New Ideas for your Skin

Oct. 31, 2007

About seven years ago, I stopped in at a deli in Beulah to order a sandwich. The store was busy and my own mind was busy with work. So when the counter guy asked for my order, I barely noticed the woman next to me. But she had taken notice of me.
“Excuse me,” she said, “but I was in line before you.” I apologized and the deli clerk, looking flustered, took her order first and went back to fix her sandwich. The woman, middle-aged, tired looking and slightly overweight, turned to me and said, “This happens to me all the time. I’m invisible. You wait. You’ll be invisible too.”
Gotcha. Thanks for the heads up.
Well, now I am older. While I don’t feel invisible, I can see where she was coming from. And then a couple of weeks ago, that invisibility thing came up again. I asked a 50-ish friend of mine why he was having problems with his girlfriend, a brunette who was once beautiful, but whose skin now ripples like the tiny cigarettes she used to smoke. He said, “She told me that she feels invisible, and it’s been pretty hard for her to take.”
The only positive thing about this phenomenon is that it’s a perfect age to rob a bank. Do you have a description of the thief? “She was, um, she was, ah…. older. And she wasn’t young.” But what was the point of the women’s movement? Wasn’t it about women finding a new place to center their sense of self besides their looks? What about their solid friendships, their good works, the mountains they climbed?
It all comes down to balance. Looking good versus doing good. With a bit of my own imbalance (trying to ignore the whole age thing), I thought it was time to talk to beauty professionals about getting back my youthful face.

Before we get to their advice, here’s what you can do for free or nearly free:
- Sleep on your back to avoid pillow lines that ultimately become permanent. I’ve tried this, but felt like a stiff in a casket, especially when I folded my hands.
- Don’t smoke. Use the extra money for the stuff below.
- Use an SPF-15 lotion every single day of the year.
- Exercise to increase your circulation and to feel young again. You may look old on the outside, but you’ll feel very young on the inside.
- Get enough sleep.
- Avoid stress. Did you read the recent article that said stress ages your skin?

So with that said, here’s the advice from four people who spend their livelihoods thinking about skin and helped me separate the science from the science fiction:
MaryAnn Fouch, aesthetician, owner of Remedy Body Spa in Traverse City
When MaryAnn Fouch told me she was an aesthetician, I had to admit that I’d never heard that term before. In fact, it’s a fairly new profession in Michigan. Up until a few years ago, a cosmetologist had to study skin, nails and hair; now it’s possible to earn a separate certification for skin care. Fouch believes that using good skin care products will give you healthy, glowing skin, and it’s generally easier on your pocketbook than laser, plastic surgery, and collagen injections. Her advice: “Look for a glow, not a plastic face.” She also cautions that if you’re going the collagen injection route (more on that later), be careful if you’re the type that exercises a lot. The $400 derma-fill injection might not last nearly as long.
Fouch said that one of her biggest decisions was choosing her product line. She ultimately went with SkinCeuticals, basing her choice on two criteria: the product line was objectively tested by Duke University and the percentage of the active ingredient in each formulation is consistently high. For example, Vitamin C is the second highest ingredient in one of her most popular lotions. And it’s real Vitamin C—listed as l-absorbic—and not a derivative of Vitamin C, such as palmate. If possible, buy your skin products from a knowledgeable person who knows the science behind the products. “You’ll keep hearing it’s natural, natural, natural. Well, lead is natural, but is it good for you?”,
Fouch said.
Biggest tip: be sure to regularly exfoliate—that means get rid of the dead cells on the surface of your skin. The dead cells linger much longer as you age. “If you don’t exfoliate, the most expensive lotion in the world won’t be able to penetrate. But be careful what you use. Some over-the-counter scrubs, such as those made from nutshells, are simply scraping up your face and damaging your skin.”
How much will a good skin care regimen cost you? For SkinCeuticals, about $200 for four months to begin with; after that it varies, depending on your skin and how much you use. And, okay, you can run the bill up into the thousands if you also choose specialty lotions, monthly facials, and chemical peels.
One more question. Do cellulite creams work? Fouch chooses her words carefully: “Cellulite is biologically complex. There is no magic cream that gets rid of it.”
Fouch said it’s important to disregard the hype and seriously monitor the results. The proof is in your mirror.

Elizabeth Swenor, D.O., Swenor Medical and Aesthetics Center in Petoskey
Dr. Swenor is a family practitioner who branched out to aesthetics two years ago, believing that good health is both inside and out. She describes, perhaps too well, what happens as you age. “After our 30s, we slow down and stop making collagen, and our skin starts to sag and droop. There’s nothing to hold it up. You lose the volume in your face — your cheeks, your nasal labial folds from the corner of your nose to the corner of your mouth. And then you get jowls, right underneath your chin, right around the jaw bone.”
Swenor sells skin care products and make-up that contains SPF 15 (she also advises using SPF 30 if you’re going to be out in the sun all day). Her advice: Don’t assume that a professional skin care line is necessarily more expensive. Prescription remedies can offer higher doses of the active ingredient such as hydroquinone 2% or 4% or Kojic acid. Only a doctor can prescribe Tretinoin, the only topical medication that has been scientifically proven to improve wrinkles (it contains Retin A).
She also recommends dermafillers for facial contouring, such as Restylane (a $400 treatment that can last two to six months), or Radiesse, a new derma-filler that costs about $750 and lasts from one to two years.
“If someone can’t afford the $7,000 to $10,000 for plastic surgery—and it’s also very invasive—they can use derma-fillers that lay down scaffolding into the dermal layer, so that over time your body absorbs the product and replaces the filler with its own collagen. The effect is instantaneous. It can take five, 10, 20 years off your life just by giving you back your cheeks, pulling your smile up, which is probably, by now, pointing down. You can also put your volume back in your lips, and it looks natural.”
Swenor also using a laser for getting rid of brown spots, redness, broken blood vessels, fine wrinkles, skin resurfacing, and tightening. Treatments start at $350.
“You can renew your vitality,” she said confidently.

Jason Myers, D.O., Defy Aesthetic Club, Traverse City
Okay, now I’m walking into Defy, the new beauty clinic in Building 50. I know you’ve seen the ads. “I, will defy” … gravity, age. Tell me more. The place is breath-taking. Everyone is dressed today in light purple, and the place is sumptuous with high ceilings, soft music, and cushy chairs. I see one of the staffers, Amy Bellechasses, gluing lash extenders on her coworker Tammi Elzinga. The lashes are amazingly thick and long. The cost is $350, although later touch-ups won’t be nearly that much.
Dr. Jason Myers is 38, handsome, and nary a wrinkle. He formerly co-owned the Bay Point Family Care and Laser Skin Clinic (Baypoint was the first to bring cosmetic laser to the area). The skin clinic evolved into Defy, he said.
Dr. Myers showed me the coolest machine that makes a map of your face, showing you the skin damage, the wrinkles, and how you compare with other people your age. He uses the machine to show his clients the “before and after” progress. He himself charted the improvements on his face after using the SkinCeutical Vitamin C product.
He gave me a tour of the salon/clinic and the myriad of rooms. There is just so much. Three skin product lines. Mineral make-up. The
Vela-Shape machine to reduce cellulite. Laser skin tightening. Laser and chemical skin peels. Botox injections. Hair removal.
You can spend a couple of hundred dollars or thousands a year. Your choice, your budget. Defy offers a special deal for “regulars.” There’s the “Gold” club, which gives you 25% off laser treatments (doesn’t include botox or dermafillers), a free treatment on your birthday from the birthday menu, and some other extras. The platinum membership costs $50 per month, and includes the 25% discount on the Botox and Derma-Fillers.
Myers doesn’t promise “miracle work,” but the before and after pictures are impressive. And the earlier you start with all this, the younger you’ll look in the long run.

Joan Griner, M.D., Associates in Dermatology of Traverse City
Dr. Griner is a dermatologist and her practice hasn’t delved into aesthetics. It’s too busy treating people with acne, skin cancer, rashes and the like. So her advice is, shall we say, more affordable. Griner, who’s in her early 40s, has used a suncreen and moisturizer every single day since med school, “and it’s made all the difference in the world.”
“It makes me a believer. It minimizes the sun damage you get when you go from your car to the grocery store, the UVA that gets through the window glass. All of these small sun moments add up. The one thing I also use is a moisturizer.”
And she also recommends mildly exfoliating every day. “The best kind of exfoliation you can use is Retinol or salicylic acid that can very gently exfoliate the skin. We use Retin A for acne; it also gets the white heads and black heads.”
She recommends Neutrogena’s anti-blemish, anti-wrinkle face wash. “It’s a nice way to get the skin cells to come off without irritating the skin.”
Griner has a little more skepticism when it comes to skin care products, a $4 billion industry: “Companies, for example, will make products that have collagen in them because people have been told about the importance of collagen. But collagen is a huge molecule that can’t be absorbed into your skin.”
Can you stimulate collagen production?
“The only thing that we have good scientific evidence on is with Tretinoin (the active ingredient in Retin A/Renova, which is derived from vitamin A). Scientific studies show that over a number of months, it can stimulate receptors in the skin that can induce the formation of elastic fibers in the middle part of the skin where you get the support. It gives the skin fullness and helps defy aging and gravity changes.”
There’s a drawback to prescription retinoid products—they can dry out your skin to the point of redness, pain and peeling. Some people are better off starting with a weaker over-the-counter product (she suggests ROC) before going to a prescription level, and even then, start with the prescription remedy every two to
three days.
Laser technology has definitely progressed, but Griner cautions that every person responds in a different way—some will see significant improvement, while others will see little change. If your budget is tight, use a moisturizer, exfoliate, and use sun screen-every single day.

Sadly, I can give you only this brief tour of choices, but no answers. But if you ever start to feel invisible, go rob a bank and then go all out with a facelift.
No one will ever know it was you.