Dear Paula's Choice Research Team - Skin Care

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Category: Skin Care

Dear Paula's Choice Research Team,
I just happened to notice something. The Resist C15 has a use-by date of three months. Three months?! I'm pretty sure I've been using six drops a day for the past three months, and I'm not even halfway through the bottle. If I'm using the product as suggested, why make the bottle so big?

—Casey, via Facebook

Dear Casey,

Great question! We suspect you’re not applying enough of this product per application. Keep reading to learn how we came to this conclusion.

If you’re using C15 at the rate of six drops per day (the average drop is 0.05ml), that's about 0.3ml per day. With 20ml of C15 in the full size bottle, if you’re using six 6 drops (or 0.3ml) per day, you will use the C15 up in about 67 days, well before the 90 day (three months) use-by recommendation.

Whenever we choose packaging, it's always a balance between what is necessary to keep the product stable throughout its lifetime, cost to the customer, and also the limitations of what is available. Bottles in this fashion aren’t something that can be tailored to the preferences of a company; rather, there is a set range to choose from.

In the case of C15, offering a full ounce was tricky for those who only used it sparingly as these customers would have it for longer than is ideal to keep the 15% ascorbic acid formula 100% potent. The size we chose for C15 means that most will use it completely within that time period, and even if one really stretches out the usage, they still won't have it for more than three-four months. A little over the PAO date is fine as long as formula doesn't dramatically shift in color in that time—say from a straw yellow to a very deep brown. Hope that helps!

One more comment: C15 can be used anywhere you have signs of sun damage. Arms, chest, neck, can be greatly improved by this treatment.

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Category: Skin Care

Dear Paula's Choice Research Team,
I need some advice about enlarged pores. In the last several months I've developed large, very visible pores in the middle of my cheeks, down the sides of my cheeks from nose to chin, as well as on my chin and between my eyebrows. I’ve used Paula’s Choice products for years, and currently use CeraVe Foaming cleanser and Skin Balancing Pore-Reducing Toner, and I alternate between the 2% BHA Liquid, the 4% BHA Weekly Foaming Treatment, and RESIST BHA 9. I also use Paula’s Choice Skin Balancing Serum, C15, Super Booster, and a 0.05% prescription tretinoin cream 3 or 4 days a week. NYX Pore Filler helps a bit, but it’s gotten so bad, I just hate to look in the mirror. Is there anything else I can do?

—Gracie, via Facebook

Dear Gracie,

The sudden enlargement of pores can happen for a couple of reasons, but it usually indicates that something in your routine is too emollient for your needs. (Enlarged pores often come about in response to an overly moisturizing product that can clog pores, causing them to expand.) Did you change anything up in terms of product textures (e.g., your moisturizer, or even change from a tretinoin gel to a cream)?

If not, you may want to consider incorporating a stronger tretinoin product, or occasional salicylic acid peels, or even in-office treatments, such as Intense Pulsed Light (IPL). These are all options you should discuss with your physician, along with other treatments to improve skin texture and firmness.

We’re concerned that you did not mention sunscreen in the list of products you’re using, so we’re assuming this isn’t a daily staple for you—it should be! Many people aren’t aware that another side effect from cumulative sun exposure is enlarged pores. As the UV light breaks down the skin’s support structure (including collagen and elastin fibers), each pore loses some of its natural support structure, causing it to stretch and sag. Both of these factors lead to bigger, more visible pores, usually by your late 30s or early 40s.

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Category: Skin Care

Dear Paula's Choice Research Team,
I've been reading about facial oils lately, and read your review as well. What confuses me is the big selection of oils available: argan, emu, olive, coconut, grape seed, jojoba, avocado, etc. I want to get all the benefits possible, but obviously it wouldn't be wise to use so many oils each day. So, which do I choose? Would applying more than one give me extra benefits?

—Mike, via email

Dear Mike,

There’s no need to use several different oils to make sure your skin gets all the benefits it can—who has time for that? All non-fragrant plant oils offer a range of benefits for the skin, so, ultimately, it’s about finding one you like, not being concerned about whether you’re using the “best” because, in all honesty, there is no single “best” facial oil.

Of course, you can look for facial oils that combine several good plant oils rather than relying on a single oil (like argan or coconut oil). Doing so ensures you’re getting more benefits from the unique elements each oil has to offer—but bear in mind that what makes each oil unique doesn’t mean that there’s that much difference between them, at least not in a way that makes any one of them stand out as superior for the skin.

Think of this as you would an approach to a healthy diet: Rather than eating only spinach (which we all know is good for us), you gain more health benefits from a salad that also includes tomatoes, carrots, watercress, broccoli, and on and on. We like StriVectinLABS High Performance Booster Oil for its great mix of plant oils plus anti-aging ingredients. If you want to experiment with a single oil, look for products that also have a good profile of essential fatty acids for the skin, like safflower, sunflower, borage, and/or evening primrose oils.

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Category: Skin Care

Dear Paula's Choice Research Team,
Dermatologist Dr. Neal Schultz states that skin-care products do not “fix” redness. I’m currently using some of your skin-care products that you state calm redness, and now am confused. Could you clarify what you mean by “calming” redness ... as in what the ingredients do to the blood vessels or skin?

—Susanne, via Facebook

Dear Susanne,

There’s some blurring of the lines in what Schultz seems to be stating. “Redness” of the skin can refer to redness from irritation, or it can refer to redness caused by broken blood vessels beneath the skin’s surface. Irritation (and the redness it causes) can be calmed by anti-irritants and/or anti-inflammatory ingredients—this has been known for centuries—and I’m sure Schultz is aware that to argue otherwise would be silly. There is plenty of research proving that topical application of anti-irritants reduces redness (often referred to as erythema) from multiple causes.

In terms of calming surface irritation and inflammation, our products are loaded with a variety of anti-inflammatory (aka anti-irritant) ingredients (see the ingredient lists on the respective product pages for details on their function) because there are a variety of such ingredients. Most of the anti-inflammatory ingredients we use come from sources like oat, from antioxidants like bisabolol, green tea, and willow herb, or from others like salicylic acid. (Yes, this superstar ingredient reduces redness, too.)

Yes, those ingredients listed above can calm redness, but nothing applied topically can affect or change what occurs beneath the surface of the skin; that is, when capillaries break and then “surface.” Sadly, this concern cannot ever be addressed by skin-care products; rather, it requires treatments like laser therapy to reduce or eliminate “surfaced” capillaries. Without knowing exactly what Schultz meant or intended by his statement, it’s difficult to know how to respond, but we assume he meant that skin-care products cannot repair broken capillaries, and that is true! It is also true that topical application of anti-inflammatory ingredients can reduce redness that stems from irritation, as well as diffuse the “flushing” that’s symptomatic of rosacea.

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Category: Skin Care

Dear Paula,
I keep coming across advice about washing your face with a cleanser morning and night before taking any further steps in a routine of skin care or makeup. If I do the whole routine at night, starting with cleanser and ending, in my case, with an exfoliant, what am I washing off with cleanser first thing in the morning? Why isn’t water enough to remove the skin cells and sebum that would be a standard night’s accumulation for my normal-combination skin? Are we doing this just out of habit, or is there evidence supporting the theory that not using cleanser in the morning would lead to more problems, including breakouts?

—Rumia

Dear Rumia,

I completely understand the desire to cut steps from your skin-care routine, but morning and evening, good skin care begins with cleansing.

At night, you want to remove any makeup or sunscreen you applied (you are using sunscreen daily, right?), plus the day’s debris. In the morning, you want to remove residue from the products left on overnight, plus the superficial dead skin cells your exfoliant loosened and any perspiration that occurred during sleep.

Women have asked me before about just rinsing with water, but, while that can be an option for someone with very dry, sensitive skin, all other skin types need more than water. Water alone cannot emulsify and remove excess oil, nor is it ideal for removing perspiration residue. Think about it this way: You probably wouldn’t shower each morning without using soap (or a body wash), so it doesn’t make sense to skip this step for facial skin either.

As for evidence that this is necessary: There aren’t any studies proving that cleansing twice daily is a must, but there’s plenty of research pointing to the importance of cleansing from a hygiene perspective. We know that when cleansing is done gently it can achieve its purpose without making matters worse. And it only takes seconds to do—especially if you shower in the morning and wash your face while in the shower.

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Category: Skin Care

Dear Paula,
Since the discovery of the Korean BB Cream (which, in my opinion, isn't comparable in quality to any of the Western or European knock-offs), I've become intrigued by Korean cosmetics.

Koreans do seem to have exceptionally beautiful skin (Is it genetics or their devotion to sunscreen?) and their cosmetics industry is "apparently" years ahead of our own, but are 8–10 skin-care steps really necessary? Are Korean skin-care products and routines really superior? Do I need to double-cleanse my skin with a cream/oil and then a foam? Do I need all these different sleeping/peeling/serum masks? What about the bee and snake venom and other exotic ingredients?

—Ally

Dear Ally,

Whenever I travel to Korea (and I do love going there, as the country and its culture are fascinating), I am amazed at the lengths to which Korean women go when it comes to skin care. Is all of it necessary, day after day? Short answer: No. The bigger question is: Why do Korean women go to such lengths to take care of their skin? And the answer to that is: It has much more to do with cultural norms than what is truly necessary from a research/science perspective. I’m not saying that skin care is simple, but for certain it doesn’t need to be as complicated or involved as most Korean women make it. A big part of understanding this is that many Korean women genuinely want to spend the time and effort on this lengthy skin-care ritual; they do not, however, need to do it with so many products!

With all due respect to Korean women, no one needs to cleanse their face with several products, use multiple toners one after the other, then proceed to numerous masks, serums, and, finally, if not exhausted yet, apply several moisturizers followed by a sleeping mask (which is really just another moisturizer). Doing so, especially for those with oily or breakout-prone skin, might make matters worse.

From personal experience, and after speaking with many Korean women face-to-face, I can assure you that while many of them do have beautiful skin, there also are many who have bad skin they seek to cover up—and they have the same problems with breakouts, large pores, wrinkles, oily skin, dry skin, and dark spots as women all over the world.

If Korean women have any advantage over women in other countries, it’s sun protection. Korean women are adamant about avoiding sun damage and wouldn’t dream of getting a tan. So, yes, in theory and in practice, many Korean women have better skin, mainly because they protect it from a major source of problems: sun damage. Sadly, that’s not the norm in most countries, including European countries and the United States.

As for the Korean cosmetics industry being years ahead of cosmetics industries in other countries, that’s just hype. Years ago it was commonly believed that European cosmetics companies knew best, then Japan-based companies had all the secrets, and now it’s shifted to Korea. In time, another country will take the crown, but this is false glory, not to be taken literally. The truth is that Korean cosmetics companies have access to (and use) the same ingredients as cosmetics companies all over the world. They may use some different ingredients on the basis of cultural, historical, or anecdotal principles, but that doesn’t mean what’s chosen or what’s unique to the Korean market is truly better. And that especially includes such exotic ingredients as snail secretion, bee venom, and the like.

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Category: Skin Care

Dear Paula,
I love, and use, Paula's Choice, but I have to tell you that your animal testing list is pretty outdated. Many of those "don't test" companies are owned by larger companies that DO test. Urban Decay is one, and there are several others. I’m not trying to be nasty, but it is a real disservice to those who go by your list to represent these companies in the wrong light. I would say that a good percentage of your test/not-test companies are classified incorrectly.

—Karen

Dear Karen,

Thanks for your feedback! We are aware of this situation and realize that some might view it as a contradiction. However, we base our list of brands that do and do not test on animals on specific criteria, which in turn are based, in part, on information from NAVS (National Anti-Vivisection Society) as well as other animal rights companies such as Leaping Bunny.

We do not think it’s fair to penalize a brand that does not test on animals just because its parent company does. This seeming contradiction may be the result of regulatory or governmental actions, and we do not feel it’s fair to punish a brand for what its parent company does or doesn’t do, any more than as a parent it would be fair to punish all of your kids just because one did something wrong.

We understand that you may very well disagree with this approach, and that's fine. We’re all aware that the issue of animal testing is controversial, and far from black and white, and we do not maintain that ours is the definitive list. Indeed, this often depends on an individual's own criteria. So, we present our list as a helpful guide, but the final decision is always up to the consumer, after they've consulted as many sources as they care to check out.

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Category: Skin Care

Dear Paula,
I stumbled upon your website while reading reviews on natural and organic skin-care lines and thought maybe you could help me with a skin-care problem I’m having. I’m only 20, but I have malar bags. They are below my eyes, but more so above my cheeks. I absolutely hate them! Could you recommend a product that could get rid of them, preferably an organic product.

—DC, via email

Dear DC,

Malar bags (also known as festoons) can occur at any age and from multiple causes. Sadly, these protrusions in the undereye and upper cheek area cannot be eliminated with skin-care products, organic or not. I’m sorry, wish I had better news for you, but I trust you’d rather know what does work rather than waste your time and money on products that cannot bring about the improvement you want.

Malar bags beneath the eyes and on cheeks may be a sign of a thyroid issue, so it’s important to have your thyroid levels checked (this means a blood test). You also should rule out any eye-area issues, such as ptosis, which is a type of drooping of the eyelids that’s caused by muscle weakness. This weakness allows the skin to become lax, in turn allowing the fat pads beneath the eye and in the cheeks to fill the space, leading to a noticeable bulge.

To improve or eliminate malar bags, you need to seek medical help. Some doctors treat these bags with radio frequency treatments, a procedure you’d need to consult a cosmetic dermatologist about to see if you’re a good candidate. Other doctors have successfully used different lasers (Erbium YAG, Fraxel) to reduce these bags.

Cosmetic surgery is also an option. Some people with malar bags undergo a procedure known as blepharoplasty, which in most cases needs to be done in conjunction with other procedures (such as surgery to address a weakened eye muscle) for a positive outcome (Source: Annals of Aesthetic Plastic Surgery¸ February 2009, pages 57–70).

Malar bags are a problem, and their appearance can be exacerbated by allergies. So, make sure you’re not constantly exposed to allergens and find out what you may be allergic to so you can follow a proper course of medication to keep the symptoms under control. And, if you smoke, this is one more reason to quit as soon as possible: Smoking worsens malar bags (Source: Plastic and Reconstructive Surgery, November 2013, pages 1085–1092).

Of course, whatever you can do to protect your skin from sun damage is very important, too. Unprotected exposure to UV light (which means daylight, not just when the sun is out) causes damage to the skin’s immune system, which reduces its ability to heal. It also damages the skin’s support structures (primarily collagen and elastin) that keep it smooth and firm. As facial skin begins to sag from sun damage, the malar bags will look worse.

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Category: Skin Care

Dear Paula,
I've purchased and used many of your products to combat my dark spots and wrinkles, but now I have so many different products that I've lost track of what I really ought to be using. Help!

—Pat

Dear Pat,

Help is here! I completely understand how a skin-care routine can get out of hand and become confusing, especially when it comes to remembering when to use certain products. What makes it especially tricky is that, other than a cleanser and a SPF product for daily use, everything else in your daily skin-care routine can be varied, depending on your skin type, concerns, and personal preferences. For example, in the morning, when you're pressed for time, you may want to include fewer steps, and take more time for your routine at night. Here are some basic guidelines to keep in mind:

  1. Cleanse your face twice daily. In the morning, you want to remove excess product and superficial debris; at night you want to remove makeup (if worn), sunscreen, and oil build up.
  2. Apply your toner twice daily, always after cleansing. Of course, this assumes you're using an irritant-free toner, which mine are!
  3. Apply your AHA or BHA exfoliant, both morning and evening or just once daily (morning or evening based on your preference) depending on what works best for your skin.
  4. Apply any skin-lightening products to treat brown spots. You can apply these products just to the areas of concern or all over your face, but avoid your eyelids and lips. If you’re using more than one product for brown spots (such as Resist C15 and Pure Radiance Skin Brightening Treatment), you can either mix them or layer them, or, if you prefer, you can apply one brown spot treatment during the day and the other at night.
  5. If you’re using an anti-aging serum, apply it at this point in your routine, either morning and evening or just at night, if that's your preference.
  6. Finally, for daytime, apply your moisturizer with SPF, and follow with makeup, if worn. For your evening routine, apply your nighttime moisturizer last.

Hope that helps. If you have any more questions about your routine, my Customer Care Team will be happy to assist you!

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Category: Skin Care

Dear Paula,
I’ve been experiencing dry, cracked skin around my eyes recently. I suspect the cold winter weather is to blame. I have sensitive skin, so I’m afraid to use any products on this area besides water. If you could give me some advice, I would be very grateful.

—David

Dear David,

You're not alone in experiencing extra-dry skin around the eyes during the cold winter months. I wish using water were enough, but dry skin anywhere on the body isn't about the skin needing water—it's about the skin having lost its ability to draw in and hold on to moisture and to the naturally occurring substances in the skin that keep it smooth, soft, and pliable. Because those substances—not water—are missing, you need to provide them.

So, how can you do that? Apply a fragrance-free moisturizer around the eyes, especially at night before going to sleep. Look for a moisturizer that’s loaded with skin-repairing and emollient ingredients, such as Paula's Choice Moisture Boost Hydrating Treatment Cream (my go-to eye cream) or Clinique Super Rescue Antioxidant Night Moisturizer, Very Dry to Dry Skin. You don't need a special eye cream, but if it makes you feel better to use a product labeled as such, our current list of top picks is here.

Make sure you're using a gentle facial cleanser—not bar soap—and that you're keeping your eye area protected every day with a broad-spectrum sunscreen rated SPF 15 or greater.

If you find that regular moisturizer for dry skin isn't enough for the skin around your eyes, try mixing a dab of super-emollient Aquaphor Ointment with your moisturizer or adding a non-fragrant plant oil such as safflower or evening primrose oil—both are rich sources of essential fatty acids that reduce dryness.

Using those products, and being faithful about the sunscreen during the day and the moisturizer during the night, you should definitely see an improvement.

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Category: Skin Care

Dear Paula,
I’m in my early 30's and I live in a punishingly dry climate. Not surprisingly, I've always had fairly dry skin. My general beauty routine includes cleansing (only once a day as my skin dries out too quickly if I do it more than that) and applying Paula's Choice 8% AHA during the day and prescription 0.05% retinol at night. I follow this with application of face oil, then a SUPER thick moisturizer. During the day I apply a zinc oxide sunblock. I don't wear makeup because foundations—and even tinted moisturizers—stick to flaky areas and fine lines, making my skin look haggard. On especially dry days I use Aquaphor Ointment as my moisturizer!

Recently, I noticed hundreds of fine vertical lines running down my cheeks. The lines are generally vertical, but sometimes when I press my finger into my cheeks the fine lines will radiate from that point. They are, of course, most prominent when I smile, but sometimes they're barely visible. I did a little research and I think that my skin may be dehydrated. So I started taking Omega-3 and Omega-6 supplements and now drink three liters of water a day, all to no avail! My skin is still tight, dry, and making me look like I am in my 90's.

Oh, Paula, please help! I can't find any information on how to correct dehydrated skin and have no idea what products I should or shouldn't be using.

—Amanda

Hello Amanda,

I am sorry you're going through this. Extremely dry, uncomfortable skin is no fun, and I completely understand why seeing all those radiating vertical lines is so alarming. First, you need to know that drinking all that water will only result in more trips to the bathroom. Water is important for overall health, but, surprisingly, dry skin isn't caused by a lack of water. That's why you haven't seen any improvement despite all the water you're consuming.

Omega-3 and Omega-6 fatty acids can be helpful, but it's possible there may be a different type of dietary deficiency going on that could be causing your severe dryness. I recommend you consult your physician or a dermatologist for a work up to rule out any nutrient deficiencies or skin disorders.

Assuming everything is fine from a medical perspective, I suspect your routine is simply too drying for your skin type and for where you live. You didn't mention what type of cleanser you're using, but it should be gentle, creamy, and water-soluble—meaning no bar soaps or bar cleansers, even if they claim to be moisturizing. A couple gentle cleansers to consider are Boots Expert Sensitive Gentle Cleansing Lotion (sold at Target stores) and Clinique Redness Solutions Soothing Cleanser.

The combination of 8% AHA and prescription retinol might be too drying for your skin, so I'd suggest you stop using both products. Instead, for exfoliation, switch to a BHA exfoliant such as ProActiv Clarifying Night Cream or Paula's Choice Skin Perfecting 2% BHA Lotion, and apply it only in the morning, once per day, or perhaps every other day. Instead of prescription retinol, switch to an over-the-counter product with retinol, such as Paula's Choice Skin Recovery Super Antioxidant Concentrate Serum or Olay Pro-X Deep Wrinkle Treatment.

Also, stop using zinc oxide sunblock. It likely contains a high concentration of zinc oxide and may not be creamy enough for your skin. High amounts of zinc oxide can feel drying and be too matte for those with very dry skin. Switch to a creamier daytime moisturizer with titanium dioxide, such as Paula's Choice Resist Cellular Defense Daily Moisturizer SPF 25 or BeautiControl BC Spa Facial Defend & Restore Moisture Lotion SPF 20.

Make sure the facial oil you're using is fragrance-free; most aren't. Facial oils that contain fragrance (like lavender) can cause irritation that will make those vertical lines look worse. You may need to switch to a non-fragrant oil such as jojoba, sunflower, or evening primrose. You can find these oils in most health food stores.

Last, you may want to consider short-term use of a scrub (try Nivea Skin Refining Scrub) to remove what I suspect are some spent layers of dull, dry skin. Use this a couple times per week, and follow through with the changes mentioned above and your skin should do an about-face that will have you smiling!

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Category: Skin Care

Dear Paula,
How do you determine how often to exfoliate? I’m in my early 30's and have fair, sensitive, combination skin. It seems I either exfoliate too often (and get rough, red, irritated skin) or not often enough (I wait too long and my skin starts looking flaky and dull until I exfoliate again).

The exfoliants I've been using are the Resist Weekly Resurfacing Treatment with 10% AHA and the Resist Weightless Body Treatment with 2% BHA—which I use on my face even though it's recommended for use on the body. Any thoughts or suggestions would be welcome!

—Monica, via Paula's Choice Facebook page

Dear Monica,

It may seem frustrating, but this all comes down to a need to experiment. Many people can use an AHA or BHA exfoliant once or twice daily and see great benefits without any unwanted side effects. Then there are others whose skin reacts best to only once-daily application (morning or evening, based on personal preference). And, as you've experienced, some people need to apply less often than that to find that sweet spot where you see positive results without redness or irritation, which, ultimately, shouldn't happen.

I am curious as to what else you’re using as part of your daily skin-care routine. If you're using fragranced products—many of which are labeled "for sensitive skin" despite containing known irritants—the addition of an exfoliant may be exacerbating the irritation caused by the fragrance.

I encourage you to make sure all of your products are fragrance-free and, from there, experiment with the frequency of exfoliant application. Your ideal rate of application may be only twice weekly in the evening. Or perhaps your skin will do best if you alternate use of AHA and BHA formulas, using one the first week and the other the next week. There's no hard-and-fast rule here, so I encourage you to be patient. In time you'll find that ideal balance!

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Category: Skin Care

Dear Paula,
I have been prescribed 4% hydroquinone cream to use at night on some dark patches on my cheeks. At night I cleanse, apply Paula's Choice toner and AHA gel, and then use a retinol product recommended by you. At what point in this routine should I apply the hydroquinone? Should I avoid applying the retinol product on the dark spots where I apply the hydroquinone? I have heard that hydroquinone and retinol should not be used together.

Thank you for your help. I love your products and advice!

-Ellen

Dear Ellen,

Your question is a common one. There is a lot of confusion among women in trying to determine the point in their routine to apply a skin-lightening product or prescription retinoid product. And it's no wonder people are confused, because there is very little definitive information! Simply put, there's more than one acceptable way to apply your products and achieve great results. Here's what I suggest:

  • Cleanse and tone as usual
  • Apply the 8% AHA Gel, allowing approximately 30 seconds for it to set
  • Apply the retinol product all over your face, including around the eyes, up to the orbital bone
  • Apply the 4% hydroquinone product to dark spots

It's perfectly fine to use hydroquinone and retinol at the same time; my team and I haven't seen any research indicating otherwise. In fact, we've come across a lot of research showing that using hydroquinone and retinol (or prescription retinoids) together is more effective at lightening dark spots than using hydroquinone alone.

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Category: Skin Care

Dear Paula,
When using the Resist Anti-Aging Trio at night, at what point should I apply my prescription Vaniqa and Retin-A-Micro, which I also use daily? Since I'm putting on several "layers" of product, I need to make sure the prescription items reach my skin as effectively as possible.

-Ann

Dear Ann,

Great question! Knowing the right order to apply each product in your skin-care routine can be confusing, especially when you add prescription topical products to the mix.

Surprisingly, there are no firm, agreed-upon guidelines to go by. It's shocking, really; you'd think after all this time, that medical experts and pharmacists would have arrived at a consensus, but that's not the case.

So does this mean you are on your own here? Of course not! You've got help - my team and I are here to help you make sense of it all. Here's what we suggest.

When using the Resist Ultimate Anti-Aging Trio you should apply all three products at the same time, but only in the evening. We don't recommend applying the Resist BHA 9 during the day due to its texture; it's just not that compatible with makeup. Resist Intensive Wrinkle-Repair Retinol Serum can be applied in the morning, if desired, but is best used as part of your nighttime routine. Resist Pure Radiance Skin Brightening Treatment may be applied morning and/or evening.

Regarding the prescription products you're using: Apply the Retin-A Micro after the BHA 9, then apply Vaniqa where needed. Follow with the Pure Radiance Skin Brightening Treatment, and finish with Intensive Wrinkle-Repair Retinol Serum. Complete your routine by applying your nighttime moisturizer to dry areas, including around the eyes.

In the morning, skip the prescription products and the BHA 9, and apply the Intensive Wrinkle-Repair Retinol Serum and Pure Radiance products under your daytime moisturizer with sunscreen. If you want to pare down your morning routine, skip the Retinol Serum and go for the Pure Radiance (it gives skin such a nice glow), daytime moisturizer with sunscreen, and then makeup, if you wear it. You can find more information about how to apply the Resist Ultimate Anti-Aging Trio by visiting the FAQ tab on the product page.

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Category: Skin Care

Dear Paula,
For years I have heard conflicting opinions about whether or not silicone clogs pores. I know there are several different varieties of silicones and some say that certain types, such as dimethiconol, will clog pores, while others, like dimethicone, will not. Some of the products I like contain these ingredients, and I do struggle with clogged pores from time to time. Can you help me clear up this matter?

-Cynthia

Dear Cynthia,

Happy to help! Simply put, there is no research showing that any type of silicone used in skin-care, makeup, or hair-care products can clog pores. The very manner in which silicones work and their chemical structure keeps them on the skin's surface; they do not move inside the pore, which is where clogs form.

Can someone be allergic to silicones and end up with red bumps that resemble acne? Yes, that can happen, but such allergies are extremely rare, and in many cases there are other ingredients contributing to the issue.

I know that trying to determine what's causing clogged pores is tricky, and that it can be endlessly frustrating, so I completely understand your desire to identify a culprit. If you want to experiment with silicone-free products to see if your clogged pores become less of a problem, go for it, but be sure to stretch the experiment out over an extended period of time (at least two months) so you can see how and if the silicone-free products help and to see if the other products still address any of your other skin concerns.

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Category: Skin Care

Dear Paula,
What kind of review can you give me about Derm Exclusive by Dr. Andrew Ordon? I ordered his Micro Peel Resurfacing Pads, Intensive Repair Serum, Collagen Lift and Fill & Freeze Wrinkle Treatment. I used all for the first time last night. This morning my face feels tight and there is a slight stinging sensation. My skin also feels slightly swollen.

-Sandra

Dear Sandra,

We ordered the Derm Exclusive trial kit ($63) for review since many people were writing to us wondering if this doctor-promoted line was the anti-aging answer. As you've experienced, it isn't the answer to "expensive, painful" cosmetic corrective procedures nor is it as miraculous as the claims and before/after pictures make it seem.

Let's go over the products you applied, which are included in the company's trial kit:

  1. Micro Peel Resurfacing Pads contain a mix of AHAs and BHA (salicylic acid) plus peptides and some good anti-irritants. Fragrance is included, too, which isn't the best for anyone's skin. You're supposed to use one of the pads twice weekly. The pads have a pH of 4.1, so some exfoliation will occur. The company maintains this is a professional-strength peel, but they don't reveal the percentage of the chief AHA ingredient, glycolic acid. We suspect it's around 10–12%, which is great but hardly unique to this product.
  2. Intensive Repair Serum is another product with AHA, this time glycolic acid all by itself. This water-based serum's pH is 4.7, so it's borderline for exfoliation, a benefit that definitely improves signs of aging. Although that's disappointing, the serum does feel light and contains a very good mix of antioxidants and repairing ingredients, including some plant extracts that can help lighten dark spots. The inclusion of fragrance isn't welcome, though, and may be responsible for some of the irritation you experienced.
  3. Collagen Lift has a brief yet descriptive name, though it cannot lift skin. Supposedly inspired by in-office tightening treatments like Fraxel, this moisturizer is, well, just a moisturizer. It contains a series of good anti-aging ingredients, just like many others, but it cannot and does not equal results possible from in-office procedures that use lasers or radiofrequency to tighten sagging skin. Although we rarely report on our personal experience with skin-care products we review, we did note that this moisturizer caused a stinging sensation the longer it was on skin. This may be due to the fragrance ingredients it contains.
  4. Last but not least is the product most people asking about Derm Exclusive focus on, the Fill & Freeze. This brush-on wrinkle filler is said to provide results just like dermal filler or injections like Botox—without "the pain and hassle of visiting a dermatologist". Applied to lines and wrinkles, this slightly thick serum smooths the area and makes it feel a bit tighter owing to the amount of film-forming agents it contains. The polymer ingredients this contains do have a "filling" effect but it's temporary, lasting hours, so this isn't a great alternative to Botox or dermal fillers whose effects are not only more impressive but last up to six months before another treatment is needed.

I suspect the combination of too much fragrance and overkill with the AHA ingredients led to the reaction you had, but it's possible other ingredients were behind this experience. I'm not stating that everyone will have the same response to Derm Exclusive products, but the way these anti-aging products are marketed is definitely disingenuous and sad to be coming from a doctor who should know better.

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Category: Skin Care

Dear Paula,
If I put on my moisturizer first and then my over-the-counter retinol cream (RoC) will it be effective? Years ago I used a prescription retinol product which was very drying. My dermatologist said I could put my moisturizer on first and then the retinol cream. I just want to make sure that I won't diminish the effectiveness of the over-the-counter retinol by doing so.

-Joan

Dear Joan,

Your dermatologist's advice was spot-on! If you find retinol products (prescription or over-the-counter) to be drying, it is a very good idea to apply moisturizer first to offset the dryness you'd otherwise experience. Doing so won't diminish the effectiveness; it simply slows the penetration of retinol into skin, which is what helps minimize unwanted side effects.

Here are some other retinol tips to keep in mind:

  • Some people have great results from using retinol products a few times per week instead of nightly.
  • If you're using a skin-lightening product, that may be applied after your retinol product.
  • Use well-formulated moisturizers or serums and a shop/skin-care-categories/cleansers/">gentle cleanser and toner to help your skin better tolerate retinol.
  • Research shows that using a retinol product in conjunction with an AHA exfoliant significantly improves its effectiveness in treating sun-damaged skin. The exfoliant is applied after cleansing and toning, then follow with the retinol product (or, in your case, moisturizer then retinol product).

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Category: Skin Care

Dear Paula,
I feel like I've missed out on some big new development in cosmetics. What is BB cream? What does "BB" stand for? Why do women think it is so great?

-Laura T.

Dear Laura,

The 'BB' in BB creams stands for "beauty balm" or "blemish balm", though the typical BB cream isn't about treating blemishes. BB creams are supposed to provide color, coverage, sun protection and other skin-care benefits in one product.

You haven't missed out on anything but the cosmetics industry at large is excels at creating a frenzy for an allegedly revolutionary new product that's not as groundbreaking as it seems. Because most BB creams are said to provide multiple (time-saving) benefits in one, who wouldn't be curious? Most people don't want to spend any more time on skin care than they have to, and BB creams are often sold as primer, moisturizer, sunscreen, anti-aging serum and dark spot corrector in one! No wonder they've captured so much attention.

Although there are some excellent BB creams out there (my team and I have reviewed over 30 of them here), they are essentially just tinted moisturizers with sunscreen. Some BB creams provide more coverage than a tinted moisturizer, sometimes approaching the coverage and appearance of a good liquid foundation, but the majority of them are on the sheer side. They typically provide broad-spectrum sun protection, which is a prime anti-aging benefit but not unique to BB creams.

BB creams are also supposed to provide your skin with other anti-aging and/or skin-lightening benefits. Some do, some don't—and a lot contain only a dusting of the beneficial ingredients they boast on the label. In short, this isn't a must-try product category but if you're curious there are some great options out there. Just keep in mind they won't replace several key products in your skin-care routine, and any SPF-rated product needs to be applied liberally to get the stated amount of protection.


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Category: Skin Care

Dear Paula,
I'm a 21 year old male. My skin color is fair and skin type is normal/combination Like a lot of fair-skinned people, I have freckles. The thing is... what are they? You talk about age spots as being dark spots on the skin due to sun exposure which is what freckles are essentially. It sounds like I'm answering my own question there but I'd like your advice.

I know that freckles can be a genetic trait but is there a healthy way to get rid of them? I've considered your Resist Pure Radiance Skin Brightening Treatment but I am skeptical as I don't know what to expect due to my skin being a little bit sensitive.

I use the Skin Balancing System but my cheeks and nose are prone to going red after applying some of these products and my face feels a little bit tight. Perhaps you could specify a routine for my skin that could help?

Anthony, via email

Dear Anthony,

Essentially, freckling is your skin's way of protecting itself against sun damage, but since fair skin lacks an even distribution of skin pigment (chiefly melanin) you see small patches of excess pigment rather than an even tan.

Although both freckles and dark (or brown) spots are caused by unprotected sun exposure, freckles tend to be diffuse while dark spots occur in smaller areas. Also, if you're away from a sunny climate or take steps to protect your skin from further sun damage, freckles generally lighten on their own whereas dark spots almost always require more than sun protection to go away. And yes, as you mentioned, there's a genetic component to freckles, too.

I suspect one of the products in the Skin Balancing routine that's causing problems for you is the daytime moisturizer with sunscreen. You may want to try my Moisture Boost Daily Restoring Complex SPF 30, and be sure you're applying it every day. My CLINICAL Instant Calm Advanced Redness Relief is ideal for minimizing facial redness and it also makes a great after-shave, so give that a try, too!

As for using a lightening product on your freckles, yes, that's a good idea. My Resist Pure Radiance Skin Brightening Treatment is quite gentle and should work beautifully for you, but realize at least two months of daily use is needed before you'll see the full effect.

Last, you can consider a series of Intense Pulsed Light (IPL) treatments from a dermatologist. This non-invasive procedure is brilliant for lightening freckles plus red spots that are more apparent on those with fair skin. Good luck!


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Category: Skin Care

Dear Paula,
You always stress the importance of getting all your makeup off at night, and I totally get that. But most days I don't wear any makeup, and I was wondering if it is equally important that I wash my face thoroughly at night on those days (I just want to go to bed!).

Clara, via email

Dear Clara,

Believe me, I understand the desire to shorten the nightly routine, especially after a long day or when traveling. Unless you have oily or breakout-prone skin, I think it would be OK to forgo washing your face on nights you don't have makeup to remove. This assumes that you won't be using other skin-care products; you'll just brush, floss, and plop into bed, day be done!

If you do plan to apply other skin-care products, it's a good idea to go ahead and cleanse, even if you just do a couple of swipes with a disposable cleansing cloth. Cleansing isn't just about removing makeup: It's also for removing the day's accumulation of dead skin cells, excess oil, and dirt (though admittedly most of us don't get that dirty during a normal day). Think of forgoing the nightly face-washing as an occasional shortcut, not a permanent way to shave a moment or two from your skin-care routine.


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Category: Skin Care

Dear Paula,
I keep reading that it's not good to combine retinol with vitamin C, yet I see that combination of ingredients in more than one of your Resist products. What gives?

Georgie, via email

Dear Georgie,

Along with AHA and BHA ingredients (which, contrary to claim, are perfectly fine to apply at the same time as a retinol product), Vitamin C (ascorbic acid and its derivatives) is another ingredient that is often cited as a problem when combined with retinol. You can relax: It's perfectly fine (and in fact beneficial) to combine any form of vitamin C with retinol, whether in one product or applied via separate products.

Essentially, this misguided advice is a case of skin-care science being confused. Depending on the form, vitamin C requires a low pH or no pH at all, as is the case in non-aqueous, silicone-based formulas) in order to remain stable. We know from research that retinol works in an acidic environment and that skin's pH is naturally acidic, so it's a clear example where three isn't a crowd!

You may be surprised to find out that research has demonstrated combinations of vitamins in cosmetics are the way to go for best results, including the combination of vitamins A, C and E. In a double-whammy myth-buster, retinol proved to be not only an effective pairing with vitamin C, but the two worked beautifully to defend skin against free radicals when used in the morning under a sunscreen.

Then, there is the fact that as vitamin C helps fight free radicals, it also helps protect retinol from oxidization as it penetrates deeper into skin—thereby increasing its anti-aging benefits to your skin! So, in the end, the question isn't should you combine retinol with vitamin C—it's why wouldn't you do exactly that!


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Category: Skin Care

Dear Paula,
At night I use prescribed retinoid product and then I apply your Resist Super Antioxidant Concentrate Serum. I read in a magazine that mixing retinoids with vitamin C may end up canceling out the benefits of both. Is this true?

Maria, via email

Dear Maria,

I am asked this question fairly often, almost always after a magazine or beauty blog advises against applying retinoids and vitamin C at the same time. The logic typically has to do with each product's ideal pH range, yet this is rarely explained in magazines (they just state not to mix the two and leave it at that, which confuses lots of women).

The truth is there's no recent research proving that applying a retinoid with a vitamin C product inhibits the efficacy of either product. The key is to make sure the retinoid and vitamin C are stable, which can be tricky, but if you follow our recommendations on Beautypedia you'll be able to avoid the unstable products and see great results.

What's rarely mentioned is the research showing that vitamin A (retinol) and C (ascorbic acid, but other, more stable forms are often used in skin care) can happily coexist in one formula without either degrading to the point where you won't see results (Sources: Molecules, February 2012, pages 2,219–2,230; Journal of Cosmetic Science, July-August 2011, pages 405–415; and International Journal of Cosmetic Science, December 2008, pages 453–458).

The bottom line: There is no research-supported reason to avoid applying a retinoid and vitamin C product at the same time. However, if you remain concerned, the solution is simple: apply your tretinoin product at night, and apply the Resist Super Antioxidant Concentrate Serum in the morning.


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Category: Skin Care

Dear Paula,
I have a graduate degree in Neuroscience and a keen interest in skin care and cosmetics. I would first like to thank you for your excellent, honest, research-based product reviews as well as your superior-quality product selection, which my family and I use and love. I have combination skin that can get sensitive and flaky, and I have had difficulties with acne since I was a teenager (I am now 25). I am still having trouble finding a foundation that provides adequate (light-medium) coverage that also looks good (natural, blends well, does not settle), lasts the day, and, most importantly, does not aggravate my acne. I am rather baffled as to what exactly to look for in a foundation formulation. I'm sure that my problem is a fairly common one, and I was hoping that you would be able to clarify what it is that women with acne-prone skin should be looking for and avoiding when it comes to foundation, and whether you can recommend any specific products.

Fran, via email search

Dear Fran,

Thank you for the positive feedback! You know, one of the reasons I suspect there are so many foundations on the market (and several new ones launching every month) is the wide range of personal preferences women have when it comes to this basic makeup need. Your requirements (and frustrations) are shared by many, and cosmetics chemists the world over are aware of it and are continually striving to create foundations that meet these criteria.
Getting the coverage you need while at the same time maintaining a natural look is relatively easy using today's best foundations. Just keep in mind that natural-looking is a relative term, because even the best foundations can still look like makeup. You probably understand that you won't necessarily be fooling anyone into thinking you're bare-faced while covering imperfections or evening out your skin tone. Finding a foundation that doesn't settle into lines is trickier, but application technique can help a lot. Using a sponge and buffing off the excess makes a difference, and setting this with a thin layer of sheer, silky powder can work wonders. Also, it can help to use only the lightest layer of moisturizer possible under your makeup, because less slip under the foundation helps keep it in place. So for your skin type, a well-formulated toner (loaded with antioxidants, skin-identical ingredients, and cell-communicating ingredients) can help a great deal.
Finding a foundation that doesn't aggravate acne isn't easy because what makes you break out may not be the same thing that makes someone else break out. It really comes down to trial and error. You may find several foundations that meet all of your other requirements, yet eventually make your acne worse. That's the agony and ecstasy. Therefore, the following foundations I am recommending are provided with the caution that there is no way to know for sure if they will exacerbate your tendency to break out. They are, however, all fragrance- and irritant-free and as such are better suited for your sensitive skin, and they all contain sunscreen so you don't need to wear an extra layer under your foundation:

  • L'Oreal True Match Super Blendable Makeup SPF 17
  • Paula's Choice Best Face Forward Foundation SPF 15
  • Almay Nearly Naked Liquid Makeup SPF 15
  • Revlon ColorStay Makeup with SoftFlex for Normal to Dry Skin SPF 15 (even though it is labeled for normal to dry skin, it is best for combination or oily skin types).



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Category: Skin Care

Dear Paula,
I have a very basic question about moisturizers. A couple of hours after you apply a moisturizer to your body or face, should you be able to feel a layer of something there for it to be effective? Dove's body moisturizer just soaks in, while Olay's body moisturizer leaves a discernible layer on your skin. So, which one is more effective?

Terri, via email search

Dear Terri,

That is a great question and not all that simple. Fortunately, the answer is quite simple: It's all about personal preference. The finish or feel of a moisturizer, for the most part, is about how it makes your skin feel. Even those who have dry skin may prefer a matte-finish moisturizer, while someone with normal skin may like to "feel" a protective barrier on their skin. Well-formulated moisturizers that contain the right ingredients do not depend on the base for their effectiveness. However, some skin types (e.g., extremely dry skin) can't get by with just healthy ingredients; they also need emollients sitting on top of their skin to soothe and provide protection for an impaired surface barrier. Think about it in terms of eating grapes versus drinking grape juice or red wine. Either way your body is getting antioxidants, the form they take is merely a personal preference.

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Category: Skin Care

Dear Paula,
I am a 26-year-old female in graduate school. I lead a very stressful life and I have aged substantially over the last three years. I still have breakouts, usually due to stress and hormones. I have these consistent small bumps in my skin so it looks rough. My pores are so huge that I can see them in a mirror standing three feet away. I also have a lot of blackheads on my chin and nose. I am starting to develop cysts around the jaw line that don't go away. Some cysts have been around for more than a year. There is discoloration in my skin some redness around the cheeks mostly. I have tried everything: benzoyl peroxide, salicylic acid, glycolic acid, skin-care lines like Murad, Shiseido, DDF, and more. Nothing seems to work. My skin is very temperamental. I have an oily T-zone, but it dries out fast due to some harsh products that I might use or the weather. When it gets dry I'll break out and the skin will be flaky. I don't know what to do. I was hoping you could recommend a skin-care regimen for my face, neck, and back (as I have major breakouts there too). Please help!

Katy, via email search

Dear Katy,
Whenever someone tells me they use everything, my initial reaction is to always want more specifics. Were they well-formulated products, did they contain irritants, did you also use moisturizers that were too emollient for your skin, or was the cleanser too irritating or the ingredients too harsh and on and on. Lacking more details, if you have indeed used "everything" and they were appropriately formulated (which seems truly unlikely, but anything is possible), then your next step would be to see a very good dermatologist to help evaluate what is happening to your skin. In some ways it sounds in part like rosacea and in part like a type of cystic acne or some other systemic skin condition. None of that can be treated with skin-care products alone. Until you get the right medication and understand what makes your skin happy, there isn't much else to do.

In the meantime, there are a few steps you must always follow. Do wash your face with an extremely gentle cleanser, use a clean washcloth at night with the cleanser to be sure you are getting all your makeup off, and wear a sunscreen during the day. A foundation with sunscreen that only uses the actives titanium dioxide and/or zinc oxide would be best because they pose no risk of irritation or sensitizing the skin.

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Category: Skin Care

Dear Paula,
I swim a couple of times a week for 60 to 90 minutes in a chlorinated pool. Is there any way to minimize the dryness of being in the water for that long plus rinsing off afterwards? Just wondering if you have any tips or suggestions as to how this might affect my skin. I know it's not so good to soak for prolonged periods in the bathtub, so I'm wondering what affect swimming has.

Zia, via email search

Dear Zia,
You're right; prolonged soaking in water of any kind breaks down the skin's intercellular matrix (the substances that keep skin cells connected—think of it as the mortar that holds the bricks of the skin cells together, creating the outer appearance of skin). There is nothing you can do about the time you spend in the water. Anything you would put on your skin would be depleted fairly quickly and just make a muck of the water (requiring the people who maintain the pool to use more chemicals to keep the water looking clear and pristine""and that's not good for your skin either). The benefits of swimming far outweigh the negative effect on your skin, so aftercare is very important. Taking a shower afterward is incredibly important, but be sure to use a gentle or moisturizing body shampoo that won't strip your skin any further (Dove and Olay have some great moisturizing body washes). When you get out of the shower, towel off gently and then apply a body lotion that contains ingredients that give your skin back what the swimming depleted, such as ceramides, hyaluronic acid, lecithin, glycerin, and lots of antioxidants. That will restore to some extent what your time in the pool took away.

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Category: Skin Care

Dear Paula,
It was wonderful hearing you speak in Stockholm recently. You mentioned that you recently reviewed the popular European line, Lumene. Would you share your research with us?

Signed,
Sofia via email search

Dear Sofia,
Thank you for writing. It was my great pleasure to meet you and so many of my European readers during my recent media tour.

European import Lumene has been on the scene across the ocean for more than 35 years, yet it's still a relative newcomer to the United States retail market, having debuted with minimal advertising and promotion at CVS drugstores in summer 2003. As of this writing, Lumene is still exclusive to CVS. Lumene consists of a large (and I mean really, really large) selection of products they promote as being "The Secret to Natural Beauty." Well, there are no secrets to be found in this line, only lots and lots of mediocre (and I mean really, really mediocre) products bearing claims that range from the typical absurd to the ludicrous.

Particularly ludicrous is Lumene's use of supposedly rare Arctic or Scandinavian ingredients, including arctic cloudberry, peat, and water lily. But none of these have substantiated research proving their benefit for skin, you just have to take Lumene's word for it. Even if such research existed and Lumene was onto something no one else was privy to, the amount of the aforementioned ingredients in their products is barely a dusting. If this is Lumene's idea of "advanced technology," then they should have paid closer attention to established research because several key elements are either missing or come up short in these products. For example, it is well established how beneficial antioxidants are when added to skin-care products, and particularly sunscreens. Lumene includes them occasionally, but not in any significant amount and often not in packaging that will help keep them stable once the package is opened. Another issue is that although all of their sunscreens contain UVA-protecting ingredients, a few of them sport woefully low SPF ratings, making them poor choices for protection. So much for advanced technology! This is also not a line to shop if you're looking for an effective AHA or BHA product or for products with cell-communicating ingredients.

Despite these shortcomings, a few worthwhile products can be found, and Lumene's price point is considerably lower than that of many neighboring lines such as Olay and Neutrogena. The exception to that is their Premium Beauty subcategory, which is about as premium as Wonder Bread. There are a couple of good serums and eye-area moisturizers to consider, as well as some basic though effective options from Lumene's cleansers, eye-makeup removers, and sunscreens rated SPF 15 or higher. Given the size and scope of this line (did I mention that it's huge?), you have to be extra careful to be sure you're getting a worthwhile product that really will make a difference for your skin. After all, a bargain is no bargain if it doesn't add up to great skin care. For more information about Lumene, visit www.lumene.com or www.cvs.com.

LUMENE Blue & Blue Sensitive Products

Blue Hydra Drops Moisturizing Day Cream SPF 4 ($10.49 for 1.7 ounces)features a pitifully low SPF rating that is absolutely insufficient for daytime protection, even though its sole active ingredient is titanium dioxide. Even if the SPF were what it should be (the minimum is SPF 15 according to the American Academy of Dermatology, www.aad.org), this is a very boring moisturizer with lackluster, ordinary ingredients. This is not recommended over superior daytime moisturizers from Olay, Dove, or Neutrogena, among many others.

Blue Hydra Drops Moisturizing Eye Gel ($10.49 for 0.5 ounce) boasts the "freshness of pure spring water," but fresh or not, water alone isn't enough to make eye-area skin look and feel better. The only ingredient of merit in this lightweight gel is glycerin, but it's accompanied by a dry-finish ingredient that likely disrupts (at least partially) its hydrating benefits. A couple of intriguing ingredients are present, but are listed well after the preservative, along with some potential irritants. All in all, this adds up to a below-average eye gel.

Blue Hydra Drops Moisturizing Night Cream ($10.49 for 1.7 ounces) is a basic emollient moisturizer for dry to very dry skin. It contains mostly water, thickeners, vegetable oil, glycerin, plant oils (including olive oil), preservative, silicone, anti-irritant, and fragrance. For basics this will do, but your skin deserves more.

Blue Hydra Luminous Matt Tinted Day Cream SPF 6 ($10.49 for 1.7 ounces)includes avobenzone for UVA protection, but SPF 6 is embarrassingly low for anyone who takes daily sun protection seriously (and that is the only way to take it!). The base formula is almost as boring as the Blue Hydra Drops Moisturizing Day Cream SPF 4 above, except for its sheer, almost imperceptible tint. It also includes tiny quantities of vitamins, but your skin deserves better than a token amount.

Blue Hydra Drops Intensive Moisturizing Mask ($10.49 for 2.5 ounces)has claims that make it sound like a dream product for sensitive skin in need of soothing. However, this is a rather basic, fragrance-free mask that lists denatured alcohol as the fifth ingredient, meaning that it's neither that intensive nor particularly beneficial for dry skin. It's a decent though unimpressive moisturizer for normal to slightly dry skin and contains a tiny amount of oat extract to support its anti-irritant claim, but in name only.

Blue Sensitive Tender Drops Soothing Moisture Cream ($15.99 for 1.7 ounces)has some promising ingredients for skin, including ceramides, anti-irritants, and antioxidant vitamins. However, their presence is a mere dusting, and even if there were more significant quantities, this moisturizer's jar packaging wouldn't keep the antioxidants stable for long. This is a good, though unexciting, fragrance-free emollient moisturizer that's an OK option for dry to very dry skin.

Blue Dream Lips Age-Defying Lip Care ($4.99 for 0.5 ounce) doesn't list an SPF rating on the package, but the active ingredient list reads: "Titanium Dioxide SPF 4." That type of sunscreen labeling is not what the FDA mandates for sunscreens, but given that Lumene products are made in Europe (where sunscreens are not sold as over-the-counter drugs), that's forgivable. What's not as easy to overlook is the SPF rating itself, which is way too low for protection. Independent of the sunscreen issue, this is a very well-formulated lip balm that contains a blend of petrolatum (Vaseline) with other emollients and olive oil. It will nicely protect and nourish dry, chapped lips; it just isn't the best option for daytime unless you apply another lip sunscreen or opaque lipstick afterward.

LUMENE Lifting Products

Lifting Time Freeze Targeted Wrinkle Treatment ($18.99 for 0.47 ounce) is one of those products where the claims, not the quality, define the elevated price tag. Bringing "a little magic to your skin care routine"¦ with surgical precision" is definitely a lofty assertion, but this product doesn't deliver any of that or have any line-smoothing benefits. This fragranced product also contains the menthol derivative menthyl lactate, and as such, it's too irritating to use around the eyes and is a waste anywhere else.

Lifting Magic Drops Instant Beautifyer ($19.99 for 1 ounce) is another water-based serum claiming to smooth fine lines, this time with a "Lumene bio-communicator compound" of natural ingredients. The minuscule amounts of seaweed, soy, and water lily extract in here won't reduce wrinkles. All in all, this is more of a plasticizer for skin than a state-of-the-art antiwrinkle treatment providing skin with beneficial ingredients.

Lifting Skin Supporter Day Firming Day Cream ($19.99 for 1.7 ounces) doesn't show an SPF rating other than mentioning SPF 4 on the active ingredient list (as in the Blue Dream Lips Age-Defying Lip Care above), which is not permitted for U.S.-manufactured sunscreen products. Regardless of regulatory issues, an SPF 4 (even if the product contains the UVA-protecting ingredient avobenzone) is too low for reliable daytime protection. Were this rated SPF 15 and packaged in an airtight container, it would be a good choice for those with dry to very dry skin. As is, it has more shortcomings than positives.

Lifting Skin Supporter Eye Firming Eye Cream ($18.99 for 0.7 ounce) is a good, though somewhat basic, moisturizer that is suitable for use around the eye area, although it would be better without the fragrance. It contains mostly water, thickeners, plant oil, algae, wax, anti-irritants, plant extracts, glycerin, and preservatives. Although light in texture, its oil content makes it best suited for dry skin around the eyes or elsewhere.

Lifting Skin Supporter Night Firming Night Cream ($19.99 for 1.7 ounces) is a passable choice if you have dry to very dry skin and want an emollient moisturizer that's not overly greasy. However, the rather short supply of antioxidants and the jar packaging don't add up to great skin care. Although this has merit for making dry skin look and feel better, it almost goes without saying that skin deserves more than what this moisturizer provides (and it won't lift your skin in any way, shape, or form).

Lifting Time Freeze Instant Lift Mask ($18.99 for 2.5 ounces) contains enough alcohol and menthyl lactate (a menthol derivative) to be considered too irritating for all skin types. Its lifting and "freezing" ability is fictional.

LUMENE Vitamin+ Products

Vitamin+ Energy Cocktail Fortifying Cream ($17.99 for 1.7 ounces) claims to pamper dry skin from the first application, and like most moisturizers with a basic blend of vegetable oil, thickeners, and emollients, it will do just that, albeit not with the most elegant texture or interesting formula. The vitamin E that is present won't remain stable in the jar packaging once the product is opened.

Vitamin+ Energy Cocktail Pampering Drops ($17.99 for 1 ounce) is a decent serum consisting primarily of water, jojoba, thickeners, plant oils, glycerin, and vitamin E. Other antioxidants are also included, but they don't account for much of the formula. However, this is still worth considering if you have dry skin, and it can be used alone or paired with another moisturizer.

Vitamin+ Radiant C-Energy with SPF 15 Age-Defying Day Cream ($17.99 for 1.7 ounces) contains an in-part avobenzone sunscreen in a lightweight base suitable for normal to slightly dry skin. Unfortunately, that's the most enticing part of this jar-packaged moisturizer. It contains several antioxidants, but they are listed after the preservatives. Given that, and the packaging that exposes them to light and air, your skin won't come out ahead. The big-deal ingredient in this product is arctic cloudberry (Rubus chamaemorus), which Lumene maintains gives your skin energy. I couldn't find any published research supporting this claim, but did discover a German publication that examined the fatty acid content of several berry species from Finland, including those in the Rubus genus, and they stated that this ingredient (as it is used by Lumene in its oil form) is considered a good source of triglycerides (fatty acids) for skin (Source: www.springerlink.com/content/j4mxw0yt4cwlhyfp/). That makes it good for dry skin, but it won't change the energy or age of your skin.

Vitamin+ Radiant C-Energy Age-Defying Intensive Care ($15.99 for 1.7 ounces) is supposed to prevent premature aging of skin due to its reservoir of antioxidants, but the only antioxidant of note in here is vitamin E, and even that is in limited supply, not to mention that the jar packaging would not keep it stable anyway. In addition, almost all of the unique or interesting ingredients are listed after the preservatives, as seems to be the pattern for Lumene moisturizers in general.

Vitamin+ Radiant C-Energy Eye Intensive Renewing Eye Serum ($15.99 for 0.34 ounce) has a unique roll-on applicator and a relatively interesting formula that packs more of a skin-friendly punch than most of the other Lumene moisturizers. That makes it a standout in this line""although when compared to other well-formulated products, this would be at the end of the list. It contains a decent blend of glycerin, plant oil, soothing agents, water-binding agents, and stabilized vitamin C, is fragrance-free, and is suitable for use around the eye area.

Vitamin+ Radiant Dual Serum Energising Morning Serum & Age-Defying Night Serum ($17.99 for 1.7 ounces) is a two-part product that, just like all the others in the Vitamin+ line, purports to give your skin energy and renewed radiance. Energising Morning Serum (no confusion here as to when this product is to be used) is mostly water, emollient, glycerin, several film-forming agents, and preservative. The peptides and other intriguing ingredients are barely noticeable. Without sunscreen, there is no advantage to using it during the day rather than the evening. All you can expect from this serum is slight hydration. Age-Defying Night Serum is essentially a more moisturizing version of the Morning Serum. Otherwise, the same basic comments apply, and there is nothing about this serum that makes it an advantage to skin when used in the evening. The two-part system is far more gimmicky than helpful and there's no reason to believe Lumene's "instant energy" claims.

Vitamin+ Retinol Night Revitalizer Age-Defying Night Cream ($15.99 for 1 ounce). In comparison to other Lumene moisturizers, this is a fairly impressive formulation and the packaging is appropriate to keep the product stable. For normal to very dry skin, this is a consideration.

Vitamin+ Vita-Nectar Vitalizing Day Cream SPF 15 ($14.99 for 1.7 ounces) is worth considering for its in-part avobenzone sunscreen, but the rest of the formula, while not terrible, is just ordinary, with no notable difference from any standard sunscreen. It is best for normal to dry skin.

Vitamin+ Vita-Nectar Eye Vitalizing Eye Cream SPF 6 ($14.99 for 0.7 ounce)lists titanium dioxide as the only active ingredient, but on its own an SPF 6 is too low to use for daytime protection. Once again, Lumene's idea of antioxidants in skin-care products has seemingly more to do with window dressing than efficacy, although this is a well-packaged, slightly emollient moisturizer for normal to dry skin. It would earn a happy face rating if its sunscreen were at least SPF 15.

Vitamin+ Vita-Nectar Vitalizing Night Cream ($14.99 for 1.7 ounces) has slightly more antioxidants than the typical Lumene moisturizer, but given Lumene's over-reliance on jar packaging that's not saying much. This is an average water-and-wax moisturizer that cannot forestall premature aging, but the amount of avocado oil it contains is helpful for dry skin.

Vitamin+ Radiant C-Energy 5-Min. Mask Invigorating Facial Mask ($15.99 for 2.5 ounces). You might as well rinse this off after five minutes because your skin won't receive much benefit from this mask no matter how long you leave it on. This very basic concoction of water, thickener, silicone, glycerin, and more thickeners is acceptable for normal to dry skin, but don't expect an application of this to rid your skin of the lingering signs from even a week's worth of fatigue!

LUMENE Premium Beauty Products

Premium Beauty Rejuvenating Day Cream SPF 15 ($29.99 for 1.7 ounces)deserves credit for including an in-part avobenzone sunscreen, but that's about it. The overall formula is tailored to those with dry skin, although antioxidants are barely present, which doesn't jibe with this product's name or its price point. The price for this product is preposterously high given its similarity to all of the other moisturizers in the Lumene line that cost a lot less. Lumene attributes the product's firming ability to peptides, yet they're clearly an afterthought, and there isn't substantiated research proving they firm skin anyway, though they can be useful skin-care ingredients. This is an effective moisturizing sunscreen for normal to dry skin, but it isn't a premium choice by any stretch of the imagination.

Premium Beauty Rejuvenating Eye Cream ($22.99 for 0.5 ounce) will pique the interest of those who are endlessly trying to get rid of dark circles in the under-eye area because Lumene claims that's what this moisturizer is for. But it is merely another ordinary eye cream for normal to dry skin, containing a standard blend of water, plant oil, absorbent, and thickeners. The dark circle-eliminating ingredient is the bioflavonoid hesperidin methyl chalcone. Although there is some research pertaining to this ingredient's effect on edema (swelling) and capillary function when administered internally, there is no research proving that it has any effect on dark circles. Darkness under the eye isn't usually due to a problem with weak capillaries or edema. Rather, undereye skin is so thin that in some people the blood passing through veins under the eye produces a bluish to purple discoloration. There are other causes of dark circles, too, such as lack of sleep and allergies, but the fact remains that hesperedin methyl chalcone is not the answer for treating the problem.

Premium Beauty Rejuvenating Instant Serum ($29.99 for 1 ounce) is premium in name only, and its rejuvenating ability is minimal due to a lackluster formula in which the only helpful ingredients are listed well after the preservative. This is an OK, serum-type moisturizer for normal to slightly dry skin, but it absolutely will not delay the formation of new lines or even-out age spots (pigment discolorations). It does contain small amounts of several fragrant components that can be problematic for sensitive skin, or for all skin types when used around the eye.

Premium Beauty Rejuvenating Night Cream ($29.99 for 1.7 ounces) is the cream version of the Premium Beauty Rejuvenating Instant Serum above, and the same basic review applies. The main difference is that this Night Cream adds the emollients and thickeners necessary to create the product's texture. Lumene claims the tiny amount of sea buckthorn oil in this will promote the regeneration of skin cells, but don't count on it. This is an average moisturizer that is best for normal to dry skin""but your skin deserves a lot more than this product can provide.

Premium Beauty Age Spot Treatment ($27.99 for 0.5 ounce) boasts of its ability to lighten and even-out age spots while keeping them from becoming darker. This is merely a moisturizer masquerading as a skin-lightening product because none of its ingredients have a proven track record for reducing hyperpigmentation. The two types of vitamin C in this "treatment" have shown promise for helping hyperpigmentation, but in amounts substantially larger than what Lumene uses. This is barely recommended as a basic moisturizer for normal to slightly dry skin.

Premium Beauty Rejuvenating Lip Care ($27.99 for 0.5 ounce) is a thick-textured cream recommended to enhance the fullness of your lips as it smooths the lines around them. The fullness effect comes from the irritation caused by the peppermint and menthyl lactate it contains. There are countless other lip balms that do not contain irritants to choose over this expensive mistake.

Other LUMENE Products

Express Touch Cleansing Wipes ($2.49 for 10 wipes) are a quick, convenient way to remove makeup or refresh skin. Despite the low price, these aren't much of a value. The cost per cloth works out to be nearly 25 cents each, while similar options from Pond's, Olay, Aveeno, and Dove cost less. If you opt to try Lumene's version, their formula is best for normal to dry skin not prone to blemishes.

Matt Touch Balancing Gel Cleanser ($8.99 for 5.1 ounces) is a very basic, water-soluble cleanser that is only capable of controlling shiny skin by removing surface oil, just like many similar cleansers. If you have naturally oily skin, you'll see shine in the same amount of time, so this option, while effective as a cleanser for normal to oily skin, isn't distinctive.

Milky Touch Gentle Cleansing Emulsion ($8.99 for 6.8 ounces) is a standard cleansing lotion that does not contain detergent cleansing agents. That makes it a gentler option for dry, sensitive skin, and it rinses surprisingly well (though you may need a washcloth to remove stubborn makeup). This can remove eye makeup, as Lumene recommends, but it would be better suited for the eye area if it didn't contain fragrance.

Moisture Dream Revitalizing Cream Cleanser ($8.99 for 5.1 ounces) is a good, water-soluble, foaming cleanser for normal to slightly dry skin. It can remove makeup and it rinses well, so don't misconstrue the cream portion of the name as meaning this is akin to a typical cold cream.

Absolute Away Eye Makeup Remover for Waterproof Makeup ($5.99 for 4.2 ounces) is a dual-phase, water-in-silicone eye-makeup remover that works well to break down long-wearing makeup, including waterproof mascara. The small amount of witch hazel it contains isn't likely to be problematic even for use around the eyes.

Gentle Eye Makeup Remover ($5.99 for 4.2 ounces) is indeed a gentle, water- and glycerin-based liquid that removes most types of eye makeup, but isn't as adept at removing mascara (waterproof or not) as is the Absolute Away Eye Makeup Remover above. This is worth trying, although the cleansing agents are best rinsed from the skin instead of left on.

Arctic Touch Dual Action Exfoliating Cream ($8.99 for 3.4 ounces)combines a cleanser and scrub in one product whose oil content makes it preferred for normal to dry skin not prone to blemishes. Polyethylene (ground-up plastic) is the abrasive agent, and the moisturizing ingredients in this cleanser keep it on the gentle side, even if you get a bit overzealous while massaging it on skin. The oils impede rinsing slightly, but their overall effect on dry skin makes this side issue easy to live with.

Dream Mist Hydrating Water Spray ($7.99 for 5.1 ounces) could not be a more basic toner if it were just water, which is mostly what this contains. More dreary than dreamy, this is almost not worth using at all given its limited benefit for skin, but it's an option if your skin is normal all around and you just need a little help removing excess makeup that your cleanser may have missed.

Matt Touch Balancing Facial Tonic ($8.99 for 6.8 ounces) lists alcohol as the second ingredient, which makes this toner too irritating for all skin types. Alcohol doesn't tighten pores, it just irritates your skin and causes it to swell, which momentarily makes pores appear smaller. That isn't helpful for skin in the least and can be problematic in the long run.

Milky Touch Alcohol-Free Facial Tonic ($8.99 for 7 ounces) is another ho-hum product from this poorly conceived skin-care line. It will help complete the cleansing process, but this bland blend of mostly water, castor oil, and preservative cannot balance skin functions, and castor oil can feel sticky on the skin. Think of this as Twinkies for the skin, just not as much fun.

Moisture Dream Revitalizing Facial Tonic ($8.99 for 6.8 ounces) has a couple of bells and whistles present in trivial amounts, but is otherwise nearly identical to the Milky Touch Alcohol-Free Facial Tonic above, and the same comments apply.

Matt Touch Balancing Moisturizer ($8.99 for 1.7 ounces) makes the too-good-to-be-true claim of being able to provide moisture to dry areas while keeping oily areas shine-free. This very basic moisturizer has a soft matte finish on skin, but its emollient content (the second ingredient) isn't helpful for those with oily areas. The fact that this moisturizer is marketed to teens doesn't excuse Lumene from ignoring many fundamentals about what it takes to create a state-of-the-art moisturizer, but that's pretty much what they've done. There are lots of beauty bargains that can be beautiful for skin, but this isn't one of them.

After Sun Soothing Emulsion ($13.99 for 6.8 ounces) comes with claims that make it sound like you can bask in the sun all day, develop a beautiful tan, and one application of this lotion will repair any damage while enhancing your bronzed result. I despise this kind of product advertising because it crosses the line between claims that are just not true and claims that are actually dangerous for your skin. Adding insult to injury is the fact that this is a really basic, unimpressive moisturizer. It will remedy minor dry skin problems, but so will most every other moisturizer being sold. The very small amount of cloudberry oil won't soothe or repair sun-damaged skin.

Sun Defence for Face Age-Defying Sun Cream SPF 30 ($13.99 for 1.7 ounces) is a good moisturizing sunscreen primarily because it contains avobenzone for sufficient UVA protection. Nothing about the formula is specific to facial skin and, as is the case for most Lumene products, antioxidants are in short supply. The formula is preferred for normal to slightly oily skin.

Sun Defence Protective Sun Care SPF 15 ($17.99 for 6.8 ounces)contains an in-part avobenzone sunscreen in an ordinary, lightweight lotion base best for normal to oily skin. Lumene's touted Sun Essence compound (consisting of antioxidant plant extracts and vitamin E) sounds promising, but there is too little of it in this product to add anything to the sun protection the active ingredients provide.

Sun Defence Protective Sun Care SPF 45 ($17.99 for 6.8 ounces) is nearly identical to the Sun Defence Protective Sun Care SPF 15 above in terms of its base formula, but the percentage and number of active ingredients is greater, which gives it a higher SPF rating. Otherwise, the same review applies.

Arctic Touch Purifying Peat Facial Mask ($8.99 for 3.4 ounces) lists peat as its second ingredient. Peat is partially decayed vegetable matter, and although it may seem intriguing due to its organic nature, peat isn't a skin-essential ingredient in the least. This mask also contains kaolin (clay), along with several thickening agents, none of them capable of purifying skin. It's an OK absorbent mask, but that's about it.

No Spots Targeted Blemish Care ($4.99 for 0.14 ounce) is an anti-acne treatment containing 1.5% salicylic acid (BHA) as its active ingredient. Unfortunately, there is too much alcohol present, which makes this too irritating for all skin types. That's a shame because without the alcohol, this would have been an effective, pH-correct BHA product.

LUMENE Men's Skin Care Line

Deep Cleanse Face Scrub ($8.99 for 3.4 ounces) is a very good facial scrub for dry to very dry skin. Its key ingredients are plant oils and polyethylene (ground-up plastic) as the abrasive agent. This doesn't rinse very easily and the film it leaves behind isn't the best for men who are about to shave, but some may find this side effect protective. Women with dry skin may also find this a gentle scrub option""that is, if they don't mind the masculine-oriented fragrance. (As a side note, it can be argued that men don't need facial scrubs because they shave, which is plenty of exfoliation for that area of the face.)

Easy Shave Shaving Foam ($5.99 for 6.8 ounces) is a basic, propellant-driven shaving foam that contains enough moisturizing agents to make it best for normal to dry skin. The price is in line with other drugstore shaving foams, but you can certainly find less expensive options from the Colgate and Edge brands.

Advanced C-Energy, Renewing Face Cream ($12.99 for 1.7 ounces) lists lots of interesting, effective ingredients for skin, which makes it a decent option for normal to slightly dry or slightly oily skin, but please don't rely on the claim that it balances sebum (oil) secretion because that is far beyond its capabilities.

Magic Lotion Active Anti-Aging Lotion ($12.99 for 1 ounce) is a stunningly boring moisturizer that contains too few beneficial ingredients for skin (mature or not), and then makes matters worse by adding irritating menthyl lactate. This product is not recommended.

Sensitive After-Shave Soothing Balm ($8.99 for 3.4 ounces) would have been a much better (but still numbingly standard) after-shave balm if it did not contain the irritating menthol derivative menthyl lactate. This product is a definite problem for men with sensitive skin, especially if it's applied after shaving!

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Category: Skin Care

Dear Paula,
What causes fingernails to split and break? Is there anything I can do about it?

Connie, via email search

Dear Connie,
You would think with all the nail products available everyone would have strong, durable nails that grow long without breaking or peeling. Sadly, we know that isn't true, but we keep hoping. Much like the hair we are born with, the kind of nails we have is pretty much genetically predetermined. Some of us are born with tough, sturdy, resilient, and almost unbreakable nails, while others, like me, have paper-thin nails that easily split, peel, and break. Unfortunately, there is very little that can be done to change this predetermined trait. There is little to no research showing that vitamin or herbal supplements can improve or change the condition of your nails. In fact, the only research that exists is dated (Cutis, April 1993, pages 303-305), and it indicates only that biotin supplements may help some people; however, this was a limited study (there are no others) and the conclusion was that biotin is probably no more helpful than moisturizing or being careful about soaking your nails in water. There's no evidence that applying or eating gelatin, calcium or other minerals, other vitamins, or herbal supplements will improve or strengthen your nails.

Healthy nails that become weak or that show a dramatic change in their appearance and growth can indicate the presence of a serious medical condition. If your nails were previously doing great and suddenly undergo a noticeable negative change, you could be experiencing health problems that require medical attention. Extreme color change, severely scooped nails, pitting in the nail, and nails lifting from the nail bed are just a few of the changes that need medical attention rather than just a shopping spree at the drugstore or an appointment with a manicurist (Source: www.mayoclinic.com).

While the severe nail conditions I just listed require medical attention, peeling nails and some breakage or weakness along the upper edge of an otherwise normal-looking fingernail is nothing to worry about. Aside from genetics, the most common cause of split or peeling nails is repeated wetting and drying. Nails swell when they absorb water and shrink as they dry. As they undergo this shrinking and drying process, the nail cells and layers lose their ability to adhere to one another. The layers subsequently separate along the outer nail edge, where air dries the nail from beneath.

You can protect your fingernails in the same way you protect your hands: wear rubber gloves when doing household chores. As often as you can, especially after long immersion in water, massage a moisturizer or just plain olive oil (it's a great emollient and antioxidant) over and around the nail and cuticle, which helps protect the nail. Trim your nails gently with fingernail clippers and file them using a fine-grained file or emery board. Nail polish remover can be drying, so apply moisturizer after using it. As a rule, don't severely push back or cut the cuticles, because the cuticle protects new nail growth.

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Category: Skin Care

Dear Paula,
My question is about retinol. I have read many of the articles you have online and know that Retin-A should not be combined with benzoyl peroxide, and that it makes sense to use one at night and the other in the morning. I have some questions related to that. Does this same directive apply to over-the-counter moisturizers containing retinol or retinyl palmitate? Should retinol products be used at night versus daytime or is that just personal preference? I have heard that it is best to use retinol products at night due to potential sun sensitivity. However, if a proper sunscreen is used, would it matter?

Rebekah, via email search

Dear Rebekah,
Retin-A, a topical prescription medication for acne (and wrinkles), contains tretinoin, a derivative of vitamin A. While it is well-known that tretinoin and benzoyl peroxide should not be mixed because the two aren't compatible (one deactivates the other), there is no information as to how that relates to retinyl palmitate or retinol (retinol is the entire vitamin A molecule and retinyl palmitate is an ester form). Benzoyl peroxide does not affect adapalene, a form of vitamin A found in the prescription medication Differin. To make an educated guess, I would say it probably doesn't matter, assuming it is something unique about tretinoin in relation to benzoyl peroxide that keeps them at odds.

In terms of sun sensitivity, there is nothing about using Retin-A or any form of vitamin A on the skin that makes the skin more photoreactive or phototoxic. Those concerns do apply for isotretinoin (active ingredient isotretinoin), however, which absolutely makes the sun more damaging to skin by causing a potential phototoxic reaction. It is easy to see where the isotretinoin in isotretinoin gets confused with the tretinoin found in Retin-A or Renova. However, what may happen when you first begin to use Retin-A or Renova is that the skin tends to become sensitive and flakes like mad because of the irritation. That can make the skin more sensitive to the sun, but sunscreen should take care of the problem because it isn't a photosensitizing reaction. Once your skin gets used to the tretinoin and the flaking stops, it will still need sunscreen, but it won't be more vulnerable to a sun reaction.

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Category: Skin Care

Dear Paula,
Your reviews are great, and I appreciate how you reference sources to back up your opinions. In your books you consistently disparage bar soaps, saying the ingredients that make them into bars can clog pores, but I've never seen a reference for this. With virtually any other ingredient present in a cleanser, you say "any benefit from this would be washed down the drain before it can do any good." Why wouldn't the ingredients that make soap into a bar wash away, too? I've used Irish Spring, body and face, for 25+ years, and never noticed any "clogs." Body washes, even ones that say "clean-rinsing," leave me feeling slimy. And non-deodorant soaps, by the end of the day, leave me with (ahem) body odor. So, why do you think deodorant soaps are unnecessary?

Marilyn, via email search

Dear Marilyn,
What an insightful question, and I can see why you are confused. In essence, there are some ingredients that cling to skin more than others. The ingredients that keep bar soap or bar cleansers in their bar form are only somewhat water-soluble, which is why a soap film can be left behind on your sink or bathtub. Other ingredients--such as vitamins, plant extracts, antioxidants, and other more fragile ingredients (like peptides)--don't like water and are easily broken down by splashing well before they would have a chance to either absorb into skin or have benefit. For example, antibacterial agents in soaps and cleansers can kill bacteria on skin, but they have far less benefit unless you leave them on the skin for a period of time. That's why leave-on hand disinfectants are more effective, and why surgeons scrub their hands for several minutes.

One way to think of it is by comparison to food substances like oil, lard, and butter, which are difficult to rinse away, while other foods are far easier to wash off a plate or your counter top. To some extent, the same concept carries over with skin-care cleansers. In terms of bar cleansers, the issue of receiving skin-care benefits other than cleansing and some deodorizing is clear. I'm not sure why there aren't studies to cite on this, but I assume it's because this concept of cleansing is well understood with no contradictory information to be found. Regarding clogged pores, there is research showing that certain trans-fatty acids (such as the ones found in most bar soaps and bar cleansers) can make matters worse inside a pore (Sources: Experimental Dermatology, 2005, volume 14, pages 143-152; and International Journal of Dermatology, October 2001, page 640). Additionally, a higher pH (over 8) can increase the growth of bacteria in the pore (Sources: Advances in Skin & Wound Care, July-August 2002, pages 176-178; and American Journal of Clinical Dermatology, April 2004, pages 217-223). That you, personally, haven't experienced skin-care problems (clogged pores) is completely understandable because while a problem is likely, that doesn't mean it happens to everyone.

One other point: My main issue with bar soaps and cleansers is not so much that they clog pores (though there is that potential), but that they are extremely drying and irritating. When skin is repeatedly irritated, it is less able to build new collagen and elastin, heal itself or keep its structure intact. This is far more of a concern from the neck up than from the neck down. That's because from the neck down, skin is usually less fragile since it hasn't been as exposed to the environment (meaning the sun) like the face.

By the way, in terms of soaps being drying and irritating for skin and causing problems for barrier repair, preventing dryness, healing, and reducing or eliminating sensitizing reactions, there is a great deal of research. Some of those sources include Skin Research and Technology, February 2005, pages 53-60; Skin and Hair Cleansers, March 9, 2005, www.emedicine.com/derm/topic508.htm; Dermatologic Therapy, January 2004, pages 16-25; Contact Dermatitis, August 2003, pages 91-96; Global Cosmetics, February 2000, pages 46-49; and Cosmetics & Toiletries Magazine, November 2003, page 63.

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Category: Skin Care

Dear Paula,
What causes fingernails to split and break? Is there anything I can do about it?

Connie, via email search

Dear Connie,
You would think with all the nail products available everyone would have strong, durable nails that grow long without breaking or peeling. Sadly, we know that isn't true, but we keep hoping. Much like the hair we are born with, the kind of nails we have is pretty much genetically predetermined. Some of us are born with tough, sturdy, resilient, and almost unbreakable nails, while others, like me, have paper-thin nails that easily split, peel, and break. Unfortunately, there is very little that can be done to change this predetermined trait. There is little to no research showing that vitamin or herbal supplements can improve or change the condition of your nails. In fact, the only research that exists is dated (Cutis, April 1993, pages 303-305), and it indicates only that biotin supplements may help some people; however, this was a limited study (there are no others) and the conclusion was that biotin is probably no more helpful than moisturizing or being careful about soaking your nails in water. There's no evidence that applying or eating gelatin, calcium or other minerals, other vitamins, or herbal supplements will improve or strengthen your nails.

Healthy nails that become weak or that show a dramatic change in their appearance and growth can indicate the presence of a serious medical condition. If your nails were previously doing great and suddenly undergo a noticeable negative change, you could be experiencing health problems that require medical attention. Extreme color change, severely scooped nails, pitting in the nail, and nails lifting from the nail bed are just a few of the changes that need medical attention rather than just a shopping spree at the drugstore or an appointment with a manicurist (Source: www.mayoclinic.com).

While the severe nail conditions I just listed require medical attention, peeling nails and some breakage or weakness along the upper edge of an otherwise normal-looking fingernail is nothing to worry about. Aside from genetics, the most common cause of split or peeling nails is repeated wetting and drying. Nails swell when they absorb water and shrink as they dry. As they undergo this shrinking and drying process, the nail cells and layers lose their ability to adhere to one another. The layers subsequently separate along the outer nail edge, where air dries the nail from beneath.

You can protect your fingernails in the same way you protect your hands: wear rubber gloves when doing household chores. As often as you can, especially after long immersion in water, massage a moisturizer or just plain olive oil (it's a great emollient and antioxidant) over and around the nail and cuticle, which helps protect the nail. Trim your nails gently with fingernail clippers and file them using a fine-grained file or emery board. Nail polish remover can be drying, so apply moisturizer after using it. As a rule, don't severely push back or cut the cuticles, because the cuticle protects new nail growth.

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Category: Skin Care

Dear Paula,
Do summertime brides need a little extra help as they prepare to walk down the aisle. What do you think? search

Dear Readers,
Whether getting ready for your wedding day or another momentous occasion, the following tips and reminders will ensure that you look beautiful in person and in photographs:

  1. Keep in mind that regardless of the product, shade, or application technique, makeup is only as good as the skin it covers. Take time in the months leading up to the big day to treat your skin well and avoid using products that cause irritation or can cause side effects such as dryness, flaking, or redness. Anticipate your skin's needs based on its history and the weather (is the event in a location where it will be more humid, arid, or cold than your skin is used to?) then choose products accordingly.

  2. Do not have a facial, microdermabrasion, peel, or any other spa or dermatologist treatment within two weeks of the event, especially if you have not had such procedures performed in the past. The last thing you want to deal with is the complications that could result. If a trip to the spa is part of your bridal bliss, use the time to get a stress-relieving massage or manicure and pedicure rather than a facial.

  3. Anticipate being photographed and take into account the lighting. Outdoor wedding photos demand different makeup than indoor photos. Outdoor lighting is most flattering in late afternoon as the sun begins to set. If possible, avoid scheduling an outdoor wedding ceremony and photos for midday when the sun is directly overhead. This casts unwanted shadows on your face and is universally unflattering. Less makeup is preferred for outdoor weddings. Use a sheer, satin-matte foundation, a light dusting of pressed powder, powder blush, soft eyeshadow colors that are matte or barely shiny, and eyeliner that is dark brown or slate gray rather than black, which can look too harsh in daylight. Lips can be any color, but keep in mind that opaque lipstick with sheer makeup can look too contrasting. Generally, outdoor makeup looks best with creamy lipsticks. For mascara, choose brown if you have blonde hair (dyed or not). All other hair colors should stick with black mascara, preferably waterproof unless you're sure you won't cry!

  4. For indoor ceremonies, you must take flash photography into consideration. A camera's flash tends to emphasize pink or ruddy skin tones, so proper camouflage with a neutral- to yellow-toned foundation is a must. Avoid foundations and powders with sunscreens in which titanium dioxide or zinc oxide are the active ingredients. Both of these mineral pigments have an opaque, reflective quality that can make your face look whiter than the neck in photos. A small amount of titanium dioxide in your foundation or powder is fine; it just shouldn't be an active ingredient where the concentration is considerably higher.

  5. Be sure your foundation matches your skin color exactly. Check to be sure there is no line of demarcation at the jaw, hairline, and temples. In general, liquid foundations with a soft matte finish work best because they are versatile and let your natural skin tone show through. Cream-to-powder and stick foundations tend to offer heavier coverage that, unless carefully blended, can look mask-like. It may be tempting, but do not mix a liquid shimmer product with your foundation to make skin look more radiant. In photos, even when used judiciously, shimmer can make skin look slick and greasy instead of luminescent, especially after wearing it for a few hours. And once the event begins, stealing away for touch-ups is unlikely.

  6. Seek a powder that closely matches your skin tone. Pressed powder is more portable and easier to use than the loose version. Look for a pressed powder with a silky texture and skin-like finish. Today's modern powder formulas (particularly those from Estee Lauder, L'Oreal, M.A.C., Prescriptives, and Maybelline) make skin look beautifully polished, not powdered or ultra-matte. Apply the powder with a professional brush, not a puff or sponge. If you have normal to dry skin, only powder the T-zone (forehead, nose, and chin) and leave the cheeks with the soft matte finish your foundation provides.

  7. For blush, powder formulas tend to photograph best and hold up over the long haul. If in doubt about which shade to choose, opt for those in the rose or pink family if you have fair to medium skin and choose rosy-plum tones if your skin tone is medium to tan. Do not make the mistake of under-applying blush, especially for indoor photos. Wedding makeup is formal, and requires more color than you may normally wear. Make sure your blush is in the same tonal family as your lipstick (for example, pair a pink blush with a pink, berry, or rose-toned lipstick).

  8. The color of your makeup design should come from your blush and lipstick, not your eyeshadow. Keep tones muted and matte so that they emphasize, not compete with, your natural eye color. As a general rule, you can't go wrong with eyeshadow colors that have a brown, tan, taupe, or neutral base. Think earth tones (slate, shell pink, bronze) and "food" tones (cream, caramel, coffee). If you want to add a touch of shimmer to your eye makeup, find the sheerest product possible, apply sparingly to highlight your brow bone or the inner corners of your eyes, and make sure you like how it looks in photos before the big day arrives.

  9. Pay attention to your eyebrows. Do not attempt any new tweezing techniques or patterns, but do see a professional brow groomer who has loads of experience shaping brows so they frame your eyes as attractively as possible. A brow pro can also show you how to make the most of sparse, thin, or barely-there eyebrows. For wedding makeup, use brow powder, a matte powder eyeshadow, or tinted brow gel rather than traditional brow pencil to shape and define.

  10. Be sure to carry your lipstick and lip liner with you for touch-ups after the ceremony and before the reception. It is also helpful to carry a pressed powder and small powder brush, as well as a clean makeup sponge in case you need to buff or smooth any aspect of your makeup, especially lipstick marks from over-zealous relatives or friends.



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Category: Skin Care

Dear Paula,
I am a medical doctor (a pathologist) and I enjoy reading your well-researched and informative articles. A nice change from the rubbish that is usually meted out to the public!

I have a lot of actinic keratosis on my face, and my dermatologist has recommended Levulan and BLU-U light therapy (activated photo facials). He stated that two treatments would be fine and I would just suffer some "sunburn" effects for the first week. As well as getting rid of the keratosis without scarring, this treatment supposedly smooths the skin and makes it look better. It is still relatively new, and I am concerned that the use of light to activate a cream which is known to be toxic to cells may be a risk for skin cancer down the line. I would be grateful for any information you can give me on this.

Margaret, via email search

Dear Margaret,

As you may know, actinic keratosis (AK) is a very common skin problem, especially for people over 40. It can eventually turn into invasive squamous cell carcinoma of the skin. These precancerous lesions are caused by sun exposure and appear on the skin as uneven brown patches that can become crusty and sometimes itch. Getting diagnosed and finding a treatment is essential.

Your physician is recommending a treatment known as Photodynamic therapy (PDT) in conjunction with topical application of 20% 5-aminolevulinic acid (ALA, under the tradename Levulan). The ALA is activated with a red or blue LED panel (light-emitting diode) or IPL (intense pulsed light), which explains the name. The IPL is not related to UV light from the sun.

Photodynamic therapy really isn't all that new. In 1999, the FDA cleared Levulan Kerastick for the treatment of AKs on the head and scalp. A year later, the BLU-U, Blue Light Photodynamic Therapy Illuminator, was also FDA approved for the treatment of AKs.

Photodynamic therapy works because the ALA is a photosensitizing chemical that is applied to a specific AK lesion. When this is followed by exposure to visible light, it causes the precancerous cells in the specific area to die off. Interestingly enough, ALA in and of itself is not a photosensitizer, but rather it causes the formation of a natural photosensitizer in the skin. There is definitely research showing that it is effective and safe. Given the short period of treatment, it is believed that the risk of UV damage is minimal, and that the risk of generating more cancer-producing cells is unlikely, given the short time the ALA remains in the skin (about six weeks). In fact, ALA stays longer in cancer cells than in normal cells. Also, ALA doesn't cause a cytotoxic response in and of itself but only in combination with a light source. Other advantages of PDT are that it causes minimal damage to healthy tissue, and that the light that is used can't pass through more than about one-eighth of an inch of skin. If anything, as your doctor mentioned, the procedure may even improve skin conditions.

Whether or not photodynamic therapy can also workto minimize or reduce wrinkles is far less well researched, and most of the research I've seen about its effects on wrinkles comes from physicians who were paid by the company that makes the light-emitting machines and the ALA. Overall, the efficacy of this process can't be ignored, especially when compared with other options. For example, AKs can be treated by curettage, which involves scraping the lesion off with a heat-producing needle, or they can also be shaved off with a scalpel. Cryosurgery freezes the lesions off through application of liquid nitrogen. All of these methods have problems, some with short-term results or skin discoloration, others with scarring.

It's important to point out that depending on the extent of the AKs on your skin, they can resolve with adequate sun protection and avoiding more exposure, but that is often easier said than done (Sources: International Journal for Cancer Research and Treatment, April 2004, pages 407-411; Journal of Dermatological Treatment, March 1, 2002, pages 19-23; Journal of Photochemistry and Photobiology, May 2001, pages 656-669; Journal of Cosmetic Laser Therapy, March 2005, pages 21-24; Journal of Drugs in Dermatology, January-February 2004; Facial and Plastic Surgery, May 2005, pages 110-116; Cancer Information Network, www.ontumor.com/cancer/photodynamic.asp; and American Osteopathic College of Dermatology, www.aocd.org).

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Category: Skin Care

Dear Paula,
Can you tell me if there is any possibility of your establishing a distribution centre in Europe? I'm sure European consumers would love your products as much as I do!

Helen, United Kingdom search

Dear Helen,

The timing of your question could not have been better! We have just opened distribution in Europe with a group of women based out of the Netherlands. Like you, these amazing women wanted to share their own success using Paula's Choice products with other women in their region. They worked tirelessly in this effort, and are happy to have officially launched operations on December 1. We believe they will be able to better serve your needs and help our European customers save on shipping expenses. They can ship to all twenty-five European Union countries and carry most Paula's Choice skin-care products and some of the makeup. As their business grows, they expect to carry the full Paula's Choice line.

Web site: www.paulaschoice-eu.com

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Category: Skin Care

Dear Paula,
I have been a reader of Cosmetics Counter Update for a long time, but it was only last month that I purchased some of your products, and I must admit I'm amazed at their quality and fair prices. I have noticed that you do not offer any retinol products. Is this because you feel AHA and BHA products are a better choice, or is there a case where you would recommend retinol instead? I have searched through the past editions of your newsletter and haven't found a retinol product that impresses you lately, so I would appreciate your comments on this one.

Ana, via email search

Dear Ana, Thanks for your thanks! And you're asking a good question about retinol. Despite its potential benefits, which are significant for skin, it has had its share of problems. Let me explain. Retinol is the entire vitamin A molecule that can be broken down into thousands of smaller components, of which one is retinoic acid (also called tretinoin, the active ingredient in Renova and Retin-A). Skin cells have a receptor site that is very accepting of retinoic acid. This relationship between retinoic acid and a skin cell allows a type of communication in which the cell is told to function normally (that is, not like a damaged or older cell), and it can conform to that request. Retinol cannot communicate with a cell until it has been broken down into retinoic acid. What has been up for debate is whether retinol can be converted into retinoic acid after it is absorbed into the skin and remain stable (in the skin, or in the product for that matter). Issues about retinol's stability and how much is enough when using the ingredient (specifically, when it changes to retinoic acid, is there enough left to get to the cell) have been the problems with retinol in cosmetics. More recently, some new, stable forms of retinol have become available, along with lots of research regarding their efficacy, and that has changed everything. As a result, several new products I will be launching next year will include retinol.

In short, retinol is a beneficial cell-communicating ingredient and an antioxidant. Simply put, it helps skin cells create better skin and skin-support substances. Packaging is still a key issue, so any container that lets in air (like jar packaging) or sunlight (clear containers) just won't cut it, something that also applies to most state-of-the-art skin-care ingredients. Lots of retinol products come in unacceptable packaging (Source: Cosmetic Dermatology, Supplement, Revisiting Retinol, January 2005, pages 1-20).

One more point: Neither retinol nor retinoic acid can take care of anyone's skin-care needs on their own. For example, they don't replace the need for a well-formulated sunscreen or AHA or BHA product. Exfoliating the skin with AHA or BHA has a long history of helping it to function more normally by removing built-up layers of sun-damaged skin. Also, retinol should not be the only ingredient you look for in a moisturizer. Skin needs a combination of ingredients to function optimally, including cell-communicating ingredients (of which retinol is one), antioxidants (to reduce free-radical damage), and substances that mimic the structure of skin. Together, all these various ingredients and elements combine to create a powerful part of any skin-care routine.

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Category: Skin Care

Dear Paula,
I am a great fan and follow your advice consistently. I am 41, and have fairly decent skin with regard to wrinkles, considering my teenage days of sun-tanning. I had oily skin as a teen, but now have combination skin with blemish-prone areas. My concern is that the skin around my eyes extending to my cheek bone and on the lids are wrinkled-profoundly so. It is almost like this dramatic change occurred overnight. I keep these areas moisturized and am careful that the beta hydroxy acid product I use does not "travel" to those areas. Short of an eyelift, is there anything I can do to decrease the appearance of the lines that is not a cosmetic corrective procedure? I am willing to use a cosmetic product to temporarily tighten them up, even just a little bit, so my makeup looks smooth again. I have recently stopped taking birth control pills and wondered if the lack of estrogen and approaching menopause could be a factor. Do you think I should use the BHA product around that area to lessen the lines?

Denise, via email search

Dear Denise,
I wish I could point to one product as being the answer to your woes, but I can't, because one doesn't exist. What will be hard for you is to avoid the seduction of the cosmetics companies wanting you to believe they have products (thousands and thousands by the way) that can erase those lines. Sun damage, age, loss of estrogen, muscle movement (especially for the eye area and forehead), fat depletion, and depleted collagen and elastin all play major roles in causing wrinkles. There isn't any one product that can address all or even most of those things once the damage is done. What can be done to improve this topically is up for debate. What most experts agree on (myself included) are the following: daily liberal use of a well-formulated sunscreen, application of a topical exfoliant (AHA or BHA), a product containing tretinoin (Renova, Retin-A, Avita), and a moisturizer loaded with antioxidants. Which antioxidant is the best isn't known, and there are those who would suggest an assortment of antioxidants is best because each exerts a different "repair" or prevention mechanism for the skin. However, whether any of that will delay the need to seek the expertise of a plastic surgeon or dermatologist who performs cosmetic corrective procedures is at best questionable.

By the way, BHA works well over all parts of the face to help it feel and look smoother. However, use caution when applying a BHA product around the eye, being careful to not apply too close to the lash line to avoid getting it in the eye.

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Category: Skin Care

Dear Paula,
The Industry Responds

Shortly after publishing my review of the Jack Black men's skin-care line in the March/April issue of this newsletter, I received the following correspondence from the company (edited to address its most critical points):

Dear Ms. Begoun,
There are several false and misleading statements in your review of our formulations. We trust that you will promptly correct untrue, misleading information that is disseminated to the public.

  1. Jack Black Cool Moisture Body Lotion: states that the preservatives methylchloroisothi-azolinone and methylisothiazolinone (Kathon CG) are contraindicated for use in leave-on products (Source: Cosmetic Dermatitis, November 2001, pages 257-274). However, these two preservatives are in fact thoroughly researched, widely used in cosmetics/skin-care products, and found to be safe and approved for use globally in leave-on products. The CTFA (Cosmetics, Toiletries, and Fragrance Association) has established a leave-on percentage of 0.5%, and the amount of this preservative used in Cool Moisture Body Lotion is at or below that level. Furthermore, the study you cited above dealt with airborne exposure to Kathon CG from industrial wall-paint products. Based on this false information, we request and expect that a retraction be made and sent to those consumers that received this misleading information.

  2. Regarding the comments you make for our Sun Guard Oil Free Very Water/Sweat Resistant Sunscreen SPF 30+, you suggest that we do not have sufficient film-forming agents in the product and tell readers "don't be surprised if it causes problems when it gets into your eyes." We would never market an over-the-counter sunscreen without doing the necessary, required testing to substantiate SPF value and water/sweat-Resistant claims. We have done the in vivo testing and have proven that the product is water- and sweat-Resistant at the claimed SPF number. Therefore, the film-formers in the product are indeed sufficient. Your speculation casts doubt on the efficacy and safety of our product, which is unacceptable.

Curran Dandurand & Emily Dalton,
Jack Black Staff search

Dear Curran and Emily,
Your letter brings up two interesting points, and I appreciate this opportunity to address them with you and my readers. Regarding your comments concerning what I wrote about Kathon CG, I want to point out that my statement that this preservative is contraindicated is not the same as saying it is prohibited. You are correct: Kathon CG is permissible for use in leave-on products (although it isn't widely used, especially in comparison to many other preservatives). However, the allowable usage level is not 0.5%, as you state in your letter, but rather it is 0.05% (Source: www.rhpersonalcare.com/kathon.html). That extra decimal point makes a big difference! It is certainly feasible that Cool Moisture Body Lotion contains Kathon CG at 0.05% because parabens (another type of preservative) are present as well. However, it is important to keep in mind that, with or without Kathon CG, I do not recommend this body lotion because, as my review also stated, it contains a form of menthol, which can be irritating to skin.

Further, there are several studies indicating that the components of Kathon CG (methylchloroisothiazolinone and methylisothiazolinone) are skin-sensitizing ingredients when used in leave-on products, even when the amount is low. According to an article on www.dermis.net, "the preservative was responsible for an epidemic of contact sensitivity, in some geographical areas, in the 1980s and early 1990s. Problems occurred mostly when the preservative was used in leave-on products at concentrations higher than 15 ppm [parts per million]. It is now mainly used in rinse-off products at lower levels (up to 15 ppm but usually less than 10 ppm). At these lower levels and use conditions, the prevalence of hypersensitivity is acceptably low and individuals allergic to the preservative may tolerate rinse-off products (e.g., shampoos) preserved with it." That sounds foreboding and somewhat encouraging at the same time, depending on how much of the preservative system is used.

However, the same article goes on to state (and I concur with this judgment): "There is no easy mechanism to assess quantitative exposure; it is exposure to an allergen in dose per unit area that is of pivotal importance for induction and elicitation [of an allergic response]. Because of this, for an individual allergic to the preservative, it is most practical to simply avoid using products identified as containing the preservative from the label. Levels of the allergen in a product may be too low to be able to elicit a reaction but the level will not be known." Because cosmetics companies do not have to reveal the percentages of nonactive ingredients on labels, a consumer has no convenient way to ascertain exactly how much of the potentially problematic ingredient is in the product. Therefore, when I come across products with suspect ingredients, I typically indicate this in the product review.

For those not allergic to Kathon CG, this may make it sound as if it's OK for your skin if a leave-on product you're using contains it, but there is further evidence that this preservative complex is sensitizing for skin (Sources: Chemical Research in Toxicology, volume 18, issue 2, February 2005, pages 324-329; British Journal of Dermatology, volume 149, issue 6, December 2003, pages 1172-1182; www.emedicine.com/derm/topic84.htm; and American Journal of Contact Dermatology, volume 11, issue 2, June 2000, pages 115-118). Despite the fact that Kathon CG is allowed to be present at low levels in leave-on products, I stand by my advice to consumers to avoid such products, especially because there are effective, less sensitizing preservatives that are widely used.

As for the source I used to support my statement about Kathon CG in the newsletter review of Jack Black, your statement that the study "dealt with airborne exposure to Kathon CG from industrial wall paint products" is only partially true. The study was designed not only to measure airborne exposure to the substance from freshly painted walls but also to evaluate its potential to cause contact dermatitis, to estimate the level of exposure from products, and to compare epidemiological results to those of other preservatives. The conclusions drawn supported replacing the Kathon CG with other preservatives, both in wall paint and in cosmetic products.

Regarding the comments I made for your Sun Guard Oil Free Very Water/Sweat Resistant Sunscreen SPF 30+, I stand corrected. I was remiss in stating that this product's lack of film-forming agents would inhibit its sweat-Resistant properties. In fact, because this product is a water-in-oil emulsion, it is inherently sweat-Resistant; therefore, film-forming agents are not required (though in high-SPF sunscreens they can help boost a product's SPF value by improving spreadability of the active ingredients-which is what I was focused on, and I apologize for my short-sightedness). I also want to point out that the FDA does allow a sunscreen to bear a sweat-Resistant claim if the product tested as water-Resistant (Source: Code of Federal Regulations, Title 21, volume 5, April 1, 2004). However, sweat-Resistant doesn't mean the product will not (as you claim on your Web site) "run or drip into eyes." All a sweat-Resistant claim means is that the product will not be degraded by perspiration over a certain period of time (typically 40 to 80 minutes, depending on how the sunscreen tested). If you apply a sweat-Resistant sunscreen and are active outdoors, you will still perspire, and if the sunscreen/perspiration mix inadvertently gets in your eye, there is no question it will cause a stinging or burning sensation.

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Category: Skin Care

Dear Paula,
What causes fingernails to split and break? Is there anything I can do about it?

Connie, via email search

Dear Connie,
You would think with all the nail products available everyone would have strong, durable nails that grow long without breaking or peeling. Sadly, we know that isn't true, but we keep hoping. Much like the hair we are born with, the kind of nails we have is pretty much genetically predetermined. Some of us are born with tough, sturdy, resilient, and almost unbreakable nails, while others, like me, have paper-thin nails that easily split, peel, and break. Unfortunately, there is very little that can be done to change this predetermined trait. There is little to no research showing that vitamin or herbal supplements can improve or change the condition of your nails. In fact, the only research that exists is dated (Cutis, April 1993, pages 303-305), and it indicates only that biotin supplements may help some people; however, this was a limited study (there are no others) and the conclusion was that biotin is probably no more helpful than moisturizing or being careful about soaking your nails in water. There's no evidence that applying or eating gelatin, calcium or other minerals, other vitamins, or herbal supplements will improve or strengthen your nails.

Healthy nails that become weak or that show a dramatic change in their appearance and growth can indicate the presence of a serious medical condition. If your nails were previously doing great and suddenly undergo a noticeable negative change, you could be experiencing health problems that require medical attention. Extreme color change, severely scooped nails, pitting in the nail, and nails lifting from the nail bed are just a few of the changes that need medical attention rather than just a shopping spree at the drugstore or an appointment with a manicurist (Source: www.mayoclinic.com).

While the severe nail conditions I just listed require medical attention, peeling nails and some breakage or weakness along the upper edge of an otherwise normal-looking fingernail is nothing to worry about. Aside from genetics, the most common cause of split or peeling nails is repeated wetting and drying. Nails swell when they absorb water and shrink as they dry. As they undergo this shrinking and drying process, the nail cells and layers lose their ability to adhere to one another. The layers subsequently separate along the outer nail edge, where air dries the nail from beneath.

You can protect your fingernails in the same way you protect your hands: wear rubber gloves when doing household chores. As often as you can, especially after long immersion in water, massage a moisturizer or just plain olive oil (it's a great emollient and antioxidant) over and around the nail and cuticle, which helps protect the nail. Trim your nails gently with fingernail clippers and file them using a fine-grained file or emery board. Nail polish remover can be drying, so apply moisturizer after using it. As a rule, don't severely push back or cut the cuticles, because the cuticle protects new nail growth.

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Category: Skin Care

Dear Paula,
I recently had collagen injections at a cosmetic surgery office. The doctor told me to discontinue using alpha hydroxy acid products because a connection has been found between AHAs and the breakdown of collagen. Could you either confirm or refute this, based on your in-depth knowledge of all things cosmetic? I'm currently using your 2% Beta Hydroxy Acid Lotion, and wonder if there's any adverse effect on collagen with that product. Thank you, as always, for your advice and expertise.

Diane, via email search

Dear Diane,
If there is a connection between using AHAs topically and AHAs causing a breakdown of collagen, I haven't seen it, and over the years (since AHAs became popular in 1992) I have read a lot of research on these ingredients. If anything, the research shows that AHAs can increase collagen production and improve skin structure. The sources are numerous, including Experimental Dermatology (December 2003, Supplement, pages 57-63), which states: "GA [glycolic acid] ... directly accelerates collagen synthesis by fibroblasts.... GA contributes to the recovery of photodamaged skin through various actions, depending on the skin cell type." Cancer Letters (December 2002, pages 125-135) says: "Glycolic acid, an alpha-hydroxy acid ... has been commonly used as a cosmetic ingredient since it is known to have photo-protective and anti-inflammatory effects, and anti-oxidant effect in UV-[exposed] skin." Or see the Journal of Dermatology (February 1998, pages 85-89): "the favorable effects of glycolic acid treatment on aging skin were [obtained] by increased cell proliferation in addition to functional activation of fibroblasts [collagen producing cells]." Or see the British Journal of Dermatology (December 1996, pages 867-875), which states "Alpha-hydroxy acids (AHAs) ... normalize [skin cell growth] and increase viable epidermal thickness and dermal glycosaminoglycans content."

I don't know how your doctor feels about salicylic acid products (he seems to have singled out AHAs), but there are no studies showing that this ingredient is a problem for skin either. You may want to ask your physician if he's concerned about the effect of AHAs on collagen injections, but again I've seen no research suggesting that takes place.

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Category: Skin Care

Dear Paula,
I often refer to your reviews of skin-care products, and I've read in past "Dear Paula" letters as well as in your book that if a potential skin irritant is applied over a long period of time, damage can be taking place beneath the skin's surface even though you may not be able to see it. Does this statement apply to facial cleansers as well? If a product is just being rinsed off the skin, can it still do actual damage to it? This question has been on my mind for some time and I have been purchasing many different cleansers in an attempt to find a "safe" one, but to no avail. I appreciate your time and hope to hear from you.

J., via email search

Dear J.,
Yes, as a general rule keeping problematic, irritating, or sensitizing ingredients off the face is very important to healthy skin. Yes, irritation or inflammation of any kind is damaging, despite the fact that your skin neither feels it nor reacts to it in any visible negative way. Yet underneath, your skin's collagen is being depleted and your immune cells are being destroyed. However, that doesn't mean you should stop using the cleanser you are using. Most likely, the amount of those ingredients is so negligible it doesn't really affect skin in the least, not to mention, as you stated, that in a cleanser they would be rinsed down the drain before they could ever impact your skin.

I always warn about potentially problematic ingredients in skin-care products to paint a clear picture of what they really can and can't do for skin. Often the amounts of those ingredients aren't significant or they are present in rinse-off products, but I still feel it is important to understand the potential problems. I regret that I haven't always made it clear that it is not as significant an issue when those ingredients are in a cleanser.

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Category: Skin Care

Dear Paula,
You are the best! I've been reading your books and using your products for years, and I'm so happy with how I look. People always ask what I do to have such nice skin, and I owe it all to you!

My question has to do with my naturally curly hair. I recently went to a salon in New York City, one that is famous for cutting and styling curly hair. Well, I have several questions based on the information (or should I say incredibly annoying sales pitch) I received while there. I mean, I just want a good haircut, not a lecture about everything I do wrong with my hair! Everyone from the stylist to the girl who washed my hair talked about how dry my hair is, blaming it on the shampoo and conditioner I regularly use because it contains silicones. Now I'm confused. Based on what I have read in your books, you really like silicones. And you seem like the kind of person who likes to wash her naturally curly hair. The salon staff thinks silicones are just awful and will eventually ruin your hair by attracting all kinds of pollutants and dirt. They also stated that washing with regular shampoos strips curly hair of its moisture. What is your take on this?

Kim, via email search

Dear Kim,
Where did this myth about silicones being bad for hair get started? I also want to know what products your salon sells (or any salon sells for that matter) that don't contain silicones. Ranking as one of the most popular and effective ingredients for hair, silicones show up in over 85% of all hair-care products. Silicones in their various forms have incredible properties for hair. Not only does silicone make hair feel like silk, but because silicone has an affinity to the hair shaft, and doesn't like water, it can hold up under rinsing, making it great for dry hair in either a conditioner or shampoo (but potentially problematic for fine or thin hair, which doesn't need much of anything clinging to it). Silicones don't attract pollutants or dirt (How does anything attract pollution?), at least not any more than the oil (sebum) produced by your scalp or the other ingredients in conditioners. There is also a great deal of research showing that silicone can protect hair to some degree from the heat generated by blow dryers and flat irons. There is even research showing it can help reduce fading of hair color (Sources: Hair Care, Allured Publishing, 2004; Fundamentals of Formulating Hair Care Products, October 2000, www.thecosmeticsite.com; and Journal of Cosmetic Science, 2004, 55 Supplemental, pages 133-141 and July-August 2003, pages 335-351). The notion that silicone is bad for hair or skin has no science or substantiation behind it of any kind. It seems to be nothing more than a strange urban myth.

And what is a "regular shampoo" anyway, other than an inexpensive shampoo that is never as good as the one your salon is selling? If there are differences between the ingredients in expensive and inexpensive hair-care products, I would love to see one shred of evidence proving that assertion. I have interviewed dozens and dozens of ingredient manufacturers and cosmetic chemists over the years and I have yet to find anyone who will substantiate, or any research that substantiates, the notion that expensive products have better quality ingredients than inexpensive ones. It's just very hard for us to accept the fact that the pricing is the caprice of a cosmetics company, and is not reflective of value or quality.

If you want to try to prove this point, the next time your stylist asks what products you use on your hair, tell them you use the ones they sell. Chances are they will immediately tell you how wonderful your hair feels and how healthy it is. I do this every now and then with a new stylist (I see lots of stylists in the different cities where I travel). Depending on the products I say I use, I get a different analysis of my hair quality. I sometimes tell the person who washed my hair that I use the expensive stuff and the person styling my hair I use the cheap stuff. Sure enough, I get two different assessments of how my hair is doing!

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Category: Skin Care

Dear Paula,
I'm a little confused about your recent high praise for Prescriptives' Redness Relief Gel. You wrote that it contains no preservatives, and I thought your position was that though preservatives might be irritating to some people, they were certainly better than nothing. Can you clarify this?

Lynn, via email search

Dear Lynn,
There is no question that in a water-based skin-care or makeup product a good preservative system is essential to controlling microbial and bacterial growth during the shelf life (and use) of the product. A product without preservatives runs a high risk of becoming contaminated and deteriorating long before it would have if preservatives were present. In the case of Prescriptives Redness Relief Gel, I double-checked the ingredient statement I have on file against the product packaging, and the formula is indeed preservative-free. I am not sure how they accomplished this since this product contains water, but I suspect the rosemary extract exerts a small amount of antibacterial activity. Interestingly, Prescriptives does not market this product as being preservative-free. I mentioned the preservative-free attribute in my original review of the product because it is meant for someone with easily irritated, reddened, or rosacea-prone skin. As essential as preservatives are to a product's stability, there is also the issue that, for some people, they can be a source of irritation. For those dealing with rosacea and its particularly intense sensitivity, a preservative-free product might be what's needed to prevent undesirable reactions. If you fit this description and decide to try Redness Relief Gel, try storing the product in the refrigerator to prolong its shelf life. If the idea of applying a cold moisturizer is not appealing, dispense a small amount of the gel into a separate airtight container, and keep the unused portion refrigerated until needed.

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Category: Skin Care

Dear Paula,
In a past issue of Allure magazine, it was suggested that Rogaine could be useful for women whose eyebrows have become sparse due to years of tweezing. They recommended that the product be applied with a Q-Tip to the brow area and that it would take a few months to see results. Could this possibly work? I am usually skeptical of gimmicky-sounding tips from magazines, but my brows are the one thing that I truly dislike about my face. I have been tweezing for about 13 years and would give anything not to have to fill in the bald spots in my brows with powder each day! Please let me know if the side-effects of Rogaine (hair growth on other areas, etc.) are still a possibility given the small area of the body it is being applied to. I hope that you can help me out with this issue.

Tamara, via email search

Dear Tamara,
The possibility of Rogaine (active ingredient: minoxidil) working on eyebrows is not supported by any research. Even if it were, there are safety issues for this kind of application, because getting this stuff in the eyes is a problem. In terms of efficacy, there is some anecdotal research that it could work to grow brow hair. This assumption is most likely due to the fact that excess (and for women, definitely unwanted) hair growth on the chin or upper lip can occur when Rogaine is put on the scalp; that is, hair can grow far away from where the Rogaine was applied. No one is quite sure what triggers the excess growth in spots where Rogaine isn't applied, but then again, no one is quite sure how Rogaine actually works to regrow hair on the scalp either.

If you decide to try Rogaine and see if it works to grow your brows (or a generic version of Rogaine with the active ingredient minoxidil), remember that it will take a good deal of time to see results, far more time than it can actually take for hair to grow back naturally. According to Pfizer, the company that makes Rogaine, even if you use the 5% strength on the scalp twice a day, it can still take up to 4 to 12 months to see results.

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Category: Skin Care

Dear Paula,
I was surprised and pleased to see your latest book, Don't Go to the Cosmetics Counter Without Me. I worked for you many years ago. You trained me as a makeup artist and I agreed with all of your philosophies and still do to this day. I use plain banana and avocado for masks, baking soda for an exfoliant, and read labels until my eyes fall out.

I was, however, extremely surprised that you changed your opinion on mineral oil! I have avoided mineral oil for 20 years because you convinced me it would clog my pores and contribute nothing for moisture. You also said that mineral oil in foundation was good because it kept unhealthy ingredients from entering the pores. I have used only moisturizers with light oils ever since. So, do you recommend products with mineral oil more so than light oils?

Let me close by saying, good work Paula! I am glad I had the opportunity to work with you.

Jan, via email search

Dear Jan,
How nice to hear from you after all this time! When I first started working as a makeup artist 25 years ago, it was in a much different world of information. Much that we took as fact during that time period has changed with the advent of new studies and research about how skin functions and what it needs to be healthy and inhibit wrinkling. Think of it in relation to the world of computers. Just like you wouldn't use the same computer today that you bought in the '80s, products and information for skin from that time period are just about as dated. I have spent years researching issues about antioxidants, irritation, sun damage, wrinkles, the physiology of skin, and many other elements of skin aging, from hormones to genetics, along with lots of other topics and issues. Here are some examples. Irritation is a far bigger problem than was once thought. Sun damage is the primary cause of wrinkles but not all sunscreens are created equal even if they have the same SPF number. Genetically programmed cell death accounts for age-related wrinkles. Antioxidants are fundamental to the health of skin, high pH makes problematic bacteria grow, and we now know hydrogen peroxide can generate free radicals, so it's no longer advisable to use it for disinfecting blemishes.

I can barely remember what I said 25 years ago, but other than using baking soda (which I no longer recommend over using a plain washcloth or well-formulated AHA or BHA product), none of what you wrote sounds familiar to me. I don't ever remember recommending bananas or avocado for skin (those are far better eaten than rubbed over the face and I'm fairly certain I've said that for years), and mineral oil has no properties that would keep environmental or free-radical damage from taking place. Nonetheless, given the limitations of anyone's memory, what years of research do show to be true about mineral oil is the following: Mineral oil does not clog, primarily because it is the wrong consistency; that is, it doesn't become hard in the pore. However, it does feel greasy and that can be unappealing on blemish-prone or already oily skin. Mineral oil is not occlusive enough to block absorption into the skin, nor does it prevent skin from "breathing," as many anti-mineral oil companies claim. I hope this answers your questions. I wish you all the best!

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Category: Skin Care

Dear Paula,
I just read the article you wrote about chapped lips. I read the ingredient list from one of the products you recommended and I don't like any of the ingredients, nor do I think they work. Castor oil and petrolatum just sit on your skin. They don't help in the actual healing of chapped lips. I know this because I use an all-natural lip balm by Burt's Bees. I'm sure you've heard of this brand and I would love to see you do a review of their products. The Burt's Bees lip balm is the best I've ever used. The ingredients actually help heal chapped lips over time.

Violetta, via email search

Dear Violetta,

I am glad to hear you found a product that worked for you. I have reviewed Burt's Bees products and his lip balm, but for the sake of your question, let me expand on the ingredients. First, there are lots of studies showing petrolatum to be healing. Castor oil also has some research showing it to have healing properties, but mostly it is just a good ingredient for keeping other ingredients on the skin. I'm not sure what it is you don't like about those ingredients, but they have an impressive history.

Burt's lip balm is indeed natural. The ingredient list is coconut oil, beeswax, sweet almond oil, lanolin, tocopheryl acetate and tocopherol, peppermint oil, comfrey root extract, and rosemary extract. Coconut oil and beeswax sit on top of the skin and aren't absorbed, and that's a good thing, because if everything were absorbed into the skin, nothing would be left on the surface of the lips to protect them. Lanolin also isn't absorbed very well, but this animal-derived ingredient is a great emollient and helpful for chapped lips. A token amount of vitamin E is added to the balm, and more would have been better as it is a very good antioxidant for skin.

My concern about this product is the peppermint. This irritating plant extract serves no purpose for skin, and can actually impede the skin's ability to heal. All in all, this isn't a terrible lip balm, but there are better ones that don't cause irritation to skin.

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Category: Skin Care

Dear Paula,
You have a terrific ability to cut through the confusion and get to the truth, so I bring this question to you. Is the antibacterial ingredient triclosan safe to use in shower gels and soaps? I recently did a Web search on "dioxin" because of the news story that the presidential candidate in the Ukraine was poisoned with that chemical. In my research I found references to triclosan being of "the same class" of chemicals. This is all very alarming to the non-chemist!

Here is a quote typical of what I read online: "Triclosan is a chlorophenol, a class of chemicals suspected of causing cancer in humans. Externally, it can cause skin irritations, " [but since] phenols can temporarily deactivate the sensory nerve endings " contact with [triclosan] often causes little or no pain." Internally, it can lead to cold sweats, circulatory collapse, convulsions, coma, and even death."¦ Stored in body fat, it can accumulate to toxic levels, damaging the liver, kidneys, and lungs, and can cause paralysis, sterility, suppression of immune function, brain hemorrhage, decreased fertility and sexual function, heart problems, and coma."

Paula this is scary stuff, so again, is triclosan safe to use or not?

Margaret, via email search

Dear Margaret,
The Internet is truly an "agony and ecstasy" mode of gathering information. The ecstasy is the copious amount of legitimate information it provides that would otherwise be hard for the average person to obtain; the agony is the counterpoint to that, with the plethora of outlandish, odious, scam content lurking around every corner. But to be brief, don't worry about triclosan.

I found one of the Web sites you must have encountered with the concerns you quoted and none of its information is sourced, so there is no way to check the assertions. Suggesting that something is dangerous simply because it has some molecular relation to a more potent substance is like saying you should never use salt because part of its makeup is chloride (salt is NaCl, sodium chloride), which is extremely caustic. Further, the risk associated with triclosan is based on its pure form when breathed in large amounts or eaten in large amounts (try breathing in or eating pounds of salt a week and you won't make it very long in life either). None of this relates to the topical use of triclosan in skin-care products.

I was not able to find any published medical or chemistry studies suggesting triclosan causes cancer. If anything, I did find a study published in Carcinogenesis (January 2005, pages 153-157) that actually found triclosan to have some anticancer properties. The study looked at rats with breast cancer that were fed a diet containing triclosan versus the same diet without triclosan, and found that the triclosan-fed rats had a much-reduced rate of the cancer present. Another journal concurred with this finding as well (Source: Cancer Chemotherapy and Pharmacology, March 2002, pages 187-193). Of course, I am not suggesting this means anyone should eat triclosan, but the risks you found on the Internet seem not to have any validity, at least not in the amounts used in skin-care products.

Triclosan is used as an effective antibacterial agent in some skin-care products such as hand washes. Concerns about its use have been argued because there is a risk that overuse of triclosan may produce Resistant bacteria strains (Source: Journal of Hospital Infection, October 2003, pages 98-107); but there is also research suggesting that not to be the case, so the debate continues.

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Category: Skin Care

Dear Paula,
Why aren't your products "dermatologist tested and approved," especially your sunscreens? I would think you would want your products to meet the standards of a respected medical organization or authority like other lines do.

Needing verification, via email

Dear Needing,
All sunscreen products and formulations are strictly regulated and approved by the FDA. Further, the American Academy of Dermatology does not have an approval system for either sunscreens or cosmetic products of any kind; no medical organization does. The Skin Cancer Foundation has an approval system for sunscreens, but their list includes sunscreens that do NOT contain UVA-protecting ingredients, which makes their recommendations precarious for skin. The need for UVA-protecting ingredients is substantiated by myriad sources (Sources: International Journal of Dermatology, May 2004, pages 326-335; and Proceedings of the National Academy of Sciences, April 6, 2004, pages 4954-4959).

The dermatologist-tested and -approved stamp is nothing more than a marketing gimmick. If you don't know who the dermatologist is or why they are endorsing the product, the approval stamp is meaningless. An individual company can pay a dermatologist for an endorsement, but that's hardly an official stamp of approval. Though I have the deepest respect for the skill and knowledge of dermatologists, they are not skin-care experts, they are skin-disease experts. Having gone to dermatology conferences, I can tell you without question that doctors pay little attention to daily skin-care routines and they are not cosmetic chemists or formulators. The entire arena of skin care is a new area of interest that doctors are only beginning to pay attention to.

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Category: Skin Care

Dear Paula,
I had never done much in the way of nail care, but when I decided to pursue becoming a competitive ballroom dancer, I realized I needed better looking nails. I began taking better care of mine, keeping polish on them, keeping them trimmed, avoiding water when possible, wearing gloves when doing dishes, and lots of other nail-care tips I've read about. For a while, things went great--my nails were longer and nicer and prettier than they had ever been. Then, one by one, they began to split in layers, splitting well down into the pink area of the nail, in some cases almost halfway down the nail, until I had to cut them all down to the quick and start over. Do you have any idea why this happened and what I can do to avoid it again? I was using all OPI products.

Sara, via email

Dear Sara,
It's hard to say what happened because, believe it or not, there are many things that can cause the problems you experienced, even though you were diligent about taking care of your nails. The first that comes to mind is an allergic reaction to the products you were using. Nail polish (even those that are formaldehyde-, toluene-, and phthalate-free) or nail-polish remover (even those that are acetone-free) can still cause allergic reactions for some, and can lead to everything from nail discoloration to the actual loss of the nail itself. A minor injury or trauma can cause nails to peel or split, and a serious blow to the nail can cause a permanent change or deformity in the nail.

The saying "hard as nails" is actually incorrect, because nails can be very sensitive to even the smallest impact. For example, constant picking and pushing at the cuticle can create a nail with deep ridges and can weaken the nail. Nails are also subject to fungus or yeast infection, which can alter the the color, texture, and shape of the nails. Thyroid disorders can produce brittle nails or separation of the nail bed from the nail plate, referred to medically as onycholysis. If your problem persists even after changing nail-care products, it may be best to see a physician to be sure your problem is not an underlying health issue for you. search

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Category: Skin Care

Dear Paula,
Your newsletter often says not to expect much from skin-care products that contain antioxidants, yet you sell a serum composed of antioxidants. I may be misinterpreting what you meant, so I'm wondering, just what should I expect from antioxidants?

Diane, via email search

Dear Diane,
Thank you for your question. I always appreciate the opportunity to explain how I am holding my own line accountable to the same critiques that I have always reported about the industry.

I understand how you came to your conclusion, because the issue of antioxidants is complicated and often overly hyped by the cosmetics industry as being the answer for every skin-care problem. What research there is about whether topically applied antioxidants can get rid of or stop wrinkling is so new that the results are hardly conclusive. No one is even sure yet about how many antioxidants are needed, or in what amounts, or which ones are the best, or even if there is a "best" among them, although research has shown there are lots of good ones. What IS known and undisputed about topically applied antioxidants is that they are powerful anti-inflammatory agents, many are excellent anti-irritants, some are even known to fight cancer cells, and all of that can be incredibly helpful for skin. This is why I added an antioxidant concentrate to my line, making sure it contains substantial levels of antioxidants. These ingredients can help reduce the inflammation caused to skin by environmental factors, such as sun exposure, pollution, or the air we breathe. There is also research showing that antioxidants can improve collagen production, boost the skin's immune response, enhance the skin's structure, and reduce skin discolorations. In the simplest terms, topically applied antioxidants can help skin function the way it should by mitigating what would otherwise impede (and, over time, destroy) these processes. (Sources: Wound Repair and Regeneration, July-August 2004, pages 419-429; Skin Pharmacology and Physiology, July August 2004, pages 183-189; and International Journal of Dermatology, May 2004, pages 326-335.)

The research into the antiaging capabilities of antioxidants is indeed uncertain. Nevertheless, it is happening at a furious pace, and there is definitely conclusive research demonstrating that topically applied antioxidants are beneficial for skin. They are particularly useful when they are part of a sunscreen formulation. Where the issue gets blurred, and where my critiques kick in, is when cosmetics companies play up the antioxidants in their products as being miracle ingredients that are able to "lift up" skin or generally erase every visible sign of aging and reduce wrinkling. More often than not, the antioxidants used in such products are present in such tiny amounts, it is unlikely they would have any benefit for skin, never mind the erroneous antiwrinkle or skin-firming claims.

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Category: Skin Care

Dear Paula,
I have been reading your book to get a new viewpoint, but I must say you really don't like much at all, do you? I am also bothered that you said Estee Lauder's Idealist is a moisturizer. It is a repair product that requires a moisturizer afterwards! You also said Lauder's Advanced Night Repair was only for nighttime, but if you had read the directions or asked anyone, it is to be applied a.m. and p.m., that is why it has a sunscreen. Do more research, rather than just writing your personal opinions. I was very disappointed; you seem very grumpy and unhappy with everything. We all know you cannot get fabulous doctor-achieved results from something over-the-counter, but we love the fact that we can try.

Veronica, via email

Dear Veronica,
Truly, there aren't enough hours in the day for me to do any more research on the beauty industry! It's what I spend most of my time doing. Depending on how you read my book (I think you may not have read the introductory material), I do understand your confusion, but I'm not sure how you missed the many products that received a "happy face" rating in my book. There are grumpy faces in my book, but there are hundreds of happy ones, too.

By any name, Lauder's Idealist is a "moisturizer" because there is no difference between a repair product and a moisturizer. All lotions, serums, and creams, no matter what the industry calls them, should help "repair" skin or, more accurately, help skin function in a more healthier manner. These kinds of ingredients, ranging from antioxidants to cell- communicating ingredients to ingredients that mimic the structure of skin, should all be present in skin-care products. If Lauder is leaving them out of their so-called "moisturizers," that cheats a woman's skin and forces her to buy more than one product when only one is needed. The good news is that most of Lauder's products contain these state-of-the-art ingredients, so you needn't worry or have to double up on your purchases (by the way, Creme de la Mer, Clinique, Aveda, and Prescriptives, all Lauder-owned companies, are for the most part well-supplied with the latest skin-care ingredients).

Lauder's Advanced Night Repair does not have an SPF rating and does not contain sunscreen. This is clear in my book as well as on the product label itself. You were either misled by the salesperson or you missed the section in my book on sun protection. Before you return my book, which you should do if you are so disappointed with the information, at least avail yourself of the sun-care section-it could save your skin.

One other point: I, too, love the fact there are skin-care products that can deliver wonderful results for skin. However, unlike you, I can't tolerate misinformed sales pitches, disingenuous marketing claims, and deceptive advertisements that bombard women with fiction instead of facts.

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Category: Skin Care

Dear Paula,
I have got to share this one with you. I just received a DHC catalog in the mail and was browsing through it over lunch. What caught my eye was a double spread on their very special Nunez De Prado olive oil for skin costing $36 for 1 ounce. I called DHC and asked if there was anything in their olive oil that was added besides just the pure olive oil, "No, no," I was assured, "It is the pure oil, cold-pressed, nothing else." I mentioned it must be the same product I have in my pantry then. "Oh, no," he exclaimed, "It's different; ours is COLD pressed." Well, so is mine and everything else he said about the DHC mini-bottle version is the EXACT same as my big bottle of olive oil!

I couldn't Resist doing the math: at $36 per ounce for DHC's olive oil, that would make the 24.4-ounce bottle in my pantry cost $878.40! Or, based on what I paid for my large bottle of olive oil, if I poured out 1 ounce of this into a cute 1-ounce bottle, it would contain $0.54 worth of virgin olive oil! Does this put things into perspective or what?!

Maria, Minnesota, MN

Dear Maria,
Great math! And that is exactly what I found to be true when I reviewed this DHC product a few years back, so your work is a great reminder of some of the absurd products and marketing hyperbole that abound in the cosmetics industry.

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Category: Skin Care

Dear Paula,
I'm so confused. It seems every time I read a fashion magazine, talk to a cosmetics salesperson, or watch an infomercial (I know, I need to stop doing this), there is always some special, super-potent, best-of-the-best, most stable antioxidant being touted. I'm concerned that I may be missing out on an important ingredient that can help my skin. Vitamin C, alpha lipoic acid, vitamin E, green tea, grape, vitamin A, the list seems endless. Do you know which one is the best?

Cindy, Chicago, IL

Dear Cindy,
To put your mind at ease, there isn't a best antioxidant ingredient for skin (or any one best ingredient for skin in any category); there are just lots and lots of good options. I wish there was only one super-duper antioxidant because that would really simplify matters for consumers and truly be best for skin, but it just doesn't exist. The research on antioxidants is extensive; a simple medical journal search brings up thousands and thousands of studies. Type "antioxidant" into Google's search page and you get over 1 million hits. Talk about overload! Despite this abundance of information, it is only recently that researchers have learned to reliably measure antioxidant activity in skin. Just because an ingredient is a potent antioxidant doesn't mean it can be absorbed into skin and stay active.

All of the antioxidants you mentioned are excellent options, with vitamins C and E having the greatest amount of research showing their benefit. However, there are many other contenders with potent antioxidant properties, including beta-glucan, selenium, superoxide dismutase, astaxanthin, glutathione, curcumin, turmeric, andrographolide, nordihydroguaiaretic acid, raspberry extract, soy extract, beta-carotene, and resveratrol. Sometime in the future, hopefully sooner rather than later, we will know what the best antioxidant for skin is, but for now the research is too new for anyone to suggest we are even close to knowing which one it is. Your best bet is to look for skin-care products that are loaded with antioxidants, the more the merrier, and higher up on the ingredient list is almost always a good sign (Sources: Free Radical Biology and Medicine, March 2000, pages 871-879; Toxicology in Vitro, October--December 2003, pages 609-613; Journal of the European Academy of Dermatology and Venereology, November 2003, pages 663-669; and Journal of Cosmetic Science, November--December 2003, pages 589-598).

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Category: Skin Care

Dear Paula,
I want to tell you about an observation I made a little while ago. I was flipping through a beauty magazine and came across a page where four women tried four different under-eye firming creams. The women gave comments about the products they tried and there were also before and after pictures. I looked at the after photos and I thought the women looked great. It seemed to me that the creams really worked. Then I took a closer look and noticed that three women had different hair colors, all four women had arched and dyed eyebrows, and one lady had lighter colored eyes. No wonder they looked so much better.

Jasmin, via e-mail search

Dear Jasmine,
This is a great example of how most beauty magazine's "before and after" pictures are almost always altered, tweaked, and manipulated to make the "before" shots look plain or shadowy and the "after" shots irResistibly appealing. A comparison of under-eye firming creams should focus on the skin around the eyes, yet instead the images are embellished using all kinds of enhancements, from brighter or softer hair color to colored contact lenses, ideal lighting, and computer-assisted airbrushing--which can eliminate any conceivable flaw and be tailored to produce whatever the intended result may be. You have to ask yourself: How good can this firming cream be if these women had to have a team of professionals perk up their hair and makeup in order to make consumers think a little eye cream can turn the infamous ugly duckling into a graceful swan? My consistent advice with these types of ads or articles is to take the results you see there with a great deal of skepticism.

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Category: Skin Care

Dear Paula,
I get facials once per month and have been told I have normal to dry skin. My skin-care routine is based on suggestions in your book Don't Go to the Cosmetics Counter Without Me. I use Cetaphil Gentle Skin Cleanser, a scrub, a toner, Neutrogena Healthy Skin Lotion (for exfoliation), and a moisturizer with SPF 15. At night I apply Clinique's Moisture On-Line, and twice per week I use Estee Lauder's So Moist Hydrating Mask.

My appearance has always been important to me, and today, at age 76, I still do not look my age. From what people tell me, I look at least 15 years younger than I am. However, after having lost 18 pounds two years ago while dieting, I immediately noticed some wrinkles I had never seen before, a result of losing fat in my face (as you have so often pointed out, losing fat makes wrinkles more evident). These wrinkles are the only downside of my weight loss because my overall health is excellent.

I'm seriously considering consulting a dermatologist about chemical peels, dermabrasion, and other cosmetic surgery options. However, I am scared to death of what might go wrong. A friend of mine had a chemical peel and today she is left with blotches on her skin. I want to ask if you think that having cosmetic surgery at my age is too risky, or if you think (because of my age) it is too late. Thank you for the advice, and for your books!
Eva, Glenside, PA

Dear Eva,
My mother and I often have this discussion. She is about your age and had a face-lift in her mid-50s. It has held up great and her face doesn't show her age, but, like you, it isn't what it was. And like you, she wants to know what she should do now. I will tell you what I told her. All corrective cosmetic procedures performed by dermatologists or plastic surgeons that have a noticeable impact on the face have associated risks. However, certain procedures have less risk than others. Cosmetic surgery and ablative laser resurfacing (done with a carbon dioxide laser) have the highest chances of causing undesirable or untoward results. On the other hand, Botox, dermabrasion, nonablative resurfacing (using either laser, pulsed light, or radio frequency) have minimal associated risks. However, except for Botox, the general rule is that the more impressive the results, the greater the risks. You simply can't get away from the potential of problems if you want dramatic results. If you are told that there will only be perfect results, then you are being misled. Unfortunately, there are some physicians who will tell women not to worry, assuring them that there is no chance of problems, and then have them sign a release, which most patients don't read, listing all the possible negative outcomes.

I am not one of those women who believes a woman over 70 should just be thankful she is alive and forget about her wrinkles or not looking her age. There are those who will tell you that the advantages of corrective cosmetic procedures are not for you. I disagree. That is a decision each woman needs to make for herself. If your appearance is important and you want to investigate options that are available for you there is every reason to start the process of interviewing plastic surgeons or dermatologists to see which one offers the best combination of procedures. Keep in mind that research has shown that women who are most happy with the outcome of the procedure they receive are those who are realistic about what type of results are really possible. Unrealistic expectations lead to disappointments. You also must be sure the physicians you talk to are licensed and affiliated with a local hospital.

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Category: Skin Care

Dear Paula,
THANK YOU, THANK YOU, THANK YOU for all the time, effort, and hard work you put into helping us make educated decisions about cosmetics and other products.

I recently received my Bachelor's degree in business administration. I minored in marketing and worked at the cosmetics counters at a major department store. Considering what I learned in my classes and through my experience selling cosmetics, I was shocked to learn how misleading advertising could be while still not being thought of as unethical.

Paula, there is one tidbit of information that has helped me to be a more educated consumer of all products. I hope you will share this information with your readers: watch out for the word "may" as in: "May help reduce" or "May aid in the protection of." In all "marketing" honesty, using the word "may" allows any company to make claims with little or no proof to support them. Paula, it is imperative that you continuously remind your readers that advertising can be very misleading. Thanks to your work and my personal experience, I am a much wiser cosmetics consumer!

Robbin, via email

Dear Robbin,
Your point is well taken, something I have been painfully aware of and warning consumers about during my entire career. After all these years it is still amazing to me how easy it is for advertisers to slink by the Federal Trade Commission's scrutiny for truth in advertising. There are many words used in cosmetics advertising that don't really lie to the consumer, but they definitely make the product sound like it can do more than what the ad is really alleging. Along with "may", cosmetics claims are littered with words like "œminimizes," "œseems to," "can reduce," "improves," and the ever-popular "our research shows."

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Category: Skin Care Date: March/April 2004

Dear Paula,
I recently went to the Estee Lauder counter at a local department store and got some information that was completely new to me! Please let me know what you think of this.

I was returning a moisturizer that seemed to cause a reaction. I wanted to exchange the product for another, and decided on one of their other products. The salesperson was keen to sell me a special moisturizer for the eye area, but I didn't really want to spend the extra money. I have tried eye creams before, but haven't seen any results that made them seem worthwhile. Maybe I don't have the discipline to use the product in the manner prescribed.

The salesperson proceeded to tell me that using regular moisturizer in that area caused some small bumps under my eyes. She said the bumps were actually trapped "moisture" from products that were too heavy and not designed for the undereye area. She had a name for it that sounded something like "miosma." I should have asked her to spell it, but I mostly wanted to end the conversation. She said that the only way to get rid of the bumps was to go to an aesthetician, who would prick them and drain the "moisture." Of course, she was completely serious about the whole thing, and said she tried to make a point of telling people when she noticed that they had the condition.

What do you think of this? You state in your book that you see no need for special eye creams. I can't remember when I got these undereye bumps, but it was many years ago, when I was young and careless with my skin. I have assumed that they were caused by excessive sun exposure.

Sharon, via email

Dear Sharon,
Your experience of being disappointed by eye creams you have purchased in the past isn't surprising; they can't perform as promised. If they did, why would the industry keep launching new ones with new formulations every month? If the ones from last year with the same claims didn't work, why would you believe the new ones would? Lots of women blame themselves when the products they've invested in disappoint them. The advertising and sales pressure is so great that women don't blame the manufacturers' misleading claims; rather they blame their ability to get it right.

First, the skin does not trap water in permanent bubbles under the eye (they would be blisters then and a troublesome problem). Second, I have never used a special "eye cream" around my eyes. I use my regular moisturizer around my eyes and I don't have bumps around my eyes, nor do the 16 women who work in my office nor do any of the women in my life (and you can rest assured that the women in my life follow my skincare recommendations).

I suspect what the woman was trying to diagnose for you was a condition called milia. If what you have around your eyes are whitish, solid bumps that are not inflamed and haven't changed in size, then they are most likely milia, though a dermatologist or physician could tell you definitively what they are. If what you have is indeed milia, they are filled with skin cells and lipids generated in the oil gland/hair follicle. It turns out milia are very common, occurring in women and men of all ages from infants to adults, and they often show up around the eyes and cheeks. There is no research or information anywhere showing that milia is the result of not using an eye cream.
Milia can be left alone safely, but they can also be removed by a physician with a tiny incision using a cutting-edge needle and then removing the stuff inside the pore. Milia can also be effectively removed with lasers or microdermabrasion (Sources: emedicine.com/DERM/topic265.htm and Lasers in Surgery and Medicine, December 1997, pages 13-19).

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Category: Skin Care

Dear Paula,
I had a little skin cancer last year, and will continue to see a dermatologist on a regular basis, but I was wondering what you would do if you had skin cancer. I have two very small spots on my face that appear light pink and scale a little even though I use SPF 15 sunscreen on my face and moisturize with a good product. Are there products that may remove any new cancer that may be blossoming, or do I have to go as far as skin peels?

The plastic surgeon who removed this cancer has given me a prescription for a cancer cream that I could use on these spots, but I'm not sure if I feel comfortable doing this. If there is an exfoliating cream that can perhaps do the trick, that is what I'm looking for. It seems the people I know who have had skin cancer on their faces continually have it recur somewhere else on their face, and continually have it removed. What should I do?

Deb, via email

Dear Deb,
It's hard to say hypothetically what I would do if I had a skin cancer because there are so many variables to address that it would be hard to generalize. An all-purpose rule to use for any health concern is to become a voracious researcher. You should be looking for all the research you can find about the issue, and be proactive about finding physicians open to answering questions. Nonetheless, for your own specific situation, it would have been far better had you been more specific in the details you provided because it isn't possible for me to understand what is really happening without knowing the exact type of skin cancer you had removed and the prescription medication you are apprehensive about using. There are three main types of skin cancers: basal cell carcinoma, squamous cell carcinoma, and melanoma. Actinic keratosis, also referred to as solar keratosis, is a precancerous condition that is often included in this group. Each condition has its own treatment modalities, health concerns, and recurrence risks. When it comes to skin cancers, there are no over-the-counter options for removing or treating lesions. An AHA or BHA peel (which affects primarily the top layers of skin) will not eliminate or prevent a skin cancer. Treatments for skin cancer and precancerous lesions lie strictly in the purview of dermatologists or oncologists. You would never want to risk your life solely on the knowledge of an aesthetician or cosmetics salesperson. If you are not comfortable with your physician's recommendation, then get a second opinion from another physician whose specialty is skin cancer, and then decide what course of treatment you want to follow.

In addition, I am very concerned to read that you are using only an SPF 15 for your sun protection, and you didn't mention whether or not it contained UVA-protecting ingredients (either avobenzone, titanium dioxide, or zinc oxide). Ideally, you should be using an SPF 30 with one or more of those active ingredients, and there are many dermatologists who would suggest that you use a pure mineral sunscreen; that is, one that contains only titanium dioxide and/or zinc oxide as the active ingredient(s), because many believe that they provide the best protection of all against skin cancer. Those with skin cancer and those who have had it previously should strongly consider using a mineral sunscreen. Be aware that if the skin turns tan or pink "in any amount" it is a sign of sun damage, and the cumulative effect of this is most likely what got you to the place you are right now.

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Category: Skin Care

Dear Paula,
Thank you for your diligent work. I am a researcher in the medical field and it seems that your rigor, thoroughness, and careful review and judgment of the evidence meets (and often exceeds) the standards scientific investigators pledge to hold. I applaud your principled and justified review criteria and how scrupulously you apply those rules. I have to admit that I have been very pleased with the purchases I have made when I followed your suggestions. I am middle-aged and have never looked or felt more like a natural beauty! Thank you!

Here is my question: My daily skin-care routine includes a number of products that leave some sort of residue. At the behest of my affectionate husband who prefers to kiss my untreated face, I'd like to go to bed with fewer products on my face and neck. Particularly for Retin-A and hydroquinone preparations, is there a time period after which the effective ingredient has been absorbed into the skin and some of the excess product can be gently sponged off without reducing the effectiveness of the product too much?

Elisabeth, via email

Dear Elisabeth,
Thank you for your supportive comments. I am always pleased when I hear that my work helps someone better understand their skin-care choices, especially when it comes from a medical researcher such as you.

My husband has the same complaint. What a shame skin-care products aren't a turn-on, given how religiously most women apply them at night! There is no specific, elapsed period of time established for when an ingredient is absorbed into skin. However, as a general rule, you can probably assume it takes at least half an hour to an hour for product to penetrate beyond the skin's surface. To be absolutely sure, letting as much time pass as possible before you remove the offending taste of the treatments you are using would be best. Still, I would not sponge or wash off the products you've put on your face. A gentle dabbing with a slightly damp cloth or tissue would be far better, with the goal being only to reduce the excess surface residue. search

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Category: Skin Care

Dear Paula,
I see you have a new hair style...it looks great. Have you also made other changes in your skin, make-up, etc? Please tell me about it. There was just a small picture on the Beauty Bulletin but from what I can see, it makes you look younger!

Meme, via email

Dear Meme,
I admit to being quite surprised at the positive reaction from readers to the new picture of me that we added to the October 23rd issue of the Beauty Bulletin and on my Web site. The number of flattering comments and questions I have received has been overwhelming! What is especially gratifying (as my 50 birthday approaches) is to hear from readers that they think I look better, more vibrant, and younger than ever. Not surprisingly, many of you have asked if I had changed my skin-care routine, had cosmetic surgery, changed my diet, or if my hair had been permed. I wanted to take a moment to not only thank you for the wonderful favorable comments I received but to address the most common questions that stemmed from this updated picture of me.

To those who asked if I had gotten a perm, I have not and would not. Pragmatically speaking, if you have dyed hair, perming it is only asking for trouble (meaning lots of breakage), especially on highlighted hair, and my hair is definitely highlighted. Functionally speaking, my hair is naturally curly, though not nearly as manageable and smooth as it appears in the photograph. In fact, this hairstyle took quite some effort, not to mention a very talented hairdresser who had the skill and patience to diffuser-dry my hair (to keep it smooth and reduce frizzies, though my hair is still pretty frizzy) and then style each tendril with an array of products and tools (smoothing serum, pomade, hair spray, and a curling iron). In my professional life and for media appearances, I wear my hair styled straight. That's how most reporters wear their hair on camera and I have followed suit. Actually, years ago, when I wore my hair curly for a talk show appearance the producer asked me if I was having a bad hair day. That took care of any notion of changing protocol and I have worn it straight ever since.

However, for this particular photo shoot, my team (who all seem to love it when I wear my hair curly) encouraged me to go for a softer, casual look. It was only after we selected the pictures I realized this is the first time a picture of me with curly hair had been used in any promotional materials. Based on your positive comments, it probably won't be the last time! I still might not wear my hair curly for TV, but for my Web site and newsletters, well, that's another story.

My skin-care routine has remained the same, though I admit to being a bit obsessed with a few of my products. I love my new Skin Balancing Cleanser and I am attached to my 2% BHA Liquid. Overall, my routine is fairly low-maintenance. I cleanse my face twice a day, and almost every night I religiously apply my 2% BHA Liquid all over my face (or switch between that and my Final Touch Toner for Normal to Oily/Combination Skin) and then apply Super Antioxidant Concentrate over dry areas and around my eyes. In the morning, I apply Skin Balancing Moisture Gel on my face (which is still slightly oily) and then use either the Skin Recovery Moisturizer or Hydrating Treatment Cream around my eyes (which are pretty dry). During the day I wear Best Face Forward Foundation SPF 15 and Healthy Finish Pressed Powder SPF 15 (for sun protection). I also apply my Pure Mineral Sunscreen SPF 15 from the neck down because the protection is fantastic and it has improved the appearance of my hands and arms which have less skin discolorations.

For the photo shoot, I opted to keep my makeup soft, and chose a warm palette of peach and gold tones to complement the orange and gold tones in my sweater (click here for a complete list of the items I wore). My eyeshadows were subdued neutrals while my cheeks and lips were colored with soft peachy-pink tones. This style of makeup is similar to what I wear on days when I take the time to apply more than foundation, blush, lipstick, and mascara (I always wear mascara, and probably too much of it!). And because this was a professional photo shoot, it should be noted that the lighting was carefully controlled in order to make me look my best. In other words, I don't wake up looking like this. Believe me, I wish I did.

Regarding whether or not I have had "work done" (meaning cosmetic surgery), the only procedure I have had done recently is the same one I have chronicled in the past--namely, Botox injections in my forehead and around my eyes. I am seriously considering other cosmetic corrective procedures for the future and have interviewed many physicians over the past year both in the United States and Canada. (Prices for corrective cosmetic procedures in Canada are often far less than in the US even when you don't take the exchange rate into consideration.) I will probably make a final decision sometime next year on exactly what procedures I am going to select, weighing out the benefits and risks.

As far as overall health is concerned, several months ago, my husband and I began making some healthy lifestyle changes, including exercise (strength training with weights and cardio-enhancing workouts) and dietary changes. I have made a conscious and ongoing effort to eat as healthy as possible, eschewing simple carbohydrates (white rice, pasta made from refined flour) in favor of high-fiber, whole grain, and high protein choices (mostly fish). I have also increased my consumption of fresh fruits and vegetables, not only for their abundant nutrients but also for their antioxidant content. I have always been good about staying away from trans fatty acids.

I am not certain the dietary changes I have made are showing in my skin, but I do know I feel better and have more energy than when I allow myself to eat whatever is available (or whatever I'm craving). Just to be clear, I am not following any particular diet (many of you asked if I was on the Atkins plan, and I am not). Rather, I am simply eating better and exercising more often in order to maintain good health and keep myself physically fit. I truly believe that real beauty can only be achieved when we take exceptionally good care of ourselves on the outside and inside. That means not only tending to our skin and hair by doing what is healthiest for our outside but exercising regularly, eating well, and maintaining meaningful relationships with family and friends, which should include ample opportunities for laughter--one of my favorite beauty tips of all!

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Category: Skin Care

Dear Paula,
Could you report on the pros and cons of the topical prescription medicine Elidel? I've been diagnosed with (alternately, depending on which doctor I've seen) seborrheic dermatitis, or mild eczema, or low adrenal-low-thyroid-related dry flaky skin on my face. My last dermatologist advised Elidel for the problem, and said I could basically use it on a permanent basis. Elidel does work. My skin, which was never perfect anyway, looks far better than it has looked in years, so I don't want to look a gift horse in the mouth. However, I'm a little nervous about long-term use of such a new product. According to the manufacturer's Web site, and all the information I could find on it, Elidel works by shutting down your skin's immune response. And, according to some studies, this may make users more prone to skin cancer. Does that mean that Elidel users will be prone to other kinds of long-range problems, too?

Elidel's maker also recommends that you only use it until the problem remits, at which point you should stop using it until the problem returns. My skin cleared up almost immediately with Elidel (though I kept using it for about five weeks), but worsened about a week after I stopped using it. Is it possible to use Elidel every other week? What about only using it once a day? What about using any other skin-care product with it?

What about the manufacturer's statements that you should not use Elidel if you're immunocompromised? What does that mean exactly? And if Elidel is used sporadically will the symptoms ever recur?

Linda, via email

Dear Linda,
Your questions are all extremely important, but I must encourage you to discuss these at length with your dermatologist or medical caregiver. I will do my best to address your concerns, but do not construe this as medical advice in any way, shape, or form.

Elidel is the trade name for the topically applied, prescription-only cream that contains pimecrolimus. It is one of a new generation of nonsteroidal medications recommended for either psoriasis or atopic dermatitis, both equally hard-to-treat skin disorders known for their extreme discomfort and for disfiguring your appearance. The first drug of this class was Protopic, which contains the active ingredient tacrolimus. (Source: Journal of the American Academy of Dermatology, February 2002, pages 228-241.)

No one is quite sure why Elidel works on certain types of dermatitis, and it is not a cure (Source: www.fda.gov/cder/foi/label/2001/021302lbl.pdf). It is intended for long-term use, but only for short or intermittent periods. That means you can start using it when symptoms show up and stop using it when the symptoms go away. When symptoms recur, you start once again, and you can keep up with that pattern of application forever.

There are indeed risks to consider when using this drug but I have seen no research associating it with an increased cancer risk. Pimecrolimus does suppress the body's immune response, which is why it should not be used by those who are immunocompromised. Immunocompromised refers to an immune system that is not working normally. This occurs when people have certain illnesses such as AIDS, diabetes, some forms of cancer, cystic fibrosis, and some liver and heart diseases.

Another concern about using a treatment that lowers the immune response is the need to avoid sunlight, because the body will be less able to defend against UVR (ultraviolet radiation) damage. Other common side effects may include headache, flu, sore throat, and fever. If you have had warts, herpes, or shingles in the past, Elidel can trigger recurrences.

Despite the side effects, there is no question that research shows this drug to be successful in treating of atopic dermatitis and psoriasis. And the sooner you use it when symptoms occur, the quicker and better your skin will respond. (Sources: International Journal of Clinical Practice, May 2003, pages 319-327; Journal of Allergy and Clinical Immunology, May 2003, pages 1153-1168 and August 2002, pages 277-284; and Journal of Investigative Dermatology, October 2002, pages 876-887).

I have no information about what kinds of skin-care products can be used with Elidel, and the dermatologists I spoke to didn't agree, so this is something best left up to your doctor and his or her experience with this drug. The good news is that once the symptoms subside and you discontinue the Elidel, you can absolutely resume using your normal skin-care routine.

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Category: Skin Care

Dear Paula,
I recently got your book and was very pleased with it. I just was a little disappointed in two areas. For years I've been hoping for a symbol to denote fragrance-free cosmetics along with your smiles and frowns and recently added "Paula's Pick" check marks. I had in mind an image of a perfume bottle with an "X" over it. How about it?

Also, the sixth edition's list of Best Moisturizers has no reasonably-priced products listed. How did all the formerly reasonable products in the moisturizer category all disappear from your current Best Products list? I found a lot less reasonably-priced drugstore brands listed in the Best Products chapter. Did the quality of expensive cosmetics go up drastically and/or the quality of cheaper brands go down drastically? I find that hard to believe.

C. H., via email

Dear C.H.,
We struggled with finding a way to indicate which products contain fragrance and which ones don't. It turns out there are so few fragrance-free products (and I mean almost none) that the number of options would be minuscule. Moreover, one of the largest groups of products to be fragrance-free is mine. Creating a special symbol that would showcase my products over others would appear to be biased or inequitable. I already take a great deal of flack for reviewing products from other companies given I have my own line, despite the fact that lots of products I review get positive ratings. It was a struggle to decide how to provide the best information possible for the consumer and avoiding any appearance of partial or unbalanced reviews.

Your last question is insightful. One of the most significant changes in the current edition of my book was how moisturizers were reviewed. Because of the abundant amount of research on the function of antioxidants, anti-irritants, and water-binding agents (ingredients that mimic or are contained in the actual structure of skin) in skin-care products showing that these types of ingredients can significantly and positively affect skin, only the moisturizers that had a high proportion of these ingredients received the best ratings. For whatever reason, most inexpensive moisturizers lack these ingredients or, if they do contain them, contain very little. If these ingredients are not important to you, there are indeed many effective, inexpensive moisturizing options at the drugstore, and these are reviewed within each relevant line.

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Category: Skin Care Date: July/August 2003

Dear Paula,
Thanks for a great book that is also very helpful to a naturopath! I would like some clarification on your entry in the Cosmetics Dictionary section of your book Don't Go to the Cosmetics Counter Without Me. You state that there is no evidence that vitamin E can help scars and that topical application can actually impede the healing process. You do not seem to differentiate between d-alpha tocopherol (natural form) and dl-alpha tocopherol (synthetic form). Within the body, the natural form of vitamin E is known to be hundreds of times more absorbable. The synthetic form is derived from petrochemicals and as such may produce irritation in sensitive skin. The natural form of vitamin E does not exhibit this. In fact, natural vitamin E is used in several serious burn units in the USA.

I doubt that anyone would use a skin cream to treat scarring--burns are another matter. Burning, whether by the sun or other means (and scarring) produces significant oxidative damage. As a premium antioxidant, vitamin E would certainly help to minimize this. I have used this therapy within my practice on numerous occasions quite successfully.

Chris, via email

Dear Chris,
I appreciate that my information has been helpful for you, despite your concerns about vitamin E. The research I quoted about vitamin E on wound healing did not indicate which type of vitamin E was used, so I can't confirm or deny your belief that the "natural" form of vitamin E would perform better than the synthetic form. Concerning the use of vitamin E in burn units, there is no research demonstrating it is being used for this purpose, and a call to the local burn center here in Seattle (the University of Washington Burn Center at Harborview Hospital is one of the largest in the United States) confirmed that they are in fact not using it.

I understand the drive to believe that all things natural are good and all things "unnatural" are bad but there is research showing synthetic vitamin E to have certain health benefits when taken orally (Source: Cancer Cell International, March 12, 2003, www.cancerci.com/content/3/1/3/abstract and Journal of Nutrition, January 2001, pages 161S-163S). Also, synthetic vitamin E is not derived from petrochemicals, though it is synthesized in the lab.

When it comes to any form of vitamin E applied topically, the following information from www.healthnotes.com might be of interest to you and my readers: "Antioxidants may protect the skin from sunburn due to free radical-producing ultraviolet rays. Combinations of 1,000 to 2,000 IU per day of vitamin E and 2,000 to 3,000 mg per day of vitamin C, but neither given alone, have a significant protective effect against ultraviolet rays, according to double-blind studies. Oral synthetic beta-carotene alone was not found to provide effective protection in a recent double-blind study, it may be effective in combination with topical sunscreen.... However, other carotenoids such as lycopene may be more important for ultraviolet protection. One recent uncontrolled trial found 40 grams per day of tomato paste providing 16 mg per day lycopene for 10 weeks protected against burning by ultraviolet rays. Another uncontrolled trial found 25 mg/day of natural mixed carotenoids also protected against ultraviolet radiation, especially when combined with 500 IU per day of vitamin E. Double-blind research has also shown that topical application of antioxidants protects against sunburn if used before, but not after, exposure.

"Despite a lack of research on the subject [and some research showing no benefit], using vitamin E topically on minor burns is a popular remedy. This makes sense, because some of the damage done to the skin is oxidative, and vitamin E is an antioxidant. Some doctors suggest simply breaking open a capsule of vitamin E and applying it to the affected area two or three times per day. Vitamin E forms are listed as either 'tocopherol' or 'tocopheryl' followed by the name of what is attached to it, as in 'tocopheryl acetate.' While both forms are active when taken by mouth, the skin utilizes the tocopheryl forms very slowly. Therefore, those planning to apply vitamin E to the skin should buy the tocopherol form."

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Category: Skin Care

Dear Paula,
I am a beauty advisor for Clinique and I truly believe in helping people with their skin needs. While I think you have some good tips, I find you don't always tell the full story. Your information about antioxidants and how they start to deteriorate upon exposure to air is true. This is why antioxidants must come in airtight packaging, and why Clinique's Advanced Stop Signs is packaged that way. The problem I have is when you say women are wasting their money if they buy any product in a jar. While this would be true if all creams contained antioxidants, not all of them do, nor do they all need to. Some treatment creams are for different things, like Clinique's Total Turnaround Visible Skin Renewer, containing salicylic acid for fine lines, a more even skin tone, and softer skin. This cream comes in a jar, which causes no harmful degrading effects to the product. I feel you have some great advice but should be more specific for your readers because I assume we both have the same goal, helping people look great inside and out.

Shannon, Toronto, Canada

Dear Shannon,
I appreciate your comments but your assumptions about jars and other ingredients are not entirely correct. While you are right about the fact that some products don't need to be in airtight containers, particularly those that have no antioxidants or plant extracts, there is still the issue of contamination for lotions and creams that have to be scooped out with your fingers. Bacteria, molds, and fungi are 100% more likely to invade a product that is in a jar than those where fingers never touch the product. And that isn't great for skin or the stability of the product. Further, your notion that salicylic acid is stable on exposure to air is not correct. According to the Material Safety Data Sheet(MSDS) for salicylic acid, it is a substance that should be kept away from sunlight and oxidizing agents (meaning air). So an airtight, opaque container is essential for salicylic acid as well.

Just two more points: Clinique's original Turnaround and newer Total Turnaround products absolutely contain plant extracts and antioxidants, ingredients that we both know are not stable in jars. And what about all the other Clinique products filled with antioxidants and plant extracts that are packaged in jars as opposed to airtight containers? How do you explain that to a customer?

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Category: Skin Care

Dear Paula,
I am a beauty consultant with a national cosmetics company and have been in the industry for 15 years, skin care being my utmost concern. I tend to agree with you in most cases and have enjoyed your books. However, on the subject of eye cream I disagree wholeheartedly. You condone eye cream only if the skin around the eye is different from the rest of the skin. The skin around the eye is ALWAYS different from the rest of your skin--you can feel it and tell it is different. It is thinner, the pores are smaller, and it doesn't have oil glands. How many people get pimples under their eyes? That is the reason the eye area can tolerate and needs more oil than other areas of your skin. I have at times used the moisturizer I use on the rest of my face on my eye area, and notice a huge difference when I use a separate eye cream. I know I am not alone in this either. Furthermore, I would never tell someone to purchase an eye cream just because it would make me more money. In fact, I previously didn't like the eye cream our company had, and therefore never recommended it. Now they have different eye creams available and one of them is really good, so I do recommend it and hear nothing but great feedback. I really think you're off base on this one!

Kim, via email

Dear Kim,
I personally can't feel a difference between the skin under my eye and on my face. Aside from my own anecdotal experience, the differences you mention, oil glands and pore size, would only be true for those women who have active oil glands or open pores on their face. If they don't they would have similar skin texture issues under their eyes. In essence, the skin around your eyes is not drastically different from that on your face and definitely not different enough that it would in any way substantially affect skin care. Thickness or thinness of skin does not alter skin-care needs. Plus, there are plenty of women who get milia (a form of clogged pores also known as whiteheads) around the eye area and who do occasionally get blemishes, something that thick, oily moisturizers or too-emollient concealers can cause.

You are assuming that the difference between eye creams and face creams is their oil content, and I have not seen that to be the case (a quick glance at the ingredient label will show that to be true). Often the only difference between eye creams and face products are the waxes put in eye products to make them thicker; and for daytime, most eye creams don't contain sunscreen. None of that is helpful for skin.

In terms of skin care, what's needed is to provide the skin with ingredients that resemble the skin's own structure, along with skin protection (sunscreens) and antioxidants (all of those factors can affect wrinkling). These needs don't differ from the eyes to the cheeks, or even the chin. What does differ is how emollient the product is (the amount of lipids it contains), and where you put it depends on how dry the areas on your face are.

Without knowing what products you are talking about, I assume that the product you were using on your face wasn't emollient enough for the skin around your eyes, and that is completely understandable. However, if you were using a well-formulated and emollient face product, using it around the eyes would also have been great.

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Category: Skin Care

Dear Paula,
What do you think of Physician's Complex Microdermabrasion Cream? I received this product from www.totalskincare.com and am very much interested in your thoughts. I am excited that this cream contains the same magnesium oxide crystals used in regular microdermabrasion procedures.

Andrea from Columbia, MD

Dear Andrea,
With the rising popularity of microdermabrasion, it was only a matter of time before cosmetics companies would begin launching products to use at home that supposedly mimic the effect of a microdermabrasion treatment. Products such as Physician's Complex Microdermabrasion Cream ($59 for 3 ounces), Crystal Clarity Microdermabrasion Cream ($47.50 for 2 ounces), EpiDerm Microdermabrasion Cream ($78 for 2 ounces), and Dermanew Microdermabrasion Cream ($42 for 2.6 ounces) contain the same (or nearly identical) abrasive ingredient used in microdermabrasion machines, namely aluminum oxide (also known as corundum crystals). What consumers often fail to realize (and the ads for these creams certainly don't mention) is the fact that adding this component of the microdermabrasion procedure to a cosmetic scrub product is not going to produce the same results as the actual treatment will. For one thing, you're asked to believe that massaging these gritty-feeling concoctions over your face is akin to a mechanical device shooting pressurized aluminum oxide crystals at high speed against your skin and then vacuuming it off, a process that is controlled and monitored by the technician or physician performing the procedure. I understand the temptation to want to continue such treatments at home, but they cannot in any way provide the benefit microdermabrasion imparts. For all intents and purposes, these products are nothing more than scrubs, and rather irritating ones at that.

The main concern for these microdermabrasion scrubs is the fact that they are quite harsh, with the rough feel of sandpaper or coarse salt. The directions for these scrubs all indicate that they should be massaged over the skin for several minutes, which can produce a lot of irritation, especially for those who are overzealous with their technique. The direct message accompanying all of these creams is that you can literally scrub away your skin problems, whether they are acne, blackheads, wrinkles, or discolorations. Further, many of these creams include other skin irritants, such as orange oil, lemon oil, and menthol. None of these are beneficial for skin, and they're even worse when they're introduced while the skin is being abraded by aluminum oxide or magnesium oxide particles. Given that real microdermabrasion procedures require successive treatments to maintain what can only be described as superficial results, you should ask yourself how likely is it that a microdermabrasion scrub will be the cure-all for every major skin woe? The bottom line with all of these microdermabrasion scrubs is that they are inadequate and potentially harmful substitutes not only for genuine microdermabrasion treatments (preferably performed by a physician) but also for consistent use of well-formulated AHA or BHA products.

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Category: Skin Care

Dear Paula,
I am an Ex-Registered Nurse and now a part-time "beauty guide" for Origins. I started with Clarins, but I eventually chose to work for Origins because although I have used and continue to use products from other lines (including yours), I found that the products I most enjoy using and the ones that gave me the best results, tended to be from Origins.

I know how you feel about the indiscriminate use of natural ingredients in cosmetics, the potential irritation these ingredients can cause, and the hype related to this practice in the industry, and I do understand your point. However, Origins maintains that each plant-derived ingredient in their products serves a specific purpose—they even publish a guide for employees explaining the purpose of each natural and synthetic ingredient in the products. You may feel the "purpose" of some of these ingredients is misinformed, based on the latest research you have seen, but it is my understanding that Origins, as a branch of Estee Lauder, conducts its own efficacy research as well. You have reversed your position about certain ingredients and skin-care practices over the years based on your understanding (and interpretation of) the latest research. Interpretation of research is key, and I sometimes wish consumers and advocates would be a bit more savvy about that.

Paula, your work has enlightened all of us about potential irritants. And yet, many of the effective ingredients that really work on skin (Retin-A, salicylic acid, AHAs, even baking soda) do their work by a form of controlled irritation. And many times, that irritation is not well-supervised or "controlled." So when someone says "it's OK to use an acid product on your skin, but it's not OK to use a product with lemon or grapefruit in it" what they are saying is "It's OK to irritate your skin if you are after a smoother, less aged appearance because the risk is worth it, but it's not OK to potentially irritate skin if you want to enjoy a fresh-smelling cleanser free of synthetic perfumes." That's a value judgment—it's a convenient interpretation of the research, based on the particular value of a youth-obsessed society.

I use AHA products and those with citrus in them because I want younger-looking skin and lovely smelling products. I discern irritation by how my skin feels after using something. If it feels irritated, I don't use it! I just don't believe we should be overly concerned with "silent irritation" that our skin might not let us know about and how it might be "preventing healing." To be so concerned about something so subtle while we acid, laser, and Botox our faces and expose ourselves to industrial pollution, wind, and the environment, it seems silly to me to worry about the potential irritation of a little spearmint or lemon¾especially if those ingredients please the senses or offer other benefits. I think [in order to] have zero irritation we would need to live in a plastic bubble. Therefore, I choose products based on how they feel and work, and not so much by the "bad" and "good" ingredients, which experts disagree on anyway.

Paula, I continue to be a fan of yours. Even though I don't always agree with your perspectives, I always look forward to your reviews because I do respect your in-depth knowledge about the skin-care industry.

Maya from Las Vegas

Dear Maya,
I appreciate you taking the time to share your thoughts with me, and your points are well taken. You're right when you say that we disagree on a few points. Yes, I absolutely interpret research I've uncovered and apply that to formulations to evaluate their efficacy and claim assertions. In my reviews, as often as I can, I cite the source of the information very clearly. You mentioned that it is your understanding that Origins (i.e., the Estee Lauder corporation) must have research of their own regarding the efficacy of the ingredients they use. Whether or not that is true is nothing more than a guess because Lauder hasn't published that research and they definitely aren't sharing it with the public or their sales staff. I've seen the training manuals for many cosmetics lines, including Origins, and the source of the information regarding their ingredients isn't indicated.

For example, Origins is quite fond of using peppermint, menthol, and camphor in many of their products. These are considered counter-irritants (source: Archives of Dermatologic Research, May 1996, pages 245-248; Code of Federal Regulations Title 21-Food and Drugs Revised as of April 1, 2001, CITE: 21CFR310.545, www.fda.gov). Counter-irritants induce local inflammation to relieve inflammation in deeper or adjacent tissues. In other words, they substitute one kind of inflammation for another. The major function of these types of ingredients is to cause irritation, period. That is never good for skin. Irritation or inflammation, no matter what causes it or how it happens, impairs the skin's immune and healing response (source: Skin Pharmacology and Applied Skin Physiology, November-December 2000, pages 358-371). And, although your skin may not show it, or doesn't react in an irritated fashion, if you apply irritants to your skin the damage is still taking place and the damage is ongoing and adds up over time (source: Skin Research and Technology, November 2001, pages 227-237). (By the way, I can point to more sources on this matter but this should suffice.)

If Lauder or any company using these ingredients has different information of any kind regarding their use and efficacy I'm open to altering my reviews, but I have yet to see any data or research to the contrary.

Your hope that it's not significant when skin is "subtly" irritated below the surface is not based on fact but rather on emotion, regrettably an emotion shared by many people. Skin damage caused by the sun's UVA radiation or by free radicals produces considerable critical harm to skin (in the form of wrinkles, skin discoloration, or even skin cancer), yet you cannot feel any of that taking place on skin while it is happening. Waiting for the skin to react before you start doing something about it is a serious mistake for the health of your skin.

In regard to interpreting research, lemon and grapefruit are actually quite acidic and not that far afield from AHAs. The difference is that AHAs have a great deal of research demonstrating their effect on skin cells and building collagen, and improving skin texture (sources: Cutis, August 2001, pages 135-142; Journal of the European Academy of Dermatology and Venereology, July 2000, pages 280-284; American Journal of Clinical Dermatology, March-April 2000, pages 81-88; Skin Pharmacology and Applied Skin Physiology, May-June 1999, pages 111-119). It isn't about controlled irritation, it is about the benefits of these ingredients, which outweigh their potential for irritation. If the positive benefit doesn't exist, there is no reason to apply that ingredient to skin. I completely agree that smelling something nice is psychologically important and there are lots of studies showing that to be true, but that is about fragrance and your sense of smell, not skin care. Light scented candles, wear perfume or cologne, use potpourri, or burn incense, but do not let your nose dictate your skin-care routine, any more than the loving warmth of the sun should dictate your acceptance of sun damage.

You also seem to be under the impression that synthetic fragrance is somehow more problematic for skin than fragrant plant extracts, but that is not the case. In fact, research shows just the opposite to be the case (Sources: Dermatology, 2002, volume 205, number 1, pages 98-102; Contact Dermatitis, December 2001, pages 333-340; Toxicology and Applied Pharmacology, May 2001, pages 172-178).

Yes, lasers or Botox are potentially extreme treatments for wrinkles (though when you consider the price of many skin-care routines they start looking like bargains), but if they are effective (and they are effective) it is my job to scour the research and present a balanced picture of their risks and benefits. It is all about gathering information that is unrelated to advertising claims and then making a decision about how you want to take care of your own skin.

You're right, it is very difficult to avoid irritation, but there are ways to do it, just like there are ways to avoid some amount of free-radical damage (antioxidant supplements and skin-care products that contain antioxidants); sun damage (effective sunscreens that contain UVA-protecting ingredients); and preventing skin injury by avoiding unnecessary skin irritants.

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Category: Skin Care

Dear Paula,
Since I was five or six, I have had little bumps on the backs of my upper arms. Today, I have them on the backs of my upper arms, below my elbow on the backs of my lower arms, on my hips and thighs down to the knee, and on the backs of my lower legs, halfway up my calves. They don't hurt (although dryness causes them to itch sometimes) but they are very annoying. When I scratch my skin or exfoliate particularly roughly and thoroughly, my skin gets temporarily smoother, but the bumps always come back. When I scratch one particular bump, I usually see little hairs come through the skin. I guessed that my hair was so fine that it couldn't make it through my relatively thick skin.

In the March 2002 issue of In Style magazine, there was a "Beauty Know It All" letter about bumps on the back of your upper arms. The magazine diagnosed the problem as "Keratosis pilaris, a genetically inherited skin disorder that affects up to 40 percent of the adult population." The cause was said to be "the skin's inability to properly exfoliate itself." The recommended treatments were exfoliation with a traditional body scrub, and with a chemical exfoliant. The magazine recommended Amlactin, an inexpensive lotion that contains 12% lactic acid to help the skin exfoliate itself.

Does this sound like the proper diagnosis? If so, does the treatment sound right? Thanks for any help.

B. L., via e-mail

Dear B.L.,
The article sounds fairly right-on as far as the diagnosis is concerned. But the treatment recommendations fall short for several reasons. Keratosis pilaris is indeed very common, finding a home on the upper arms, thighs, and shoulders. Keratosis pilaris tends to be more severe during the winter months but no one is sure why that is the case and it definitely isn't consistent for everyone. Basically, the bumpy rough spots are clogged pores that sometimes get red and irritated but rarely itch. Regrettably there is no available cure or universally effective treatment, though it is generally well accepted that unclogging pores and reducing inflammation can improve matters greatly (Source: eMedicine Journal, July 2, 2001, Volume 2, Number 7).

Lactic acid (a very effective form of alpha hydroxy acid) can help exfoliate skin cells, but lactic acid isn't effective for dissolving lipids, so it can't penetrate into the pore and exfoliate the lining of the pore that is a major cause of the problem. For that, you would need a beta hydroxy acid product where the active ingredient is salicylic acid. It is also helpful to avoid soaps that can irritate skin or cause clogged pores. A gentle body shampoo is best. The recommendation to scrub away the plugs can mean you inflame the area and still leave the skin feeling rough and bumpy below the surface where the abrasive can't reach.

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Category: Skin Care

Dear Paula,
Many of your comments about botanical ingredients are misleading. You don't clarify which part of the plant you are referring to and how the extract is made. For instance, Arnica montana tincture as prepared according to the HPUS is not the same as "arnica extract." Arnica montana, in tincture form or in pure potency has been used in the practice of homeopathy for about 200 years and I have used it often in my practice over the past 15 years without any contact dermatitis. I never use it on broken skin, but otherwise a 1% or 10% solution works just fine. Many of your references are just collections of statements made from various articles over the years and as mentioned above don't include the amount of detail necessary to be informative. I don't doubt that contact dermatitis can be caused by exposure to the fresh juice of Arnica montana but this is not the same as the mother tincture made by percolation of the plant for three weeks in 87% ethanol.

What may be a skin irritant full strength may become a useful treatment for irritated skin at a much lower dilution. An educated consumer should know that individual reactions to both natural and synthetic substances are variable. As in food allergies, we wouldn't avoid eating nutritious food because somewhere in some book somebody noted a possible allergic reaction. We would know by trial and error (or some medical testing) which foods are best for each of us. The same is true for cosmetics.

Domenick, via e-mail

Dear Domenick, Thank you so much for your excellent feedback. You are right about the limitations of my ingredient dictionary. When I review plant extracts included in cosmetics the best I can do is give a general impression of the ingredient as it is represented on the product label as that is almost always the only information I can obtain from the company making the product. In regard to any plant extract's risk to the skin, my statements are indeed a condensation of information; they are not meant to be a final assay of any single ingredient. But the single most important aspect of my comments is to explain what an ingredient's general pattern of action is, and whether or not any research exists about its positive impact on skin issues such as wrinkles or acne, and whether it's an antioxidant, anti-irritant, and so on. In regard to irritation, my intent is to minimize the risk to the user of "volatile" or problematic ingredients, particularly if they don't have some other purpose (sunscreen, disinfectant, antioxidant, etc.). Irritation poses serious health problems for skin and I feel strongly that the goal is to use ingredients that do have a benefit and are not just thrown in to make the product look more "natural." Keep in mind that the way a homeopathic or naturopathic doctor might use a tincture is not the same as how it would be used on a daily basis on a woman's face, perhaps by someone who is likely to also be using exfoliants, scrubs, masks, and a host of other products or treatments that may abrade skin. The average woman is applying over 300 cosmetic ingredients a day on her face, so even if they were all "natural," irritation in some measure would be almost inevitable. Moreover, there is a good deal of research establishing that skin does not always tell us when it is being irritated or has an allergic reaction. Rather, surface skin often hides the damage that is taking place in the lower layers of skin. That's why I tend to be more concerned with the potential for an irritant response with an ingredient (related to the presence of volatile oils, terpenes and the like, or phenolic compounds) when I don't find it offers any other benefit.

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Category: Skin Care

Dear Paula,
I read in a fashion magazine recently that Vitamin C products and retinoids are not pH compatible and therefore are less effective when used together.

It also stated that antioxidants should be applied after washing and before moisturizing. Adding to the confusion, it also explained that acidic products and antioxidants should be used at different times of the day. Is there any truth to this? It didn't make sense to me given everything I've read from you.

Karen from New York City

Dear Karen,
Let's start with retinoids. "Retinoid" is the technical name for all forms of vitamin A. Not all forms of vitamin A are acidic. For example, in cosmetics retinol (the entire vitamin A molecule) and retinyl palmitate (an ester of vitamin A) are not acidic, so pH compatibility is not an issue.

On the other hand, prescription-only retinoids such as tretinoin (found in Renova and Retin-A), tazorene in Tazorac, or adapelene found in Differin, are stable at a lower pH of around 3. This pH 3 stability is also true for alpha hydroxy acids and salicylic acid, though the pH range of AHAs and BHA has a tiny bit more leeway. When Retin-A was first acknowledged as a wrinkle-fighter, it was thought that it was important to maintain its pH environment on the skin. It soon became clear that the pH was only an issue if an extremely alkaline product was used just before or after applying Retin-A. For example, washing with soap, which typically has a pH of over 8, or using an alkaline skin-care product could potentially negate Retin-A's effectiveness. Acid forms of retinoids, or AHAs and salicylic acid, however, are not negatively affected by the pH of skin (pH 5.5) or water (pH of 7).

So the issue is only significant if you are a soap user or use alkaline skin-care products, and that is rare indeed, as most skin-care products nowadays are formulated with a pH of 5 to 7. Actually, the only potential problem could be from the occasional sunscreen that may have a pH of 8.

If antioxidants are pH sensitive this is the first I've heard of it, and I couldn't find any research to support this notion. It seems especially doubtful given that many antioxidants, such as ascorbic acid (a form of vitamin C) and several plant extracts including grape seed and blueberry do well at low pH levels. Really, the major concern about antioxidants is that many tend to be extremely unstable in the presence of air and sunlight. This is one of the reasons it is questionable whether moisturizers made with more unstable forms of antioxidants can remain stable and active once the product is opened (unless it is packaged in an air-tight, opaque container).

Another fallacy the article you found seems to be promoting is the idea that antioxidant ingredients have to be in a product separate from your other makeup, something the cosmetics industry would love consumers to believe. It's a concept that would encourage increased sales, but nothing could be further from the truth. Moisturizers, toners, skin lighteners, and exfoliants, if they are well formulated, can and should contain potent and relatively stable antioxidants. It doesn't require a separate specialty product or a specially timed application to get the benefits of antioxidant though there are several "specialty" products available that contain an array of antioxidants.

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Category: Skin Care

Dear Paula,
I was wondering if you think it is okay to use exfoliating "peels" that are rubbed off the skin into eraser-like particles, as with Sisley Peeling Cream, and those from Clarins, or Darphin? If a person allows the product to dry like a mask and then rubs it off, isn't that similar to your lip exfoliating treatment (only yours costs a lot less money)? I have been curious about these products and was wondering what you think?

Wondering, via e-mail

Dear Wondering,
All of these kinds of rub-off skin-exfoliating products are quite similar if not identical to mine. They are something I recommend for lips, elbows, knees, heels, ankles, and cuticles, but generally not for all over the face. That's because the oil glands on the face can become clogged from the very thick, relatively hard waxy substances these products contain. This isn't a problem for lips as they don't have oil glands. Not to mention that rubbing at the skin isn't the best for the face, as any facial pulling can break down the skin's elastin, making wrinkles worse.

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Category: Skin Care

Dear Paula,
I am sending you a printout of an e-mail letter I received from Clinique in response to my question regarding the pH balance of their Turnaround Cream and its effectiveness as an exfoliant. Their response doesn't make any sense to me. Does it make sense to you?

Turnaround Cream is formulated to exfoliate the skin. This formulation claim is substantiated by our Laboratories. We appreciate the opportunity to explain all products are made to be either more acid or alkaline depending on their intended function. It is the total formulation of a product-with all the ingredients included in the formulation-which contribute to the product's efficacy.

Therefore, we are certain you can understand that the exact pH level in each product is proprietary information. Additionally, as you may be aware, it is a known fact that a skin's pH level returns to normal very quickly after any product's use. We trust the above addresses your concerns..."

Dawn from Jupiter, FL

Dear Dawn,
Their response doesn't make any sense to me either. You asked a simple question. What is the pH of Clinique's Turnaround cream? And you were informed it's none of your business because it's a secret. Yet pH is one of the easiest aspects of a product to test. A strip of pH-measuring paper is all you need, and you can see for yourself what the pH is. Big secret! The research about the effect of salicylic acids (like BHA-the exfoliating ingredient in Turnaround cream) on the skin is well established, and so are the basic formulary concerns (in regard to pH), and information can be found in many medical journals and cosmetics industry journals as well as through the FDA and the American Academy of Dermatology. I guess that's another big proprietary secret Clinique didn't want to divulge. Basically, what you were told is "trust us, we know what's best for your skin and we don't have to tell you why or how we made that decision." From Clinique's perspective I guess that makes sense.

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Category: Skin Care

Dear Paula,
I recently read an article in which herbal laxatives were recommended as a way to open and clean pores. The instructions were to mix a powdered laxative (like Swiss Kriss) with boiling water, then steam your face with it. The article stated, "As a laxative cleans out the body, it cleans out the pores!!" I've heard of similar treatments being provided at spas and salons and wonder if there is any merit to it.

Karen, via e-mail

Dear Karen,
Many recommendations like this are either silly, a waste of time, or harmful for the skin. This one falls into all three categories. First, the way herbal laxatives (or any laxative for that matter) work inside the body is radically different from what takes place on skin. It should go without saying that the digestive/elimination process is unrelated to anything having to do with skin or pores. But just to spell it out again, laxatives work internally via some aspect of the gastrointestinal tract (stomach, intestines, colon), and that effect has to do with the actual physical movement of the intestines and the quantity or the consistency of digested food.

You can't open and close pores like doors, hoping that whatever is clogging them will come out. Women have a long history of attempting to do this with a long list of astringents and masks for years, with the end result being the continued search for what might work when all of these have repeatedly failed.

The other major problem is the damage that can be caused by steaming the skin. Heat can exacerbate rosacea, cause capillaries to surface, and create irritation (which is a serious long-term problem for skin). Steaming the skin doesn't open the pore, but it does swell the skin, which can make the pore temporarily look "open" although nothing has changed. The wax in the pore can be softened and then manually squeezed more easily, but you can't attack the whole face without causing problems. And because nothing about the shape of the pore has changed, it will fill up again, quickly becoming replugged, and then you have to go through the whole process again in short order.

Another strange notion about pores is that steaming the skin will eliminate toxins from the body. Sweating (perspiration) absolutely is a pathway for the elimination of a small amount of toxins from the body, but that amount is minimal in comparison to the elimination of toxins via the digestive tract. But then, other than when you exercise, the other methods that cause sweat, namely heat, can cause more problems than the sweating helps.

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Category: Skin Care

Dear Paula,
For the second time in just a few weeks I have heard on QVC and then read in a women's magazine a marketing spiel for products that basically indicate that they can "thicken" your skin. They also indicate that while this is counter to the recent popularity of AHA and BHA products that promote exfoliation that this exfoliation is actually a "thinning" of the skin and is specifically not what you want to happen as you age. What do you think of this reasoning?

Kim, via e-mail

Dear Kim,
It is often the case in the world of skin care that you can find a bit of truth in any marketing "spiel." The truth is that skin absolutely does become thinner as you get older. For women in their 70s, 80s, and 90s (and onward), the skin can become so thin it can literally tear when gently scratched or rubbed. This thinning is a result of many factors but primarily it is brought about by a combination of genetic aging and sun damage that cause the skin cells to produce "less skin" as we age (a preprogrammed slowdown mechanism seems to exists in all skin cells), as well as a slowing down in skin-cell turnover, causing dead skin cells to stay around longer than they should. So yes, it would be helpful if there was a way to tell skin cells not to slow down production. But for now, Renova is the only real option we have for this, due to its effect on improving cell production. Products such as Kinerase and others that contain "growth factors" (not to mention those that just make crazy claims) are supposed to tell skin cells to continue making skin. Let me state categorically that those products probably (and hopefully) don't work in such a manner as to alter cell communication by telling skin cells to make more "skin." If they did we would be looking at a potential risk of making too many skin cells, because how would these products or the user know when the skin is making too much skin? And multiplying cells can be a cancer issue.

So where does that leave us in the world of AHAs and BHA? These do indeed help the outer layer of skin to shed by helping remove surface dead skin cells. For some women in their 70s, 80s, and 90s with extremely fragile skin that may be problematic (they may indeed need the dead skin cells to stick around on the surface longer). However, for many women who don't have that kind of fragile skin the benefit of removing surface dead skin cells is that it absolutely helps improve the appearance of skin and allows "healthier" skin cells to come to the surface. For example, removing thickened layers of calluses on your feet helps feet look better. That thickening is in essence what has happened with sun-damaged skin.

Please keep in mind that when AHAs and BHA are used correctly they do not affect skin cells below the outer surface layers (the epidermis) of skin, so it's not that they thin the skin, but rather they help remove built-up dead skin cells. (It is important to note that AHAs and BHA can cause problems when they are overdone, as when people use too many of these on the skin, have repeated peels, or use products with high concentrations.)

One more point: it is also thought that AHAs and BHA can stimulate the production of collagen, which also has benefit. I recommend that women who are over 70 (my mother included) should only use AHAs or BHA three times a week, and then judge how their skin is doing. More times than not (especially for those older women who have been good about staying out of the sun and protecting their skin with effective sunscreens), this works beautifully!

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Category: Skin Care

Dear Paula,
I have a question regarding the daily use of over-the-counter hydrocortisone creams. In your book you write that the stronger creams can cause problems if used for longer periods of time, but what about Cortaid 1%, for example? I use it to "cut" my 0.1% Retin-A, which I use full strength on my body for keratosis pilaris. Ever since my isotretinoin treatment, my skin gets irritated by plain moisturizer-cut Retin-A, but when used with Cortaid, I get beautiful, clear, smooth skin with none of the dermatitis.

Will daily use of Cortaid on facial skin cause problems? If not, is there a problem with mixing it with Retin-A before application? Or would I be better off diluting the 0.1% Retin-A with water for application at night and then using the Cortaid during the day?

Sarah, via e-mail

Dear Sarah,
Almost without exception, any topically applied cortisone thins the skin and, over time, can make wrinkling worse. But there are studies that indicate that the use of cortisone with Retin-A or Renova prevents the cortisone cream from having a negative effect on the elastin and collagen in skin, while still retaining the positive effects of reducing or eliminating irritation. For example, when skin-lightening products with high concentrations of hydroquinone are prescribed by a physician, they are often accompanied by a cortisone cream and Renova or Retin-A. This way the hydroquinone's potential irritation is eliminated and the Renova does double duty in preventing collagen loss and improving cell production.

Another option for you is to consider using the cortisone as needed. So rather than using it every day, only use it when the irritation first shows up. Intermittent use of cortisone does not present a problem for skin.

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Category: Skin Care

Dear Paula,
I just finished reading your current newsletter and I have a question about some information in the "peel" section. You wrote that "if you stop using AHAs, in a short period of time the skin will return to the way it was before." Also: "Duration [of AHAs] is ongoing while the product is being used." My question is, what is the benefit of using an AHA product if it does not give any permanent results? And why will the skin eventually return to its original condition if damaged surfaces have been already exfoliated? I would think that if you use enough sun protection, the new skin should remain smooth after all that exfoliation.

Victoria, via e-mail

Dear Victoria,
There are no cosmetic products anywhere to be found that will provide a permanent change to skin. Even Retin-A and Renova (prescription drugs) don't provide permanent results, and neither do laser resurfacing (though it can last the longest) or peels. The damage of thickened, discolored skin you see on the surface is a result of damaged cell production occurring far deeper in the dermis than AHAs, peels, and lasers can reach. Retin-A and Renova have more effect on actual cell production, but their effect does not continue after you stop, either. The damage that has taken place from previous years of unprotected sun exposure (and that starts from when we are children) is the culprit. Stopping unprotected sun exposure prevents further damage but does not undo what took place in the past.

Many women feel (and I agree) that the benefit from any of the resurfacing treatments is that while you use them for some period of time, the skin absolutely looks better. However, permanently affecting or repairing damaged cell production has yet been discovered, and the likelihood that it will be in the near or far future is slim.

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About the Experts

Paula Begoun is the best-selling author of 20 books on skin care and makeup. She is known worldwide as the Cosmetics Cop and creator of Paula's Choice. Paula's expertise has led to hundreds of appearances on national and international television including:

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The Paula's Choice Research Team is dedicated to helping you find the absolute best products for your skin, using research-based criteria to review beauty products from an honest, balanced perspective. Each member of the team was personally trained by Paula herself.

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