Skin Care Regimen – by request

Skin Care Regimen – by request

Skin care!!

My skincare routine has been HIGHLY requested by friends. So, here you are.

A little background into my skincare geekitude: I almost went to medical school and became a dermatologist, and would have likely wanted to do plastic and reconstructive surgery as well. Instead, through an entirely accidental set of circumstances, I became a corporate accountant for a Fortune 500 company, and skincare remains a side passion. Someday, I’ll take some reduced hours and go to aesthetician school so that I can dabble in my skincare love in a more direct way, and help others to love their skin as I’ve learned to do.

Let me tell you a little about my skin story. As a teenager, I had acne. Not only was it on my face, but I had it on every single part of my body. Fingers, toes, legs, backs of knees, inside my elbows, in my hair, my neck, my belly, my groin, my butt, my neck, behind my ears… These were bad enough. I wore turtlenecks and two layers of tights every day under everything. In San Diego. Year round. I would be sweltering in the heat and refuse to take off my turtleneck because I was so embarrassed of my skin. Worst of all was the horrific cystic acne on my back and chest, in my armpits and over my entire trunk. It was painful – even hugs hurt! – and humiliating. I didn’t change in locker rooms, I avoided changing in front of friends, was careful about going shopping or to the beach or anywhere I would have to strip down. I spent my life covering my skin in layers of thick clothing to hide the lumps.
On the flip side, at home I slathered my skin in baby oil and laid in the yard in a bikini to attempt to dry out the acne. I was on many, many prescriptions, both topical and systemic. I tried antibiotics, benzoyl peroxide (HIGHLY allergic!) and every other wash, lotion, potion, serum, wipe, pill and vitamin.

Finally at age 17, after I had just graduated from high school, my dermatologist suggested Accutane. I was headed to college, and the medication requires careful monitoring, so he sent me with instructions to see a doctor at the student health and ask for accutane. They denied me and told me my acne “wasn’t bad enough.” I was devastated and tears were brewing. The doctor then paused and asked if I also had body acne. I said yes and he peeked down the back of my shirt and said, “oh Honey, you NEED Accutane.” I was on the highest possible dose for the longest course available at the time: six months.

My lips cracked first. Then I began to flake. The corners of my mouth were shredded and it hurt to eat. My skin hurt all over due to dryness, something I had never experienced before. I was flaking EVERYWHERE. My skin was cracked and sore no matter how hydrated I was. I found Bag Balm one day and covered myself, head to toe. It was bliss. I also discovered I could apply lotion to my scalp – who knew that dry scalp could be helped with lotion!?! Certainly not I. Not then.

During this first course of treatment, I got heat stroke. I didnt fully realize the risks of sun exposure while on the medication, and I had been tanning my whole life. I was lying next to the pool where my roommate was a lifeguard, and I suddenly felt really sick. I was shaking, trembling, felt strangely cold despite the 105* day. I was nauseated and felt weak and flushed, and then hot and cold began to alternate. I felt like I had the worst flu of my life, times ten. I went to the bathroom and couldn’t vomit. I couldn’t pee. I felt weird and like I had been drinking heavily and things weren’t very real or solid. The world spun and tilted.
I told my roommate I needed to go home, and she left me sitting on the corner in a shady spot while she went to get the car from the large parking lot beyond the pool. It took her about ten minutes, and two pedestrians and two drivers stopped to ask if I was ok, if I needed help, and if I needed an emergency room ride or for them to call an ambulance. I must have looked horrible! I was in the middle of a major college campus, not in a small town. For people to stop was strange. For that many people to stop was unheard-of.

My roommate took me home. Neither of us realized how serious it all was, so I took an aspirin, drank a glass of water, and went to bed. I passed out for at least six hours, and woke after dark feeling weak and shaky but much better. Knowing better now, I’m aware that I had heat stroke and should have gone to emergency for rehydration. I was very, very lucky I woke up from that nap with no real harm done other than a lifelong heat sensitivity.

I finished my course of accutane and my skin looked great for a few months, and then began to get worse again. This time I saw the dermatologist again right away and they put me on another high-level, long round. They told me it was exceptionally rare for anyone to need more than one round, especially at the high dose. This time I got more side effects. Joint pain was miserable – especially in my ribs. Every time I took a breath, I felt like I was breathing with broken ribs. My joints in my hands hurt, and my knees and ankles, my back, hips, shoulders. It was painful. More importantly, I was also depressed. Severely. The depression is a story for another day, but it has since been added to the known side effects of accutane in a black box warning, as many people have completed suicides while on accutane. At that time, however, we didn’t know. I joined support groups and took medications. Ten years after the end of my third round of accutane, almost to the day, the depression lifted as if by magic. I’ve never had it since. Those ten years were tough, to say the least.
My third round of accutane was about five years later, in my early-mid 20’s as my skin started to break out again! The dermatologist told me that not only was three rounds medically questionable, as it hadn’t been studied, it was just plain dangerous and he was concerned, but that if this time didn’t work, there was nothing else. So he extended the time period and increased the dose to what I recall as double the highest dose. I had to re-explain to the pharmacist every time I got it filled, as it was so unusual.

Sadly, a few years later my skin began to break out again. Considerable testing revealed high testosterone levels, and the new dermatologist put me on an androgen blocker, at a very high level – as high as or higher than many transwomen! It worked!! I’m still on it today, and if I ever run out, my skin immediately breaks out horribly. So I stay on the hormone blocker and my skin is happy.

All those rounds of accutane left me with exceptionally dry skin. It killed most of my sebaceous glands – even those around my eyes. I have dry eyes, dry mouth, peely, flaky dry skin. So I am very cautious with my skin. Dry skin ages faster than oily. It has less bounce and shows wrinkles more. It’s thinner. It can be fragile. I cannot shower every day, or even every other day. My full shower is twice a week, and VERY fast with layers of moisturizer on my damp skin afterward. In – shower lotion, the prescription lactic acid lotion, then shea butter cream, then a custom blend of highly moisturizing oils, then a flannel nightgown or cotton pajamas to protect my sheets and allow it all to absorb overnight. I also oil my hair and only wash it 1-2 times every 3 weeks. It gets more and more dry between washes, so I add oil and condition it periodically in between, I moisturize my scalp, and I never use shampoo with detergents – always conditioner or “co-wash.”

And now here is the facial skincare routine.
This is extremely long, but I wanted to break down why I use certain ingredients in skincare. I get questions about my skin frequently, and want to really break it down.

I love vitamin c creams and serums in general. They brighten the skin, plump up fine lines, fade age spots, etc. If you don’t understand why it works, toward the end of this post I will post an explanation of free radicals and antioxidants and what they do.

Morning:

Here is what I use, in the order I use it. Amazon links for ease of finding equivalents. Each item should be applied and then given a few seconds to dry.
I usually drop the serums all into my hand and apply them together. The toner is critical to the regimen as it clears all sebum that may prevent absorption of the serums and moisturizer.
Emma Hardie Moringa Cleansing Balm. It’s soft, gentle, and creamy. Bonus: it comes with a gorgeously soft cleansing cloth, and you can buy a package of them so you have a fresh one daily. Scoop out a thumbnail-sized dollop of the balm and lightly massage it into your skin, swiping upward and outward. If you prefer, you can add some water after massaging in, and emulsify into a milk before rinsing off. I prefer not to, and just use a warm, wet cleansing cloth to wipe it away.

Recherge Biologique P50 1970 toner

SkinMedica Vitamin C and E Complex 1 fl oz. or 20% Vitamin C + E Ferulic Acid Serum 4 oz refill

Matrixyl 3000 Serum Refill 4 oz

Niacinamide 5% Vitamin B3 Serum

Hyaluronic Acid Serum

Bite Beauty Agave Lip Mask 

Indeed Hydraluron Moisture Serum

StriVectin-SD Intensive Concentrate for Stretch Marks & Wrinkles, 5 fl. oz.

belif The True Cream Bomb or It Cosmetics Confidence in a Cream

Then I add a few drops of Fresh Seaberry Moisturizing Face Oil

Let it absorb for about 5-10 min. Tissue off if too moisturized after absorbing for a while.

Cotz Spf 40 UVB/UVA Sunscreen for Sensitive Skin

Natasha Denona Glow Foundation mixed with a couple drops of the Fresh Seaberry oil to sheer it out.

For those on a budget, here is my alternate list of budget-friendly skin care products with similar active ingredients to the above. Each alternate is in the table below next to its equivalent:

Original Budget Alternate
Emma Hardie Moringa Cleansing Balm MUAC Oil Cleanser
Cleansing Cloths Cleansing Cloths
Cotton Pads Cotton Pads
MUAC Mandelic Acid Cleanser MUAC Mandelic Acid Cleanser
Clarisonic Thena Facial Cleansing Device
Recherge Biologique P50 1970 toner Pixi Glow Tonic
MUAC Gly-Uronic Serum MUAC Gly-Uronic Serum
SkinMedica Vitamin C and E Complex MUAC Vitamin C E Serum
Matrixyl 3000 Serum Refill 4 oz MUAC Phytocell Renewal Serum
Niacinamide 5% Vitamin B3 Serum MUAC Niacinamide Serum
Hyaluronic Acid Serum MUAC Hyaluronic Serum
Bite Beauty Agave Lip Mask  Lanolin
Indeed Hydraluron Moisture Serum MUAC Hyaluronic Mist
StriVectin-SD Intensive Concentrate
belif The True Cream Bomb MUAC Antioxidant Moisturizer
Fresh Seaberry Moisturizing Face Oil MUAC Argan Oil
Cotz Spf 40 UVB/UVA Sunscreen for Sensitive Skin Cotz Spf 40 UVB/UVA Sunscreen for Sensitive Skin
Natasha Denona Glow Foundation 

 

Night:

Here is what I use, in the order I use it. Amazon links for ease of finding equivalents. Each item should be applied and then given a few seconds to dry. I usually drop the serums all into my hand and apply them together. The alpha-beta peel is critical to the regimen as it clears all sebum that may prevent absorption of the serums and moisturizer.
Remove eye makeup with Neutrogena Cleansing Oil-Free Eye Makeup Remover and cotton pads – these are my absolute favorite and are a good dupe for the more expensive Shiseido ones! Don’t wipe. Saturate the cotton pad in remover, hold it on your closed eyes for 60 seconds and lightly wipe away. Repeat with the other side of the cotton pad if it’s not mostly gone. Don’t try to get every last bit with the remover. Let your cleanser get the rest.

Remove face makeup with Neutrogena Makeup Remover Cleansing Towelettes if you absolutely must. In order to avoid creating wrinkles, hold the towelette against your face for 30-45 seconds, pressing in to allow it to dissolve makeup. Then LIGHTLY wipe it away.

Wash with Emma Hardie Moringa Cleansing Balm. Scoop out a thumbnail-sized dollop of the balm and lightly massage it into your skin, swiping upward and outward. If you prefer, you can add some water after massaging in, and emulsify into a milk before rinsing off. I prefer not to, and just use a warm, wet cleansing cloth to wipe it away.

I follow with Dr. Dennis Gross Skincare Alpha Beta Peel as my “toner” at night, as it helps prep the skin for the various serums and lotions.

SkinMedica Vitamin C and E Complex 1 fl oz. or 20% Vitamin C + E Ferulic Acid Serum 4 oz refill

Matrixyl 3000 Serum Refill 4 oz

Niacinamide 5% Vitamin B3 Serum

Hyaluronic Acid Serum

Bite Beauty Agave Lip Mask 

Indeed Hydraluron Moisture Serum

StriVectin-SD Intensive Concentrate for Stretch Marks & Wrinkles, 5 fl. oz.

belif The True Cream Bomb or It Cosmetics Confidence in a Cream

I add a few drops of Fresh Seaberry Moisturizing Face Oil to my moisturizer and three times a week I add Retin-a along with the moisturizer. 

Last thing before I go to bed I put on a layer of [Laneige] 2015 Renewal – Water Sleeping Mask mixed with a few drops of Moroccan Argan Oil and a very thick layer of LANEIGE Lip Sleeping Mask 20g

Once a week, I do a light peel – usually on a Thursday or Friday night. The page in the link has a really great description of which peel does what. For me, I alternate Lactic Acid 65% peel, TCX or PhytX peel and Mandelic Acid peel, and then once every three months or so I do a TCA peel on my sun spots. The TCA peel is hard core and I’ve slowly built up to a 24% peel which I do on my entire face about once a year, as it does have significant down-time of about ten days of massive peeling. This peel is no joke, and you have to build up to it with lactic acid at low percentages, higher percentages, and then TCA at the lowest percentage and SLOWLY build up according to the instructions that come with the peel. You can really mess up your skin if you don’t do this carefully, so don’t screw around with it if you don’t want to follow instructions. MUAC does also maintain a heavy social media presence and answers questions and makes recommendations as needed.
My skin looks amazing! The picture below is without ANY face makeup on – eyes and lips only. I’m 43 years old, for frame of reference. Before discovering vitamin c, my skin looked dramatically older! The picture below with the shorter hair was at age 29, 14 years ago. I looked older then, than I do now. I attribute this to vitamin C and hyaluronic acid, primarily, with help as well from retinol and very high quality humectants and moisturizers.

age 43, no face makeup – just moisturizer/sunscreen and lip balm:

43- no MU

age 43, minimal makeup (summertime, so more freckles are showing):

43-a

age 29, no face makeup:

img_2352-1

I want to talk about some common skincare ingredients that have misconceptions.
Purified Water is first. We need to add moisture to skin before we seal it in. Most skincare products begin with water to hydrate.

  • Tetrahexyldecyl Ascorbate is a form of vitamin c that’s fat-soluble, making it easier to absorb into skin’s lipid barrier.
  • Caprylic/Capric Triglyceride is a specific coconut fatty acid, which is extracted without fractionating (this is a good thing) and helps to moisturize and plump skin.
  • Cyclomethicone and Dimethicone give products a little “slip” and smoothness on the skin, making it feel nice, texturally, and absorb leaving a soft finish.
  • Cetyl Alcohol is a fatty alcohol – another moisturizer! Don’t be misled by the word alcohol.
  • Glyceryl Stearate is a compound of glycerin and stearin acid that makes a fatty texture which is used to help lotion smooth into your skin.
  • PEG-100 Stearate is another emulsifier. When combined with Glyceryl Stearate, the two stabilize one another and the product as it is emulsified, so you don’t get that separation into oils and water.
  • Retinyl Palmitate is a man-made vitamin A, which is an antioxidant as well, but when applied to the skin in this form, it converts to Retinol, and then to retinoic acid, the primary active ingredient in the widely-used prescription retin-a, which aids in turnover of skin cells, revealing fresher skin over time.
  • Tocopheryl Acetate is a topical form of vitamin e
  • Hyaluronic Acid is a humectant: it attracts water to its molecules and pulls it in, plumping the cell, and then holding onto the water.
  • Glycerin is also a humectant, but doesn’t hold onto the moisture, but picks it up and puts it down, so it requires some “sealing” with fatty stearates like those above that provide the barrier.

I prefer to use NO Sulfates, Pthalates, Parabens, or Formaldehyde.
A bit more about free radicals and antioxidants. Free radicals are simply molecules with an electron missing. They’re looking to bond with another molecule in order to replace that missing electron. This process is called oxidization, and it’s a natural and normal process. That doesn’t sound so bad, right? Guess what is also oxidation? Rusty metal. The problem is that when these molecules steal an electron from a healthy skin molecule, they leave it damaged. So an air pollution (smog) molecule is wandering around, snatches an electron from your face in order to balance itself out, and now your skin is missing an electron. Times billions. And it’s not just smog. Toxic food ingredients, chemicals, radiation, second hand smoke, and so many more are all attacking our skin constantly. This is commonly known as environmental aging.

Anti-oxidants are very special molecules which can give away an electron without being hurt, themselves. Vitamin C is an anti-oxidant. Applied to the skin, it encounters the free radical molecule, hands over its electron, and off goes the free radical without damaging your skin. This is why I look for a combination of multiple antioxidants: Aloe Vera Leaf Extract, Green Tea Leaf Extract, Grape Seed Extract as well as vitamins C, E, and retinol, the version of vitamin A.

Antioxidants are a critical step in skin care.
After cleansing skin and applying any toner or water-consistency treatments – I use niacinamide (vitamin B) spray and hyaluronic acid spray, apply serums such as hyaluronic acid in a slightly thicker form, vitamins, stem cell serum, or any other serums you may prefer.
Next, use your slightly viscous or thicker liquid products such as an undereye serum, tone corrector for age spots, or other treatments in a thin liquid.
Continue with your thicker liquids, always layering thinnest consistency first, or in case of equivalent consistency, put on the item with more active skincare ingredients in it first.

For those who are lower-maintenance about skincare, this would be immediately after cleansing and toning.
Next apply a skin oil or cream if you need further hydration in nighttime, or sunscreen during the day.
It takes about thirty days to see a truly dramatic difference with vitamin c, but age spots and hyper pigmentation can begin to lighten right away and you may notice a change in just a few days.

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