IPL (Q + A)

As we age, our skin naturally loses elasticity, experiences collagen break down, and fine lines and wrinkles inevitably appear. In addition to these undesirable changes, most patients also experience some form of hyperpigmentation from excessive sun exposure. While there are many procedures that help to address the tone and texture of the skin, an extremely beneficial “go-to” to treat the unwanted pigmented lesions is Intense Pulsed Light Therapy (also known as IPL/Photofacials). As the Registered Nurse of Hobgood Facial Plastic Surgery, I’m here to answer the most commonly asked question regarding this procedure and help you to determine if it may be right for you.

Why should you have IPL? Patients that have exisiting hyperpigmentation (red and brown spots), broken capillaries, sun damage, acne, and patients that would like to prevent any underlying hyperpigmentation from surfacing would benefit from IPL. If you have had extensive sun exposure (and most Arizona residents have), IPLs/Photofacials are a great way to prevent future discolorations in the skin and maintain an overall even and bright complexion.

How does IPL work? Our unique DyeVL and long-pulsed Nd:YAG Laser induces selective photothermolysis of specific melanin chromophores in the tissues. Both specific spots of concern can be targeted, as well as larger surfaces areas. The light energy that is delivered into the skin will gently heat the upper most layers of the skin, which then causes new collagen stimulation and cell turn over by the absorption of energy.

How often should I have IPL? Patients are safely able, and should have IPL/Photofacials performed every 3 to 4 weeks. Staying compliant with this recommended treatment schedule is suggested for best outcome of the patient because of the skin’s natural cell turnover process.  Different patients require various treatment pathways for many reasons; some of which include the amount of damage their skin has endured, as well as genetic background. Patients may also choose to have occasional touch-up treatments once desired skin is acheived to maintain optimal results.

What is the down time with IPL? IPL is gentle and considered non-invasive as patients typically do not require any topical anesthetics. An additional benefit to this effective treatment is that downtime is very minimal-resuming regular activity and wearing make up is allowed almost immediately post-treatment.

How soon will I notice results? While each patient is different and recommended treatment options vary, most patients see results around the 3-6 treatment range. Something else to keep in mind when treating pigment is that patient’s pigment often appears more visible before it “lifts”. In other words, as the pigment is being treated it looks “worse” before it looks “better” and that is both normal and a sign that your treatments are working towards your end goal of a more even complexion.

For more information or to schedule a complimentary comprehensive consultation, please call 480.214.9955 and ask to book an appointment with Annie Bruno, RN, LE, CLT.

 

 

Eye Cream Everything.

            The importance of eye cream is often times questioned- “Is it really important?” “Does it really do anything?”. The simple answer to this is, yes. 

Not sold? Eye cream not only provides periorbital skin with specific ingredients tailored to the delicate area, it also provides an instant improvement in appearance after application. When your eye area is hydrated, your fine lines + wrinkles are immediately better. Some formulations are built to help with puffiness, while others have light-reflecting properties to improve dark circles and bags. 

Application is also key when it comes to various eye treatments. Instead of wiping the product on the eye area, your product of choice should be gently tapped until absorbed. Wiping on product can cause unnecessary tugging which can age the skin prematurely. Another favorite way to apply eye cream is through use of the clarisonic opal. This amazing device will push your product (delicately) into the deepest layer of the skin- your dermis. 

Also important to remember is that a little bit goes a long way. Over application in the morning can cause caking around the eye area, and as a result an uneven makeup application. Over application in the evening can cause irritation during the hours of sleep. 

 

Some of my favorites include: 

skinmedica tns eye repair: $102

skinmedica uplifting eye serum: $60

 

skinmedica HA5: $178

jan marini c-esta eye repair: $62.00

To find out more about which specific eye cream would best benefit you, schedule a complimentary appointment with Annie at Hobgood Facial Plastic Surgery (Scottsdale/Paradise Valley, AZ). For scheduling: 480.214.9955

Move Over, Melasma!

 

                Different skin conditions can be difficult to diagnose, and sometimes even more so to treat. Melasma (chloasma) is one of the more complex conditions that affects many patients leaving them frustrated and struggling for answers. Melasma is different than sun damage and hyperpigmentation because of its unique mechanism of action-it is stimulated by hormonal fluctuations. Unlike UV-induced pigment, melasma has some key characteristics that can make it easier to identify. Having a better understanding on this tricky condition can help you to better control your symptoms. 

What does melasma look like? Unlike a diffuse distribution of hyperpigmentation (like you commonly see in sun-damaged patients), melasma has a patchy distribution with a distinct line of demarcation. These brown, or sometimes grayish/brown patches will most likely be present in the face, cheeks, chest, forehead, nose, and chin areas. 

 (photo: American Academy of Dermatology)

“My melasma seems to get worse in the summer, and better in the winter” This observation is commonly seen with this condition. Sun exposure can make the hormonal spots appear darker, and heat exposure can have the same effect. Unfortunately, any time a patient experiences any type of internal heat (even working out, and hot yoga), the pigment can become worse.

What can I do to treat my melasma? Treatment for melasma includes reducing stimulating factors (sun + heat exposure) when possible, and following a strong home-care regimen. Unlike other sun damage, deep chemical peels and lasers can actually cause more harm to melasma patients because of the stimulation of heat. Gaining control of your hormones can also be difficult because typically eliminating pregnancy, birth control, and breastfeeding are not desired options, or preferences.

What products should I use at home? Patients will see a huge benefit from a few powerhouse pigment products: Vitamin C + E (to help lighten, tighten brighten), retinol (to speed up cell turnover), SPF (to protect from sun damage), and Hydroquinone/Other lightening agents such as kojic acid, azelaic acid (to lighten and brighten existing pigment). Some patients are even diagnosed short-term steroids to gain control of inflammation; this will need to be initiated and controlled by a physician.

What products do you recommend? I would suggest picking at least one product from EACH category to treat melasma effectively.

Vitamin C: I will warn you that NOT all Vitamin Cs are created equal. L-Ascorbic acid is a very difficult ingredient to stabilize and although many products claim to contain vitamin C, there are very few formulations that are still active after packaging. A few of my favorites include:

Skinmedica Vitamin C + E ($102)

 

PCA Skin C + E Strength Max ($96)

 

PCA Skin C-Quench Antioxidant Serum ($74)

Retinol: Again, not all retinols are created equal. Some formulations are not “cosmetically elegant” and can cause skin irritation, redness, and excess flaking and peeling. I would recommend any of the following:

Skinmedica Retinol 0.5 and Retinol 1.0 (0.5: $78, 1.0: $93) 

 

 PCA Skin Intensive Clarity Treatment ($106)

 

SPF: PLEASE Do not minimize the importance of SPF! It is protecting you from future damage as well as skin cancer, and future aging.

Skinmedica Total Defense + Repair (Tinted + Non-tined formulations available) ($68)

  and PCA Skin Perfecting Protection broad spectrum spf 30 ($34)

Hydroquinone/Brightening Products:

Hydroquinone- Products that include this ingredient are typically available for purchase through a physician or medical practice. Hydroquinone has specific instructions for use, and they should be followed closely for safety. 

Skinmedica Lytera Brightening Complex ($130) this 4% Hydroquinone equivalent is highly effective in patients that cannot tolerate hydroquinone, or need to be on their “hydroquinone break” as directed by physician. 

Intensive Brightening Treatment 0.5% pure retinol treatment ($106) Similar to 

Lytera Brightening Complex, this hydroquinone-free complex is highly-effective in treatment pigment. 

 

PCA Skin Pigment Gel 2% Hydroquinone spot treatment can be applied to specific patches of pigment on the face. A 2% may be ideal for someone new to using hydroquinone, or that cannot tolerate a full 4% formulation. 

 

For questions or comments, please post below or feel free to contact me at the office. You may schedule a complimentary consultation at any time and we can review the specific needs for your ideal skin health.

For appointments, please call: 480.214.9955 and ask to schedule with Annie Bruno, RN.  

Be well,

Annabelle

xo

The Lazy Girl’s Guide to Skin Care!

          Let’s be honest, after a long day the last thing you probably want to do is wash your face. That being said, it is crucial to adopt at least some type of regimen to maintain overall skin health. I personally am a product junkie, but I know it is not always realistic to expect the same of my patients- and that’s where my bare minimum recommendations come into play.

                 

Often times, patients can accomplish many of the necessary steps while lying in bed and winding down from all the day’s activities (and simultaneously enjoying the daily dose of Bravo TV). Even if you aren't the typical "lazy skin care patient", I’ve listed a few of my favorites to help keep you on track, beat breakouts, and have on hand just in case.




Jane Iredale: "Dot The I" Eye Makeup Remover Swabs
These cotton-tipped applicators are already loaded with makeup removing solution- convenience at its finest. Individual wrapping also makes great for traveling.

Jane Iredale: Beauty Prep Cleanser

This super-refreshing cleanser smells of delightful cucumber, and requires no water for use or removal. Ideal for the bedside cleanse, or to prep your skin for fresh makeup after a lunch-time workout. Available January 20, 2016, so be on the look out!

SkinMedica TNS Essential Serum:

This all-in-one super active serum restores youthful volume by use of antioxidants, peptides, and epidermal growth factor. Daily use will cause significant improvement, with noticeable changes at the 90-day mark. This product is perfect for the patient who wants minimal effort and maximum result.

 

Clarisonic: Opal

This handy gadget provides a gentle massage and maximum penetration of serums in the delicate eye area. I find it particularly relaxing to use my opal during my favorite nighttime TV shows. It is also super helpful to use on mornings you may have sacrificed some sleep as it immediately improves puffy eyes and bags.

Satin or Silk Pillowcases:

Research has shown that making a simple switch to the luxury threads (if only for your face) can dramatically lower the risk of creating fine lines and wrinkles while you sleep.

For more information on customized a regimen made just for you, please contact 480.214.9955 and schedule an appointment with Annie. I look forward to helping you achieve your goals!


*All Jane Iredale, and SkinMedica products available at Hobgood Facial Plastic Surgery*
8415 North Pima Road Ste 120, Scottsdale, AZ 85258
480.214.9955

Why You (And Everyone Else) Should Be Using Retinol

 

               Selecting the right products for your skin can be very overwhelming. With a plethora of products and brands to choose from, it can be difficult to nail down exactly which products would benefit you best. The truth is that everyone’s skin is incredibly different, and the needs of each person can vary greatly. With that being said, there are also a few products I recommend to EVERY one of my patients. That’s right, EVERY patient.

                The price of products can add up quickly, and so your selections should be chosen wisely. If my patients are on a budget and want the most “bang for their buck”, I recommend they are armed with AT LEAST these three weapons at all times: Retinol, topical Vitamin C, and SPF. Vitamin C and SPF both benefit new and existing skin, while retinol helps to speed up the cell turnover and allow the new skin to shine. As we age, our cell turnover rate begins to slow and only continues to do so. Thick, keratinized skin begins to build up and appear dull and even “crepe” like. Retinol helps to prevent this thickening process and keeps the skin cells moving <and exiting> in a speedy fashion. In addition to keeping the newest and freshest skin visible, retinol also helps to smooth out fine lines and wrinkles, kill p. acnes bacteria known to cause breakouts, and even out the overall skin tone.

                A common misconception about retinol is that is always irritating and causes constant peeling, redness, and itching. Many improvements have been made in product development, and retinols are now <much> more cosmetically elegant than in previous years. Strengths available vary, and most formulations are now packed with hydrating ingredients that keep irritation and visible flaking and peeling at bay. Something else to keep in mind about when using retinols is that most patients have to develop a tolerance, meaning that nightly use needs to be reached over time. Patients also need to remember that using an exfoliating product, like retinol, means sun exposure needs to be eliminated. If a patients skin is exposed to the sun while using an actively formulated product the skin is more susceptible to future damage, and the dangerous, cancer-causing rays of the sun. You can remain safe by minimizing exposure, wearing hats when outdoors, and always lathering up the SPF (even if most of your time is spent indoors). Your skincare products are an investment, so you want to make the most of them!

For more information about retinols and home care regimens, please contact Hobgood Facial Plastic Surgery and schedule a complimentary consultation with Annie.

Hobgood Facial Plastic Surgery

480.241.9955

8415 North Pima Road Ste# 120

Scottsdale, AZ 85258

“Why Do You Work In Plastics?”- My Truth About Working In Aesthetic Medicine

                For as long as I can remember, I’ve been a girly-girl. “Lipstick Dependent”, as my mom and Aunt Jan like to call it (a trait that I proudly-inherited). I’ve always enjoyed beauty, skin care, and everything in between.  My career that started in traditional spa-like esthetics was a natural calling to me. After working in the field for a few years, it became apparent just how much you could do to positively affect the skin as a nurse working in the same industry.

                I can remember arriving to nursing school and always feeling like the classroom’s black sheep when our professors would ask us <every time>  “What kind of nurse do you want to be?” on each course’s first day. Common answers always included pediatrics, trauma, ER, ICU, etc…. You can imagine the surprise and confusion of my instructors and classmates when my answer was always “Aesthetics” (sealed with a smile). But… “Why do you want to work in plastics?” (cue the judgey eyes). The answer for me is simple, and it is that aesthetics allows me to help others. While it is obvious that aesthetics isn’t exactly saving lives, it is a critical piece that involves improving self-love, self-esteem, and allowing one’s best self to shine through. As a nurse, I can work on deeper layers of the skin and produce clinical results with measurable changes. And when you look good, you feel good.

                While plastic surgery is typically viewed as something extremely superficial, and sometimes even scary when overdone, I’d like to put a (polite) reminder out there that it doesn’t have to be. I didn’t go to nursing school so I could over-inject lips and send my patients out to scare the public. Many of our patients suffer skin issues that while may not be life-threatening, are extremely important, and even sometimes devastating to them. Imagine (and maybe you don’t have to because you’ve experienced this yourself), if you had severe acne, burns, or scarring on your face that you had to literally wear on your face for everyone to see all of the time. Some skin issues, like cellulite and hyperpigmentation can be easily concealed-facial issues aren’t always that simple. When plastic surgery, aesthetic enhancement, or a new skin care routine is adapted, you shouldn’t be able to tell. Sure, you can tell that the person looks better, but you can’t quite hit the nail on the head- “What did she do? She looks so… well-rested.”

                I love my job, and sincerely appreciate the opportunity to help people every single day. It doesn’t feel like work when I spend my days at the office because I get to share my excitement and education with others. I feel very privileged to be appointed someone’s go-to person that they trust with their insecurities, and self-appointed flaws. Nothing warms my heart more than having someone tell me that they appreciated my information, or how I have been able to positively influence their skin health and self-love. I love watching patient’s skin <and self-esteem> glow! Please know that if you visit me at Hobgood Facial Plastic Surgery your information and treatment plans are always confidential and I am here to help if ever you need. I hope for the chance to meet you soon, and welcome you with open arms!

Be well,

Annie

 

 

 

For more information, or to schedule a complimentary consultation please contact:

.Hobgood Facial Plastic Surgery.

480.214.9955

8415 North Pima Road Suite #120 Scottsdale, AZ 85258

Shopping Skin Care (Safely) Online

 

 

 

 

I consider myself a shopaholic. A buyer. A trier. A product junkie- I can’t help it! And with online shopping, I am even more enabled. My sick addiction is literally available at my fingertips, and can be completed with the click of a few buttons (in my pajamas). But this isn’t about me, this is about you…

 

 How do you know which sites are safe to buy from when it comes to skin and hair care? Which sites are authentic, certified distributors of the companies they are selling? Frequently we have patients call with frustrations to ask about products that they see online for sale that are listed below MSRP price on websites such as Amazon.com , Ebay.com , etc. We often hear statements such as “Why should I buy it through you, when I can get it for less?” -allow me to explain. I do not feel that the dangers of purchasing on unauthorized sites is fully-comprehended.

When purchasing online, you should always buy directly through the company, or a certified distributor. How do you know a certified distributor versus an illegal third party seller? When it comes to skin care, hair products, and herbal remedies I can tell you that more likely than not, sites like Amazon and Ebay, and those selling at a lesser cost are selling illegally. With lowered prices, it can be tempting to purchase from them, but it is not at all deemed as “safe” by the FDA. It is a confusing concept to accept because often times they do represent authentic products, like books, movies, clothes, furniture, etc. But when it comes to your skin, you need to avoid purchasing through these sites at all costs. The reason you’re often finding cheaper prices is because the product could be expired, watered down, or have additional chemicals added to add volume (after half of the bottle’s contents have been removed).

I always stick to buying my products through local vendors, major department stores (Nordstrom.com , Sephora.com , Blissworld.com – to name a few) and authorized online dealers. I can tell you with confidence that Dermstore.com , SkincareRX.com , Lovelyskin.com , and Skinstore.com are all safe, and authorized dealers for the companies that they represent- and they often offer free shipping. You can also contact the companies directly and ask a customer service representative if you find a site offering your coveted product (because sometimes they can be hard to find), if the site offering it is legitimate. As a former representative of a few skin care companies, I can tell you that we loved hearing from our customers, identifying local distributors for them, and identifying safe sites to purchase through. On the flip side, it was also important to be alerted of illegal sales so illegally-sold products could be removed from the websites. I say, if ever in doubt, reach out.

Your skin is the largest organ your body has, and it needs to be protected. Try to remember that all products applied are also absorbed- so choose wisely. I hope this helps, and as always please comment with any questions- I am always happy to help! Have a great day.

 

XO Annabelle