The "A" Train

Buyer Beware (or Fraud Alert)

About a year ago I started seeing ads for unbelievable skin care products that promised to make you look younger over night. If memory serves me correctly, that product was called Hydroderm. Hydroderm is still around despite the fact that they received this warning letter from the FDA (this is the longest FDA warning I have ever seen).Well, due to the success of that ad, I am now seeing more and more companies jumping on the band wagon. The newest is an ad that takes you to a heathers-diary.com which looks like a personal blog of a woman named Heather that lives in your hometown!

Upon further inspection, Heather lives no where near you or anyone else because she doesn't exist. The company is using your IP address and inserting your location into this "person's" blog. Here is the ad with your IP address and it shows Heather lives near you and here is the same link done through a proxy server that shows that she is from nowhere. This is fraud and I have reported my findings to the FDA...however, they probably won't do anything in enough time before this company makes millions.

Heather is pumping two products that promise to turn back the clock 20 years. One product is a capsule that has resveratrol which is produced by a Greek company named Purplesky limited. Because this is a foreign company, I could not find a lot of information on them, but I did find this entry from the complaint board http://www.complaintsboard.com/?search=Purplesky%20Service If you want to get the benefits of resveratrol into your body...buy a bottle of red wine. It's cheaper than the $79.95 price tag for the capsules and its more fun when you share it with a friend.

The other product Heather is pumping is a skin cream called Dermapril which has Matrixyl 3000 a peptide. This product is being produced by company called Rauscher | Bekke LLC. If you look into this company on the Better Business website you get this glowing report. http://www.seflorida.bbb.org/Business-Report/Rauscher-Bekke-LLC-92010110 This company has over 580 complaints against them for poor business practices.

I have two points, 1) there are no overnight miracles 2) know who you give your hard earned cash to

The Most Disturbing Thing I Have Seen On the Internet (re: beauty)

For the past week I have been debating whether or not I should comment on the following 

video I found, but I think it is better to be informed than to bury your head in the sand.

When applied by a trained professional (i.e. a doctor) botox is safe. However, the thing 

you must understand is that botox is a poison.

Here is a video of a woman who is demonstrating how to "botox yourself". I cannot under-

line and overstate how dangerous this is. First, there are a litany of side effects that only 

a trained physician can screen and treat. However, an untrained person could cause 

permanent damage to their facial muscles and/or eyesight. If injected in the wrong place, 

you could cause death.

Lastly, you need to trust the source of your botox. The people that are selling botox through 

the internet is violating a myriad of internet laws. So, can you really trust someone that is 

violating laws to send you a safe batch of botox?

http://www.youtube.com/watch?v=9C3UBh1rZHs

New Drug MAY Extend the Lives Of Melanoma Patients

Roche has conducted a Phase II clinical trial that shows the lives of melanoma patients can be extended several months on their new drug Avastin. http://www.reuters.com/article/healthNews/idUSTRE58K1KS20090921?feedType=RSS&feedName=healthNews&rpc=22&sp=true

Though this is a great step forward, death doesn't have to be an option when it comes to melanoma. The key is early detection. Everyone over the age of 45 needs to see a dermatologist (not their family physician) every year for a full body examination.

How To Find A Skin Care Pro

As products become more sophisticated and effective...it's becoming more difficult to sift through the pseudo-science and misinformation to find out what works for you.

Everyone's skin is different and the skin is a dynamic organ that requires individual attention. One size fits all just does not apply to your skin and what is working now for you may not be so good 5 years from now.

However, just because someone declares themselves a skin care pro doesn't necessarily mean that you find the ideal solution for you. I hear about horror stories almost everyday about laser mishaps, allergic reactions and inappropriate behavior coming from individuals in our business.

To find a skin care pro you can trust, your best bet is to get a referral from someone you know. This can be very difficult for most people and the internet is starting to become an alternative. However, I place a very large grain of salt on anonymous reviews...so, finding someone you know that has found success is your best bet.

Generally speaking, I find that the older 40+ pros that have been in the business long enough to see through all the BS can steer you to a solution that is best for your skin. Plus, they could not have been in business long if they haven't successfully helped create results.

That doesn't mean that there are not younger professionals that don't know their stuff. They are just harder to find and you need to be able to ask critical questions to get to their knowledge on the subject of skin care. If they don't lead with a physical sunscreen and a retinoid...you may be in the wrong place.

I would avoid anyone that:

1) Has an attitude of superiority...I see this alot in the Medical Spas, Plastic Surgery Centers and Spas...these places want to peddle exclusivity instead of knowledge and results. 

2) Promises instant results...first, there is nothing on the planet that delivers instant results...if it does... there are going to be serious long term side effects you need to consider.

3) Tries to sell you skin care products that are over $100 a bottle, tube or can...Consumers have the perception that expensive is better. I have never seen a product that costs that much that delivers consistent measurable results. 

4) Advertises excessively...good skin care pros survive on word of mouth and don't need large ads to bring in customers...the best skin care pros I know are booked several months in advance and I never see them advertise. 

In a slow economy where we all have little time, going through the process of finding a skin care professional can be exasperating. However, the results will be worth it. If you don't find the perfect person for you first time out, don't get discouraged...there are good people out there and your skin will thank you.

The Beauty Business...It's Ugly

When I first started in this business 9 years ago, a very prominent Madison Avenue PR maven told me, "the beauty business..it's ugly". After about a decade in this profession, I think I finally understand what she meant.

We started with a formula invented and proven by New Orleans Dermatologist Dr. Nia Terezakis. We are passionate about retinoids because of her passion. I have never met anyone so driven to get a message out to her patients about the proven effects of lifelong Vitamin A therapy. 

When we first brought high potency retinol to the market...we were the only company. We had no competitors other than Tx Systems which was not actively selling or marketing its products. When I passionately pleaded my case to this PR maven, she dismissed us like we were nothing and made the above statement about the beauty business being ugly. Oh, how time proves people wrong.

Since we have introduced our product, there is no credible skin care company that doesn't offer some kind of retinol product. They say imitation is sincerest form of flattery...well I'm flattered, I guess. But, I am very happy that more and more companies are starting to see the light...retinoids (vitamin a)  are that important to the health of our skin. I only hope that the rest of the public catches on...soon.

Despite the fact that we have more third party independent clinical data on retinoids (do your own search at www.pubmed.com for "topical retinoids") than any other active, we still hear about AHA's, peptides, vitamin c, and now I am starting to hear about stem cells. The fact is, the beauty business is a business built on fads.

Marketing people drive this ship and research and development is propped up and prettied by pseudoscience.

So why do we hear so much about the fads and the science gets ignored? It's for the same reason that we hear about the killer down the street and not the fireman who saves a life. We are drawn towards sensationalism and the belief that a magic potion will make us younger overnight.

The large skin care companies spend millions with magazines and networks to influence their editors (if you don't think editors are swayed by ad money...you are incredibly naive). This is true for websites nowadays (they used to be truly independent) but, as the money flows, the raves follow.

With contradicting research, and information overload...how do you cut through the clutter? Find a skin care professional (dermatologist, plastic surgeon or esthetician) that has experience and will deliver results. In my next post, I will give you some tips on how to find a skin care pro.

 

Yeah, we twitter

Like all the other cool kids, we are on twitter now...catch us at http://twitter.com/advskintech

A New Acne Medication

Thanks to the folks a Galderma, they have now released a new acne treatment called Epiduo. What makes this gel  unique is that it has combined .1%  adapalene (the gentlest of the prescription retinoids) and 2.5% benzoyl peroxide.

Here is my take on this new drug.

PROS     - it is a gel formulation which will lessen irritation and increase bio availability.
             - two active ingredients combined into one treatment which will save you money

CONS     - I couldn't find it in their literature, but I am sure they are using micro-encapsulation to protect the two actives from each other. This does a great job of suspending the active, but does not do the best job of delivering into the skin.

            -though retinoid treatment combined with benzoyl peroxide is the preferred topical treatment   protocol for dermatologists, you typically apply the retinoid at night and the benzoyl peroxide in the morning. By seperating the application of the actives, you tend to lessen irritation which can only help patient compliance.

The reality is, that if you can get a teenager to brush their teeth, you have made a major accomplishment as a parent. Therefore, combining two proven acne treatments into one is a great thing...if their skin can tolerate it. If irritation and adaptation is an issue, I would recommend that you stick with the retinoid at night and the benzoyl peroxide in the morning routine for a couple of months. After a period of time you may can move to the Epiduo treatment for convenience and cost.

Facials: The Debate

Facials are promoted as a  simple massaging of the skin to miracle "at the touch of a hand". But, at any level are they worth the $40 to $200 a session? Here's what the experts say:

Pro: Aesthetician, Rowena Woo: (I'm paraphrasing) Facials can be beneficial if you stick to the basics like cleaning, extraction and exfoliation.

Con: From dermatologist, Dr. Leslie Bauman: aestheticians “often don’t know which products are right for the skin of each client” and that facials cause breakouts most of the time.

Reality: There are many aestheticians that are very well trained and know their business better than some of doctors. However, most expensive facials are a waste of money and time and you can pretty much bet the farm that it has no anti-aging benefits. However, a facial can be a great luxury if you can afford it. Just understand that the benefits from a physical standpoint are small such as light exfoliation, blemish extracting (which is really good for clogged pores) and cleansing. The meta physical benefits can be significant, a time to be caressed and pampered is a great thing. Again, if you can afford it.

My advise is find an aesthetician that has experience and doesn't push alot of unneeded products and services. Also, if they don't lead with a retinoid as their first line of defense for healthy skin, then I would keep looking (this goes for the docs too!).

Want to read more on the subject? A New York Times Article and Dr. Baumann's Blog Posting

Lasers for Acne

As much as the laser community wants us to believe that lasers treat acne. The fact is the cost does not justify the result....However, that may change in the future.

http://www3.interscience.wiley.com/cgi-bin/fulltext/119408075/PDFSTART?CRETRY=1&SRETRY=0

Topical and oral treatments remain the best protocols for acne

http://atrain.typepad.com/atrain/2009/03/acne-now-classified-as-a-chronic-disease.html

Acne: Now Classified as a Chronic Disease

According to The Acne Global Alliance, acne is now classified as a chronic disease that needs appropriate diagnosis and long term strategies to effectively treat.

The Alliance says that acne effects 85% of the World's Population in the age of 12 to 24.

So how do you treat this disease? The Alliance recommends the following (and I am paraphrasing).

Mild Acne     - 1st Choice - Topical retinoid
                   - 2nd Choice - Azelaic acid, salicyclic acid, physical extraction
                   - Alternative for women - see 1st choice
                   - Maintenance - Topical retinoid

Moderate Acne     - 1st Choice - Topical retinoid + topical antimicrobial
                           - 2nd Choice - Azaelaic acid, physical extraction
                           - Alternative for women - see 1st choice
                           - Maintenance - Topical retinoid

Severe Acne     - 1st Choice - Oral antibiotic + topical retinoid and/or benzoyl peroxide
                       - 2nd Choice - No consensus among experts so they default to first choice and azelaic
                       - Alternative for women - Oral antiandrogen + Topical retinoid and/or topical                                                                           antimicrobial
                       -Maintenance - Topical retinoid and/or benzoyl peroxide

Disfiguring Acne  - 1st Choice - oral isotretinoin
                          - 2nd Choice - high dose oral antibiotic + topical retinoid and/or benzoyl peroxide
                          - Alternative for women - High dose oral antiandrogen + topical retinoid and/or                                                                            topical antimicrobial
                          - Maintenance - Topical retinoid and/or benzoyl peroxide

This is alot of information to digest, but the bottom line is that a topical retinoid is your best weapon when fighting acne.

Please do not use this information to self diagnose and treat your acne. But, use this information to talk to your dermatologist as the best ways to treat your condition.

I often hear from frusterated people that lament they have tried man of these therapies and are not getting results or that they cannot tolerate the retinoid. There is no one best way to treat everyone's acne, but requires a trial by fire mentality to best approach your condition. Your doctor has the insight and training to help your search for the best path to treatment....so, don't lose faith after a couple of visits!