Wrinkles and Acne
The other main reason I was there was to get a presciption for topical acne/wrinkle products. I have been using Differin for several years for acne, however I don’t know if it’s the best treatment to use for fine lines as well. I have used Retin-A Micro in the past, but it was pretty harsh on my skin, so I wanted to avoid that. After some research, I discovered that Renova looked like a promising alternative. Renova is basically Retin-A, but in a moisturizing base. For some reason, I thought Renova contained pore-cloggers, but that doesn’t appear to be the case.

The doctor gave me a prescription for both Renova .05% cream, and Differin .03% gel. Differin is usually preferred over Renova for acne, however now that my acne is minimal, Renova should be strong enough for my acne, and it will give me a chance to see if it works better on wrinkles than the Differin. If I end up hating the Renova, then I will just go back to Differin. I had been using the .01% Differin, but the doctor said the new .03% isn’t any harsher, and that I might as well try the stronger one. Renova is generally not covered by insurance for acne (but my insurance doesn’t cover Differin either) so I order my products through a reputable online pharmacy.

Blackheads
The only acne I can’t seem to get rid of are the blackheads on my nose. They are super annoying, and they are always there! I also asked the Dermatologist for a prescription for Tazorac, because I’ve read that is the best treatment for blackheads. Luckily he gave me some sample tubes of it, which I will only use on my nose. Tazorac is similar to Differin, but it’s stronger, and also harsher. It’s probably better for someone with oily, non-sensitive skin.

Eyebrows
Finally, I told the doctor my eyebrows have been thinning a lot – especially the outer edges of them. They also feel itchy all the time – like something is crawling on them. Ugh. He said they look fine, and since there’s no redness or scaling, that there’s nothing he can do. He said it’s probably just heredity, or possible an auto-immune problem, but he had no suggestions. I briefly mentioned I have been struggling with hair loss for five years, but he had no comment or suggestions.

This is why I hate going to the doctor – they rarely have helpful answers to anything. It’s extremely frustrating going to the doctor, only to feel worse than before you got there. That’s why I do all my own research, and figure out what will be the best choice for me on my own. I just get frustrated when I have a problem I can’t fully solve (hair loss, thinning eyebrows) and the doctor knows less than I do.

Anyway, I will keep you informed on my experiences with the Renova and Tazorac!

Related posts:

1. Dermatologist Visit
2. Renova vs Retin-A Micro vs Retin-A
3. Blackheads

Why I’m going to the Dermatologist
I don’t have good health insurance, so I try to make as few trips to the doctor as possible. Since it was me (and not the Dermatologists) that figured out how to cure my skin, I don’t feel much need for Dermatologists anymore when it comes to acne. I have been using Differin for the last several years, a topical retinoid, and always got the prescription renewed at the gyno.

My Differin prescription has lapsed, and I have no pending doctors visits. I’m afraid to go without the Differin! I use the .01% Differin Gel, but have learned there’s a new .03% version out. I want to ask the Dermatologist about the difference, even though I could probably find the info on the internet. I also want to get a prescription for Tazorac, which is another retinoid that is good for wrinkles, and acne. I’ve read this is the best retinoid for blackheads, so I figure I might as well finally try it.

I also have a sort of suspicious mole on my back, so a skin cancer screening is a prudent idea, since you should really have it done yearly to be safe.

Any questions I should ask the Dermatologist?
I like to get the most for my money, so I’m trying to think of any other concerns I can bring up while I’m there. Even though I haven’t resolved my hair loss issue, I’ve sort of given up on Dermatologists knowing anything whatsoever about hair loss. Why they are so clueless about women’s hair loss is beyond me. Oh, maybe I will ask them about my thinning eyebrows, though. If you can think of anything you’d like to know, let me know, and maybe I can work it into the 5 minute office visit! I’m also in need of a new full-time job, so I may drop my resume off (again) while I’m there. Now that I have a year of working at a Medical Spa under my belt, they might be more inclined to hire me, since they do Botox and all sorts of Cosmetic Dermatology there.

Related posts:

1. My Dermatologist Visit
2. What A Visit With Family Taught Me About Aging
3. Acne Treatments That Didn’t Work

I’m always concerned about sweating because I sweat even when I’m cold! When I’m anxious it gets worse. I’ve tried every deodorant out there, although I haven’t tried Drysol, the prescription one. But Certain Dri, the super strong over-the-counter one, did nothing for me, except make me itch like crazy. Hmm I just noticed there’s a new antiperspirant for excessive sweating called Maxim that you can get on the internet. I haven’t tried it either. It’s annoying because there’s so many things I can’t wear because of the sweating problem. When antiperspirants don’t work, there’s always a surgical option, but that’s pretty extreme.

Botox to treat sweating!
Luckily Botox can now be used for sweating! We offered the treatment at my Medical Spa, but for some reason not too many people did it. The one or two people that actually had the treatment said that they had good results, and I’ve read about it being pretty successful. Last night I was watching “Dr. 90210″ and Dr. Will Kirby (he was on my favorite show Big Brother) did Botox injections on his male friend’s underarms. First Dr. Kirby shaved the patient’s armpits, and then he applied cornstarch. Over that he applied iodine, and waited a few minutes. When the patient started sweating, you could see purple dots where there was sweating. Dr. Kirby then did a quick series of Botox injections into the armpits, and then he was done! Since I’ve had Botox, I can tell you that the pain isn’t bad at all, and I hate needles! I am pretty nervous about getting shots in my underarms, but I doubt it really hurts that much.

At my Medical Spa, the injector says she does about 8 shots on each underarm, and uses a total of 100 units of Botox for both sides. That’s a lot of Botox, and it would cost at least $1000! The good news is that Botox for your underarms lasts 6-7 months, as opposed to the 3-4 months in your forehead. There’s more good news. A lot of times insurance will cover Botox for sweating!! So check with your health insurance, and then with your Dermatologist. I don’t know how “much” sweating you have to do to be considered having Hyperhidrosis, and I have a feeling your health insurance wouldn’t pay for the treatment if you weren’t considered an excessive sweater. Also, if you do have excessive sweating, read up on it, and ask your doctor about it, because this could be a symptom of a larger health problem.

On Dr. 90210, Dr. Kirby said it would take about 3 days to start sweating less, and within a week, you should be not sweating at all in the treated area, or not much. I totally want to try Botox for sweating, but just haven’t done it yet. I would only do it if it’s covered by my insurance. Right now Botox is mostly used to treat the underarms, but the hands, feet, and face can also possibly be treated.

Related posts:

1. Robinul For Hyperhidrosis (Excessive Sweating)
2. 101 Uses For Botox
3. Botox Tips

You do no want to go on Accutane without doctor supervision!
Aside from the severe possible side effects, there are also all sorts of different doses for Accutane, so you need a doctor to determine this. Plus, if you buy Accutane online without a prescription, who knows what you are really receiving!

Don’t perform medical-grade chemical peels on yourself!
I’ve also heard of people buying chemical peel ingredients online such as Glycolic Acid and Salicylic Acid, but in the medical-grade versions! While you normally find 2% Salicylic Acid or 10% Glycolic Acid in skin care products, Doctors and Estheticians can use much higher percentages. Just because unscrupulous websites may sell these chemicals, don’t buy them and use them on yourself! I get nervous enough letting a Dermatologist or Esthetician do a light chemical peel on me, so I can’t imagine trying to “figure it out” at home. Plus, these are burning chemicals, so do you really want to have your eyes open while you are looking at what you are applying?

I haven’t looked, but I can guarantee there are tons of horror stories out there of people that have burned their faces from at-home chemical peels, or caused horrible damage from taking isotretinoin on their own. So that’s my little preachy warning – just because you “can” do something doesn’t mean that you should! It may cost more and take more time, but visit a Doctor or licensed Esthetician for your medical-grade skin care needs!

Related posts:

1. Burning Skin Care Ingredients
2. Skin Care For Everyone
3. Asian Skin Care

Make sure you are receiving Botox Cosmetic
Currently, Botox Cosmetic is the only Botulinum toxin A that is FDA approved for cosmetic use. Before you receive your treatment, don’t hesitate to ask to see the box and bottle of the Botox, to confirm that it’s the real thing. Of course, an unscrupulous person could always put something other than Botox Cosmetic in the bottle, so you need to make sure you are at a trustworthy practice. If you’ve heard about the deaths or paralysis of people that had Botox injections, they were not injected with Botox Cosmetic. Here in Nevada, a doctor has recently been accused of injecting his patients with something other than Botox Cosmetic, but telling them it was the real thing, and he faces serious jail time if he’s found guilty.

Botox Cosmetic is not cheap
Allergan, the maker of Botox Cosmetic, currently charges all of its buyers $505 per 100 unit vial. That means a Medical Spa or Doctor is paying $5.05 per unit of Botox, plus they need to pay the injector, the rest of the staff, and all the bills that go along with running a medical establishment. So if you see Botox specials at places for $99, or $6 a unit, you probably aren’t going to get a good treatment! At the Medical Spa I worked at, we would charge between $9.50 and $13 a unit, depending on the special we were running. I personally got 35 units, which covered my forehead, between my eyes, and around my eyes. That’s about $350. Most of our clients got between 20 and 80 units, depending on the severity of their wrinkles.

Botox injections require skill and practice
In Nevada, you only need to be a Medical Assistant to inject Botox. In other states, you must be a Nurse or Doctor, however any type of Doctor can take a weekend course in Botox and then be able to inject it. Just because a Doctor is doing your treatment doesn’t mean you will get good results. Botox must be injected very precisely, and skill and practice are necessary for good results. When I got my Botox at the Medical Spa I worked at, my treatments were done by a Medical Assistant, yet she had been doing injections for several years, was trained by Allergan, and she had worked on hundreds and hundreds of happy clients. I saw Doctors that were affiliated with the Spa that didn’t provide the best results to clients, and the clients were happier with the Medical Assistant. Also, at the Medical Spa, one Medical Assistant literally had a week of training before she was injecting clients!!! That freaked me out. Read about my Insider Guide to Medical Spas here. Ask for referrals from your friends, ask a place to see before and after pictures, ask how long the person has been doing injections, and check with the Better Business Bureau before choosing an establishment. The official Botox website also has a list of Doctors with whom they are affiliated.

On a side note, I saw great results with the 35 units the Medical Assistant recommended, however when I asked another doctor and a nurse how many units they thought I needed, they both said 60. I’m not exactly sure what to make of that.

Ask if the results are guaranteed
While every patient is different and won’t get the same exact results, there are several factors that can effect your treatment. Botox needs to be mixed with sterile saline, but some unscrupulous places may dilute the Botox too much, which can make it less effective, or it can wear off faster. Botox also needs to be used within a few days after it’s mixed, so if you aren’t getting fresh Botox, you might not get good results. You also want to get an ample amount of units, so it’s best to pay per unit, rather than per area. Some place may charge $99 an area, but who knows how much Botox they are injecting. You need to tell a skilled injector what results you are hoping to achieve, and you need to let him or her decide how many units you will need to achieve those results. If you only have $100 and want “some” Botox, save your money til you can afford to get the units you need. If you are being treated at a reputable place, you should be really happy with your results. But see if you can get some sort of guarantee in writing, so that you don’t get Botox that fades after two weeks, and you’re out a lot of money.

Continued use of Botox and Side Effects
Since Botox Cosmetic hasn’t been around that long, no one really knows what its long term effects will be. It’s recommended to get Botox every 3-4 months, although with continued use, you should need it less often, and may need less units to achieve the same results. But if you continually get it, who knows how it will effect your looks in 10, 20, 30 years. That scares me a bit! Make sure to tell your Botox provider what medications you are on before the treatment, and don’t drink alcohol before the treatment. Botox parties may be fun (if you get a skilled injector) but you don’t want to be drinking at them! Don’t lie down for 4 hours after the injections, and don’t rub your face. The good thing about Botox is that while you have it, it will prevent your wrinkles from getting worse, so you are sort of stopping the clock. However, if you stop getting it, the wrinkles you had before will come back, and it will be like you never had the treatment.

Related posts:

1. My Botox Experience
2. Bye Bye Botox
3. Botox For Excessive Sweating

The pain actually wasn’t bad at all, and it just stung a tiny bit around my eyes. A topical numbing agent was first applied to my skin, and the actual procedure took 10 minutes. Probably about 10 pricks total were made around my eyes, between my brows, and in my forehead. All together I got 35 units. Normally I have faint wrinkles in my forehead and between my eyebrows, and small crows feet around my eyes. It took several days before I started to see results from the treatment, and a full two weeks before I had the maximum results. All the wrinkles were essentially gone, and when I smiled, my cheeks puffed out just a bit more under my eyes. My eyebrows were slightly lifted, and the best part was that my eyes looked totally even for the first time ever! I have one slightly droopy eye, but the Botox totally fixed that!! I also had one unit injected under my bottom lip to cause it to pout. I already have big lips, so I wasn’t crazy about the results on me, but it would be good for someone with thinner lips.

The day after I got the treatment, I had a horrible headache, and I was paranoid it would never go away, but it did! That was the only side effect I had. When the Botox took effect, my forehead felt a bit stiff, and it was hard to lift my eyebrows up that much, and it was impossible to furrow my brows, so I had to frown with my mouth to show expression! It felt a little weird having a stiff forehead – kind of like I put a big piece of masking tape there – but it wasn’t a big deal. No one noticed I looked any different, so it looked very natural, and I would get compliments all the time at the Medical Spa about how I looked young. Before the Botox, I think I looked almost my age. After about two months, the Botox started to wear off slightly in my forehead, and I was able to move my forehead more. It took three months for the Botox to wear off in my forehead, and four months around my eyes. At four months, I had it done again, but was told I didn’t need quite as much the second time, since the wrinkles weren’t as pronounced. I was able to move my forehead more the second time around, so if you don’t get as much Botox, you will have the ability to have more facial expressions. But if you don’t get enough, you won’t see the results you’re looking for. It’s best to tell the injector what you’re trying to accomplish and let he or she tell you how much Botox you will need.

Overall, of all the beauty treatments I’ve tried, Botox, and sunscreen have made the biggest improvements in keeping my skin looking young. Since I didn’t have to pay for the expensive treatment, it was great, but I will probably only continue to get it around my eyes, since it doesn’t take a lot of units in that area, and the wrinkles there bother me the most. I will write a separate post about Botox tips.

ps. This picture of me was taken on Friday. Sheesh, my California Tan has totally worn off (or maybe the flash was just really bright!)

Related posts:

1. Botox Tips
2. Bye Bye Botox
3. Botox For Excessive Sweating

The new Dermatologist switched me from Differin cream to Differin gel, and I don’t know if that made any difference or not. Random note: I use the .1% Differin, but notice they now have a stronger .3% version. Interesting. Well the good thing about Differin is that is has NO side effects on me at all. It doesn’t dry out my face or make it oily. It’s expensive, though. Oh, yeah, and so is the Yasmin, since there’s no generic for it, but it’s worth it!!!! At the same time, I had just finished reading Don’t Go To The Cosmetics Counter Without Me – Paula Begoun which talks about all of the major skin care products on the market. The book helped me narrow down which products were worth using (for acne and for wrinkles), and it taught me even more about what actually works for your skin, and what is crap (a lot of products!) You should check out Paula’s website: Cosmetics Cop. Also at the same time, I found the fabulous MakeupAlley which lists products and has viewer reviews. It’s extremely helpful to see what “real” people have to say about products, and whether or not they work or cause their skin to breakout, etc. Finally, the last key to my product research came when I discovered several websites that listed product ingredients that can cause your pores to clog and your skin to breakout. I will make a separate post about these sites and the ingredients because it’s a long list! So guess what, almost EVERY single moisturizer or acne product I owned contained ingredients that were alleged huge pore cloggers! WTF? It turns out (from my estimate) 75% of the products on the market will possibly clog your pores, if you are acne-prone. Even acne products, and non-comodogenic, oil-free products contain these ingredients! Why? So that you will mess up your skin even more and buy more products?? I don’t know. Also, a lot of the acne products I used dried out my skin even more, making me need even more moisturizer, and making the acne worse.

Here is the “acne safe” morning regimen I follow:
- Wash my face with Philosophy Purity Made Simple cleanser. This is a great cleanser because it hydrates as it cleanses, so my skin doesn’t feel parched. If I travel to somewhere humid, I use Neutrogena Healthy Skin Anti-Wrinkle Anti-Blemish, which is a little more drying.
- Apply Paula’s Choice Skin Recovery Super Antioxidant Concentrate or Olay Regenerist Deep Hydration Regenerating Cream. Sometimes I mix in a pinch of Philosophy Hope And A Prayer topical Vitamin C powder. I need antioxidants, and peptides to fight against wrinkles!
- Apply Clinique Moisture On-line. Remember I live in Vegas and have super dry skin. When I go to Hawaii, or somewhere else humid, I don’t need as much moisture!
- Mix Shiseido Ultimate Sun Protection Cream For Face – SPF 55 with Maybelline Pure Makeup Nude (nude). I know I am diluting the sunscreen, and I need to research how much this effects its SPF.
- Put on Maybelline Instand Age Rewind Under Eye Concealer (medium) on any spots (I’m not crazy about this concealer, but it’s fine), and then put on Neutrogena Healthy Skin Pressed Powder (medium) with a powder brush. It’s a very light, non-cakey powder.

Here’s my night regimen:
- Use the same cleansers as the morning.
- Apply Differin .1% gel. I used to rotate this with TxSystems Afirm 3x, a strong retinol, but it’s drying, so it sometimes makes my face flaky. I am pretty sure the Differin also works similarly to Retin-A as a wrinkle-reducer/preventor, but I haven’t found any studies comparing the effectiveness of Differin to Retin-A.
- Apply Dove Energy Glow Night Cream. Sometimes I use Burt’s Bees Marshmallow Vanishing Creme, but I think it clogs my pores, so I just use it around my eyes. I don’t love these creams, but haven’t found anything better.

Specialty products:
- If I feel a breakout is coming, I’ll use Paula’s Choice 2% Beta Hydroxy Acid Gel in the morning, instead of the antioxidant serum. Paula says that Salicyclic Acid needs to be at the proper ph level to work, and supposedly a lot of products are not effective because of the wrong ph.
- If I do get the rare pimple, I’ll dab it with Paula’s Choice Blemish Fighting Solution and TxSystems Afirm 3x.
- Once a week I use the fabulous Philosophy The Microdelivery Peel. Even though the Differin keeps my skin exfoliated, this is gentle enough that it makes my skin look great, and it’s not irritating at all
- When my face feels especially dry, I’ll use Paula’s Choice Skin Recovery Treatment Mask.

Other things I do to help my skin include washing my face with lukewarm water (no hot water or ice on pimples – FU The Acne Cure book). Then I bought a big pack of washcloths at Target and use a new washcloth every day to very gently pat my skin dry after washing. And from Wal-Mart of all places, I found some fabulous satin (well 100% poly) pillowcases that I make sure to change often. These leave you with no wrinkles on your face in the morning, and they are good for your hair!

After three months of this regimen, I was acne-free (and my skin wasn’t super flaky anymore), and I still am two years later! That’s my “after” picture in this post. I do not believe my acne would be gone if I didn’t do all of the things I do – the pill, the non-pore clogging products, and probably the Differin (I don’t know if it “really” works, but I’m afraid to not use it at the same time). For women that have hormonal acne who don’t want to take the pill (or Accutane) I honestly don’t know what to do to be acne-free. Maybe acne laser treatments (oh yet another post). Also, aside from the Differin, I don’t think the products I use help my acne as much as they don’t make it worse. Once my acne went away, I was left with about 50 red spots where the acne used to be. Luckily I only got one actual scar during the whole process. The saga of the red spots will be left for another post as well. And the saga of the blackheads on my nose will also be left for later.

Related posts:

1. The Pill To Treat Hormonal Acne?
2. Avoid Cosmetic Cornstarch If You’re Acne-Prone
3. Guide to Cure Acne

My hair was also falling out when I got the acne, so I thought I had some sort of hormonal imbalance. I stopped the Ortho Tri-Cyclen (stopping of course made the acne even worse) and went to a Dermatologist. Then I saw two more Dermatologists because the hair loss thing was really getting to me, even more so than the acne and the doctors didn’t seem to know anything. I did a TON of hair loss research, and was diagnosed with Chronic Telogen Effluvium but that’s a whole other post (or book) because I have yet to “cure” the hair loss/thinning. So for the acne, these three Dermatologists gave me antibiotics (which initially worked, but once I stopped them, the acne came back), and Benzaclin, a prescription topical Benzoyl Peroxide/Clindamycin cream that didn’t do anything, except stain my towels. They also gave me some Sulpha wash, and Cetaphil cleanser and moisturizer, neither of which I like at all. I can’t even remember now what else these Dermatologists gave me, but none of it worked AT ALL. I didn’t want to go on Accutane because one of the side effects is possible hair loss, and being bald was worse to me than bad acne.

I then started my own acne research. Of course I tried Proactiv because those stupid infomercials are so persuasive. Proactiv didn’t work AT ALL. Then I got the book The Acne Cure. Finally a cure for acne! Ha! I followed the book’s advice and got a drugstore 2% Salicylic Acid and a 10% Glycolic Acid from Sephora and the Benzoyl Peroxide, and I iced my face, and I applied an oil-free moisturizer with SPF. 4 weeks later, I still had acne and it wasn’t any better! My face was always so dry from the different products, and maybe from the hard water in LA, so I was always slathering on moisturizer on my dry, flaky, acne skin. Next, I tried probably 8 different acne creams and washes from the drugstore, all of which promised to banish acne forever. Ha.

I started eating better, and ate tons of fruits and vegetables and protein. I took vitamins – Evening Primrose Oil and a multi-vitamin, and a bunch of other vitamins good for skin and hair. I read more books: The Acne Prescription and The Murad Method and a few other hair loss and anti-aging books. I spent probably 50 hours researching acne cures on the internet. I tried Dr. Murad products and Dr. Perricone products. I still had acne. At least I was becoming extremely knowledgeable, though, on every way you were “supposed” to get rid of acne. I took my time with treatments and didn’t try too many things at once, and steared clear of anything that was known to make acne worse. I moved to Las Vegas, and still had acne and my skin was even more dry than ever due the 5% humidity. I visited another Dermatologist. And I will leave the How I Cured My Acne Finally to the next post…

Related posts:

1. Dermatologist Visit
2. How I Cured My Adult Hormonal Acne
3. My Hair Loss Story