The fat that you lose is killed and permanently removed from the body.

The ideal candidate is already leading a healthy lifestyle

Since Sculpsure is for getting rid of stubborn fat anyone who eats right, exercises a few times a week, and leads an all-around healthy lifestyle is perfect for the process.

It takes time to see results

“You do it and you?ve got to wait six weeks to two months to see results,” says Dr. Gross. “People do it, they literally forgot they did it, and then all of a sudden they think ‘oh my gosh, I look like I?ve been dieting, but I haven?t been dieting.'”

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How much it hurts is completely subjective

It’s not comfortable, says Gross, but it’s also not horrible. For those who are more sensitive Gross suggests taking a pain killer 30 minutes before the procedure. Otherwise, it’s simply an uncomfortable feeling rather than actual pain. “It feels like a charley horse in your calf,” says Gross.

There’s zero downtime

“If you press on the area where the fat is treated you may feel a little soreness, but it?s normal and goes away in about a week,” says Dr. Gross. “There?s no recovery otherwise. You?re fine to exercise and carry on as normal.”

Sculpsure is an investment, but really works

Two to three sessions are recommended at $1600 per session, which while expensive is worth it if you have the extra cash.


Your Skin and Stress

If you have not thought about it, stress and anxiety can really affect your skin. Have you noticed you get breakouts when you are under pressure or going through something stressful? Other skin ailments besides breakouts can be linked to stress and anxiety too. Learn what they are and more about how your skin is affected by stress in the article below.

If you’ve been feeling super stressed, you are not alone. According to a 2017 survey of stress conducted by the American Psychological Association, over 50 percent of Americans say that now is the worst period of U.S. history in their memories. And many of us are literally losing sleep due to stress: The survey also found that 45 percent of people reported lying awake in the past month because of it.

We’ll be the first to admit that our stress can get the best of us sometimes. It not only trickles from our brains to our bodies: It can show up on our skin, too, or exacerbate existing psychological conditions that can then in turn wreak havoc on our complexions. Here’s what to know about what stress can do to your skin.

Anxiety and stress can be linked to scarring.

Tic behaviors ? for example, pulling your hair or picking at your skin ? can cause serious skin problems, says Abigail Waldman, a dermatologist at Brigham and Women?s Hospital in Boston. Sometimes, those problems can be permanent. ?There are people who cause their own balding from pulling out their hair, which is [a disorder] called trichotillomania,? she says. Waldman says that research suggests between 0.6 percent and 3.6 percent of adults suffer from trichotillomania. Researchers aren’t totally sure what causes trichotillomania, but if you do have it, stress is known to exacerbate it. Subconsciously, you might also pick at or scratch your skin, which could lead to wounds and scars.

Stress can cause flare-ups and worsen pre-existing conditions.

Eczema acting up? Psoriasis flaring again? You might be stressed out, says Waldman. A flood of the hormone cortisol can tank your immune system, a response that takes a toll on your skin and your Zen.

Stress and skin woes also have a bit of a cyclical relationship. ?Patients who have skin conditions have been shown to have higher instances of anxiety and social avoidance,? says Waldman. ?It?s all interconnected in that stress and anxiety can impact skin conditions, and having skin issues can lead to anxiety and negatively affect someone.? For what it?s worth, Waldman notes that skin freak-outs in tense times are usually NBD ? they?ll clear up in due time. But if you have chronic skin concerns that could be linked to mental well-being, check in with both a dermatologist and a psychiatric professional, she suggests.

Lack of sleep makes it worse.

Even small stressors and anxieties can add up and negatively impact the quantity and quality of your sleep. And unfortunately, skipping out on sleep doesn?t just result in you wanting to take a nap under your desk at work. It can lead to swollen eyes and dark circles, Waldman notes.

A daily moisturizer with caffeine can help lighten and tighten the eye area, says Kavita Mariwalla, a dermatologist in West Islip, New York. But there?s really no solution like getting a good eight hours of quality rest ? and not just on the weekends but through the week. ?Sleep is when our neurons recharge and our brain does its repair,? she says. ?Similarly, it?s a time when we tell patients to use medications that can also work to repair skin.?

Superanxious times can make your hair fall out.

Telogen effluvium is a condition in which the number of hair follicles that are growing hair drops, which results in hair loss. Normally, hair has a predictable pattern of growing and falling out and growing again, Waldman says. But in cases of TE, less of the hair follows this pattern and the hair on the scalp thins. The cause is not completely understood, but there appears to be a link between chronic stress and TE. Doctors speculate that if your body is perceiving anxiety as a threat, it may not view growing hair as worth the energy, Waldman notes.

Of course, on a less extreme scale, many of us have seen clumps of hair in the drain before (then gone straight to WebMD and diagnosed ourselves with anemia or bubonic plague ? or convinced ourselves we?re pregnant). But thinning and shedding hair can be normal when you’re experiencing heightened anxiety or stress. Fortunately, the effect reverses itself in calmer times, says Waldman. To help with hair growth, make sure you?re eating enough protein, Mariwalla says.


Now, find out what it’s like to sink into a red wine bath:


‘Tis the Season for Plastic Surgery?

Many plastic surgeons report that business increases during the holiday season. So, why is that? The article below explains that and talks more about the most common procedures that are desired. On the other side of the coin, however, what if all those people knew that there were some alternatives that were less invasive if not completely noninvasive altogether? That’s what places like the Clearskin Institute can do. From laser treatments to facial injections, you could look like you got a facelift without going under the knife!

It’s the most wonderful time of the year?to visit the plastic surgeon. Seriously. According to plastic surgeons around the country, requests to go under the needle or knife spike during the holiday season.

“The time between Thanksgiving and Christmas definitely is a busy time of year for my practice. Patients want to look freshened-up for holiday parties,” Marina Peredo, a New York City-based dermatologist, tells Allure. “They want to look their best for the pictures and selfies that are taken during the holiday season.”

Besides the never-ending parade of holiday party photo booths, the season is also an oddly practical time of year to have a procedure, Min S. Ahn, a Boston-based facial plastic surgeon, adds. “A lot of companies shut down and people take vacation time right around the holidays,” he tells Allure. “This not only provides people with a good excuse to be away from work, but it also is the perfect amount of time to recover from a surgical procedure, which is about one to two weeks.”

So, what are the most popular holiday procedures? According to the doctors we spoke with, patients prioritize putting their best face forward during the holidays ?
face-lifts are a big pre-New Year’s trend. The kind of facelift on patients’ wish lists, however, totally depends on their yuletide schedule.

If you’re taking some much-needed time off?

Once you decide to go under the knife, find the perfect surgeon, and write the check, there’s still a major hurdle to getting any cosmetic surgery procedure: blocking off enough recovery time. “One of the most difficult parts about surgery is finding the time to recover. You have a lot of the time during the holidays, so that tends to be one of the main reasons why people do it,” Rady Rahban, a Beverly Hills-based plastic surgeon, tells Allure. “There is also the added boon of using your holiday bonus on the surgery.”

While no-downtime-needed injectables are quick, easy, and relatively affordable, going under the knife is a whole new ballgame.

Face-lifts are a holiday miracle for patients who aren’t into fillers, according to docs. “Many of my patients are tired of looking over-plumped and somewhat distorted by fillers, opting for a face-lift instead,” Melissa Doft, a plastic surgeon in New York City, tells Allure. “The procedure is performed in a surgical suite as an out-patient procedure that typically takes three to four hours.” After an incision is made in the folds of your ear, the surgeon lifts the inner layer of your face and neck muscles, giving you a more sculpted jawline.

“Patients are swollen and have some bruising after surgery,” says Ahn. “One day after the procedure, we have them come to the office to remove their dressing and after a week, they return to the office and have their sutures removed.” Typically, it takes that full week to start feeling like yourself again, he says.

While results can be dramatic ? and worth saving all year for ? the recovery for the procedure takes a full two weeks. Sipping hot cocoa on the couch while binge-watching your favorite holiday movies is advised.

If you have more holiday parties than Santa?

For some of us, however, the holidays are non-stop ? an office party here, a brunch gift exchange there. Read: No downtime to recover from the swelling, bruising, or redness that comes with a surgical procedure. In-office plumping and tightening procedures (which include ever-popular injectables) offer instant results and zero downtime ? theoretically, you could get a little plump and tighten on your way to your Secret Santa.

Peredo says she performs a lot of non-surgical face-lifts (a.k.a. the Silhouette InstaLift) during the hustle and bustle of the holidays. “This treatment gets the job done, redefines the face and is fast becoming a very popular solution for men and women who don’t want a [surgical] face-lift,” she says. “It offers little downtime and immediate results, and takes only 30 minutes to perform ? if a party is coming up, the patient is ready and feeling and looking great.”

How to book a holiday procedure

“One of the things that we see besides an uptick in procedures, is the fact people want to get procedures done immediately,” says Rahban. But, “one of things that is most important while undergoing procedures during the holidays is planning in advance. I can’t stress that enough,” he adds.

Fitting a procedure to make you feel merry and bright into a calendar that resembles a game of Tetris is fine as long as you’re not rushing your decision or your recovery. “You never want to have surgery under the gun or in a compromised fashion,” says Rahban.

Just because time off over the holidays might be convenient, it doesn’t mean it’s the only time you can book a procedure. “Remember, this is elective surgery,” says Rahban. “I would stress not to choose timing over skill set or talent. The idea is that your research tells you that this is your preferred surgeon ? if the timing doesn’t work out, it doesn’t mean you should go to your second or third choice.”

Considering the increased popularity holiday procedures, it’s perhaps not surprising that surgeons are also reporting a rise in an interesting gift: plastic surgery gift cards. But before you stuff a loved one’s stocking with the gift of a face-lift, make sure it’s something they’ve expressed interest in.

For more holiday beauty:

Now, watch as a dermatologist explains lip injections: