Laser Follow-Up

Photos before laser treatments.

On the left, November 2015. On the right, October 2016.

Current age: 36. History: daily sunscreen use since age 20. General sun avoidance because #indoorsy. Retinoid use for past 10 years (?), Botox intermittently for past 5 years (contraindicated while pregnant/nursing or trying to conceive (retinoid)). Skincare regimen: nightly/every-other-night Retin-A plus antioxidant serum + ferulic acid/vitamin C. Genes: my mom has essentially no wrinkles. Thanks, Mom!

Prior to treatment photos and analysis are performed and stored by this computer.


These are photos of the same screen with my camera - I've included two because the exposure is little different.

In November 2015 Quenby administered the BBL (broad band light - technically not a laser) and then Halo laser (hybrid ablative and non ablative laser) - wrote all about it here. With my latest trip to Chicago, I wanted to start an annual regimen of BBL treatments (based on this data) and see this comparison! What I see: decreased freckles; decreased vascularity in my upper cheeks; more even skin tone; more luminous.

BBL, this time

Procedure: My red and brown spots respond to the same filter, decreasing the number of passes (how many times the face is treated) - lucky me! The treatment consists of short, very hot zaps, most uncomfortable on the upper lip and most tolerable on the sides of the face. I find this very uncomfortable but tolerable. I am a huge wimp, remember. Elise received one too and she is much more of a trooper than I am. Quenby used a different filter for the cystic acne that has developed since I got a Mirena (that reminds to me start a new series on the blog called I Hate That F*&%ng Thing, the first five installments of which will be about this IUD). ANYWAY, focused treatment for acne. Out, damned spot.

Time: 20 minutes? Probably less. She treated my face twice plus extra zaps for acne.

Cost: $600.

Downtime/recovery: None. We immediately went shopping next door at Water Tower Place. I didn't have any redness, peeling, flaking, etc. Elise said she had some mild periorbital swelling the next day but I couldn't see it.

Effects: Nothing too dramatic - but I am thinking of the long game here. Definitely the faint freckling on my upper cheeks has faded.


Plans

Yearly BBL. Repeat Halo at some point with lighter settings; I didn't mind the cosmetic downtime but the procedure itself was *very* painful (low discomfort threshold) and I'm not eager to do it again. However, the results are there. Daily sunscreen (I have some new favorites). Hats hats hats. Botox. Retin-A. Proactive prevention!

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Lasers Pew Pew Pew

About eight months ago during a Chicago visit I saw my friend Quenby at her cosmetic dermatology office for facial laser treatments. Here are the results!

Monday morning. Here I've already had BBL treatment for red and brown spots and my face is covered in numbing cream in preparation for the Halo laser. I also have eyelash extensions and suddenly remember how much I miss them. Note to self: have tiny hairs glued to eyelids whilst reflecting on how strange womanhood is.

The BBL treatment was brief and consisted of very short, zinging staccato zaps.

Click here to see before and after photos of a long term followup study of BBL. (Caveat reader: the authors are affiliated with the laser manufacturer but hey science ain't free).

NOTE: I am not a dermatologist and not much acquainted with the different types of lasers, indications, etc. Get your information from a reputable source and visit a board-certified dermatologist -- this is not a Groupon-type procedure!

In contrast, the Halo treatment took about 45 minutes and was very painful, because it took a long time and consisted of drawing the wand across my face, section by section (instead of zap here, zap there as the BBL was). I am also melodramatic and have a low pain threshold. I don't like getting my teeth cleaned, can't bear to load weight on my kneecap during yoga, etc. I complain about discomfort so you can imagine how I carry on when in pain.

For an hour after the procedure my face felt very hot (this is normal). This photo is four hours post-laser. 

Tuesday morning.

Wednesday morning. This looks painful but was actually completely painless. My face felt a bit tender to the touch and my face was taut with swelling so smiling felt awkward, but not painful.

Thursday morning. You would think Clem would have said something about my face but she didn't -- she probably couldn't articulate it then.

Friday morning. Swelling going down, sloughing starting.

Saturday morning.

Pretty quickly back to normal after this - so much so I forgot to take photos. I went about my daily schedule this entire time -- I am vain enough to have this procedure but not self-conscious enough to stay home (no reason to). If you'd ever like to know how much no one is looking at you, walk around with a red-brown peeling face and swollen eyes and observe no one even giving a second glance. (At least that's how it felt, but again, I'm not very self-conscious and disfigured people are commonplace where I work - everyone is conditioned/too polite to even look). The men I work with said: WTF did you do to yourself?! and the women said TELL ME EVERYTHING! and there's more fodder for nature-of-womanhood reflection.

I wish I had taken a 'before' photo where I could recreate a same-lighting 'after' but I didn't think of it. I have an assessment photo in the dermatology office and look forward to the 12-18 month out comparison. My skin overall isn't quite where I want it because 1) I'm struggling to find the right retinoid-exfoliant routine -- lately my skin has been pink and irritated + broken out (thanks no thanks Mirena) and 2) I don't have a regular Botox schedule (coming soon). Botox and epidurals really make me happy to be alive in the modern era.

Here's the best 'after' I have:




 Whoops, it's a face swap with dad that is real nightmare fuel.

Thoughts: I'll get a BBL treatment annually or semi-annually for brown/red spots (did you see the results of that paper?! Small cohort but long term follow-up - impressive results.) The Halo was mucho painful (remember: wimp) and will not do again for a few years (my settings were also 'aggressive' because I wanted the most bang for my buck and wasn't concerned about cosmetic downtime). There is a brown spot between my eyebrows that is visible on the first photo - it darkened and flaked off. So satisfying. My overall skin tone is much more even and, amazingly, my pores are less noticeable.

Other laser treatments: Spider vein assessment led to diagnosis of incompetent leg veins (no surprise there - family history + pregnancy); I had laser ablation of the greater saphenous veins in December and March. Each procedure was quick and easy with very little post-op discomfort. Post-op instructions included wearing compression stockings, walking a prescribed amount, and forgoing heavy exercise for two weeks. Some people told me how much lighter their legs felt after the procedure but I never had any symptoms like leg heaviness or noticeable swelling by the end of the day. Hopefully I won't develop varicose veins now, bringing me to the theme of this post:

   💥💥💥The best defense is an offense armed with a laser! 💥💥💥

(Really, it's all about sun avoidance. This year's Sun Safety kit from Sephora is available - $20 of the proceeds go to the Skin Cancer Foundation. I like all the products in it that I've tried so far (but, as always, am mystified by the inclusion of self-tanner, which promotes the beauty standard of tanned skin.))

            Happy first days of summer, friends! If you need me I'll be lurking in the shade.

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New Products

// Dr Dennis Gross Dark Spot Sun Defense SPF 50. I tried this as a sample at Nordstrom and then regretted not buying it halfway home. This sunscreen has very little of the white cast that makes zinc oxide products difficult to wear until makeup. (Beautypedia hates this product - maybe I'll change my mind after a few weeks of use.)

// Urban Decay One and Done - though Armani CC cream remains my all-time fave because the finish and amount of coverage are exactly what I want.

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// Urban Decay brush - a weighty, densely bristled brush. I'm debating whether I prefer using this or a BeautyBlender.

// Urban Decay bronzer in Sun-Kissed. As someone with pink skin made more pink by my aggressive skincare regimen, I've finally been forced to admit all the pink lipstick and pink blush I'm drawn to is a terrible idea. This bronzer is much lighter in person.

// Exhibit 2: Pop of Passion Lip-Oil Balm in Nude Passion. Doesn't look at all pink in the tube but goes on lip color.

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// Smith & Cult Tainted lip gloss. I like it for the texture (not tacky or too shiny, the reasons I dislike most lip gloss) and slight stain but love it for the website descriptions of the two shades:

When I wait, hoping for them to come back, I am stuck watching a parade of work out clothes and mindless ensembles that only make me realize I may never see my perfect, color coordinated, quiet couple again.

 It smelled like cotton candy, not in the gross way, but like a puffy sweet pink cloud.

// Tom Ford Burnished Copper creme eye color - doesn't crease much even without a primer.

image via

// R+Co dry shampoo paste - dry shampoo in a paste form that's great but would be perfect if I could get my learning-to-do-face-framing-braids game together.

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My Beauty Routine

.... bwhahaha! Lately I've been paying more attention to a dedicated skincare routine and even wearing makeup! - I've found some great stuff that I want to share with you.

First and foremost I've been using Retin-A and finally following Quenby's advice to LET YOUR FACE DRY COMPLETELY. I wash my face, apply toner, exfoliant, serum + booster, let dry for 15-20 minutes (yoga/Get To Work Book/pack lunches/mindless scrolling/I just joined Skillshare and omg I can't wait to fall down that rabbit hole), then Retin-A and moisturizer. Letting my skin dry and being consistent with daily or every-other-day application has mitigated dryness, redness, and flaking considerably.

I enjoy the ritual of it all.

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Cleansers and such: It turns out I really love rubbing oil on my face. Remember how oil and fat were anathema for so long but now everything is bacon, prime rib, grassfed butter, argan and essentials oils? Well I love it. It's probably terrible for my skin type but I adore Josie Maran's cleansing oil and its drugstore counterpart (absolutely the same, I'm certain -- see a discussion of the phenomenon that drives my every purchase here). I'm using the Paula's Choice advanced kit for wrinkles + breakouts (the kit pictured below plus the weekly foaming treatment, moisturizer, and antioxidant serum). I've used up the exfoliant in this kit and am using another PC exfoliant that was a gift with purchase (still going at Nordstrom.com) -- I like the face-feel of the Resist product more but as I'm applying this at night, no big deal.

images via Sephora and paulaschoice.com

I add a few drops of C15 booster (ferulic acid + vitamins C and E) to the antioxidant serum and moisturize either with a PC moisturizer or oil (a sample that I like but don't feel strongly enough about to purchase). [For a description of how to use PC products with a retinol/retinoid, click here].

Other cleansers: My sister gave me a Clarisonic that I use several times a week in the morning. Beautypedia (a Paula's Choice website) raved about First Aid Beauty's Milk Oil Conditioning Cleanser. I like it but the pump struggle is real.  

Sun protection and makeup: I wear at least SPF 30 everyday on my face. My new fave is Perricone MD's Photo Plasma which despite being rather heavy doesn't translate to shininess. Bonus points for titanium dioxide. Maybe I'm hook, line, and sinker for the tagline - No Makeup Makeup - but I love the No Foundation Foundation, No Lipstick Lipsticks (other colors only available as a kit), and No Eyeshadow Eyeshadow -- my enthusiasm for which even confounds me because it's freaking invisible. I'm not saying it makes sense, folks. I like most of the PC facial sunscreens - all are available as single use samples for $1. So much of sunscreen is desired finish and acceptable texture and this is great way to try out several.

** IMPORTANT NOTE: I'm not a dermatologist, just a gal who's enthusiastic about smearing things on her integument. None of this is advice - it's just reporting from the front lines of my medicine cabinet. **

Lipsticks: Armani sheers all the way.

Armani CC Luminessence cream remains my all-time favorite. It has a low Beautypedia rating but I don't care. I love it. On the rare occasion that I apply makeup to go out at night, I use Armani Luminous Silk - beyond fabulous. On a typical day I'll wear sunscreen and add a bit of coverage with the Luminous Silk compact and that's it.

Better Than Sex Mascara: awesome. 

Beautyblender and Blotterazi: a real upgrade from the finger-schmear application technique I usually employ. I like that I use more product because I have so many little bottles hanging around. (Following Gretchen Rubin's advice to use it up!) Blotterazi is a fantastic upgrade from those little papers.

images via sephora.com

Other Paula's Choice products that I love: the eye cream, body butter (not greasy and a tube not a tub - this stuff is awesome), heavy duty moisturizer/mask (I used this heavily post-laser treatment... more on that later), body lotions with 10% AHA and retinol.

Neurotoxins and laser blasts: I've gotten Botox about every 8-12 months since age 30. Once I'm able to establish a routine I'll increase that to 2-3 a year. Botox is the greatest. I have my forehead, crow's feet, and glabella (the 11 crease between eyebrows) injected. I had my first ablative and non-ablative laser treatment two months ago - upcoming post!

Now for the best part! Click on over to Paula's Choice for $10 off your first order!* I love this company -- their customer service is fantastic and the products are domestically sourced and made in the USA. No animal testing. No fragrance. No bogus claims. There are frequent sales, free shipping promotions, a 100% satisfaction guarantee, and free samples with each purchase.

*if you use this link and purchase items, I receive $10 toward PC products. SO GET SHOPPING. I kid. Then you can refer-a-friend and get money money money.

As I read over all this, I think wow, that's a lot of stuff and wow, that's a lot of money. I suppose some people spend a lot on makeup - actual colors of makeup - and while I have some of that too, I focus on looking like the best barefaced version of myself, both au naturel and made up. I will never, ever buy a contouring kit, for example. That is too much time/effort/skill level in a way that a seven-step-in-under-three-minutes skincare routine isn't to me. I live by the 'ounce of prevention is worth a pound of cure' maxim -- prophylactic Botox, sunscreen and hat use, retinoids, laser for wrinkles/skin tone - and because I'm actually kind of lazy - I've enjoyed eyelash extensions and keratin treatments by the same principle of investing 2 hours on a Saturday in order to greatly streamline getting ready each morning for several weeks to months.

Happy long weekend, lovers! I'd love to hear about the products, potions, and procedures you swear by.

Blush. It Makes Such a Difference.

Sometimes I wear makeup and I'm reminded of how much better I look with it on.

I went on a little e.l.f. bender at Target, throwing a bunch of items in the basket, and at about $3 apiece, it's ok.  You add some Twizzlers, a caffeine free Diet Coke, and some Biore nose strips and you have yourself a relaxing Friday night.

On Saturday I tried the blush/bronzer duo (just the blush - I've never figured out how to use bronzer without looking like I did a face plant in Georgia red clay) and it must be good because Laura commented on my Instie from that day:

The St Lucia color is a dupe of Nars Orgasm blush/bronzer duos (oo la la)

via e.l.f.

 

via Sephora

 

But the e.l.f. is $3 and the Nars $41!  In my recollection the Nars blush has much more shimmer, and is more orange; the e.l.f. wins, hands down.  I am going to track down the bright pink shade, Antigua, on my next Tarzhay run.

I also picked up two Almay liquid shadow + primers in the grocery store due to its NO CREASE promise.  I love cream shadow despite oily skin and oily eyelids (it's ok: it's going to have benefits).  Almay, you impress me!  This pic was snapped after sitting outside for three hours in 98 degrees?  100 degrees?  what does it matter.  It was hot, like SATX always is, and this stuff stayed put and barely creased. I bought the khaki and the purple; they have some shimmer and buildable color, but start out as a just a wash of color.

I didn't like this mascara when I found it at the bottom of my makeup bag that morning, a sample that was nearly dried up, but it looks rather lush in this photo.

 

What are you using and loving, friends?  Any drugstore gems out there?

Paula's Choice

OK I've given up on trying to make this blog well-written... I'd rather have something written than none at all, so here goes!

 

thanks for understanding,

The Mgmt

 

 

ON TO IMPORTANT MATTERS:  

 I'd been looking for a skin care system to replace, temporarily, my Cetaphil- retinoid - sunscreen routine while pregnant/nursing [a time when retinoids are verboten.]  I was familiar with Paula Begoun from her books and narrowed in on her skin care line as a a return-to-pre-pregnancy-weight treat/incentive.  That goal met, and after chatting with the online representative (who sent me free samples!), I bought the skin-balancing system, sent the retinol-containing serum to my mom, and swapped in the retinol-free Resist Ultra-Light Antioxidant Serum.  I used it for a few weeks and

READ THIS NEXT PART IN AN ITALIAN ACCENT:

Touch my cheek - it is so smooth.

Press my cheek - it is so firm.

OK BACK TO YOUR NORMAL READING VOICE:

I love it!  I am firmly against any feeling of Stuff On My Face which is why I am very picky about sunscreens.  And despite the application of toner/exfoliant/serum/sunscreen (day) or toner/exfoliant/serum/moisturizer (night), my skin feels treated but not gloppy, greasy, or squeaky-clean and parched.

ITEMS I LIKE THE MOST:
The gel moisturizer and liquid exfoliant

FEATURES I LIKE:
Made in USA; no animal testing; no dyes or fragrances (big plus plus plus next to this); detailed product descriptions including customer ratings, product details, research with references, ingredient list, how to apply, and FAQs (how is [x] different than [y]? safe for use around eyes? ok to combine with another product? and so on); excellent customer service including online chat availability and quick shipping; Beautypedia reviews you can cross-reference by product and your skin type.

ITEMS I AM EXCITED TO TRY:
Retinol body-smoothing treatment (shoulders and chest, I'm coming for you!); the only fragrance-free all-in-one body and hair shampoo I've ever seen (if I ever figure out how to get to the gym occasionally during the workday, this would be a gym bag staple); fragrance-free body lotion; another sunscreen (I like the skin-balancing formulation but it is a bit runny)

IN SUMMARY:
I'm a Paula's Choice convert!  Click on over and see if anything strikes your fancy - I think you will be pleased.

Dear Few and Cherished Readers,

It goes without saying this is NOT a sponsored post.  But wouldn't it be great if it were?! 

I love you, PC!