Posted on: July 26, 2007

Facial Awareness

Some skin conditions need special care. The next time you pamper yourself with a facial, consider this ...

By Deborah Douglas
CTW Features

A smear of this, a dab of that and a face-covering glop of stuff — that’s what passed as a beauty regimen for many a teen. Fast-forward to age 30 and now you really do need some help. Those fine lines are not a mirage. Your skin even feels thicker. No matter how much moisturizer you slather on, your skin is ‘oh so dry.’ Don’t even talk about acne. Even those of us who escaped it in our teens face it in middle age.

What gives? What now? What next?

Regular facials are now considered a vital part of any maturing woman’s beauty repertoire. But facial menus rival those of restaurants. And if you have a host of specific conditions such as adult onset acne or rosacea, how do you know where to start?

The first thing to know: What you did in your 20s won’t necessarily work in your 30s and 40s. Likewise, your age 50 face has different needs than your age 60 one. With every decade comes concern about stimulating cell turnover, boosting moisture, alleviating swelling and jumpstarting your home-care program.

“[Facials] won’t cure wrinkles or scars, but they can be a good adjunct to a good topical regimen and a good pick-me-up for patients who don’t feel their skin is turning over fast enough,” says Dr. Suzan Obagi, head of the University of Pittsburgh’s Cosmetic Surgery and Skin Health Center.

Let’s look at your baseline facial needs for typical skin conditions:

If you have: Acne

Characterized by: facial lesions, including whiteheads, blackheads, papules, pustules, nodules and cysts.

Acne affects 17 million Americans and while it is common in teens and young adults, middle-agers in their 40s and 50s can still get it, according to the National Institutes of Health. It can be caused by hormonal changes from pregnancy, stopping and starting birth control pills, and even some types of medicine.

Facials won’t cure acne, Obagi says. And overzealous cleaning and exfoliation can actually irritate it. However, gentle facials are great for stimulating skin cell turnover because it slows down as we age. She approves of acne facials every six weeks, because that’s the length of a typical skin cell turnover cycle.

At Chicago’s Ruby Room wellness retreat, aesthetician Amy Halman uses something called an Acne Buster facial using deeply exfoliating enzymes that detoxifies and decongests pores. She follows that up with a soothing herbal mask that quells inflammation.

If you have: Rosacea

Characterized by: redness and rashes on part or all of the face.

Be gentle. That’s the key to treating faces plagued by rosacea, a chronic condition that affects 13 million Americans, typically between ages 30 and 60.

“A lot of times people can come in with slight redness in the cheeks,” Halman says. “At the other end of the spectrum, they can have pimply red skin and swelling that can look somewhat disfigured.”

Skin afflicted with rosacea can be painful to touch; a sensitive approach is needed to strengthen and moisten skin without overstimulating it.

Gotta haves

When Pittsburgh’s Dr. Suzan Obagi opens her medicine cabinet, what do you see? “You’ll see Vitamin C serum, a good cleanser, sunscreen, a topical hydroxy acid and my Retin-A,” she says.

Following are some of her must-haves for a skin care regimen that works.

Cleanser

Strong and thick enough to remove oil, makeup and pollution. Dr. Obagi doesn’t like to play favorites, but she admits Neutrogena makes a pretty good cleanser.

Vitamin C

Fight fine lines and wrinkles by applying it topically. It’s the only vitamin that works better applied to the skin than by taking it orally, she says.

“Vitamin C is one of those things where cost is probably related to how good the product is,” says Obagi, who suggests starting with an $80 investment in Vitamin C serum to ensure that it will not oxidize and become useless.

Retin-A

Thirty years of research backs up its anti-aging and sun-damage fighting powers, says Dr. Obagi, noting that it is important to use the right amount because people tend to use too little.

“You’ll want to use calming agents and replenish moisture – things like Vitamin C derivatives, low-concentrations of salicylic acid, botanical acids, polyphenols and willow bark (where aspirin comes from),” Obagi says.

At Ruby Room, rosacea sufferers are treated with an organic product line that contains live fruit enzymes to help the skin rebalance itself on a cellular level. Clients are treated with two masks - one to strengthen and one to lightly soothe.

“It’s not just slapping it on the skin,” Halman explains. “It’s reminding the skin how to take care of itself. It’s going to help strengthen cellular walls without causing more inflammation and redness.”

If you have: Hyperpigmentation

Characterized by: darkened skin patches due to melanin overproduction, includes age spots.

Sun damage is one of the biggest reasons for hyperpigmentation.

“So many factors can encourage skin damage,” Halman says. “Like not protecting your skin and using things like Retin-A that make your skin more photosensitive.”

Halman queries clients about their lifestyles to find out where hyperpigmentation can be coming from. Then she applies a sunscreen made of distilled water, fruit acid, titanium dioxide and zinc oxide for full-spectrum sun protection. In addition, she uses an enzyme treatment to exfoliate well and recommends an at-home spot treatment containing kojic acid serum, a lightening agent that inhibits melanin production.

For dealing with sun damage, Obagi loves products containing retinol, a Vitamin A derived antioxidant. Over-the-counter retinol products are OK for people 25 and younger, but over age 25, she suggests seeing a dermatologist.

“Retin-A tends to be one of the best tolerated [versions] and it has had 30 years of research on aging and sun damage that says it’s safe,” Obagi says. “Over the long term, it tends to do better. We use it as chemoprevention to minimize skin cancer. This regimen is good for anyone with any skin type.”

If you have: Fine lines

Characterized by: loss of elasticity provided by collagen, a sponge-like protein underneath the skin

Starting at age 25, skin starts to slow down the production of collagen, the protein that gives skin its elasticity. Fine lines become more apparent and wrinkles follow.

Facials billed for their anti-aging properties are designed to prep the skin to tackle the effects of age. “It strengthens the skin, reminding it to pick up collagen production,” Halman says. “If anything, you walk out with lifted skin. The texture is smooth, and you’ll notice a stimulated sensation.”

Obagi agrees that you’ll walk out with smoother-feeling skin, but you definitely keep aging. Using sunblock that contains zinc or titanium oxide (even in place of a moisturizer) is the best way to stave off the effects of aging.