Celebrating Earth Day!

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Dr. Chiu and TDI’s Favorite Eco-Friendly Lines:

  1. Tata Harper

We are in love with this 100% natural luxury skincare line!  Manufactured in tataharperskincaretraceable batches on an organic farm in Vermont, where ingredients and essential oils are made right on the farm.  It’s a truly unique, non-toxic skincare line that offers results, luxury, and some unbelievably divine smells!

Our favorites:  Resurfacing Mask, Hydrating Floral Essence, and Beautifying Face Oil

  1. Colorescience

Specializing in healthy makeup and sun protection products that are healthy for the skin.  Colorescience is a makeup line designed with active antiaging skincare ingredients.  Always pure, the company never uses mineral oils, alcohol, talk, fillers, dyes, or fragrance.  We never leave home without its truly unique Sunforgettable Powder SPF 50 brush to reapply sunscreen while keeping makeup fresh.

Other favorites:  Skin Brightening Face Primer, Mineral Corrector Palette, Antiaging Serum

  1. Juice Beauty

Skin, hair, and makeup products from the Juice Beauty line
are all made with clinically tested certified organic ingredients.  The company is committed to achieving powerful clinically proven results with natural, non-toxic ingredients, while at the same time practicing sustainable corporate practices.  Juice Beauty line is endorsed by Gwyneth Paltrow and Goop . . . need we say more?

Our favorites: Green Apple Peel, Stem Cellular CC Creams

  1. The Honest Company

The Honest Company, developed by glowy skinned Jessica Alba, features premium, non-toxic, natural skincare products that are reasonably priced, and safe for the whole family, including baby products.  Simply packaged and simple ingredients without additives makes this skincare line unique and approachable.

Our favorites:  Organic Healing Balm, Sunscreen Stick SPF 30

  1. Suki

Tsuki skincarehis cosmeceutical line is a synthetic free line where every product is tested safe for sensitive skin, pregnant women, nursing moms, and babies. Their extensive skincare line contains no parabens, phthalates, petrochemicals, fragrances, dyes, and sulfates. From mineral cream makeups to convenient kits, Suki offers skincare for every skin type, oily, dry, or sensitive.

 

Try the 21 day Dermal Detox Kit to brighten your skin in 3 weeks!

 

 

… Shared by the TDI Team

5 Things You Didn’t Know (but should) About Sunscreen

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  1. You are supposed to reapply every 3-4 hours.sunscreen041501

Sunscreen starts breaking down as soon as you apply it to the skin.  Even if you don’t get wet or sweaty, it pretty much is inactive in 3-4 hours.  Reapply!  We love Colorescience’s Sunforgettable Brush  for easy reapplication.

 

  1. Spray sunscreens are not all that good for you!

sunscreen0415Sunscreen sprays may seem like an easy way to apply, and they do work for areas like the hair and scalp.  However, recent studies show very little sunscreen actually gets on the body, and even worse, spray sunscreens can get into the eyes and can be accidentally inhaled.  The FDA is studying the safety of spray sunscreens, and there is a real possibility it may be pulled from shelves.

 

  1. If you have a hyperpigmentation condition such as melasma, sunscreens are not adequate protection.

Recent research shows Visible Light, Fluorescent lighting, lamp lights, computer screens, and even infrared light from ovens can worsen conditions such as melasma.  Typical sunscreens do not protect against visible light or infrared light.  Look for sunscreens that contain iron oxides, such as Colorescience Sunforgettable SPF 50 Brush or CoTZ Sunscreen 

 

  1. A SPF 100 is not much more protection sunscreen041502than SPF 50.

The American Academy of Dermatology recommends daily use of SPF 30 or above.  Sunscreens with SPF greater than 50 are somewhat misleading, as they do not give you much more protection.  A SPF 100 is NOT doubly more effective than SPF 50, its closer to less than 1% more effective.

 

  1. Antioxidant ingredients boost the effect of sunscreens by scavenging free radical damage caused by UV Radiation.

Some of Dr. Chiu and the TDI team’s favorite?  La Roche Posay’s Ultralight Fluide 45 and Supergoop’s Antioxidant Infused Sunscreen Mist with Vitamin C SPF 50 (note that this is not an aerosol spray as described in #2 above, but a mist).

Protect Your Skin All Year Round and From the Inside Out

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heliocareAs we head into Spring, we know it is easy to forget that you need to protect your skin from sun exposure. But actually UVA rays are strong all year round, despite the season, and these rays can cause not only skin damage, but premature aging as well. One great product to help give you an even greater edge than even just sunscreen is a simple once daily orange pill, but before we get into that lets go over some important skin facts and the dangers of the sun.

Sun Exposure and Facts:

Leaving your skin unprotected can have some shocking effects both long term and short term:

Short Term effects of Sun Damage:

  • Sunburns
  • Damage to outer layer or skin
  • 2nd degree burns that can blister and damage nerve endings

Long Term Effects of Sun Damage:

  • Dark Spots
  • Wrinkles
  • Breakdown of Collagen and Elastin, this leads to premature aging
  • Damaged skin cells
  • Pigment Changes
  • Dry Skin
  • Skin Cancer

What can you do to protect yourself?

Following the national guidelines of the American Academy of Dermatology, The Derm Institute recommends daily use of a sunscreen, with minimum SPF of 30, as a part of your skincare regimen. Whether rain or shine, you should make this a daily habit!  The American Academy of Dermatology also recommends reapplication every 3 hours.

If you are active outdoors, on a tropical vacation, live in sunny southern California, prone to skin discoloration (those with sun spots or melasma) or just find it hard to be perfect about reapplication, try a whole-body approach to your sun protection.

Protect your skin from the inside out with the dietary supplement Heliocare. Heliocare is an all natural oral supplement derived from a fern extract. Heliocare acts as a superantioxidant to reverse the oxidative stressors of sun exposure. The oral pill has over 15 years of research, and is highly recommended by dermatologists. We find it the perfect adjunct for an active lifestyle or for anyone concerned about the aging effects of the sun, and want an additive protection on top of sunscreen.

This ionce daily oral supplement helps maintain your skin’s self-protecting mechanism against the sun and photoaging year round, no matter the season.
Remember, Heliocare is an ADJUNCT to sunscreen, not a substitute. But it is fantastic for those of us who are active, imperfect with reapplication, and for all those areas like the scalp where sunscreen is difficult to get on.

Stop by The Derm Institute today to learn more about this product. It’s a great addition to any skincare regimen. With help from The Derm Institute, and products like Heliocare you can be sun safe and sun smart!

Remember to Cherish the Skin You are in.  Protect it with sunscreen and products like heliocare.  Maintain it with regular skinchecks and procedures that enhance its beauty, and you can feel comfortable and confident every day.

 

. . . Shared by the TDI team.

On the Cutting Edge . . . Beauty Breakthroughs on the Horizon

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2015 is set to be an exciting year for new cosmetic procedures. At The Derm Institute, we are always on the cutting edge to deliver the newest and best procedures in Cosmetic Dermatology. Below are soon to be offered brand new procedures to keep you confident and happy in your skin.

1. Restylane Silk for “smoker’s lines”, “lipstick lines”, or vertical lip lines.

Modified 11/22/06 19:03 AlterImage® V3.10Repetitive puckering of the lips from pursing or frequent use of straws and water bottles can cause creasing wrinkles around the mouth area. Restylane Silk was recently approved for use in the United States by the FDA to treat these pesky “smoker’s lines” that age the face. Dr. Chiu is one of the first injectors to offer this product exclusively to TDI patients before its official launch. Restylane Silk differs from classic Restylane, in its particle size. Because of its makeup of finer particles, Restylane Silk will be a “fine line” filler, perfect for those stubborn thin smoker’s lines around the lips, or other fine, shallow lines that can look etched in the skin. The smaller particle allows for a smoother, less bulky fill for a more natural appearance.

Uses:

  • Vertical lip lines or “smokers” lines
  • Etched lines on the cheeks or in the smile area
  • Stubborn forehead or glabellar etching that is not fully treatable with just a neuromodulator such as Botox or Dysport
  • Horizontal necklace lines on the neck area

2. VANQUISH for the thighs, hip area, and arms

At The Derm Institute, we have been getting amazing results around the abdomen, flank, waist, and back with non-invasive fat elimination utilizing radio frequency with the VANQUISH system.  We are now introducing a new subsystem to use the same efficient, yet comfortable technology to treat the thighs, hip area, “saddle bags”, and arms.  Unlike some of the other fat elimination systems in the market, VANQUISH is unique in that it can treat a more comprehensive area:  such as both the inner and outer thigh to reduce the entire thigh circumference if desired.  Treatments will be once a week for 4 weeks, with each treatment lasting about 45 minutes.

Uses:

  • Inner thigh and outer thigh contouring and reduction in fat
  • Reduction in excess fat around the hips or “saddlebags”
  • Inner knee fat pockets
  • Upper arm fat for more attractive contours
Before
Before
After
After

3. Kythera ATX-101 

This is procedure in late clinical trials with the FDA, with likely launch in early 2015. Kythera ATX-101 is what Dr. Chiu considers a “game changer” in the rejuvenation of the face and neck. The procedure consists of a series of simple injections in the area under the chin and jawline to reduce the fat and sagging that occurs over time. This is a first in class non-invasive cosmetic treatment to better define the jawline by treating the underjaw and underchin fat. Fat is disrupted by ATX-101 and clinical studies show some possible collagen stimulatory effects that tighten the area and allows for a more defined jawline and neck.

Uses:kythera

– For the treatment of a “double chin”

– For the treatment of fullness or jowls around the jawline and neck area

– In expert hands, for the treatment of other small areas of stubborn fat pockets such as the neck and arms.

 

. . . Shared by the TDI Team

Debunking Age•Old Beauty Myths!

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We hear it all the time—your mom told you, or you read it once in a beauty magazine, below Dr. Chiu helps you separate fact from fiction . . .

Myth #1:  If you pluck a white hair, many more will grow back in its place.

Each follicle typically grows a single hair, except in certain skin conditions.  Plucking hairs cannot change how many follicles you have.  If you notice more white hairs with plucking, it’s probably more just because they would have come anyway!

Myth #2:  I don’t need sunscreen because it’s not sunny and I work mostly inside.

70-80% of harmful UV rays penetrate even on cloudy or even rainy days.  UVA rays, which cause not only skin cancers, but are “Aging” rays, penetrate glass windows, and are the same strength all year round.  If you drive or walk by a window, you are getting UV rays.  Be proactive about antiaging and wear sunscreen year round.

Myth #3:  My scalp is flaky and dry so I am going to wash it less often.

Most commonly flaky scalp is a condition called seborrheic dermatitis, commonly known as dandruff.  This is a multi-factorial condition which is caused actually from overactive scalp oil glands along with increased turnover rates of scalp skin.  So the flaking is actually caused not by dryness but by oiliness!  Increasing frequency of washing your hair in this instance can actually keep the condition under better control by regulating the scalp’s natural oils.

Myth #4:  I love products which “shrink” pores.

True shrinkage of pores never really Girl with beauty maskhappens—you can make the appearance look smaller with things like retinols or chemical peels, but pore size is more genetically dependent than what products we use.  Plumping the surrounding collagen with peels, non-ablative fractional laser, and good skincare can definitely minimize the appearance of pores though.

Myth #5:  If I shave, the hairs will grow back thicker.

Studies have shown the thickness of hair is absolutely not affected by shaving.  However, naturally, hair grows in a tapered fashion, with the top of the hair being slightly slimmer.  After shaving, hairs may feel a bit coarser, only because you have trimmed off the tapered end.  But shaving itself actually does not change the texture or thickness of the individual hairs.

Myth #6:  I have oily, acne prone skin, so I don’t need a moisturizer.

Healthy skin is about a balance of hydration, overdrying the skin with acne products or not using a moisturizer can actually cause oil glands to be MORE confused and produce MORE oil.  Ask your dermatologist for a recommendation of a non-oily moisturizer that still gives your skin barrier protection.

Myth #7:  I will use cocoa butter during pregnancy to stop stretch marks.

Sadly, development of stretch marks during pregnancy is something we do not yet have control over.  It seems to be more genetically determined.  Products like olive oil and cocoa butter cannot penetrate into the dermis, where fibrosis occurs to cause stretch marks.  Good news is, once they develop, early treatment with non-ablative fractional resurfacing can definitely improve their appearance.

Myth #8:  The more expensive a skincare product is, the better it works.

Not true.  Look for good scientific studies and quality ingredients like retinols, L-ascorbic acid (Vitamin C) or peptides, not fancy bottles and expensive marketing.  Skincare companies spend more on packaging than the products, so ask your dermatologists what ingredients to look for and what brands actually have studies to show benefit.  It is not always the MOST expensive, spend where it counts.  Consider a Skin Health Consult to go over a skincare regimen best tailored for your needs.

Myth #9:  If a product is “all-natural” or if I buy it at Whole Foods, I cannot be irritated by it.

This is a common misconception.  Even “natural” plant extracts can be irritating to certain types of skin.  Our favorite example is poison ivy:  all natural, pretty darn irritating!  Currently, the FDA does not regulate who can label their products as “natural”, so none of us are sure exactly what that means.  Irregardless, products with lemon extract, or other botanicals can still cause allergic reactions.  In fact, as most of us know, pollen (which is obviously naturally occurring) is a common cause of hayfever.  Skin allergies are not very different.  Your body can react to almost any product, “natural” or not.

Myth #10:  My skin is dry, I can drink 8 glasses a day to combat that.

Actually, dry skin is typically caused by poor skin barrier that results in loss of water through the epidermis.  And it’s oil that keeps the skin moisturized.  Using products that help repair the skin barrier (like moisturizers with Ceramides) is more effective in improving dry skin.

 

Shared by the TDI team…

10 Skin Tips for this Fall

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1. Consider a peel

Erase summer sun damage and skin stress by giving your face a fresh start this fall.

cream2. Change to a heavier night cream

Get ready for drier weather with a slightly heavier night cream this fall, like SkinMedica’s Dermal Repair Cream or Murad’s Hydro-Dymanic Moisturizer available in our skin boutique.

3. Invest in a Serum with Anti-aging Properties

Invest in an all purpose antiaging serum to nourish your skin.  Dr. Chiu’s absolute favorite?  SkinMedica’s TNS Essential Serum!

pumpkin4. Keep your skin and body healthy with a medley of Fall Vegetables

Fall vegetables like squash and pumpkin are filled with antioxidants that can boost your skin health and reduce sun damage.

5. Use Hydrating Soap or Shower Gel to keep your skin hydrated

Using an oil-based cleanser to help lock in moisture for your skin.  We like Avene’s XeraCalm Lipid Replenishing Cleansing Oil  

6. Consider In-Office Treatments Best done in the Fall

Treatments like IPL, Sclerotherapy, and Chemical Peels can be optimized in the Fall and Winter, schedule now so you won’t regret it when the weather warms up again!

7. Keep those Hands Moisturized

Turn back aging hands with a hand treatment like Revision’s Lumiquin.  Our patients love it, check out the before and after!a

8. Get some Sleep!

Take advantage of the shorter daylight hours by establishing a good sleep routine and getting to bed on time!  Your skin will thank you for this extra time to repair and regenerate.

9. Add an exfoliating Eye Cream

Improve texture, puffiness, and crepeiness with SkinLab’s iGloss eye cream.

10. Consider a Vitamin B 12 shot

Boost your metabolism and immune system to fight off winter colds and fatigue with a series of B 12 shots.

. . . Shared by the TDI team

5 Bad Skin Habits and How to Break Them!

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We all have a few bad habits that we can improve on. If you aren’t seeing the healthy radiant skin you want, take a second to review your skin care regimen. Here at The Derm Institute, Dr. Chiu is committed to helping you achieve healthy skin, so take a look below and see how you may have a beauty habit that can be improved.

cleaningmakeupbrushes1. Not washing your makeup brushes and sponges.

70% of women don’t wash their makeup brush or sponges, EVER. Bacteria, dead skin cells, and oils can all accumulate to contribute to breakouts, irritated skin, or just uneven makeup application. Dr. Chiu recommends washing your brushes at a minimum of every 2-4 weeks.

sleepingwmakeupon2. Sleeping with your makeup on.

Pollutants and dirt that causes oxidative stress can be trapped against your skin under your makeup, causing premature aging, breakouts, and inflammation. Sleep is an important time for the skin to repair. Even an easy makeup removal wipe before bed is worth the time!

3. Over•exfoliating or over•washing oily skin.

woman-exfoliating-skinThere is such a things as “too clean”. When the skin is overly dried through cleansing or exfoliating, oil glands can actually get confused and produce MORE oil to compensate. This can cause more acne breakouts and paradoxical oily skin. Wash with a gentle cleanser twice a day, and keep aggressive exfoliation to about three to five times a week.

4. Giving up on skincare products after a few weeks.

Most skincare products take at least 8-12 weeks before clinically significant results can be seen. If you try a product for a few weeks or even a month, then change it, you are likely never getting the benefits of the product. Dr. Chiu always recommend using a product for at least 3 months to truly evaluate if your skin is responding. Skincare products are not magic, but definitely can improve skin quality if used consistently.

5. There is sunscreen in my moisturizer, so I don’t need anything else.

The American Academy of Dermatology is recommending daily sunscreen use of SPF 30 or above. A lot of people do not actually use enough of the moisturizers with sunscreen to achieve the actual SPF on the label. This can significantly increase your risk of skin cancer. Dr. Chiu recommends that you use at least a generous nickel size dollop of sunscreen for your face to get the SPF protection that is on the label.

Three Tips to Brighten Undereye Circles

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Under eye circles can be caused by a number of different things: lack of sleep, sinus problems, sun exposure, age, allergies, smoking, and even genetics.  The appearance of undereye circles results from where the bone along the orbit of the eye transitions to just skin.  Naturally, there may be a groove in this area that makes the undereye appear hollow, shadowed, and thus darker.  The skin is also very thin in this area, allowing the underlying structure to be seen through the skin.  Blood vessels and muscle can all be slightly seen through thin skin, again making the area appear dark or pigmented.  There are several different approaches to help manage and treat this troublesome issue that many of us suffer from. This includes prevention, treatment, and the benefits of cosmetic procedures for under eye circles. This information will hopefully help you decide which approach (or combination of them!) to take, and which ingredients to look for in products designed to help get rid of those dark circles.

 

1. Prescription Retinols


Products that include a retinol, especially prescription strength retinols such as Renova are an essential part to a good skincare regimen. Retinols helps with cell turnover and collagen synthesis, and can be used for restoring and reviving skin around your eyes by thickening the collagen to help reduce wrinkles and crepy texture. Retinols can be a bit irritating to use, so make sure you follow the correct directions.

 

 

2. Eye brighteners and depuffers


Brightening ingredients such as Vitamin C can reduce the appearance of dark circles by inhibiting melanin which causes pigmentation on the surface of skin.  Eye creams with caffeine also can help reduce puffiness and the appearance of undereye bags.  At The Derm Institute one of our favorite eye creams is Neocutis Bio-Restorative Lumiere Eye Cream, which contains caffeine, for depuffing, Vitamin C for brightening, along with PSPs (or Processed Skin Cell Proteins) that harnesses the power of growth factors and cytokines to boost skin thickness.  It is also packed full of anti-oxidants such as green tea extract to firm the skin This is an ideal all in one product for dark undereye circles and is available for purchase at The Derm Institute.

 

3. Fillers and Peels

One of the most powerful ways to address undereye darkness, circles, and sometimes even puffiness are in-office procedures such as chemical peels and hyaluronic acid injectable fillers.  Products such as Restylane  are sugar molecule gels that can be administered under the eye through a syringe, leaving the undereye area lifted and brightened dramatically. By adding volume back into the undereye, the skin here can be filled in to smooth out any negative contours, effectively eliminating the dark color and shadowing, and erasing the perceived tired look.  Not all dermal fillers can be injected in this area, as have more of a tendency to lump than others.  Placement is also extremely important, as too superficial placement can lead to a bluish visible tint under the skin.  Here at The Derm Institute, Dr. Chiu is an injection instructor, and has extensive experience in addressing this area, including the use of microcannula technique to reduce bruising if necessary.

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Physician-grade medium to deep chemical peels including the Phenol Peel can also be used to lift superficial pigmentation, sunspots, address wrinkles and refresh the texture ,

The best part about these procedures is that they can lead to rejuvenation lasting over a year, contact us to find out more!

The TDI Guide to Best Sunscreen Use

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SunscreenApplicationThe weather is warming up and it is definitely beach weather! It’s great to head to the beach, but it is important to be sun safe. Everyone should be sure to apply a sunscreen daily, you can actually have more exposure to UV rays on overcast days. Didn’t know that? Good fact to know and be aware of when you step out of your home each day.

Here at The Derm Institute we want to keep our patients aware and up to date on the information they need to know regarding their sun safety.

Sunscreen Choosing Tips:

  1. Choose a sunscreen that you will use over and over again. Make sure you like the feel,
    that it is not too heavy or pasty, there are many elegant formulations on the market, so find one you love! 
  2. Select a sunscreen that offers broad-spectrum protection (look for both UVA AND UVB protection on the package)
  3. Look for a minimum of SPF 30 or greater
  4. Find a water resistant sunscreen if you will be outdoors to combat sweat and water
  5. Cream sunscreens are best for dry skin and the face area
  6. Gel sunscreens should be used for hairy areas, like the scalp or even a male chest
  7. Stick sunscreens are good for around the eye areasunscreen2
  8. Spray sunscreens are best used for REAPPLICATION, as the coverage from a spray is not protective due to scatter of active ingredients
  9. Use a powder based sunscreen like Colorescience Sunforgettable SPF 50 Sunscreen Powder for reapplication every 2-3 hours
  10. Has a minimum SPF of 30, and is also water resistant.

 

Sunscreen FAQs

1.  Is the higher the SPF better?

Dr. Chiu and the American Academy of Dermatology recommend a SPF of at least 30 or above, as it will block about 97% of harmful UV rays.  But SPFs higher than 50 do not offer more significant coverage, so products with SPF 100 are not necessary, nor do they block 100% of rays.

2.  What sort of sunscreen should I use on my child or baby?

It is best for babies that are under 6 months to not spend time directly in the sun, if necessary, sunprotective clothing can be used to protect the delicate and sensitive skin of an infant. It is also recommended to have babies at this young age to wear sunglasses and a wide brimmed hat; especially if they are to be outside in direct sunlight for a prolonged period of time.

baby-sunscreen1It is important to apply sunscreen to an infant or toddler over 6 months of age if they have any exposed skin that is not protected by clothing. Look for a PHYSICAL sunscreen, such as Blue Lizard Baby. Physical sunscreens have only zinc oxide or titanium dioxide as active ingredients. These sunscreens are the ones to be used on infants and toddlers because it is the most suitable for their skin. The sunscreens that contain these ingredients do not penetrate the skin and are less likely to cause irritation to the skin.

At the age of 2, sunscreens of all types are safe for use.

3.  How much should I apply?

The general rule is a golf ball size for the entire body.  This includes about half a tablespoon for your face.  And don’t forget to toss out last year’s expired sunscreens!

At TDI, we recommend using sunscreens generously, daily, and reapply.  We carry all the sunscreens mentioned in this article.  If you need guidance on what’s best, please be sure to stop by The Derm Institute to take a look at our sunscreen selection, and any one of our staff members will be happy to help you! Let us help you be sun safe and sun smart!

. . . Shared by the TDI team

10 Tips for Summer Ready Nails!

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Now that warmer days are here, it’s time for sandals and pedicures.  In fact all year long, who doesn’t love a pampering at nail salon with a manicure and pedicure. It’s a quick easy process that leaves our hands and feet looking and feeling great.

PedicureBelow are The Derm Institute’s Top 10 Tips for Healthy Manicure and Pedicures for summer ready nails!   

 

1. Cleanliness is key. All nail salons should use an EPA-registered hospital disinfectant. Be sure your nail salon uses an approved disinfectant for their pedicure bowls. It is also recommend to choose a salon that sterilizes their instruments in between all clients. Be sure your technician opens the sterilized packet of instruments in front of you.

2. Do not shave, wax, or use hair removal products up to 24 hours before getting a pedicure. These procedures cause the opening of pores, leaving your skin more prone to picking up an infection.

3. Do not get a pedicure if you have bug bites, scratches, broken skin or lesions on your legs or feet. These breaks in your skin can increase your chances of picking up bacterial and fungal infections.  Wait until these areas are healed before heading to a salon.

4. Go traditional on pedicures! You’re better off with pedicures that utilize traditional soaking buckets rather than spa chair pedicures. Spa pedicure chairs are more likely to trap mold and mildew in the filters unless they are cleaned between every client.

5. Bring your own equipment. It seems bizarre, but plenty of people do bring their own instruments, and love having control over that part of their mani-pedi experience. We suggest buying your own mani-pedi kit to take in with you so you can ensure cleaniness. You can disinfect your instruments by wiping them down with alcohol after each use.

6. Gel manicures are all the craze, but be careful. If you are fond of gel manicures be sure to go to a salon that uses LED lights for curing the gel nails instead of the traditional UV lamp. UV lights expose your skin to harmful rays and can cause damage and increase your chance of developing skin cancer. If your salon does not offer LED curing lights for gels, we recommend wearing finger-less gloves to UV protect your skin.

7.  Give your nails a break sometimes!  We recommend the cycle on/off pattern for those of you who put on acrylics or gels. The glue used in acrylic procedures and the acetone used for removing gels dehydrate and weaken the nail plate. Therefore, we recommend you cycle off every third month or so to prevent the damage of your nail bed.

8. Apply a base coat before applying dark polish. Dark polish can stain nails which can lead to a yellowing pigment. If you experience yellowing of nails soak them in lemon juice to lighten the nails.

9. To prevent ingrown nails, we suggest cutting/filing down your nails straight-across rather than rounded. Please be sure to tell your nail salon specialist that you only want to push back your cuticles and not cut them. Cutting of cuticles can cause chronic paronychia or inflammation of the cuticles.

10. Fungal infections are uncommon, but can be serious when it affects the skin. Paronychia is a fairly common infection seen from removing hangnails or cuticles. This infection can lead to a red and swollen area surrounding the nail, and tends to be painful. If you suspect a bacterial or fungal infection, be sure to make an appointment to see Dr. Chiu at The Derm Institute.

Your mani-pedi treatment should be relaxing. Use our ten tips above to avoid stressful conditions that mani-pedi’s can lead to. Always remember to apply sunblock to your hands and feet when showing off your polished nails!

. . . Shared by the TDI team

Who Needs Beauty Sleep?

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For glowing, healthy, happy skin it turns out we all need beauty sleep!

sleep-tips_06Scientific studies support the importance of sleep on overall skin health and appearance. Sleep deprivation has been shown to reduce the natural moisture barrier of the skin, leaving it prone to dehydration and a dull appearance. A reduction in skin barrier as a result of inadequate sleep can increase skin irritation as it will be more susceptible to environmental pollutants. Poor sleep results in higher levels of stress hormones in the body, such as cortisol, which can lead to increased inflammation of the skin. This type of inflammation not only leads to flares of inflammatory skin conditions such as acne and rosacea, but it can also increase inflammation induced oxidative damage that leads to collagen breakdown and wrinkles. Poor sleep quality is associated with increased fine lines, pigmentation, reduced elasticity, and slower recovery from environmental stressors such as sunburns. Another reason lack of sleep may lead to poor skin health may be due to the decrease in secretion of proper levels of melatonin, which has natural antioxidant properties.

Having a regular sleep schedule is an important habit to develop for glowing, healthy skin. Washing your face before going to bed is an easy and important MUST in basic anti-aging skincare. Throughout the day, pollutants, sweat, and makeup buildup oxidative stress and irritation on skin, which can lead to redness, increased pore appearance, and an overall more aged appearance. During sleep, the skin undergoes repair at a cellular level, and may be more receptive to anti-aging products such as retinols. Dr. Chiu’s favorite retinols include SkinMedica’s Retinol Complex or prescription strength Renova, both available at The Derm Institute.

General skin and sleep tips:

1. ALWAYS wash your face before beautysleepbed to reduce irritation and the buildup of collagen oxidative stressors such as environmental pollutants.

2. Use a satin pillowcase to reduce the friction of your skin when you mash up against a pillow–reducing creases and etching of sleep lines on the face.

3. Reduce salt and alcohol intake and elevate the head slightly elevated on a pillow: this will reduce the natural pooling of excess fluids around the eyes and face that can lead to a more tired or puffy appearance.

4. Keep a humidifier in the bedroom to keep the skin hydrated. Because of the active repair processes that occur below the skin surface while we sleep, the skin can actually can lose up to 25% more water overnight when compared to daytime. A light moisturizer with humectants such as hyaluronic acid can counteract these effects.

5. Skin repair hormones such as Human Growth Hormone are secreted in higher amounts during sleep, so aim for at least 7 hours of sleep a night so your skin can rebuild collagen that breakdown with ultraviolet damage during the day.

We love skin products with growth factors, and using retinols sparingly to avoid irritation. Pairing a moisturizer with a retinoid product is an ideal nighttime regimen because sunlight weakens retinoid effects and moisturizers reduce irritation. Retinoid products increase collagen thicknesses, decreases overactive oil production, and encourages skin turnover–meaning reduced fine lines and more even pigmentation. Dr. Chiu can go over all the finer points of how to layer the best skincare products to maximize your skin appearance during a Personalized Skin Health Consult.

If you already have sleep lines or loss of collagen, consider dermal fillers or Sculptra to soften those lines and rebuild collagen for a more rested, youthful appearance.

Contact us for an appointment today! Wishing everyone restful nights this week.

 

Dermal Fillers for Acne Scarring

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Here at The Derm Institute we see many acne patients with wide variations of acne scarring. There are five common types of acne scars:  ice pick acne scars, boxcar acne scars, rolling acne scars, hypertonic acne scars, and keloid acne scars. Ice pick scars are among the most common types of acne scars and are narrow scars that form pits in the skin. Boxcar scars are similar to chicken pox scars and have angular, well-defined edges that make them appear like a box. They create an indentation in the skin and are most often found on the temples or cheeks. Rolling scars create an indentation in the skin that looks like a wave, due to its wide size and shallow depth. Hypertrophic scars create a raised area on the skin within the boundary of the original wound. Unlike most acne scars, these can diminish in size and appearance over time. Keloid scars create a raised area on the skin that extends beyond the boundary of the original wound. Keloid scars are rubbery, firm and sometimes itchy. In many instances, they grow to be larger than the original inflamed blemish.

Dermal fillers are a great way to treat and potentially get rid of certain types of acne scars, being particularly effective for rolling scars and some less defined boxcar scars. They are safe and well tolerated, with great results to fill the depression associated with scars. They are excellent for volume loss caused by acne scarring.

Considering Dermal Fillers

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The dose required for acne scar filling varies and is dependent on the patient’s facial anatomy, the scarring and where the patient wants to get to in terms of desired results. There are also many types of dermal fillers that you want to go through with your dermatologist. At the Derm Institute we recommend to our patients hyaluronic based fillers such as Belotero, Juvederm, or Restylane.

The dermal filler gives great results immediately and also continues to modify over the next few months.  This modification and improvement occurs as a result of the technique of injection of the filler breaking up some scarred down bands, and because the product and technique stimulate collagen modification due to the stretching of the fibroblasts with the dermal filler.

How this works

A topical numbing cream is usually applied to the skin to alleviate any discomfort. Ice is always used to decrease pain and to reduce the risk of bruising. So if you are concerned of feeling any pain from this procedure, you do have relief options.

What to expect during the procedure

First the doctor and patient will have a discussion about which scars will be filled. Often patients have certain scars in particular that disturb them more than others. We want to make sure we focus on these. After the discussion of which scars will be treated, the skin will be cleaned with alcohol, ice will be applied to the area briefly before treatment, the doctor will inject using a very fine needle and then pressure with gauze will be applied.

After the doctor has filled all of the scars which seem suitable for treatment, the patient will be shown the mirror, and then the patient is offered the opportunity to point out further scars that bother them. These will then be filled.

After your treatment

Acne Scar Before and AfterWe will give you a personal ice pack to hold in the areas that are treated. Treated areas may be red, swollen, and bruised for the first 2-7 days. DO NOT get a facial or massage for 1-2 weeks after your dermal filler procedure. AVOID strenuous workouts and alcohol for the 24 hours if possible. If bruising occurs, Arnica supplements or applying arnica gel have been shown to decrease bruising. *Another trick, drinking pineapple juice, and/or take Bromelain supplements is suggested to help bruising resolve faster. Bruising can be covered by make-up.  The Derm Institute recommends Dermablend (available at CVS or Macy’s) or the Colorescience Corrector Palette.

 

Other Methods for Acne Scarring to Consider

Here at The Derm Institute we offer a 360 degree approach to acne scarring. This is why it is very important to go see a board-certified dermatologist to assess your skin type and your specific type of scarring. Punch excisions, TCA cross technique for icepick scars and fractional non-ablative laser are other great option and we often combine different treatments for the best results.

Icepick or pitted scars can be treated with the “TCA CROSS” trichloroacetic acid (TCA) and chemical reconstruction of skin scars (CROSS). TCA Cross is a skin care method in which a very high percentage of TCA is applied to the acne scar tissue only. The TCA Cross method needs to be repeated every 1-2 months so that dermal thickening and collagen production occurs inside the acne scars. After 3-9 months, you should see a great improvement in the appearance of your acne scars!

Fractional non-ablative laser offers both superior results and a little to no downtime! This laser has a hand piece that delivers light in an array of narrow, focused microbeams to create columns of coagulation within the skin. These columns initiate a natural healing process that forms new healthy tissue. This results in an improved skin appearance! Downtime is milder than other lasers, and typically resolves in 3-5 days.

Dermal Fillers show great results and improves the appearance of acne scars by lifting the depressed scars. Their effect is temporary. The results can last from between a few months to a year using fillers such as Belotero, Restylane, Juvederm, and Perlane, etc. However, with a combination of laser treatments such as the fractional non-ablative and very effective chemical peels, this can help dramatically reduce the appearance of acne scars with improvement in overall skin texture and healthy, happy skin.

Dr. Chiu and her medical team are personally involved in every treatment here at The Derm Institute. We are happy to answer any questions you may have about any of the procedures. To learn more about treatments at The Derm Institute or to schedule a free consultation, contact us by phone or email today.

 

. . . Shared by Dr. Chiu and The Derm Institute Team

Tips for Treating Large Pores

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We all want satiny smooth skin, unfortunately big pores often stand in the way of having that. Here is The Derm Institute’s Tips on minimizing the appearance of large pores.

Skin Care Tips There are a number of factors that will cause large pores, but of the many, there are three main culprits. The first one is age. As we age we will naturally lose the elasticity in the surrounding skin that supports the pores, causing pores to appear bigger than they actually are. Secondly, men are more likely to have larger pores compared to women from their genetic makeup and increased oil production. And last but not least, our body uses a substance called Sebum, which naturally hydrates our skin to prevent from drying. This substance however is very oily and individuals who produce more than average will find that oily skin causes larger pores.

 

The good news is you can make your large pores appear smaller and here’s some quick how-to’s:

1.  Cleanse:

One of the easiest and quickest ways to reduce large pores is implementing a daily routine of constantly keeping them clean. Use a mild cleanser twice a day and exfoliate so that your skin doesn’t become overly dry.  You can consider a cleanser that contains a gentle lactic or salicylic acid to declog the pores.

2.  Exfoliate:

Removing dead skin cells from the upper skin layer to brighten skin texture and get rid of heaped up cells surrounding and in the pores.  Removing the dull layer of dead skin cells on top of your living skin layer gives you brighter, smoother, more radiant looking skin with a velvety soft texture.  You may want to think about investing in the Clarisonic Mia which uses sonic energy and the vibrations of a brush to pulse your cleanser down into your pores. Oil and clogged pore debris can then be lifted out of the pores.  Empty pores look cleaner and smaller because the black appearance oxidized pore debris make pores look  more obvious.

3.  Treat: 

The use of topical treatments such as retinoids, salicylic acid, alpha hydroxy acid or benzoyl peroxides will not only reduce the size of the pores but will also aid in the destruction of bacteria that cause acne and treat sun damage.

If you still feel like your pores look big with the tricks I’ve mentioned above. You may need a little extra help. There are many dermatological advances in skincare which has led to the development of a number of effective treatments for large pores. If you have large pores, you may benefit from the following treatments:

4.  Chemical Peels:

Our team at The Derm Institute will work with you to transform your complexion into beautiful, healthy-looking skin. Our chemical peels use varying types of prescription-strength acids including salicylic, lactic, retinol, and trichloroacetic acid to remove your outer layers of dead skin – revealing the fresher, healthier, softer skin underneath.

5.  Fractional Non-Ablative Laser Skin Resurfacing: 

Fractional Non-Ablative Laser Skin Resurfacing works beautifully to create micro-zones of collagen boosting to reveal fresher, smooth skin.  It can minimize the appearance of pores as well as acne scars.  Downtime is minimal with some mild redness and flaking.  Typically a series of even 2 treatments is enough for long-lasting results.

Laser Treatments for Large Pores

View our before and after gallery

6.  IPL Photofacial:

Intense Pulsed Light (IPL) treatments are also fantastic for refining the texture and appearance of pores.  Skin feels incredible after even a single treatment.  IPL causes tightening of the pores, gives the skin an overall glow, and addresses any unwanted red or brown spots.

7.  Photodynamic Therapy:

Photodynamic Therapy uses a light activated solution to improve the skin texture by minimizing the size of oil glands on the face.  Typically 1-2 treatments can address pore size significantly, as well as reducing signs of early sun damage.

8.  Smart Makeup:

If you suffer from large pores your first instinct may to immediately reach for that makeup bag to reduce their appearance. But wait! Before you rush into it, double check that you are using the correct products first. What you want is a product that is an oil free formula without a lot of talc, which can actually settle into the pores and make them appear larger.

Dr. Chiu and her medical team are personally involved in every treatment here at The Derm Institute. We are happy to answer any questions you may have about any of the procedures. To learn more about treatments at The Derm Institute or to schedule a free consultation, contact us by phone or email today.

 

. . . Shared by Dr. Chiu and The Derm Institute Team

 

6 Steps to Soft, Smooth Skin!

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Whether you want to fade fine lines, get rid of flaky patches, or just up your overall glow, these six procedures can help. From anti-wrinkle procedures to skin-sloughing treatments, here are six ways to keep your skin smooth starting this New Year.

1. Start with something basic, like moisturizer. Some moisturizers are not very moisturizing. A lotion may smell good and look nice, but if you can’t tell you put it on five minutes after you put it on, it’s not doing much. Dr. Annie Chiu recommends switching to heavier, thicker products that contain humectants, which attract moisture to skin, when the weather gets colder. One of our favorite’s at The Derm Institute is, SkinMedica’s Dermal Repair, it works like a multi-vitamin for the skin by using nourishing ingredients to support the skin’s barrier and improve signs of dry aging skin. SkinMedica’s Dermal Repair Cream offers intense skin hydration and helps replenish firmness and moisture.shaving legs

2. Shaving. In the morning: Many women shave their legs with regular bar soap. But soap plus the calcium in hard water forms a gummy coating and makes skin drier than soap alone. Use a body wash, a soap alternative. *The Derm Institute Tip: Shave every day to every other day, with a body wash or shaving cream, with warm not hot water. A razor removes the protective top layers of your skin, along with hair. When you do de-fuzz, choose a four-blade razor — it offers the closest shave, allowing you to use a gentle hand, which preserves natural moisture — and opt for a hydrating shaving cream, not gel.

3. Chemical Peels, a common cosmetic procedure, works by removing your skin’s outer layer by exfoliating the skin and removing dead cells on the surface. Dr. Chiu’s Physicians Blends allows you to enhance exfoliation to promote a healthy, more radiant layer of skin while boosting collagen production. Most peels can be used on any part of the body, the most popular being the face, neck, décolleté, arms and hands.

4. Intense Pulsed Light (IPL) Photofacial to address any brown spots or broken blood vessels. Dr. Chiu’s IPL Photofacial utilizes Intense Pulsed Light for a gentle treatment that is safe, painless, and requires no significant recovery time. IPL sends light through the skin to target the undesirable tissue, and leaves the surrounding tissue unharmed. The process is gradual and, collagen production is stimulated, rejuvenating the skin, shrinking pores, and giving the skin an overall glow. After about 5 days of very minimal “beauty downtime”, this procedure will reveal new glowing skin with improved texture, pores and decreased wrinkles. The result is healthier, younger looking skin.

5. Photodynamic Therapy. The Derm Institute uses a LED (light-emitting diode) that healthy-skin-winterproduces a narrow spectrum light to boost collagen, which creates plumper, younger-looking skin, or to kill the bacteria that causes acne. LED photo facials are painless, cool and relaxing, and carry no risks. The best results come after a series of photo facial treatments. LED photo facials are a good choice for people who want to boost collagen or treat acne. Their collagen-boosting, facial rejuvenation properties have been proven with medical research. The results won’t be as dramatic as plastic surgery, but it’s a gentler, more natural, less expensive way to go.

6. If you’re not wearing sunscreen: Start now. It won’t get rid of the lines you have, but it will prevent new ones from forming. Begin using a prescription retinoid cream nightly; Dr. Chiu often recommends Renova because patients find it less drying than other formulas. You’ll notice lines softening in two to three months.

 

If you want to be more aggressive, you could try Botox, a favorite here at The Derm Institute. Botox is a botulinum toxin that blocks the nerve impulses that cause muscle activity—and expression lines. Dr. Chiu can inject it around the eyes, between the brows, across the forehead; the lines in those areas then fade away over about a week. Fine lines are generally about 20 percent genetic and 80 percent environmental (in other words, brought on by the sun and smoking). They usually occur in the most expressive areas of your face—like around the eyes and forehead.

 

. . . Shared by Dr. Chiu and The Derm Institute Team

 

 

 

Boost Your Skin A•PEEL!

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What is more a•peel•ing then looking like a more luminous you?

Medical Grade Peels Manhattan BeachGet ready to slough off the summer photodamage with a Physician Grade Chemical Peel  and welcome fall with refreshed, even-toned, glowing, and tighter appearing skin.  Daily assaults on our skin including ultraviolet rays and environmental pollutants degrade molecular structures in the skin resulting in sunspots, wrinkles, blemishes, and other imperfections.  Chemical peels exfoliate the top layer of skin cells that can dull the skin, penetrate the dermis to increase collagen synthesis, shrink oil glands, and makes the skin more receptive to your current skincare regimen.  Although most popular for the face, peels can actually be applied to any part of the body.  In fact, they are AMAZING right before a vacation or spray tan, and can help improve dry, bumpy skin on the arms and legs.

 

Chemical Peels Manhattan BeachWe find most people are nervous about chemical peels, thanks to unforgettable images of Samantha in the infamous episode of Sex in the City.  But at The Derm Institute, Physician-Grade Peels can be customized by Dr. Chiu from light, no downtime, to deeper, more aggressive peels, all depending on your goals. The word “chemical” in Chemical peels is really a misnomer, as most peel solutions are derived from combinations of fruit acids, milk acids, Vitamin A and Vitamin C.  These ingredients essentially loosen the “glue” between the dead cells on the top layers of the skin, promoting improved skin renewal.  The natural cycle of skin renewal slows as we age. Babies shed superficial skin cells every 14 days, teenagers every 21-28 days, middle aged adults every 28-42 days, and after age 50, it takes an average of 50 days for skin rejuvenation.

Get knowledgeable on the Peel Process and some common ingredients of Physician-Grade Peels:

Timeline:

Gentle peels such as our Red Carpet Peel give an immediate result of glowing, dewy skin, often popular amongst our patients for a night out, photoshoots, or even the day before weddings.  This peel smooths and tightens the skin, allowing makeup to go on flawlessly immediately after.  For those who are looking to treat fine lines, discolorations, or unevenness in the skin, deeper peels that have downtimes ranging from a couple days of dry flaky skin, to a week of peeling can be applied.  Typically, the first one to two days post peel reveals tighter, glowing skin.  On days 3, 4, and 5, there can be mild to moderate flaking and dryness of the skin.  By day 7, fresh new, soft and radiant skin is revealed.

Chemical Peels Redondo Beach
TCA PEEL: Day 1, Day 4, Day 7

Alpha hydroxy acid (AHA) peels are light to moderate peels most commonly based on glycolic or lactic acids. Although very popular, higher percentage glycolic peels need to be used with caution as it can cause inflammation, especially in darker skin types.  AHA peels are utilized to minimize fine lines, and to improve tone and texture.

Beta hydroxy acid (BHA) peels are also mild to moderate peels most commonly consisting of Salicylic acid.  Salicylic acid works well to penetrate oil glands and declog pores, making it a popular ingredient for peels that treat acne.

Trichloroacetic acid (TCA) peels are considered moderate grade peels.  They work beautifully to correct fine lines, pigmentation, decrease pore size, and boost collagen production.

Carbolic Acid or Phenol peels are considered the deepest form of chemical peels.  They promote collagen growth by penetrating the deeper layers of the dermis, and the results can rival CO2 ablative laser resurfacing.  These are used for deeper, etched wrinkles, especially those around the eyes or mouth area.

Medical Grade Peels Redondo BeachMost Physician Grade Peels offered at The Derm Institute are customized and blended for each individual client.  Different acids may be layered to achieve the desired depth of peel, and often ingredients such as retinol, Vitamin C, or other botanical extracts are used to boost the radiance of our peels.  Lighter peels are more effective in a series, while deeper peels can be beneficial about once or twice a year.  Weekly Glow Pads are fabulous to maintain the improvements of your newly refreshed skin.    We also offer complimentary hydration masks after deeper peels to promote the sloughing of dull skin.

So come explore the beauty of “aPeeling” skin, our own staff here at TDI are addicted to them!  Oh-and don’t forget to always use a SPF 30 or greater to maintain your refreshed and gorgeous skin.  My personal fav:  Colorescience’s Sunforgettable SPF 50 Brush, available at our skin boutique . . .

 

. . . Shared by Dr. Chiu and The Derm Institute Team

 

*Special thanks to Gabbie Wei for research contributing to this article.  Youtube video of her peel experience coming soon . . .