Cosmetic Dermatology Procedures To Consider

Airdate: 4/7/11

Discover which state-of-the-art beauty procedures, such as Botox, laser treatments, or dermal fillers, are worth the cost and proven to work, as well as the risks associated with each.

Paula Begoun: Hello, I'm Paula Begoun, the Cosmetics Cop, keeping you beautifully informed on Blog Talk Radio every Thursday evening live in Seattle. Except I am not in Seattle right now. I'm in the South of France. And it is snowing in Seattle so Desiree, my producer and assistant, and Bryan Barron, my co-write and alter-ego, are sitting there freezing and hating me. Hi Bryan and Desiree.
00:00:36
Desiree Stordahl: Hello, the sun actually has peeked its head out for the last couple of hours. But, yes, it has been snowing recently which is just ridiculous. This is April, isn't it?
Paula Begoun: And hailing! I got an email from somebody showing me pictures of like hail, you know, snow and sleet. Really?
Desiree Stordahl: I know. Needless to say we are a little bit jealous of where you are right now.
00:01:00
Paula Begoun: I'm here and I'm jealous of me. It is not cold. Actually they are having a bit of a, the South of France here is actually having a warm spell. This is like unseasonable weather for them. I mean it is, it is picture perfect weather; it has been in the low 70's and high 50's/low 60's at night. I mean it is perfect and it is gorgeous and the sun is out and it is in the Mediterranean for gosh sakes. Oh my gosh.
00:01:30 And I told, who was I saying this to, Desiree it was you or Bryan I said, because I write travel logs back to the office and to my family and I said this trip is going to be called "Death by French Cooking." I mean, I got to – just one thing – I got to tell you the appetizer I had tonight and I know this is so off the diet we talked about, about getting in shape. I can't believe I ate this.
00:01:57 So, it is pate, it is duck pate, foie gras, and they served it with white onion ice cream. And –
Desiree Stordahl: Wow.
Paula Begoun: I know! Who even thinks of putting onion into ice cream? It was –
Bryan Barron: I'd eat that.
Paula Begoun: It was incredible. Oh, and also with some, they made this kind of jam out of figs and apricot and something else. And you know I often ask what is it they are serving, and I can get most of what they are saying.
00:02:33 But you know you don't want to ask too many times. You just want to get to the eating. But, oh, white onion ice cream. This was a brilliant idea. But separate from being in France, and by the way, I have to tell you – whatever – and it is not that French women aren't gorgeous. French women are –well women all over the world are gorgeous. But the women sunning themselves – I mean I don't think – I think I must be the only person wearing sunscreen.
00:03:02 Of course I am exaggerating, in all of the South of France. It isn't even that warm out and they are sitting half naked, just all out in the sun. In fact, these three women on the beach wearing visors but they were naked and staring up in the sun. What was that about? I wanted to go up and say, "Here is some sunscreen, it is called Paula's Choice," but I behaved myself. I was good.
00:03:30 I was just sitting there dumbfounded. So, what we are going to talk about tonight, separate from my being all the way half around the world – by the way it is – what time is it here? It's 3:00 am. It's 3:00 am in the morning. I am dedicated to my listeners or I am a lunatic. It's probably a little of both. I'm dedicated to my listeners and I'm a lunatic. But it is – it is 3:00 am in the morning but it is nice and quiet. I've been getting some writing done.
00:04:02 I've been doing some research and actually you know one of the things I was doing research on that we are going to talk about in a few minutes is dermatologists are just a buzz and plastic surgeons about this new procedure called Ulthera that we will talk about in just a second.
00:04:26 But, so this is a topic near and dear to my heart as I am slowly but surely over the next few months approaching 58, is dermatology procedures, treatments, that put off having to have plastic surgery. Now I am absolutely going to have plastic surgery. There is no doubt about it. It is coming. I would like to put it off as long as possible because I am nervous about getting cut and pasted. It is just not – like I wake up in the morning thinking I can't wait to go and get my skin cut off and patched back together.
00:05:06 I have no Frankenstein like wishes in my life. In fact, women who get plastic – there is a Web site called, and actually it is actually a really good Web site called – Bryan and Desiree, have you gone to this Web site called "Yes They're Fake." Do you know that Web site?
Desiree Stordahl: No, what is it?
Bryan Barron: I usually have fun looking at www.awfulplasticsurgery.com.
00:05:30
Paula Begoun: Actually, you know, doing research for the show I got to tell you, it was fun – well doing research for all of these shows. But www.yestheyrefake.net actually, it is www.yestheyrefake.net, and it is about this woman, primarily this woman who has just done it all. I mean I don't know what she hasn't had done. She has had dermal fillers injected under her eye which is actually a kind of risky procedure. It is not a very typically done procedure.
00:06:02 I mean she has had it all and she is a very busy woman. And I haven't read much about her but her information both from a technical point of view and from a personal point of view is actually pretty complete. I mean it is relatively objective and personalized at the same time which given this topic it is actually a lot of cosmetic corrective procedures is part art, part opinion, and part science which is somewhat what makes this topic so tricky and so complicated for women.
00:06:38 And it makes it complicated for me. And this is what I do for a living – I research these topics. And one of the things about getting procedures that put off plastic surgery is that they have their own problems as well. They are not perfect.
00:07:00 Nothing out there to make us look younger is perfect. If it was, nobody would get older. You wouldn't eventually end up – well I don't even want to think about it – I'm never going to go to that end point, but you get my drift. So, here is what I want you to know. The first thing is that I am giving you really in essence the five experiences I have had, supported by research and supported by physicians I have interviewed about what really works in terms of looking younger –
00:07:36 looking healthier, looking less beat up and forgoing plastic surgery for awhile. Because it is going to sag, the lids are going to droop. You can put it off for so long, I mean actually I am not telling anybody to go get cosmetic corrective procedures or go get facelifts, but in terms of getting the results that you want.
00:08:04 You know what the problem is we are living so much longer. None of us were supposed to be around here much past, what, I mean our age range over the past few hundred years, we weren't even supposed to make it to 60. And now a lot of us are making it all the way well into our 80s and 90s, and it is just your personal decision of how you want to get there. This is what I know.
00:08:31
Bryan Barron: Or how you want to look when you do get there.
Paula Begoun: Right, because personally I would like to drive up in a limo, but I get the feeling I am going to be using one of those carts. But nonetheless, what the goal is to understand what you can do and to be realistic about it. And you know I was looking over, and I take full responsibility for this because I review our little blurbs that we send out about our radio topic, our BlogTalkRadio topic, Keeping you Beautifully Informed.
00:09:08 And as the Cosmetics Cop, as I looked at what we wrote and what I wrote is that I found it way too positive. Watch out for any doctor or me or anybody else being way too positive about any one procedure. Or any one doctor being the best. Or anything being, "the best."
00:09:35 There is a lot of stuff out there. I'm giving you general categories and then it comes down to the art and the talent of the physician. Some amount of opinion, and some amount of research. And that is what I am going to give you. So, we are going to start at the top with what is the most popular cosmetic corrective procedure. And that is Botox. And the reason, I mean millions –
00:10:00 I think in the United States alone over 4 or 5 million, 4.5 million, give or take a million injections of Botox were done last year. That is astounding. Especially when you consider that for most people it lasts anywhere between four months and a year. That is a lot of people getting Botox. And the reason they get Botox is because it works.
00:10:30 It works. Now, not for everybody. There are a number of people who actually don't get any results. The results don't – actually you know Bryan and Desiree it is kind of interesting. My sister Avis who got Botox, hers went away after a month. She [unintelligible] to go through all of that and it didn't last on her. Now it is rare. Most people it does take and take very well.
00:11:00 It does erase – I mean literally erase. There is no question about it; erases the lines on the forehead. It doesn't erase the – when you get the shots around the corners of your eyes for the crow's feet, it doesn't, depending on how deep they are and how deep you smile it doesn't smooth them out quite the way I would like them to be.
00:11:27 It's not like my forehead. And depending on how deep the lines are between your eyebrows. You might also have to get dermal fillers in there because Botox might not be able to smooth them out again quite like how you would like. But Botox, you get it done, bye-bye, they are gone.
Bryan Barron: Paula, there is also much, much high level of caution is needed when Botox is being injected around the eyes. They can't be as "free-wheeling" with it as they might be on the forehead.
00:12:01
Paula Begoun: Well, hopefully you are not seeing any doctor who is too free-wheeling, but yes, the eye area – I mean you have to see – you don't go for the one that is advertising a sale on Botox –
Bryan Barron: Or free champagne during your procedure.
Paula Begoun: Let's make sure that that is not high on the list of criteria. But, yeah, definitely when you are getting it done around the eyes. Well, you know, the injection technique is really, really important.
00:12:36 I remember once seeing a doctor and he was bragging about his technique of doing it inter-muscle and he was just going to do one shot in one area. And I watched him do it and then I went back to see how – not on myself, on a series of patients and then he was showing me the results a week later or something like that. This was awhile ago.
00:13:00 And I thought the results looked bad. I thought it kind of looked cockeyed, it didn't look even. It didn't look as smooth as when you get a series of injections along the forehead. Now I am not a dermatologist. I'm not saying I know how to – well, I mean I go to these seminars and I do the research but I am not saying that there is one absolute way to do it. but in terms of research there definitely is this technique where there are several injections along different points of the forehead and around the eyes and particularly over a corner of the eyebrow that can actually give you a lift kind of look to the back of the eye.
00:13:41 Botox is something. It is something to consider. There are risks, of course there are risks. The problems with the initial stuff about injecting it wrong and getting drooping – it is the rare occasion. But to say that it doesn't happen, of course, that wouldn't be true.
00:14:02 But it is rare. It is rare. And when you do have it done, I mean it is, yeah. Okay, I'm done carrying on about Botox. I haven't lifted my eyebrows in 11 years because that's what Botox does is it prevents muscle movement where it gets injected. The next one is dermal fillers. There are over by some estimates 128 dermal fillers.
00:14:32 Now dermal fillers are injectable materials, some synthetic, some natural, some naturally-derived, some that they, you know, fat grafting that they take from your body. They have all kinds of names. Perlane, [Hyaluronan], Radius, Juvederm, Sculptra, there are names of these things on and on and on.
00:14:56 There isn't a perfect filler. There are some – most doctors are very fond of Juvederm, Radius, Hyaluronan, Perlane, and Sculptra. You hear those a lot. They are some of the most popular ones in the United States and then there are a handful of doctors that do – the ones that I just mentioned, the Juvederms and the Radius, the difference between the different fillers is that some are natural and some are synthetic, or naturally-derived. The naturally-derived ones and the natural – well they actually aren't natural-natural.
00:15:34 They are naturally-derived. They have the least risk of causing allergic reaction or sensitization. The results are good; you don't get granulomas, little lumps under the skin. If you do get granulomas, these little lumps, they go away because one of the things about these "natural fillers" is they don't last all that long.
00:15:56 I mean they last – some people would say between six months to 18 months. Some make claims of two years. Almost everybody argues about those numbers. Because some of it is how long they last – has to do with how deep your lines are, how much you use your face, how healthy you are – all kinds of things contribute to how long dermal fillers last. But for what they call the nasal labial folds which are the smile lines that run from your nose to your mouth, the marionette lines that make the corners of your mouth look like they are drooping, that pull down your corners of your lips down, the marionette lines –
00:16:34 and the lines between the brows, absolutely dermal fillers work and they work immediately. Now some of it is you leave – now I have had fillers. I have had synthetic fillers two different times over 10 years because synthetic fillers last. They have higher risks because they do last, they don't go away.
00:17:01 And actually you get improving results with them as time goes. But they are riskier. By far they are riskier because if you do have a problem like a granuloma, the doctor doesn't inject it quite right, it is something they have done wrong, it is a problem to get rid of it.
So, most doctors really love these naturally-derived fillers. They love them because if there is a problem you don't hate them for that long. And they do work; they are safer.
00:17:32 So, that kind of a decision is one of those ones that is about the creativity and the skill of your physician. It isn't about you going in saying, "Oh, I heard Hyaluronan is the best thing." It's not. It is one of the many great options that are out there and depending on how deep your lines are, your skin tone, the amount of sun damage, I mean there are so many factors that a skilled dermatologist would have to make a decision on. There isn't one best.
00:18:00 So, we have to let go of that. Don't read something in a fashion magazine or some celebrity had this and then call up a dermatologist and say, "Do you do this procedure?" Don't do that one. Especially in the world of – you know Botox there is only really one Botox and there is Dysport but not many people are using Dysport. It is still in trials, right? Bryan, have they approved Dysport? Am I just blanking out here?
00:18:27
Bryan Barron: You know, I can look that up. I don't recall seeing an official approval of it. Only seeing that it was poised for approval.
Paula Begoun: Can you take a quick look. Dysport is trying to get approval or if they have I am not exactly sure, to compete with Botox. Some doctors have been involved with the trials. Some of them are nuts about Dysport, some aren't. That is one of those things where it really is about opinion and art sometimes more than science.
00:19:00 Because both work. Both work. There is some talk that Dysport might last longer.
Bryan Barron: It was approved in the summer of 2009.
Paula Begoun: Oh, it has been around that long?
Bryan Barron: Yeah.
Paula Begoun: You know, you don't hear many doctors doing it. You know we need to have – Lesley Baumann who wrote a book called "Skin Type Solutions" who we just adore, she is going to be on in – when is she going to be one, Desiree?
00:19:31
Desiree Stordahl: April 21.
Paula Begoun: April 21. Oh, she is going to be soon.
Bryan Barron: Two weeks from tonight. Very exciting.
Paula Begoun: Yay, Dr. Baumann. She is wonderful. Well, we will carry on about Dr. Baumann later. But she – we will have to ask her because she has strong feelings about Dysport, so we will have to ask her why she is a fan of Dysport versus Botox.
00:19:57 The third thing is getting rid of brown spots. Now there are a lot of machines out there, particularly what they IPL – Intense Pulse Laser. And now people are making claims about Intense Pulse Laser as tightening skin. I wouldn't get too excited about seeing a big difference in your skin from an Intense Pulse Laser, but in terms of brown discolorations, they call it photorejuvenation. You do get some tightening but mostly what you get is improvement in brown discolorations.
00:20:29 And those brown discolorations, those sun damaged spots, what we used to call liver spots, are damaged, brown discolorations from the sun and getting rid of them isn't easy. You know 2% to 4% hydroquinone. I mean that is skincare product so we will leave that off right now. But without question an IPL makes a huge difference. But when you look a little bit more at the research, IPL has no downtime, there is no minimal risk.
00:21:01 Occasional bruising but not really. But the one that literally zaps, just zaps these little brown suckers off of your hands and face is what they call the Q-Switched ND Yag laser. And again, you want a doctor who has a few machines to choose from, takes a look at what is going on with your skin and your hands and makes your face and makes the decision and helps you understand what your best options are.
00:21:33 But by far, IPL, Intense Pulse Laser, and this Q-Switched Yag laser, among others, is really considered state of the art for zapping the brown spots and then of course religious use of the sunscreen and considering a hydroquinone-based product, it just doesn't get – it is about the best that you are going to do out there.
00:21:58 And then I wanted to talk about some of the deeper laser machine, light machines, that are out there to tighten, to really firm – well how much firming, of course, is relative. If your skin is hanging down around your neck there are limitations as to how much is going to get back up to where you want it to be. However, where Thermage used to get a lot of attention for, which is a radio frequency – wait, Thermage is a radio frequency or an ultrasound? Oh, god, I am blanking out. Bryan, save me. Thermage, are you looking it up? Do I hear you typing?
00:22:39
Bryan Barron: Thermage? Is that?
Paula Begoun: Is it radio frequency or ultrasound? I can't remember.
Bryan Barron: Thermage is radio frequency.
Paula Begoun: Oh, I was right, okay. I feel so much better now. So, my brain isn't fried here in France at 3-something in the morning.
00:22:58 So, Thermage never quite worked the way people would have loved it to work. The results were okay, it was state of the art at the time. But now, and Fraxel, which is a way of getting a deeper laser to the skin without downtime and with minimal risk of injury. But the new one that doctors are talking about that it is worth looking up on the Internet and considering is something called Ulthera. And now I have talked to over –
00:23:32 Let's see – specifically four different dermatologists and read an article from one that they just – the buzz on the Internet and from these doctors I interview and respect their opinion, Ulthera is like this new kid on the block who is making everybody's job easier. Because dermatologists want their patients to walk away happy and come back again for more because they are happy when they left.
00:24:06 And Dr. Perry, Dr. Baumann, I mean just several doctors who we work with and talk to just are crazy about this machine. And what it is they like about it is that it tightens skin. As a matter of fact, it is one of the few machines that is actually being used on the underarm when it starts flabbing around actually hanging lower than any part of your face hangs.
00:24:40 And they are actually using Ulthera to tighten up the underarm as well as the jaw and the neck. It is fascinating, it is interesting. Of course now I want to line up and get it down. I'm doing more research on it.
00:24:56 But it is one of those things to start looking out for when you are looking and talking to dermatologists about procedures because Ulthera seems to be, that with Fraxel and IPLs, an incredible combination to get the brown spots gone and to get the red discoloration gone and to tighten skin. Those are kind of the power house kids on the block. And then the last thing is Sclerotherapy. Now this isn't about the face as much because –
00:25:30 Well, they do Sclerotherapy on the face. But that is mostly about the legs and as I am sitting here looking at my legs, unfortunately like anything with cosmetic corrective procedures what it corrects doesn't necessarily mean it is permanent, obviously. When you get the skin tightened doesn't mean you stop aging. Your skin is going to continue to sag and lose elasticity. It is not like it stopped the aging, it just took it back a little bit but it is still moving forward.
00:26:01 Sclerotherapy is an injection into the surface veins on the face that lasers generally are more effective depending on the size of the vein but on your legs, Sclerotherapy is actually one of the cheaper treatments you can have done. And it makes your legs look young because you get rid of those surface veins, those clusters of veins on your legs.
00:26:28 And it sometimes only take two or three treatments and it is really amazing. I mean it – so that is my top five list of cosmetic dermatologic procedures to consider. And the last one, I know I said five, but now I just have to say one from the dentistry world. Get your teeth whitened. At least do it once in life. It is worth it. Nothing makes you look younger like having a beautiful white smile. That is the top list, plus one.
00:27:02 Did I get to everything? I think I got to everything. That was pretty good. Did I leave anything out?
Desiree Stordahl: No, you covered quite the gambit. You didn't talk about Microdermabrasion too much. Would you want to say what the pros and cons of that are?
Paula Begoun: Because I don't like it.
Desiree Stordahl: Well, there is the con.
Paula Begoun: It's not that I don't like it. That is, my liking something, although these are the ones I personally like. The research about Microdermabrasion and the reason I have never personally had it done, and it is not that I don't recommend it.
00:27:34 I think of it more as a facial. It isn't changing. It's really more about the irritation and the swelling. You have to have it done frequently. The results go away quickly, whatever results you get.
Bryan Barron: Yeah, some of the places that I have been to for consultations and what not, Microdermabrasion really gets the hard sell.
00:28:00 It's almost like it is an extra that, you know, yeah you are consenting to this treatment but, oh, don't forget that Microdermabrasion in between.
Paula Begoun: Well, I think because it is an extra up sell that is now downside to the physician. There's no downside. Microdermabrasion, it makes very little impact. Nobody is going to walk away bruised and unhappy; you are going to be a little swollen and look a little smoother, pores are going to look a little smaller, because you skin is swollen, and not terribly so so you look bad.
00:28:36 So, there is no downside. I mean, in fact if you are into facials, forget the facials and get Microdermabrasion. It's temporary but it makes a difference. But here is the problems is that there is some research. There isn't a lot of research about Microdermabrasion. But there is some research that says if you get it done too often, you actually start seeing negative results. You get diminishing results.
00:29:00 Probably because if you have it done like once a month, the kind of irritation it causes on a regular basis would eventually cause collagen breakdown. That is the problem with getting it done too often. But it is very tempting to get it done too often because you get that swollen looking going – it is cheap – and it makes you look younger temporarily. So, if you do want to get it done, of all the facials you can get done, I personally think an alpha-hydroxy acid or actually salicylic acid peel would be even better once every –
00:29:36 depending on the level of depth of the peel, once every three to four months versus a Microdermabrasion. But, yeah, it is not terrible. Don't get it done too often. I don't know. Save up your money for the other stuff, I guess. But it is not terrible. It's just not anything – doctors consider it a throwaway. It is an up sell.
00:30:01 Women want it. It is easy, it's cheap. I've carried on too much about it. There was something else I was going to say. You know I forgot to mention salicylic acid peels. We will have to do that for another show. Maybe we can ask Lesley, Dr. Baumann, about that in a few weeks. Desiree, let's take our first caller.
Desiree Stordahl: We have Lisa from California on the line.
Paula Begoun: Hi Lisa.
Lisa: Hi Paula, how are you? Au Revoir. You are so lucky.
Paula Begoun: No, Au Revoir is saying "goodbye," you mean bonjour or bon soir.
Lisa: Oh my, can you tell I haven't been there. I blew it!
Paula Begoun: Don't say goodbye just yet. What can I do for you Lisa?
00:30:40
Bryan Barron: That's cute. Next caller!
Lisa: I'm so glad I got through. I'm 47 and I have extremely dry skin and I was wondering if there are any of the laser treatment that can help the surface of my skin look a little better?
00:30:57
Paula Begoun: Well, it can make it look better but dry skin, there are no dermatologic procedures like lasers or Microdermabrasion that have anything to do with helping or repairing or changing dry skin that I am aware of. If it is out there, oh boy, I have not seen any research. Now if your dryness is from – you said Southern California, right?
Lisa: Right, I'm from LA. I have sun-damaged skin.
00:31:31 And you know, Paula, I used to bake as a teenager with baby oil. But I did stay away from the sun starting my 20s when I realized what I had done. But I am paying for it now.
Paula Begoun: So, do you feel you advanced sun damage, Lisa, or just sun damage? Cause that is a pretty young age to start staying out of the sun.
00:32:00 So, how do you feel your skin compares?
Lisa: It just feels very tight. No matter what product I use. I have tried different products and it always feels tight, especially around my eyes and my cheeks.
Paula Begoun: Are you using any of my products or have my products not worked for you?
Lisa: You know I haven't. I'm pretty new to your products and your show. And I'm so glad I found out about you when I saw your book at the bookstore; that's how I first heard about you. So, I'm pretty new to everything.
00:32:32
Paula Begoun: Well, we will get you set up. So, some of it is that, what I want you to start doing tonight is you have to have some plant oil somewhere in the house, like olive oil, safflower oil.
Lisa: I do use olive oil but it doesn't really help. It just kind of sits on my skin.
Paula Begoun: Because you don't use it by itself. You have to put your moisturizer on first and then you put the oil, a very thin, thin –
00:33:03 THIN layer of olive oil or safflower oil or whatever oil you have got, just a very thin layer over it and you only do it at night. And that feeling, the fact that you feel it left on your skin is actually a very good thing. The trick is to put it on thin enough that you don't feel like you are salad dressing. But use it tonight, just keep using it.
00:33:32 And then I am going to send you some of my Resist products. I'm going to send you my cleanser. I'm going to send you my toner which is going to be back in stock in a few days so I know we will have it to send to you. And I'm going to send you my Skin Recovery cleanser as well and my Skin Recovery moisturizer and my Skin Recovery sunscreen to try.
Lisa: Oh, that's fabulous.
Paula Begoun: And see how those go for you.
00:33:59 If they are not rich enough for you. It is kind of interesting. We are working on what we are going to call our Critical Care line. There is the kind of skin type you are mentioning that is just such a difficult skin type to treat because that tightness, that dryness, it almost feels like if you don't get something on your face it is burning. So, I am also going to send you our body butter and my lip balm and a couple of my antioxidant concentrates –
00:34:32 One from my Skin Recovery Line and one from my Resist line. That is a different kind of fluid oil to get on your skin. So, I want you to play with some of these different products to see which one. Because skincare is – just like putting together cosmetic corrective procedures to look younger, skincare when you have difficult tricky skin, it sometimes takes experimenting to find what works for you. So, we will send you those products.
00:35:07 Start with the oil tonight. And you don't have to – when you get my antioxidant concentrates, that would replace the plant oil and you will find that that doesn't give you the feeling, that layered feeling you are talking about. But in the meantime start that. See how these products work for you and then you will let us know if we have helped.
00:35:31 If not, then we really need to look into some of the old style, just getting grease on the face like the old style Eucerin products and sometimes just going – mineral oil, Vaseline, just going back there. I don't want to send you there just yet because I think there are more elegant ways where you can still get the antioxidants to your skin and those really incredible ingredients.
00:35:58 So, before we go down the old road, which is sometimes what very dry skin needs, let me see how these new products from my line work for you and we will talk later.
Lisa: Great Paula. Thank you so much. And can I ask one question? I know you have other callers waiting – regarding Botox. If I have allergies, should I be concerned? Is there a way to pretest it to see how I will react to it?
00:36:26
Paula Begoun: I have never heard of somebody having a Botox allergy, but that is a medical question that I can't answer. That is a great question for a dermatologist though. That's a good question. Now you can say Au revoir.
Lisa: Paula, thank you so much. Au revoir.
Paula Begoun: Desiree, next caller.
Desiree Stordahl: Next caller is Tina from California.
Paula Begoun: Oh, we have California tonight. Hi Tina, how are you?
Tina: Hi, hi Paula. I can't believe this. I finally got on after about six tries.
00:37:00
Paula Begoun: Well, I'm glad to talk to you.
Tina: First of all, yeah, you are not too far from my home town, Italy. But, anyway --
Paula Begoun: Wait, that's a whole country – where are you from in Italy?
Tina: I'm thinking of Bari. B-A-R-I. Bari.
Paula Begoun: Oh, no I don't know that.
Tina: It's on the Adriatic side down at the heel of the boot.
Paula Begoun: Oh, that must be gorgeous.
Tina: Very small town.
00:37:30 But anyhow, I want to thank you for being you all of these years and for entertaining all of us with so much information and your own information, your personal information. I really appreciate you.
Paula Begoun: Oh thank you.
Tina: My question for tonight is could I use a tool called Derma-File, are you familiar with the Derma File on sensitive skin? Even though it is really, really grainy and in need of exfoliation?
00:38:03
Bryan Barron: Paula, it is a, Derma-File is a skin polishing and resurfacing tool that is made of finely crushed cosmetic diamonds.
Paula Begoun: Oh, oh, no. No!
Bryan Barron: No, don't use that at all.
Paula Begoun: Oh, you so cannot use that.
Tina: The woman at the store said it is fine for sensitive skin.
Paula Begoun: Oh bullsh -- . Oh, god. Oh my god.
00:38:30
Tina: You can swear, you are in France now, it is okay.
Paula Begoun: I was just going to say, can I say, "Merde?" Will I get in trouble? Oh merde!
Tina: I didn't hear any beeps.
Bryan Barron: Yeah, we are not on a five-second delay here. When you are hearing us it is live.
Paula Begoun: So, don't. So, two things. One is that for a million reasons that is way too irritating and damaging. Do not do that. And specifically do not do that if you have dry, irritated skin. Do not do that.
00:39:06 However, I would encourage you to consider using Olay's new cleansing brush.
Tina: I have the Clarisonic already.
Paula Begoun: Try the…well how is that working for you? Obviously you think it is not enough or you wouldn't be --
Tina: I can't use it too often because then my skin is sensitive and thin, I guess, and then it gets pinkish.
00:39:32
Paula Begoun: If you think the Clarisonic is too strong for your skin, this other stuff is going to take you down to the bone. So, --
Tina: I can't have that.
Paula Begoun: Yeah, don't do that. I do think you might want to consider the Olay, what we are hearing about the Olay brush is that it is soft. It is supposed to be very soft. Bryan, have you guys tried that out yet?
00:40:01
Bryan Barron: No, not yet. It has been ordered. I have actually – I have seen a sample of it at Ulta. They had one and they let me get a sense of how the brush feels. I didn't actually use it. There wasn't a sink there. And washing your face in public isn't the most –
Paula Begoun: Don't do it. Bryan, I know you are dedicated to your job, but you don't have to do that. So, how did it feel?
00:40:30
Bryan Barron: It's very soft. In fact having experienced the Clarisonic before, I think that they are comparable. Not having the two right next to each other, I wouldn't go on record in saying that Olay's is softer. But they are so similar and there just is nothing else from a budgetary standpoint. If you are curious about what this could do for your cleansing routing, spend the $30 on Olay and don't bother with $200 for Clarisonic.
Tina: Okay.
Paula Begoun: So, Tina let's just go back a little bit.
00:41:02 So, the Clarisonic, too strong. The Derma-File is going to be beyond strong. So, what are you trying to achieve with the brush? What do you want for that?
Tina: I don't care about the brush. I just want my skin to be smooth again. Like across my forehead I could get my finger nails and just feel the sand, the sandy little particles.
Paula Begoun: How old are you, Tina?
00:41:31
Tina: I'm mature, but I look like 30 years younger.
Paula Begoun: Oh, come on, Tina, give me your age. Fess up.
Tina: I'm really up there. I'm really up there but I haven't had any surgery.
Paula Begoun: Tina, come on. Give me a number. I can't help you if you don't…
Tina: Okay. Over 70.
Paula Begoun: Oh, you are? God, you have the youngest voice. So, here is what the problem is. Let me tell you why age sometimes is a skin type.
00:42:02 It's rarely a skin type but if you have sun damage and you are older. And of course who of us gets to be 70 and hasn't had sun damage. One of the things that starts happening is skin stops reproducing like it did. You make less skin cells. And then the skin cells you do have are rough. So, it is a trickier skin type.
00:42:29 And exfoliating that skin away, you can't do it. Once you go over a certain age, that kind of manual exfoliation is a no-no. And so I just realized that I was giving you information that I needed to – gosh, forgive me. It is really early in the morning here. Don't brush away your dry skin. Here is what I want you to do.
00:42:56 There's definitely other products out there on the market but I am just going to give you some of my Skin Recovery cleanser and my Resist cleanser. I want you to experiment with both of those. And I want you to experiment with my 1% BHA lotion and my 2% BHA lotion. But I only want you to start with the 1%. Some of it is that your skin is not coming off. Your initial inclination that you have got to get that skin off is a good one.
00:43:30 The way you are going about it is the wrong direction. You need to just get that surface layer off gently, a 1% beta hydroxy acid, the active ingredient is salicylic acid – will get it off for you in lotion form that is moisturizing. I would like you to give that a try. Start out by using it every other night. Use the cleanser and the toner and then I am also going to include the Skin Recovery sunscreen and the Skin Recovery moisturizer as well as my antioxidant Skin Recovery concentrate.
00:44:02 I want you to play with those. I think you will fall in love with me and be able to go and tell everybody that you are 70 and now you really do look like you are 40. I'm teasing. I'm exaggerating.
Tina: No, that sounds wonderful. In fact, I have used your products up till a couple of years ago when I started getting facials and they insisted I start using their line.
00:44:30 But I want you to know that while I was using your product I used to carry around cards with your name and your phone numbers because you weren't online yet. Because everybody wanted to know what I used on my skin because I looked so young and never had had surgery.
Paula Begoun: We are going to send you some more stuff. You can still get your facials if you want, but let's get you back on taking care of your skin and do not try to scrub it away.
00:45:01 And Tina, stay young, you are doing very good.
Tina: Thank you so much. I'm taking the liberty for all of us to say we love you, Paula.
Paula Begoun: Take care.
Tina: Okay, thank you.
Paula Begoun: Bye-bye, Tina. Desiree, do we have – oh, we are doing good on time. Desiree, next caller?
Desiree Stordahl: We have Shirley from Canada on the line.
Paula Begoun: Shirley?
Shirley: Yes.
Desiree Stordahl: Shirley, are you on a speakerphone?
00:45:30
Shirley: No, I am not on a speakerphone.
Desiree Stordahl: [unintelligible]. Okay, go ahead.
Paula Begoun: No, I'm hearing an echo.
Bryan Barron: Everybody is echoing. We might need to skip Shirley's call I'm afraid.
Paula Begoun: Yes, Shirley, let's take hers via email, Desiree, because it is just not sounding – well it is sounding kind of odd.
Desiree Stordahl: Alright, so let's go to Bobbie in California:
Paula Begoun: Hi, Bob. Let's make sure –
Desiree Stordahl: I will get Shirley's question via email. We can go on to Bobbie.
Paula Begoun: Thank you. And who am I talking to now?
Bobbie: Bobbie from California. Hi, I've been following you for years.
Paula Begoun: Bobbie, not Bob.
Bobbie: Bobbie. B-O-B-B-I-E.
Paula Begoun: Okay got it. Hi Bobbie, what's going on?
Bobbie: Hi. I had laser skin resurfacing about a year ago. And it is from a doctor; I used to actually work in a hospital and he has a very, very good reputation. And he has done other things and they have been great.
00:46:29 But, and my skin, by the way, is very thin and light. I'm 62. And what happened though is that surgery, I'm not sure whether it was the kind that you referred to or not [unintelligible], I'm not sure if the [unintelligible] was around then. And my skin is very good though, really good and in good condition and I have had surgeries and I always get, I always survive quite well.
00:46:56 But this time it left some dark marks on my skin. Not really terribly, terribly noticeable. But some dark marks and I wonder if you have heard of that happening before and what caused it?
Paula Begoun: Yes, you know, did you go back to the dermatologist who did your laser and ask them about this?
Bobbie: No, I didn't. I should have, of course.
Paula Begoun: Oh, you know we are, we are afraid of our doctors. What is it? And you know what it is is we don't want to fight.
00:47:30 We don't want to go back and the worse thing is, "Well, I have never seen this before." You want to take your fist and go, "Well, now you have seen this." What is that, you have never seen it before? What am I, like there are billions of people on the planet – it's not possible you are the only one. They are just limited – okay, I'm carrying on too much. I'll stop. So, you do need to talk to that dermatologist. You really need to get a second opinion because it is hard for me to say why that did or didn't happen.
00:48:02 You know, was the frequency too high? Did you go in the sun too soon afterwards? One of the things that doctors need to be really good about, in fact, I really love doctors that say that they only do certain procedures at certain times of the year because they know that you will be out in the sun less. Or they make you sign something that says you are not going to go out in the sun without a layer of zinc oxide for days and weeks and weeks until you heal.
00:48:34 Because sometimes it isn't the machine, it is what happened afterwards that you went out into the sun and your skin is that much more vulnerable after some of these procedures are done. So, that they are still there is what is worrisome. They should go away.
00:48:55 And I know it sounds crazy to say, well, this machine caused them. But if they are certain kinds of brown discolorations, other machines get rid of that. And the doctor should do that for free.
Bobbie: Oh, okay.
Paula Begoun: So, it is hard to say exactly but you need to talk to the doctor and depending on the kind of discoloration you are talking about, you get it corrected, you get it taken care of. And you are good about wearing sunscreen.
Bobbie: Absolutely.
00:49:30
Paula Begoun: So, now are these brown marks like brown like they look like sun damage marks or?
Bobbie: They are faint. They are not terribly, terribly noticeable. They are faint.
Paula Begoun: And they are brown in color?
Bobbie: No, they are not [brown]. Actually what happened is, when he did around my nose, right around, like especially under my nose where it is red I have Rosacea.
00:50:00 It is just like a little bit of brown underneath my nose and around my nose.
Paula Begoun: Okay, definitely have this doctor evaluate that. And I guess, I'm going to guess that they are going to suggest an IPL or give you some hydroquinone which actually isn't the best of Rosacea but hydroquinone is an option. You know one of the things, Bobbie, what I want to do – we are working on an alternative.
00:50:30 Oh, I hate saying this because then I am going to get like a million emails. We are working on an alternative product for skin lightening to hydroquinone. It is not going to work as well as hydroquinone. Hydroquinone is state-of-the-art. But make sure Bobbie that Desiree gets your email and we will put you on our list to send you one of the prototypes we are working on. And after you talk to your doctor. After you talk to your doctor and you find out what is going on with your cute nose.
00:51:02 So, Bobbie, tell me your skin type. Let me send you some Paula's Choice products. What is your skin type?
Bobbie: It's very dry.
Paula Begoun: Well, we have a lot of dry women tonight.
Bobbie: I'm a natural blonde, or at least I was.
Paula Begoun: So, I am going to send you a set of my Skin Recovery products to play with and see how they heal your skin. And you need to consider that same trick with the plant oil until you get my antioxidant concentrate.
00:51:31 Bobbie, take care and let me know; email Desiree and let me know what your doctor says about the brown marks under your nose.
Bobbie: Thank you so much. And you know I have been following you for years and years and years and years. And I really do appreciate your work because you are just so informative. And I don't know, it is just really wonderful to be able to not have to [unintelligible].
Paula Begoun: Thank you. Thank you. Desiree, next caller.
00:52:04
Desiree Stordahl: Alright, our next caller is Leah from Massachusetts.
Leah: Hello.
Paula Begoun: Say the name again?
Bryan Barron: It's Leah from Massachusetts.
Paula Begoun: Hi Leah, it's Paula.
Leah: Hi Paula, great to talk to you. My question is, I am inundated with these skin tags everywhere. And I just paid a dermatologist --
00:52:29 Paula Begoun: They are the easiest thing to get rid of.
Leah: I know, but the dermatologist considers it a cosmetic procedure, so for $150 they will snip as many as they can in like 10 or 15 minutes. But I was wondering if there was some sort of laser procedure or?
Paula Begoun: No, no. Well, first of all laser is vastly more expensive. I mean, I am telling you, this is an easy.
00:53:00 This is like an intern who has just had one year of anatomy class can snip off --
Leah: Oh, I know. But it is just the number of them, so.
Paula Begoun: Right. Now there are some doctors when they have as many as you are saying, sometimes cauterize them off. They burn them off. But that would be a decision that the dermatologist would have to make. I would get a second opinion because there are –
00:53:30 Especially depending on your skin color, they cauterize it. I don't know if I have even seen any research about lasers for skin tags.
Leah: Or like a chemical peel? I don't know. I just thought there might be something a little bit more time efficient.
Paula Begoun: They cauterize. Some doctors cauterize – you know burn them off as opposed to snip them off. But you would be surprised at how fast it goes. And I mean [fast cutting noises].
Leah: What if I bought a pair and just did them myself?
00:54:04
Paula Begoun: That I am so not going to touch. But having said that I am not going to say anything, I snip mine. I mean not ones that are really attached, but the ones that are hanging that are disgusting. I don't have time to go see a dermatologist every time. But I would never recommend anybody else on God's earth do that, because I am a crazy woman. But yeah, it's nothing. It's just nothing.
00:54:30 It is such a – it bleeds and you have to disinfect it. You have to use a sterilized – not that you should do this. In fact nobody should do this. I don't want to get letters that people bled all over their bathroom. But it is so easy. It is so easy.
Leah: I know. I just thought there was a more time efficient way.
Paula Begoun: No. It is snipping or cauterizing is all I know of. Leah, what is your skin type? Let me send you some Paula's Choice products.
00:55:00
Leah: Normal to dry.
Paula Begoun: Well, I only have normal to dry ladies tonight. We will send you a set of…well, should I do something different? Let me send you my Moisture Boost…no, never mind. My Skin Recovery is the best for your skin type. I will send you a set of my Skin Recovery skincare products for dry skin and you will tell me how you do with it. Leah, thank you for calling dear.
Leah: Thank you. Could I just have one more quick question?
00:55:30
Paula Begoun: Sure, real quick.
Leah: When is your Resist SPF coming out?
Paula Begoun: Oh, I wasn't supposed to mention that. I don't think till May. When is it coming out Desiree?
Leah: I'm dying to try it.
Desiree Stordahl: Well, anybody who is a fan on Facebook is actually going to get an exclusive sneak peek at it coming up in the next couple of weeks here. So, follow us on Facebook and we will let you know. Alright, you will see the exclusive sneak peek, and for everyone else you will see it in May.
Leah: Thank you.
Paula Begoun: Be my friend on Facebook! Thanks Leah. Take care dear.
00:56:01
Leah: Thank you, Paula. Goodbye.
Paula Begoun: So, what do we have? We have three minutes left. Can we maybe get one call? What do you think?
Desiree Stordahl: We are going to have to take it fast. Let's go to Rebecca in California.
Paula Begoun: Rebecca, talk to me. Quick, quick, quick.
Rebecca: Hi Paula.
Paula Begoun: Hi.
Rebecca: I have a question. I usually don't go to the dermatologist because I can't afford it, but I was wondering, for scarring other than discoloration but having a texture scar from acne, what is the best way to get that smoothed out?
00:56:40
Paula Begoun: Okay, it's hard. It's hard. Oh god, that is a big discussion. So, I am just going to send you some product. We did talk about scarring for acne on another show, so if you can look at some of the archives, but the best way to deal with it, if you can't see a dermatologist –
00:57:01 But I would say up to it because there are lasers and treatments that really do lift up and puff out some of those scarrings. But the best thing you can do is a 2% BHA salicylic acid based product. I'm going to send you a couple of mine, my gel and my liquid, to get you started. But save your money. Stop wasting it on skincare products that don't work. But there really are lasers out there that just make a huge difference. Thank you for calling Rebecca. Take care.
00:57:35
Rebecca: Thank you so much.
Paula Begoun: Take care, dear Desiree and Bryan, two minutes left and I can go to bed. It is almost four in the morning here in the South of France. I'm wondering what I am going to have for dinner tomorrow night, because you know death by French cooking. And I'm having a wonderful time.
00:57:58 I do miss you guys, I have to tell you. I don't miss the weather in Seattle but I do miss you guys.
Desiree Stordahl: We miss you, too.
Paula Begoun: Oh, you miss me a lot. So, next week we are going to be talking with M'chel – Bryan I never can remember this beautiful woman's name, Mikhail, Michael, Mitchell? What is her name, Bauxal?
Bryan Barron: When I spoke with her she pronounced it Michelle. I think it is just a fancy way to spell Michelle.
Paula Begoun: Okay, I'm typing an "i" in there because her name is with that apostrophe. How do you pronounce an apostrophe?
00:58:35 M'chel Bauxal is a celebrity makeup artist. She is going to tell us everything that we need to know about putting on our makeup and looking gorgeous. All of these tips, just stuff you have never heard of before, we are going to share it with you. And then on the 21st I am really excited to have Dr. Lesley Baumann on, author of "The Skin Type Solutions." She is an amazing woman. One of the true – just a dermatologist with a mission to be honest and share information.
00:59:05 She has an interesting viewpoint on skincare. She is great to discuss things with. We will challenge her with some new research about different kinds of some of the things that we have been talking about, lasers for acne, and just – oh, tons of stuff. Tons of stuff. And then the week after that, on the 28th, this is one of my favorite shows. We are going to talk about five secrets to keeping your hair younger.
00:59:33 Anti-aging tips for your hair. I'm going to shock you with this one. You are not going to be happy with me on some of them, but I promise if you just listen out of the five, if you just listen to two or three you are going to think I am an incredible cool. I am Paula Begoun, the Cosmetics Cop, keeping you beautifully informed. Desiree Stordahl and Bryan Barron. Stay well so we can talk next week. Take care.
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