One of my doc friends was told by a total (crusty old male) stranger that she looked “haggard”…so, naturally, she came in to see me.  While such brutal honesty can be refreshing, it reminds us that people  make snap judgments…and your skin is truly a reflection of your inner health.

So, how do we reduce the signs of stress on the face?

First, get some quality sleep; women typically need more (and suffer more from inadequate) sleep than men. Drink a gallon of water daily, so your cells can function optimally and stay plump. Stop self-medicating with caffeine or alcohol, as they dehydrate you, promoting sunken under-eyes, and dry, deflated skin. Eat a balanced diet. Exercise regularly to get the circulation to your skin, build bone and muscle mass (foundation for your skin), help with stress and release endorphins. Vitamin C serums counteracts the damaging rays of the sun (car windows don’t help) that cause wrinkles and brown spots. Retinoids help skin turnover and promote collagen production, so you don’t look dull and ashy. Wear sunblock with SPF 30+, and reapply every 80 minutes. Limit sodium (salt) intake to 1500 mg daily, as it bloats you and contributes to hypertension…no need to look haggard and have a stroke.

And then, there’s a little help from your friend…here are a few medical cosmetic procedures that are great rejuvenators…some best performed in the fall / winter, when you generally have less sun exposure…

Wrinkles…from concentrating, reading computers, cell phones and fine print…

• Botox Cosmetic, Xeomin, or Dysport are neuromodulators that relax the muscles that create expressions.  These start working a week later and can last 3-6 months.

Sunken under-eyes…

• Dermal fillers (Belotero, Juvederm, Restylane) placed under the thin skin for instant gratification.  I use a cannula, which is a blunt-ended fine needle that is less traumatic to this sensitive and highly vascular area. These can last 6 – 12 months.
• CO2 fractional laser, which stimulates your body to build collagen to thicken this delicate skin and decrease the appearance of dark circles, as well as lift falling lids.
• Eye cream with retinols specially made for the delicate eye area…I recommend PCA Skin Ideal Complex Eye Cream.

Jowls / migrating fat pads / double chin…

• Mesotherapy, or Kybella are injections that disrupt fat cell membranes.
• TruSculpt utilizes radiofrequency to cause fat cell death and tightens loose skin

Sunken cheeks / hollow face…

• Dermal fillers (Belotero, Juvederm, Restylane, Radiesse, Sculptra, Voluma) strategically placed in temples, cheekbones, hollow cheeks, for instant gratification.  These can last 6 – 25 months.
• Skin Tightening with an IPL provides instant gratification with no down-time.  Treatments can be performed monthly.

Dull, lifeless skin…

• Microdermabrasion uses fine crystals to exfoliate the top layer of dead cells, and whittles down fine lines and wrinkles. Instant gratification glow.
• Chemical peels (about a week delay; performed monthly) encourages sloughing of skin
• Microneedling or the CO2 fractional laser to stimulate collagen production (6 months delay).
• Platelet-rich plasma can be combined with microneedling and the CO2 fractional laser, contains 8 growth factors to stimulate all sorts of goodness.
• Face brush for cleansing on a daily basis helps exfoliate superficially.

Sun spots…

• Photofacial with the IPL (Intense Pulsed Light) destroys the unwanted pigment, which sloughs off over the next week. These treatments are usually performed on a monthly basis until they disappear.
• Lightening creams containing hydroquinone, azelaic acid, or resorcinol help bleach them.

Acne scars…

• CO2 fractional laser stimulates collagen production to fill in the scars. Depending on the depth and nature of the scars, multiple treatments every few months may be necessary.
• Microdermabrasion and chemical peels performed monthly can reduce their appearance

Rosacea / broken capillaries…

• Laser or IPL specifically for blood vessels can help reduce the appearance of these, along with avoiding alcohol, hot showers and saunas. These are usually performed on a monthly basis until the unwanted vessels disappear.
• Anti-redness serums can help calm down reactive blood vessels

Unwanted hairs…

• Laser or IPL specifically for hair removal. These are usually performed every 4-8 weeks for 6-10 treatments.
• Dermaplaning temporarily removes the peach fuzz
• Check hormone levels, if you notice an increase in dark chin and mustache hairs

Bony / veiny hands…

• Dermal fillers (Juvederm, Restylane, Radiesse) placed under the thin skin restores the smoothness instantly.  I use a cannula for this area as well. These can last 6 – 12 months.

Yellow teeth…

• Professional teeth whitening makes a world of difference

Schedule a consultation with your cosmetic physician friend today, because you don’t need to be told by a total stranger that you look haggard.