Your Biggest Skin Care Questions Answered by a Dermatologist

Airdate: 4/3/12

Learn the secrets of great skin care from top New York Dermatologist Dr. Debra Jaliman, author of Skin Rules. Find out solutions for your most challenging skin concerns, from wrinkles to uneven skin tone and persistent breakouts.

Paula Begoun: Hello, I'm Paula Begoun, the Cosmetics Cop, keeping you beautifully informed. Well, actually, I'm not the one these days keeping you beautifully informed, my team has been. Usually it's Bryan Barron and Desiree Stordahl, but Bryan Barron is out celebrating tonight, so it is just Desiree. Desiree, how are you?
Desiree Stordahl: I'm good. A shout-out to Ben - Happy Birthday, Ben! That's Bryan's husband.
Paula Begoun: Happy Birthday, Ben. The hubbers, yes, they are out celebrating.
00:00:31 And I have to say I am glad I am doing this show tonight, but I would rather be celebrating and having a martini, but that is another discussion. I do like my martinis. I wish a martini was health food. So, we have got a lot to talk about tonight. I'm very excited because I love talking to wonderful dermatologists. You know, I would love to say that every dermatologist is wonderful, but we all know that is not true.
00:01:00 So, when you get a really great dermatologist it is really thrilling. Don't know if I just insulted Dr. Jaliman or not, but the guest tonight is Dr. Debra Jaliman. She is author of "Skin Rules: Trade Secrets from a top New York Dermatologist," and indeed that is what she is. And we are going to be talking to her in a little bit. Her book is great; it's actually an unusual book for a dermatologist to write because derms generally like carrying on, and they write even bigger books than I do.
00:01:31 And her book is just very succinct tidbits, rules that she gives, that are very easy to read, very easy to understand. I'm going to probe a few more questions for her, and of course any questions you have we want you to call in and ask. And, of course, as always you will get some Paula's Choice products.
Desiree Stordahl: Oh, and the number to call in is 347-426-3783.
Paula Begoun: And they can still ask us questions on Facebook, right?
Desiree Stordahl: They sure can.
Paula Begoun: Facebook!
00:02:05 Our wonderful Facebook. But before we talk to Dr. Jaliman, I want to go over a few things. I always want to go over a few things, because my job is to keep you beautifully informed, and I got some information that is fascinating, just fascinating. Because I have been getting caught up on my research. I have medical journals that line my office like piles, and piles, like columns - like I'm building the Coliseum or something.
00:02:31 So I'm trying to get through my research, and one of the articles I found from Dr. Howard Maibach, of California in San Francisco, he is fascinating, and he writes a monthly column in an industry, a cosmetic industry journal. And he wrote a fascinating article, the title of it is, "Interpersonal Hormones Transfer." It actually had a few other things in it, but that was the top part of this story, this research he has done.
00:03:07 And basically what he is saying is that you are using, a woman is using a topical estrogen or testosterone cream or lotion, and rubbing it on parts of her body and hands - obviously if you are rubbing it on parts of your body you are probably using your hands and not wearing gloves to apply it - that you can actually get what he is calling Dosed Transfer to spouses, children, and friends, to whoever you touch on a regular basis.
00:03:41 Can you imagine? I mean, the significance of what he is saying, because lots of women use topical estrogen, topical progesterone cream, and rub it all over their bodies on a daily basis. And if after that you touch your family members or your friends - well, probably more your family members, your kids and whoever you are with at night cuddling - that you could be transferring some of the dosage you are getting on a repeated basis.
Desiree Stordahl: So, Paula, does he say how long that that transfer can last up until? Is it hours, is it days?
Paula Begoun: He does.
00:04:20 24 hours. A whole day. Can you imagine? So in other words, the drug - the testosterone, the estrogen, or the progesterone - topically on the skin because it is not fully absorbed, what he is saying for 24 hours. And that means for 24 hours it is available for what he is calling Interpersonal Transfer. I know, you are speechless. I know! I mean, of all of the things I ever thought I would read, this one just threw me over the top.
00:04:57 And it is a longer discussion. He quotes a lot of research on it. But, I mean, really - so you need to first consider who you are touching after you put that stuff on, and particularly what parts of your body are coming in contact with other people, like your children, because those hormones aren't for them. They are for you. I mean, really, it is just - that just - I'm still kind of reeling from that one.
00:05:26 Another journal that I got caught up on over the weekend is from the Journal of Cosmetic Science. It is way too technical, very boring, dry, way too...and a lot of it is over my head because it is way too chemistry, charts, and percentages, and numbers, and equations I don't understand. But I read it all the time and try to understand as much as I can. So, in the Journal of Cosmetic Science, this is "the official journal of the Society of Cosmetic Chemists," you know, it is not often the cosmetics industry, industry magazines say things that so clearly represent - acknowledge what it is that I have been saying.
00:06:17 And so I just love it, because of course my ego just flies out the door. So, one of the things that this article, this research paper states is that another factor that can affect stability of products is jar packaging.
Desiree Stordahl: Ding, ding, ding!
Paula Begoun: Oh, I do love it. I do love it. But so the point they are making, they say not only because of light sensitive and air sensitive ingredients, but their focus because this article was mostly, this research paper was mostly about alternative preservatives in cosmetics to use natural ingredients or less volatile - to not use formaldehyde or a lot of people are looking for paraben alternatives, not that parabens are bad. The information is out there and brainwashing everybody that parabens are some kind of evil thing for skin. So not the truth. So not supported by the research.
00:07:25 But nonetheless, it is out there, and people are looking for alternatives. So there is a lot of research going on about finding alternatives about preservatives. And so one of the strong statements this article, this research paper makes is that it is particularly difficult no matter what preservative system you are using to keep a product stable in jar packaging. Ding, ding, ding, ding! Give me another "ding, ding, ding, ding," Desiree.
Desiree Stordahl: Ding, ding, ding, ding! There you go. It's like "The Price is Right."
Paula Begoun: It doesn't work when I do my own, "ding, ding, ding, ding."
00:07:58 But isn't that fascinating. Because when you think about it, a lot of this desire to find natural alternatives and preservative systems for cosmetics which we are using a lot in our products, and especially in our new Earth Source products that will be on our website live tomorrow - is that right? It is tomorrow, right?
Desiree Stordahl: Right.
Paula Begoun: Are all 98% natural. 98% natural line of three skincare products. And formulating with natural ingredients is hard enough as it is, but particularly preservative systems because they are not quite as broad spectrum. Like they might kill bacteria but they don't kill fungus and mold.
00:08:39 But the natural ones work far better, and you can get far more stability when they aren't in jars. So I thought that was very supportive and interesting. I loved it. And then this is interesting, and as we are coming up here to spring, and in some parts of the world it is actually spring, just not here in Seattle yet.
00:09:04 So there is this whole issue that has been ongoing in the skincare world and the cosmetics industry, and medical, I mean, dermatologists as well, is this issue of vitamin D versus sunburn, versus skin cancer. Vitamin D is a critical body. It is actually not a vitamin, but separate from what it technically really is - the only way to get it is either from direct sun exposure, and not the sun that comes through windows, because it is the UVB rays of the sun that interact in your body and your body then can make vitamin D.
00:09:47 The rays that come through the windows are UVA rays, those are the non-burning rays of the sun. It is the UVB rays directly from the sun that help the body make vitamin D. By the way, that is why - I'm going off on a tangent here - but that is why tanning beds, they lie to you about their tanning beds making vitamin D. They lie.
00:10:10 Because tanning beds mostly emit UVA radiation. That is not the rays that create vitamin D. 99% of the rays that come out of - well, I think it is 99% - I actually shouldn't say that so strongly. Most of the rays that come out of a tanning booth are UVA rays, and those aren't the rays that create vitamin D. It is the UVB rays, direct UVB rays.
00:10:42 Unfortunately, those are the sun burning rays - well, and actually both UVA and UVB rays cause wrinkles and skin cancers. So, the good thing about the sun is it produces vitamin D. The bad thing about the sun is it causes wrinkles, and well, every kind of aging you can think about for the face practically when it comes to wrinkles and skin discolorations, and sagging. I mean, there are other factors, but majorly it is about sun damage.
00:11:15 And I just lost my train of thought. Wait, where was I going? Oh, I don't want to lose it...wait, wait, wait...oh, I remember. So, the issue is that the sun gives you this beautiful vitamin D in your body, and it also gives you a risk of getting skin cancer - not a risk. I mean, you are going to get wrinkles and uneven skin tone from not being protected by sunscreen.
00:11:39 However, and a high risk of skin cancer if you are not being sun smart; however, there are all kinds of issues around how do you get vitamin D. And I was reading a research paper and there are many advocates of this. It is somewhat controversial. People fall - the research falls on either side of the coin. But a lot of experts, a lot of scientists feel that the best way to get vitamin D is from the sun.
00:12:05 They feel strongly about that. The body can handle it better. Not everybody can adapt vitamin D supplements. So there is controversy; not everyone agrees with it. But for those of you who feel, and I see it on the web, and on chat rooms, and all kinds of skincare things, you know that, "Oh, you got to get it from the sun; if you wear sunscreen it is going to block the rays of the sun." Not everybody agrees with that.
00:12:30 Let me say that unequivocally - not everybody agrees with that. However, most experts would say about 15 to 20 minutes of sun exposure on 54% of your skin, that is a general number that I have been seeing, is what you need to make vitamin D. Now, of course what is bizarre about that is if you are in Alaska you aren't ever going to see 15 minutes of sun six months out of the year; definitely you are not going to get - where the sun is in the sky makes a difference. On, and on, and on.
00:13:02 I feel strongly, and I don't have any research to back this up, however, I am looking into it so I can make a far better statement. I still feel that vitamin D supplements are the best way to go because you don't want to give up good-looking, wonderful skin and not getting skin cancer to get vitamin D when supplements are available, but if you are one of those people who are a proponent of getting vitamin D from the sun, what you can do, and I am fairly certain this would work, and we will ask Dr. Jaliman about this maybe in a minute, see if she agrees with me, is that you can get a UVB machine, a sunlight machine.
00:13:40 Because for those people who have, you know, when I was a kid and we used to want to get tan, we would sit in front of a machine that emitted UVB rays. So they are out there. You can go to Amazon, look it up. But don't do it on your face and arms. Every other day expose your thigh or your rear end, because it has to be over a large percentage of body; it doesn't work to just stick you face in the sun, it is not a large enough area.
00:14:09 So at night, while you are watching "Law & Order," or you are me and you are watching "Once Upon a Time," or "Family Guy," turn on that little machine for 15 minutes on your thigh and backside, and then the next time do it on the other side, and then do it for a few months and don't give up that 1,000 - I think that is the new USDA/FDA, whoever does the recommended daily allowance.
00:14:35 I think it is about 1,000, some experts would say 1,000 to 2,000mg of vitamin D a day. But see if your body picks up the next time you get a blood test. But if you are doing the sun, just don't do it on your face. Get one of those machines and it's easy. And especially depending on where you live in the world, going out in the sun isn't going to work anyways because there is not enough sun.
00:15:00 Did I explain that well? I carried on a little bit about that, Desiree.
Desiree Stordahl: Yes you did. It would be interesting, because you said that they recommend covering about 54% of your body, getting that much of your skin affected. So, you bum, depending on how big it is, could be your whole 54% if you have got a rather large one.
Paula Begoun: Mine is 54% of my body...at least! Maybe more! I never have done a measurement. But it is interesting that the issue is about how much of your body is exposed.
00:15:32 Because I think what is happening, especially in colder climates in the winter, a lot of sun advocates for vitamin D are going out thinking, "Well if I just show my face in the sun, that's enough." And actually it's not. That isn't the way to get enough. It needs to be over a larger percentage of your body.
Desiree Stordahl: And the face is really the last place you want that to happen because of all the other side effects that you are going to get with sun damage.
Paula Begoun: Yeah! Don't transfer one for the other. And before I ask Dr. Jaliman if she thinks I am crazy about this suggestion of getting a UVB light machine and tanning your rear end and thigh instead of your face, one other thing that is interesting, and I am going to talk to Dr. Jaliman about this because she likes ultrasound machines, the medical kind that is used in derm offices and I think Thermage is radio frequency.
00:16:32 Ultrasound is Ulthera. And that a lot of spas and salons say that they have machines that work radio wave or ultrasound wave machines that work just like the ones that the derms have. I have said a million times that that is not the case, and then again I love it when a magazine, an industry magazine supports what I say. And so in a magazine that is aimed at salon and spa owners, it is a whole article on ultrasound machines. And it says, and I'm quoting - this is straight out of it - "Can the claims for these machines be true?"
00:17:15 And this author - who is the author? Do I have the name? Somewhere I have the name. I don't know where it is at. Where is it? It's in the [unintelligible - French Journal]. "And can these claims be true for these ultrasound machines? If one studies the science behind the use of ultrasound in spas and salons, the answer is a resounding now from most manufacturer assertions." Ah! And of course I am sure that...ironically or sadly it actually goes on to say what machines you should buy anyway. I mean, go figure.
00:17:50 Okay, so, and Dr. Jaliman, are you there, because we need to talk to Dr. Jaliman.
Debra Jaliman: Absolutely. I'm here and I have heard every word.
Paula Begoun: Dr. Debra Jaliman is a certified board dermatologist in New York City. She has written a book called "Skin Rules." Just an easy to handle, not intimidating, completely understandable tips and rules to take care of your skin and product recommendations. Of course, I love when she recommends my products.
00:18:20 Dr. Jaliman, how are you?
Debra Jaliman: Oh, I'm doing great.
Paula Begoun: So what do you think? Am I crazy about using a UVB machine and sun-tanning your rear end?
Debra Jaliman: Well, I think this is a controversial area, but it is very interesting. You know, if you use a UVB machine, just like the sun you can still get skin cancer. So that is the problem with the UVB machine. There are people that can't absorb vitamin D from their gut. They have absorption issues, like they have Crohn's Disease or Ulcerative colitis, so they can't absorb vitamin D, so they can't take a pill.
00:18:58 So for those people maybe, but I think for most people that can take a supplement, I would go with the supplement because it is easy, and it is effective. And, you know, I live in New York for example, so we don't get enough sun in New York to even get vitamin D from the sun. Because it is interesting - in these northern areas, like if you are in Florida, and even where you are - you are in Seattle I think, right?
Paula Begoun: Right.
Debra Jaliman: I don't think you get enough sun.
Paula Begoun: Oh god, we definitely don't get enough sun.
Debra Jaliman: So even if people spend 15 minutes a day in the sun, they are probably going to get the skin cancer, but they are not going to get the vitamin D. And they have done so many studies on this where darker skinned individuals, certainly African American, Hispanic, they don't make vitamin D because there is too much pigment in the skin. And then blondes, blue-eyed, green-eyed individuals are going to be the ones that are going to get the skin cancer. So I don't see anybody who is going to benefit from a half hour, or 20 minutes in the sun myself.
Paula Begoun: Actually, I hadn't heard that before.
Debra Jaliman: Yes.
00:20:05 And there are studies on it, I promise you; you can look them up.
Paula Begoun: So women and men of color, African American or black skin or Hispanic skin that have more melanin, because...
Debra Jaliman: Yes. They will not make vitamin D. Right. They don't make vitamin D well because they are blocking it.
Paula Begoun: So it doesn't matter how much time in the sun...
Debra Jaliman: Right.
Paula Begoun: Whoa!
Debra Jaliman: They tend to be deficient.
00:20:29 So they can't make the vitamin D. Anybody that has good pigment protection isn't making vitamin D. And they are the ones that can stay in the sun better than somebody who is a light Caucasian. And then the light Caucasians generally get skin cancer, so they shouldn't be in the sun. So I have patients who had skin cancer and they are telling me that they should - they heard, I'm not going to say who, but some doctors on television are telling them go out in the sun for a half hour. And those are my patients who have already had skin cancer, and I don't want them in the sun without their sunscreen. So I am fighting this issue a lot.
Paula Begoun: Yeah.
00:21:06 And some of it is...that is why I thought the UVB machine was at least an option to not get it on your face and hands. But I hear what you are saying especially if you are darker skinned - it won't make a difference where you get the light. So what concentration of vitamin D supplements, because here in Seattle it is actually very typical because we have a large percentage of vitamin D deficiency, specifically because of...
00:21:36 Even when we do have sun, in the winter for months and months it rides the lower hemis - it never comes up overhead, so you are never getting great direct sunlight anyway. And a lot of people are on medical grade 50,000mg of vitamin D, it is a typical dosage here for people who with vitamin D deficiency. If you are not sure because you haven't had a blood test, what do you recommend in terms of the supplement?
Debra Jaliman: Well, you know, it's interesting. The recommendation now is 1,000mg.
00:22:06 But, interestingly, there are many people who believe that vitamin D is good to prevent cancer, that there are a lot of studies that people with low vitamin D have a higher incidence, for example, of breast cancer. There are a lot of studies that show that. And a higher incidence of lymphoma. So many people - I have been to many conferences for cancer where they recommend that you take 2,000mg. So, I myself take 2,000mg of vitamin D.
Paula Begoun: The author of that article about vitamin D that I quoted, his recommendation, [Hollack], I think it is a Dr. Hollack; his recommendation is 1,000 to 2,000mg of vitamin D.
Debra Jaliman: Right.
Paula Begoun: So I have so many questions for you. In your press release, I've got to tell you, that I got about your book "Skin Rules" by Dr. Debra Jaliman, Dermatologist, was it said to ask you how can a derm shrink your waist.
00:23:12 I see a lot of derms and none of them have offered to shrink my waist. How does a dermatologist shrink my waist?
Debra Jaliman: Oh, so we do in my office, we do something called Coolsculpting. It was developed at Mass General. And what it is...
Paula Begoun: I'm sorry. What's Mass General, Dr. Jaliman?
Debra Jaliman: Massachusetts General Hospital at Harvard.
00:22:36 And what it is, it was developed actually the scientist who developed a lot of the laser technology that we use. And what it is, it is an external freezing device, and we put it on you, and it is very cold. And you sit in a room watching either a movie, or working on your iPad, or listening to music, and it freezes your fat cells.
00:24:00 And it takes an hour or two. And it is like non-invasive liposuction. There is no medication, no pain. And you sit there, and when you leave you look exactly the same. And then over the next two to four months you start to shrink. And then your body metabolizes that fat and then you pee out the fat, and it never comes back in the course of your lifetime. You selectively destroy those fat cells. But, yet, it doesn't raise your triglycerides; it doesn't raise your cholesterol.
Paula Begoun: Okay, wait.
00:24:34 Let me get this straight. I can't believe no derm has ever said this to me. This is like headline news.
Debra Jaliman: It's unbelievable.
Paula Begoun: Because, you know, you see the infomercials. You know, I was just watching one of the old TV shows - I love old TV shows. So I was watching one of those old TV stations, the old TV show stations, and watching an old Dick Van Dyke Show and Jack Benny, and I was just getting off on that, but I had to tolerate all of these weird infomercials.
00:25:01 I'm thinking, God, who watches these channels on a regular basis that they think I would be interested in it, but I figure, well, it must be couch potatoes, because there was this recurring ad for putting - you don't have to exercise, you put this thing on, and you lose weight. And I didn't even quite get what they were talking about, and I barely paid attention. But now that you are saying this, you are telling me that I sit in your office wrapped in something around my waist, and I'm not in pain yelling, Get it off me! Get it off me."
00:25:35 It doesn't hurt. It is just cold. Is that what you are saying?
Debra Jaliman: Yes. It's cold. It is attached to like suction, to it is on the fat for about an hour in each area.
Paula Begoun: And I'm not in pain?
Debra Jaliman: No. No pain.
Paula Begoun: I'm just cold. You put a blanket over me?
Debra Jaliman: Exactly. You have a blanket. We give you tea to drink to keep you warm.
Paula Begoun: You can give me a martini if I wanted.
Debra Jaliman: You could have a martini if you like. Though we can't disconnect you from the machine, so just for an hour or two depending upon how much fat you have.
Paula Begoun: So don't drink a lot of martinis, so you don't have to get up and go to the bathroom.
Debra Jaliman: Exactly.
00:26:13 We don't want you to get up and pee. And then that's it. I mean, then you go home. You look the same when you go home. You may have a slight redness to your skin for a day or so, but no pain. You can leave there and go exercise, you can go to a party; you don't have any pain.
00:26:30 And then over the next two months to four months you start to shrink. I can send you pictures. You would not believe it. I mean, people who never had a waist suddenly have a waist. We get rid of back fat, belly fat. It's like having Spanx.
Paula Begoun: Can I make an appointment? Do you have your calendar in front of you? When am I going to be in New York? You are kidding!
Debra Jaliman: This is really one of our most popular things. But the funniest part of the story, this will make you laugh, is that we were one of the first people to get the machine.
00:27:00 And I read all of the science behind it. It made sense to me. We bought the machine. And I was one of the first people to be frozen. So I had them freeze my back. So, every day, you know, after I froze my back, every week I would pinch my back and it felt exactly the same, and I started thinking maybe this is some kind of scam, just like you are saying.
00:27:27 I thought, maybe this doesn't really work, and now I have bought this very expensive machine that doesn't work. But interestingly enough, by week 16, by the fourth month, one day I went to pinch my back and there was nothing to pinch. I was onto bone. I had absolutely no back fat. So, in order to get onto the machine you have to have an inch. Our motto is you need at least an inch to pinch, otherwise you can't get onto the machine at all.
Paula Begoun: I take it this isn't the same as putting ice cubes on my back?
Debra Jaliman: No, no, no. This is a real technology. You know, they won't divulge what temperature the machine is at. I don't even know because it is patented. But all I know is that it works. And we have done many, many patients.
00:28:14 And nobody ever believes it until we show them pictures. At first when I would tell this to people, they looked at me cross-eyed, like is this for real, just like you are saying. But it works.
Paula Begoun: So the machine is called...
Debra Jaliman: Coolsculpting.
Paula Begoun: And what is it, an Erbium? It's not a laser, it's..what is it?
Debra Jaliman: No.
00:28:35 It's cold. It's just really...I always say it is good to have a cool friend. It's a very cold machine.
Paula Begoun: It's called Coolsculpting. If I wanted to look up research on it I just would go to Pub Med?
Debra Jaliman: Yes. You can look up research on it. It's done by really substantially researchers. And let me tell you how they discovered this.
00:28:58 There was a little girl who went to the Harvard Clinic with her mother, and she had depressions in her cheeks. And it turned out that the mother was giving her popsicles all day long to keep her quiet. It's a form of child abuse, I guess. So she had atrophied all of the fat in her face from popsicles by her cheeks.
Paula Begoun: No!
Debra Jaliman: Yes, it's a really true story. And they call it is called Popsicle Pinniculitis, because the fat was destroyed by ice popsicles all day long, the mother to keep the child quiet. So when they saw that, they decided there must be a good use for this. And that is how they made this discovery really.
Paula Begoun: Oh, now that is too good. That beats Botox and Latisse all over the place.
Debra Jaliman: Yeah. It does. It's one of our most popular treatments in my office.
Paula Begoun: So, Dr. Jaliman, who is author...do you have this in the book? Is this in your book?
Debra Jaliman: Yes, I do. It's one of our rules?
Paula Begoun: Do you know the page? No, you don't have to tell me the page.
00:30:00 People should read the whole thing. So I am talking to Dr. Debra Jaliman, dermatologist from New York. Wrote a great book called "Skin Rules." She agrees with me on a lot of things. We don't have to talk about what she doesn't agree with me on. And so, how much do you charge for this Dr. Jaliman?
Debra Jaliman: It varies. But it is like, let's say you freeze your belly, it's like $750. But the fact is, it's permanent. It's finished. It's gone.
Paula Begoun: You are saying that $750 and that beats...okay, all right.
Debra Jaliman: It's a good deal I think.
Paula Begoun: Let's move on. I'm going to take a couple of calls here in just a second.
00:30:36 But real quick, give me some, if you can, fast answers. So, everybody always hears about lasers - lasers for Rosacea, lasers for spider veins, lasers for acne. What about blue light? What about red light? All that stuff. So, what kind of laser do you recommend a consumer write down right now that the next time they are going to see a dermatologist and talk about a laser, or an IPL machine, Intense Pulse Light Machine, for Rosacea, what should they ask the doctor if they have?
Debra Jaliman: Okay.
00:31:17 So it depends what kind of Rosacea you have. Let's say you have active Rosacea, and you have to get it under control. You may want to go for a red light/blue light/infrared. So, when we take our red light/blue light. We set it, depending upon the inflammation in the skin, we would put somebody under red light/blue light with infrared light. So we use all of the different settings, and we calm down the Rosacea. So that is if we want to treat active Rosacea.
00:31:46 Now let's say we want to just treat the background red of the Rosacea, then I would use a Genesis Laser and take out background red. Other people with Rosacea just have broken blood vessels, then we would use a broken blood vessel. We use like a cool glide to do the vessels.
00:32:05 So it really depends. And with Rosacea you really have three different types of lasers that you may use with Rosacea. But don't forget, with Rosacea whatever lasers you are using, you always have to use a physical sunscreen, because all of that can come back if you don't use a physical sunscreen.
Paula Begoun: Physical meaning titanium dioxide or zinc oxide?
Debra Jaliman: Exactly, or zinc. You don't want to ever use chemical sunscreens with Rosacea, because it will flare the Rosacea.
Paula Begoun: So you seem to like retinol.
00:32:33 I have noticed that in your book...
Debra Jaliman: I do like retinol because I think it is inexpensive and it's effective. You can buy a $20 retinol product and you are going to see a response. So it is inexpensive, and you will see something happen to your skin. Do you like retinols?
Paula Begoun: We just, you know, the research about retinol has been compelling for some time, stabilizing it is a nightmare from a formulary point of view.
Debra Jaliman: Yeah.
Paula Begoun: And we also don't take a single approach to skincare. We like what I call the cocktail approach, that skin is complicated and it needs a complex array of ingredients.
00:33:12 So trying to find a happy marriage of retinol with other antioxidants.
Debra Jaliman: Yes.
Paula Begoun: We just recently launched a retinol serum as a matter of fact.
Debra Jaliman: Oh that's great.
Paula Begoun: That's getting really nice reviews. But it wasn't easy.
00:33:26 This was like four years in the making to get a stabilized retinol. By the way, retinol in a jar is a joke, but that is a whole other story. Tell me what kind of -
Debra Jaliman: Well that is one of my rules - pump and tubes. Pumps and tubes for retinol. Absolutely.
Paula Begoun: Keep the air out. So, what kind of laser do you use for spider veins?
Debra Jaliman: So for spider veins, yes, so there are Yag lasers that, you know, I use a CoolGlide for spider veins very effectively. And with spider veins, of course one of the most important things is you want to wait four weeks between treatments. I can't tell you how often people come back at two weeks and they want another treatment.
00:34:06 And you know what? If you wait four weeks often times the veins are gone. And you don't need another treatment. So you really have to wait for the treatment to work. We don't want to waste anybody's money, and we don't want to over-treat any patients.
Paula Begoun: So, in other words, when you first zap a vein on the face using this Yag laser, the CoolGlide that you said, and I take it obviously that works for Rosacea surfaced veins as well?
Debra Jaliman: Exactly.
Paula Begoun: That even though you don't think it has gone away, wait another week or two and it is going to be bye-bye?
Debra Jaliman: Exactly. It takes time. And patients are very impatient.
00:34:45 They don't like to wait.
Paula Begoun: Why do they come back? It just pissed me off? Because I've had it done.
Debra Jaliman: Why do they come back? Sometimes they come back because people are taking medications they don't realize. For example, is somebody is on steroids, let's say they take Prednisone because they have asthma, that will bring back your blood vessels.
00:35:06 Sometimes people don't use their sunscreens very effectively. Sometimes people ski and they have windburn. So, a lot of times vessels come back for other reasons. Sometimes people take estrogen. That will bring back your vessels. So you really have to take a good history to find out what your patients are doing because maybe you can change what they are doing. Or, sometimes people use very abrasive soaps, cleansers, sponges, you know; you know what people do. And then they are bringing these vessels on.
Paula Begoun: So let's say I need my medication and I can't get off it, and I'm a skier.
00:35:45 So, it is it a problem to come back? Like how often can you get your veins, the surface veins on your face zapped? Does it matter? I mean, is it is a problem to keep going back?
Debra Jaliman: No, it isn't a problem. But, you know, sometimes they modify what people are doing. Like I am a skier, so I try to wear something over my face to protect it so I am not getting terrible wind burn.
Paula Begoun: Right. I mean, not irritating your skin is good for many reasons - inflammaging, which is just why skin, one of the major reasons why skin ages.
00:36:20 Yes. Always protection versus going back in and giving you money to zap my veins.
Debra Jaliman: Right.
Paula Begoun: Desiree, we have some questions from callers for Dr. Jaliman, author of "Skin Rules," top board-certified dermatologist from New York. First question, Desiree.
Desiree Stordahl: We have Sandra from California on the line.
Paula Begoun: Hi Sandra. You're talking with Dr. Jaliman.
Sandra: Can you hear me?
Paula Begoun: Yeah. We hear you great.
Sandra: My question is, actually I wanted to change my question based on the beginning of the show. And I have plaque psoriasis since I was a teenager, and in my early 20s I did treatment in a light machine where you go...it's kind of like a tanning booth but you stand in it and the doctor would monitor it.
00:37:15 And I would stand there for like five or, I think it was like five minutes at the most. And I would go in like once a month for it. So years passed, and I stopped doing it, and I did other treatments with a pill that didn't really work, and I have tried everything. And I started going to a tanning booth and doing it myself for five minutes once a month.
00:37:37 And I'm wondering should I stop that? I mean, I wear sunscreen every day and everything like that, and I put sunscreen on the areas where I don't have the psoriasis because the rays from that booth really worked. Except for my scalp, the psoriasis areas are practically gone. I had some discoloration, but that went away, too.
Paula Begoun: So, Sandra, you are asking Dr. Jaliman if using a tanning booth for, you said five minutes once a month?
Sandra: Yeah.
00:38:11 I go like five minutes. Sometimes I do seven minutes depending on how - when and if it comes back.
Paula Begoun: So once a month? And that is keeping it under control?
Sandra: Yes.
Debra Jaliman: Pretty amazing.
Sandra: Except for my scalp, on the bottom of my neck.
Paula Begoun: I don't know. I'm not a doctor. But that just sounds like you found a miracle.
Debra Jaliman: Yes. I mean, I'm not in favor of tanning booths, but truthfully for psoriasis it is one of the approved treatments. And it seems like you have so little light that you are using. I mean, they usually use so much more light for psoriasis, and it seems like at least you are protecting the rest of your skin that doesn't have the plague. And the plague skin is such thick skin that it is not penetrating that well into the rest of the skin anyway.
00:39:02 So it sounds like...but what I would do, the one thing I would suggest is at least get your skin checked once a year by a board-certified dermatologist just to make certain that you don't have a skin cancer. But otherwise I think it is okay.
Paula Begoun: I am just blown away. I don't know that I have ever seen anything...
Debra Jaliman: Clear up so easily.
Paula Begoun: I mean, you are like a miracle child.
Sandra: The worst part is I haven't had any real side effects other than, like I have a slight tan, but I don't have any wrinkles or anything like that.
Debra Jaliman: Can I ask how old you are?
Sandra: 32. I've been doing it since I was 23.
Debra Jaliman: You are still young. But I do think you still should get a mole check every year. I do think you should be checked.
Sandra: I agree.
Debra Jaliman: So just do that and I think you are okay.
Paula Begoun: And 32 years old is kind of young. The wrinkles will come. You wouldn't be seeing wrinkles yet anyway. And I think following what Dr. Jaliman is saying is be really good about the parts of your body that don't have the psoriasis. Don't get a tan on your face. Wear sunglasses. Wear physical block.
00:40:12 Cover the parts of your body when you go into the machine. Even for that brief of a time, the research about sun damage and tanning booth damage in particular, because it is such intense UVA rays is one minute of exposure is bad. You can actually see in studies that things are going south.
00:40:32 Collagen is breaking down. Immune cells are breaking down. So, protect the rest of your body where the plaque isn't and take vitamin D supplements and be very proud of yourself. Sandra, we have to go to another caller, but tell me what kind of skin type you have real quick. Tell me your skin type.
Sandra: It's combination. I just placed a huge order with you, Paula, so I'm like one of your best customers. I don't need anything!
Paula Begoun: So I will have Desiree get your information and we will send you a $20 gift certificate for the next time you load up.
Sandra: Okay, cool. Thank you.
Paula Begoun: All right, take care Sandra.
00:41:11 Desiree, next caller.
Desiree Stordahl: We have Maha from Oregon.
Paula Begoun: Maha?
Maha: Yes, it's Maha.
Paula Begoun: Maha? M-A-H-A?
Maha: Yes. Hi Paula.
Paula Begoun: Hi, what a great name, Maha. What can we do for your dear?
Maha: Thank you. Well actually I had a question, but now if it is okay also I can change it based again of what I have been hearing?
Paula Begoun: Of course you can change it.
Maha: We are changing our questions.
00:41:38 Well, I'm going to ask you. My daughter, she is ten years old, and she has very, very, very thick hair. As a baby she had the cradle [capping] they call it. But now it has been for the last two or three years she still has almost like cradle cap under the hair. And we went to the dermatologist, we got some topical solution. It is liquid.
00:42:01 But it doesn't seem to be helping. She says it stings a lot. And also what I was reading also on the Mayo Clinic that sometimes this can be related, or it goes with some neurological disorders, I know Parkinson's Disease, but I don't know what other.
Debra Jaliman: Well, it's very rare. I mean, more people have it not related to neurologic diseases I would say. And I think probably the solution they gave you is an alcohol, and that is probably why it is burning. But I would try a shampoo first before I would go to a solution maybe.
00:42:33 Maybe you could use - you know, there are so many shampoos like with Selenium Sulfide, with Zinc Pyrithione, that might help her. Did you ever try a shampoo?
Paula Begoun: Like Head & Shoulders. Have you tried Head & Shoulders? Or a shampoo called Nizoral?
Maha: No, I used Head & Shoulders. It didn't do much. And I used, is it Selsun Blue, I think, or something like that.
Debra Jaliman: Did you ever try Nizoral shampoo?
Maha: No, uh-uh.
Debra Jaliman: Why don't you try that.
Paula Begoun: Write that down.
Debra Jaliman: And the other thing, you could always ask the dermatologist - they make those medicines not in liquid.
00:43:12 They make it in foam and it is not as irritating. It's the same medicine that you have. We don't use it in a liquid. We really use it in the foam because it is less irritating.
Paula Begoun: Dr. Jaliman, does the foam not contain alcohol?
Debra Jaliman: Yes. It doesn't. It doesn't. So it is not irritating. It is much easier on the skin.
Paula Begoun: Do you know the name of that foam that you use?
Debra Jaliman: Yes. It's called Olux Foam. And I'm sure they must make a generic as well.
Paula Begoun: Can you spell that?
Debra Jaliman: O-L-U-X.
Maha: Olux, okay.
Paula Begoun: What Dr. Jaliman is saying is very significant. I want everyone to pay attention. She is being brilliant, because most derms....okay, I'm sorry, I'm insulting your profession. Forgive me.
00:44:01 Most derms...Dr. Jaliman, I grew up with horrendous acne, and by the age of 20 I had been to over a dozen dermatologists, and all I had was - I still had my acne, and all I had was red, irritated, inflamed skin. I was in hell. So, I don't have a lot of love for derms.
Debra Jaliman: No, but what is so funny is when I read about you, I said you and I should have been friends, because you had acne, I had acne. You had eczema, I had eczema. That's why I decided to become a dermatologist.
Paula Begoun: Oh, you are kidding!
00:44:32 Oh, is that what you meant when you said in your press release that you had sensitive skin is that you had eczema?
Debra Jaliman: Yes, I had eczema, but I also had acne. So I spent all my time at the dermatologist. So I decided if I was going to spend all my time with a dermatologist I might as well just become a dermatologist.
Paula Begoun: It was hell! I think it is why I went into the skincare research business.
Debra Jaliman: Isn't that funny, that we both just entered it from different angles.
Paula Begoun: Well, Dr. Jaliman, I wasn't smart enough to be a derm.
Debra Jaliman: I don't believe that for a minute, Paula.
Paula Begoun: I wasn't smart enough to be a doctor.
00:45:08 So, Maha, what Dr. Jaliman is saying that I want everyone to pay attention to is a lot of topical medications that dermatologists prescribe contain alcohol. Alcohol in the form of SD alcohol, benzoyl alcohol, isopropyl alcohol is death to skin, because that is what it does, it kills skin.
00:45:31 It is irritating, drying, and causes free radical damage. It is the opposite of healing. I can't believe they still make dermatological solutions with alcohol.
Debra Jaliman: True.
Paula Begoun: So, Maha, what Dr. Jaliman is saying is that this product, these active ingredients your daughter could tolerate it if it came - it's not the active ingredient that might be causing the problem, but rather what they are mixing it with.
00:46:02 So, you are going to take a look. Nizoral is over the counter. You get that at the drugstore. By the way, is Neutrogena T/Gel, is that an option for her to try as well?
Debra Jaliman: Yeah. I like that as well. I like it very much.
Paula Begoun: So, Maha, you have a pen to write this down?
Debra Jaliman: She could either use T/Gel, or she could even use T/Sal. They have one with [tar] and salicylic acid that is also very good.
Maha: Okay.
Paula Begoun: So the over the counter is Nizoral, because you always want to start over the counter because it is cheaper.
00:46:34 so, Nizoral, or Neutrogena's T/Gel, or what was the other one you said? The one with salicylic acid?
Debra Jaliman: T/Sal?
Paula Begoun: T/Sal. And if that doesn't work, start with the Nizoral, the Neutrogena T/Gel or T/Sal, and then, these are all shampoos, and then if that doesn't work go see your dermatologist. And Dr. Jaliman you spelled it O-L-U-X? Olux?
Debra Jaliman: Yes. Olux Foam.
00:47:03 It's a foam. We never use those solutions. I really dislike them.
Maha: So the one they gave her, it is a very long name, but it is S-L-U-O-P...
Debra Jaliman: I know what it is. But it is in alcohol. We never use alcohol because your scalp is irritated already. So, put alcohol on a wound, on a red, inflamed area, it is going to burn.
Paula Begoun: You might as well take a lemon and squeeze it over a wound. I mean, really. What are derms thinking? I just...
Debra Jaliman: I don't know. We never use those liquids.
Maha: She's only a kid, you know?
Paula Begoun: Don't even start me.
00:47:37 It shouldn't be for adults either. But, yes, it is even worse when it is a kid. And it is not like derms don't know that alcohol is bad. I mean, I talk about having martinis. I know it is bad. I am not going to recommend it for somebody else. Sorry, I can go off. I will stop yelling. So, Maha...
Maha: What's the best thing for eczema since you mentioned, you know I will squeeze this one - because I have finger eczema, those contact. What would be the best thing?
Paula Begoun: Your turn Dr. Jaliman. Go on.
Debra Jaliman: Next call?
Paula Begoun: No, no. Answer her question quickly and then we will take the next call.
Debra Jaliman: With eczema the most important thing is you don't want to take the surface oil off your skin, so you have to use mild cleansers to wash your hands.
00:48:23 Most people over-wash their hands. They use antibacterial soaps. They use antibacterial wipes all the time. So you have to use something very mild and you have to use a lot of emollients. That is the most important thing with eczema in my opinion.
Paula Begoun: So I am going to make a radical comment, because I still have eczema that flares up on my hand. I am pretty free of eczema at this stage in my life, but I still can get flare-ups. And I know this is going to sound like an anathema, and I am going to shock a lot of people.
00:48:55 But I only wash my fingertips. I don't wash - I don't scrub down like I am going into surgery after I go to the bathroom. And if I have an antibacterial wipe, I only use it on my fingertips. And, I try to avoid shaking hands. Because really what the issue is is touching other people. And so it is about being careful about what you touch. And so, you know, I love the way the Indians do it where they just press their hands together and say, "Namaste."
00:49:27 And so I wish we would all adopt it because the major way we transfer germs is by shaking hands and the Europeans hug and kiss, which I bet you is even worse. I mean, muah, muah, on either cheek. Talk about...you can't get much closer to the mouth and the nose. But nonetheless, I agree 100%. I'm sorry, I go off, you know, because eczema drives me crazy. So, what drug do you recommend? What topical medications do you recommend?
Debra Jaliman: My favorite, and if you have never tried it Paula, I'm going to send you samples of it tomorrow, because I have eczema and I have finally solved mine, is Hylatopic Foam. It's a prescription. And I have samples in my office I will send you.
Paula Begoun: Hylatopic? Spell that? H-Y...?
Debra Jaliman: Here's my bottle I have to spell it off my bottle.
00:50:14 It's H-Y-L-A-T-O-P-I-C. Hylatopic. Now they call it Hylatopic Plus Foam. And it is amazing. And there are no steroids in it. What it does is it recreates the normal barrier of somebody who doesn't have eczema. Because people who have eczema don't have natural oils, the natural barrier that a regular person does. So this actually puts the regular barrier back onto your skin. It recreates the natural barrier.
Paula Begoun: Wait, wait, wait, wait, wait...let me get this straight. What you are saying has worked for you is not a cortisone?
Debra Jaliman: No, no, no.
Paula Begoun: Oh, come on. You work for this company?
Debra Jaliman: No. I don't work for any company.
00:51:01 If you read the beginning of my book, one of the things that is so great about this book, "Skin Rules," is that it is totally unbiased. I don't work for any company. No. I don't work for them.
Paula Begoun: Okay, sorry, forgive me. I actually did know that.
Debra Jaliman: It's okay.
Paula Begoun: I'm almost 60 and I have never been able to deal with...now definitely I use my Body Butter and that keeps my moist and under control, but I still get flare-ups. I mean, there is a lot of over the counter, thick beautiful balms that keep...
00:51:34 But when it flares up, you are telling me Hylatopic can keep it under control? Really?
Debra Jaliman: It's really an amazing...well, I just keep it at my bedside and I use it constantly this product. Because it really treats the root of the problem. That is the interesting thing about it. I'm going to send you some tomorrow.
Paula Begoun: Please. Please. Is it expensive? What's the cost for this?
Debra Jaliman: Well, you know, I get it on a prescription.
00:51:57 So you probably have health insurance so you probably have a prescription plan, so you can probably can get it on your prescription. So I don't know what it costs without a prescription.
Paula Begoun: All right. I'll take a look. All right, Maha, tell me what kind of skin you have. What's your skin type for your face?
Maha: I'm normal, but also I bought a lot of your product just last week.
Paula Begoun: Everyone has already...
Maha: People love you, but I wouldn't mind body products, or for body acne or something if you recommend something.
Paula Begoun: All right, I can.
00:52:24 So what I will send you for your hands, I do want you to consider the Hylatopic Plus that Dr. Jaliman was talking about, but we are going to send you my Body Butter, and we are also going to send you my 2% Salicylic Acid Body Lotion for your body. But also I am going to send you my 2% Salicylic Acid from my Acne line, my Clear line, the regular strength. It's weightless. You won't feel it. Salicylic Acid can, even without benzoyl peroxide, can be very effective for reducing some types of acne.
00:53:03 But I am also going to send you my regular strength Benzoyl Peroxide product. You just want to try it with the salicylic acid first on your body. Because benzoyl peroxide when it comes in contact with clothes can bleach it, can stain it. So, if you want to try it, wear it at night and wear an old t-shirt that you don't like. You would put the 2%, the exfoliating salicylic acid - Desiree, I'm getting, what is the name?
00:53:34 I can't remember the name of my products. What is the Clear Regular Strength Exfoliating Toner? That's the name!
Desiree Stordahl: That's it.
Paula Begoun: That's the name. I'm sorry, excuse me. So we are going to send you one of those, and we are going to send you one of our Regular Strength Clear Acne Treatment. What's that called?
Desiree Stordahl: Acne-Fighting Treatment.
Paula Begoun: Acne-Fighting Treatment. And so at night you would put the salicylic acid on first, and then the benzoyl peroxide, and then wear an old pajama thing that you don't mind getting messed up.
00:54:05 And we will send you the Body Butter. And thank you, Maha. Good luck with your daughter.
Maha: Thank you so much for answering so many questions. Thank you.
Paula Begoun: Take care, sweetheart. Desiree, next caller. Do we have time? We have time for one more.
Desiree Stordahl: We will have to make it really quick. So, Jackie, you are on the air.
Jackie: Hi.
Paula Begoun: Hi Jackie.
Jackie: I have a question. I am in San Antonio, we have lots of sun. It's 70-something degrees here. When do you decide to make that choice and see a dermatologist?
00:54:31 I have had really bad experiences with doctors, and I am really scared to make that initial leap to find one, because you get these spots on your face, and you are like, "Oh, is that cancer? Or is that just because I am not wearing sunscreen?"
Debra Jaliman: Well, you know, I think it is important - I know it is a scary thing. Believe me, I know when patients come to see me. But I think it is important to get it checked, because you don't want to end up with a skin cancer that spreads. So, I think you should go. Make an appointment tomorrow when you wake up, and go see your dermatologist. Find one. Ask a friend.
00:55:03 Ask your doctor. Get a recommendation. And hopefully find one that you like, because you do want to make certain that you don't have a skin cancer, especially you do live in a sunny climate, you know.
Paula Begoun: And you have to wear sunscreen. Go on.
Jackie: I have a face sunscreen, it is one of yours. But I don't know what to do for the body. And I really am very bad about putting it on.
00:55:28 And I live in like sunny blue skies all the time.
Paula Begoun: Do you want to take this one? Or do you want me to nag/mother Jackie to death.
Debra Jaliman: Let me just tell you something. Every day, probably every week in New York I see a melanoma. And I have to cut it out. And you don't want to end up with surgery and a melanoma and it can spread. So all I can tell you is better to be safe than sorry. And please wear your sunscreen. It's so important, because melanoma is the one skin cancer that can kill you.
00:56:00 And it is on the increase in young women. So, you don't want to get a melanoma. You don't want to get any skin cancer. So, it is one thing you can do; it's so simple - put your sunscreen on every day. An SPF of 30 or above.
Paula Begoun: What we are going to do for Jackie. Desiree, we are going to send Jackie - are you ready for this, Jackie? We are going to send you one of each of my body sunscreens. And tell me your skin type for your face? What's the skin type?
Jackie: I'm dry. I have dry skin. I use your Moisture Boost.
Paula Begoun: I'm going to send you my Skin Recovery Sunscreen.
00:56:36 I'm going to send you my Resist Sunscreen. I'm going to sunscreen you up so you have no excuse for not taking good care of your skin, because all the other stuff doesn't count if....and, by the way, one other thing - please remember, as much as I love Dr. Jaliman, and I wish she was in Seattle, or I was in New York, you don't have to marry the first dermatologist you see.
Debra Jaliman: Yes, that's true.
Paula Begoun: You don't like that dermatologist...
Debra Jaliman: Yeah, move on.
Paula Begoun: Yeah, bye-bye. It is okay. Don't worry about that. You haven't lost any money. It is like you buy clothes all the time that sit in your closet. We do that - we will buy an outfit and wear it once, or that pair of pants that really didn't fit, and then we are staring at it.
00:57:21 You don't have to live with the first dermatologist you see. You chalk it up to, "I have got to go shopping again and find something else that fits." So, you don't have to marry that dermatologist. You do have to marry sunscreen. Absolutely. I actually prefer physical sun block, like Dr. Jaliman was saying. I agree with her. Titanium Dioxide and Zinc Oxide, but for some people that can feel thick and heavy. So the most important thing is getting sunscreen on your cute body, being sun smart. You don't sit on a beach tanning, staring up at the sun and then put sunscreen on.
00:57:58 That is not being sun smart. That is being sun stupid. And cover s much of your body as you can. Lots of sexy, cute outfits that cover your little, cute body up. Does that make sense, Jackie?
Jackie: And I have a really fast question. The spray sunscreen, is that the chemical sunscreen you are talking about?
Paula Begoun: Those are chemical sunscreens.
Jackie: So you are talking about the lotion sunscreens?
Paula Begoun: Right. The ones that say Titanium Dioxide and Zinc Oxide. I have to say goodbye. Dr. Jaliman, thank you so, so much.
00:58:28 Dr. Jaliman, I...
Debra Jaliman: Paula, it is great to talk to you. Thank you so much.
Paula Begoun: We have got to do it again. You're the best.
Debra Jaliman: Yes.
Paula Begoun: So, Dr. Jaliman, author of "Skin Rules," New York Board-Certified dermatologist. She is good. Boy, she is smart. Darn, how come I didn't have her as my dermatologist when I was a kid? Oh, because we are the same age.
Debra Jaliman: Because I was a kid with you probably.
Paula Begoun: All right, Dr. Jaliman, take care. I hope to talk to you again soon.
Debra Jaliman: Okay, thanks Paula. Bye.
Paula Begoun: Bye-bye, dear. So, I hope she sells a lot of books. What a wonderful woman. Dr. Jaliman, author of "Skin Rules."
00:59:02 So, I'm Paula Begoun, the Cosmetics Cop, keeping you beautifully informed on our BlogTalkRadio Show, with Desiree Stordahl. And, I'm sorry, Desiree, I didn't give you a chance to say much; I was talking a lot tonight.
Desiree Stordahl: That's okay. It was a fascinating show.
Paula Begoun: Next week, on the 10th we are going to talk about the worst beauty tips we have ever heard, and what you should do instead. On the 17th of April, skincare and beauty questions only, I won't talk as much, with our Facebook and Twitter fans. And then on the 24th, one of our other favorite dermatologists, Dr. Brandith Irwin to talk about new anti-aging devices and treatments.
00:59:39 Again, I'm Paula Begoun, the Cosmetics Cop, keeping you beautifully informed. Come visit us at PaulasChoice.com. We are launching my Earth Source products, 98% natural products tomorrow. Come take a look. Until next week, take care. Bye-bye.
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