Skin Care

There’s been a little bit in the media recently about whether or not patients with darker skin tones, known as skin of color patients, do they really need sunscreen? The answer is, absolutely yes. Although darker skin types are less likely to get skin cancers, it is not a zero risk. And importantly for many of my patients who have darker skin tone, they really dislike irregular pigmentation. Often, when they get acne, the acne inflammation will result in some pigmentation. So some of the things I recommend for my darker skin patients with acne, EltaMD UV Clear SPF 46 is a particularly nice product, aesthetically for darker skin tone. Fine chiffon (not sure of the name) which is actually FDA approved for Rosacea is an excellent treatment for acne with pigmentation and finally Tazorac which is tazarotene is one of the best treatments for darker skin patients with acne and pigmentation.

So today you are going to see what I do for hand washing. I wash my hands all the time, especially during flu season and before every patient. But, certainly I think all of us are paying a little bit more attention to our hand washing that we ever were before because of COVID-19. So let me tell you what I think is important. First of all, you want to get your hands wet. I am using CLN a lot. Because CLN’s active ingredient is Sodium Hypochloride. Sodium Hypochloride is the same ingredient in bleach which kills just about everything. Notice that I am getting between my fingers. I am getting on the tops of my hands, the wrist, the sides and then you want to make sure you are getting in the fingernail and cuticle area and believe it or not when you do that, it does take a good 20 seconds. And then you want to rinse it really good. Keep lathering up. And rinse away. And then go ahead and dry your hands. Notice I kept my rings on. So I think it’s important to go ahead and wash your jewelry, your rings. Yes, it might get a little soap film on you but you can always clean them later and certainly we know, and now I use my tissue to turn the water off. Certainly we know that you can germs on your jewelry as well. And then one of the things I love is to use this particular product. This Eucerin has a great source of extra ceramides and the reason you want to do this and I use so much, I usually have to wipe a little off. The reason you want to do this is you don’t want to get little cracks in your hands in the skin of your hands. Because those cracks can be a portal of entry for viruses, bacteria and funguses etc. So you want to make sure that you are hydrating and replenishing the compromised barrier of skin which is compromised by all of that washing. So keep washing and keep moisturizing.

When people are under a lot of stress, many things bad can happen to their system. A lot of this is the result of cortisol. Now, when we are under a lot of stress, either emotional stress or true physical stress like childbirth or surgical procedures or illness, you can get a condition called tiligative fluvium. Telogen effluvium results when the hairs of your scalp, which normally cycle in their growth phases. Androgen is the growing phase and telogen is the resting phase, where the hair actually gets shed and a new hair replaces it. But under conditions of stress, the androgen phase can be cut short and too many hairs can be triggered into the telogen phase at the same time. This can often result in clinically visible thinning of the overall hair and then generalised shedding. Often people will notice that they see their scalp a little bit more than they used to. So what can you do when you are under real stress to prevent Telogen effluvium from causing your hair to fall out which will cause you more stress. Well, one of the things that’s very important to do is to watch your diet. I recommend that you eat a lot of fruits and vegetables because the nutrients that are in there are very good for hair growth and overall health and your immune system. Also meat is good because of the iron. Iron has been found to help the hair grow. And the other thing that I am doing is I am increasing my dose of nutrifall. Now most of you all know that I have been on nutrifall for a long time. I started it many years ago, about four or five years ago and I started with the full recommended dose and I used to for about a year until I saw my hair doing what I wanted it to be doing. But when it got there I actually decreased by dose to a maintenance dose. I was taking a half dose. But during these times of stress, as a preventative, I have increased my dosage back up to the usual dose of four per day. So what I want you all to do is to do everything you can now that you are prepared for coming back and having the world see you looking as beautiful as possible. So take your supplements, eat right, try to get enough sleep, meditate or pray or whatever makes you handle stress better. And we will see you on the other side of this pandemic crisis.

Ageing is a very dynamic process and it is important to understand all the things that really do age our faces. So we all know that dischromia and collagen breakdown and fine lines and wrinkles are caused by sun damage. If you sleep on your face, that can also accentuate lines. If you are a smoker, if you have a poor diet, all of these things can affect your skin. In addition as we age, there are changes to the fat pockets on the skin and the deflation and shifting of fat pockets actually causes the face to descend and to sink in, in some areas and give you a very tired or gaunt or aged appearance. But the third thing that’s very important are the bones. Now everyone knows that when you are post menopausal that you need to take calcium supplements to prevent osteoporosis which can cause the spine to shrink and cause hip fractures and wrist fractures. But when you lose bone, it can also affect your face. Now, you want to define a high cheek bone and a distinct and defined jaw line and the way to continue that as you get older is to take a very good calcium supplement. Now, I recommend and take Cardio tabs for bone health and the reason I have chosen that after a lot of research is because of the microcrystallized calcium form of it allows lower levels of calcium in the blood stream. Blood calcium can cause calcifications in soft tissue where you do not want calcifications. You want the calcium to go into the bone. So when you use a calcium like this you will get decreased calcifications of your arteries, your coronary arteries, your carotid arteries and a decreased risk of kidney stones. I also like that this formula has vitamin D. Remember vitamin D is extremely important to the overall health of everything in your system, your hair, your skin, your bones. Even your immune system. So take a good supplement. Know what you are taking and make sure that you are always taking care of yourself. Not just now during a pandemic but everyday because doing little things disciplined and everyday are really what make you look better when you are in your mid sixties like me. So take care, be well and let’s all get through this pandemic without any more deaths and illness. Bye!

Good morning! It is Melanoma Monday. Do you know where your sunscreen is? The most important part of skin cancer prevention is the daily use of a good, broad spectrum sunscreen, preferably forty SPF or higher. You must do it everyday. There is no excuse.

So happy Memorial Day and I hope those of you who are outside joining the sun which is a great thing to do if you are using sun protection. Because when you are out in the Sun, you are usually doing wonderful things like interacting with friends or doing exercise which are both very very important. But I want to talk to you about the Eryfotona line from Isdin. Because my good friend Molly Kimball posted about it and tagged me and I have gotten a lot of questions about it. So I want to give you the details about these two products. So, the first one I started carrying is the Eryfotona Actinica. And what I want you to know about this product is it has a Zinc SPF 50 and I think that’s important because Zinc is an inorganic sunscreen that’s not easily broken down. So it is very substantive and it lasts. And gives you very very good broad spectrum protection in both the UVA and UVB category. It is 11 per cent which is great. But in addition to that, there’s antioxidants. But the most important ingredient is their DNA repairsome. This is a DNA repair enzyme of phytalase that actually finds and cleans damaged DNA that causes skin cancers. What I was particularly impressed when I learned about this line is the clinical study that was done in Spain. They took 50 patients who had a precancer skin condition called Actinic Keratosis and they treated all fifty with the same treatment modality which is photodynamic therapy which treats both visible Actinic Keratosis and what are called sub-clinical inivisble soon-to-be coming out Actinic Keratosis. And they cleared the field. Then they took the 50 and they divided them in half. They took 25 of them and gave them the Zinc portion of the Eryfotona Actinica and then they took the other 25 and they gave them the Erftona Actinica full formula that also had the DNA repairsome. They then followed these patients prospectively for one year and monitored how many new skin cancers and pre cancers the patients got. And what was found was a statistically significant decrease in new actini keratosis in the patients who had been using the full formula. So that’s why I started using this formula. But unfortunately, this formula is not cosmetically acceptable to all patients. Well, last year, I am happy to report that they come out with a new product called Eryfotona Ageless. Now this has a slightly lower Zinc percentage. It is 10.7. But it has the DNA repairsome and it has antioxidants. It has Vitamin C and it has Vitamin E. And it also has collagen stimulating penne peptides and tri peptides which also make it an anti-ageing product. It also has a lovely tint which believe it or not is even good on skin of color patients. My good friend Peterson Pierre in California who is an African American board certified dermatologist and a good friend of mine was actually the one who turned me onto this product and told me how wonderful it is on his darker skin. And sure enough I found that in my patients in my practice they like it just as much. So, this is why I love these two products. The DNA repairsome is anti-ageing and anti-cancer. And these products really deliver for me, for my patients who either have skin cancers or who have concerns about skin ageing.

So the product of the month is the Zoë QykSonic device. Now this is an at home device that is usually used for cleansing with the sonic cleansing action to deep clean your pores. But I want to show you my favorite way to use this product. I like to use a serum all over my face and neck, and then use the ultra sonic device to penetrate that cosmeceutical deeper into the skin, so what I do is I go up and out, with the serum on my face, along and under the jaw line and on the neck. I go around the mouth, and I go by the eyes and above the eye brows and I do this for the duration of the cycle. Another great trick is this cool metal part can be used under the eye to help with puffiness that sonic vibration will help prevent pooling of fluid around the eyes, so this is a great device, use it every day for best results.

Patients often ask me how do I choose the products that I recommend from the office. As you know, we do quite a bit of skin consultation at the office. And what people want to know is how do we make our skin look brighter. How to make scars look less noticeable. And how to get rid of some of the sun damage. Now the truth is that products can never act as a total substitute to the procedures that we do in the office. But they can definitely supplement what we do. So for example, we will often like to use a retinoid before we treat a patient because retinoids before procedures have been shown to improve the result. Then once a patient has been treated we use products that help to maintain that benefit longer. So, I always look for companies that do a lot of good science on their products, they actually do clinical testing and they publish those results. So that you know when we recommend a product that’s available either at our office or on our website, it is because we have evaluated the company, the product and we either use it ourselves or we recommend it to our friends and family.

So everyone knows they need to use sunscreen everyday. But let me tell you a few other important tips. Wear a hat, preferably one that has a wider brim to protect the sides of your face. Wear sunglasses so that you don’t squint and get those little tiny wrinkles around your eyes. And no one likes to reapply sunscreen during the day. So I get a powdered SPF 50 that I can not only reapply my sunscreen but touch up my makeup at the same time.

have a number of really good new retinoids available. There is a Raslow, there is Eltrino and there is Acleave. But a lot of people, no matter how gentle the retinoid is, sometimes have difficulty tolerating retinoids initially. So let me give you a few tips on how you can tolerate your retinoids so you can be more compliant and use them so that you can acne cleared faster. The first thing you can do is alternate the nights that you start the retinoid. In other words, use it Monday, Wednesday, Friday or use it only on odd days or even days. That’s one option. Another is to put a lightweight moisturizer on your face immediately before you put on your retinoid. The newer generations of retinoids are still effective if you use the moisturizer first. Finally for people who are super sensitive, you can do what I call ‘the mask therapy.’ That means you actually put your retinoid on but you only leave it on for three to five minutes. After which time you take a lightweight moisturizer and some water and mix it on your face and wipe off the product. So you are only using retinoid for a short period of time like a mask.

Our product of the month, this month is BodiFirm. The reason we love it is because BodiFirm does two things. It not only firms the appearance of the skin but it also has ingredients to improve fat cells. To let them excrete the fat more easily. It is particularly good this time of year when we are all interested in the appearance of our thighs and our buttocks and our upper arms. We use this especially in conjunction with procedures to improve cellulite and skin firmness on the body.

My last step before I do filler injections is I take Cln and I clean the area off instead of using alcohol. It is less irritating to people’s skin and the antiseptic action of the Cln gives me the safety that I want to prevent infections and biofilm from fillers.

There’s been a lot of information in the news media about the importance of Vitamin D and our immunity. And our resistance to diseases. But vitamin D is also very important in dermatology. Low vitamin D levels can be associated with hair shedding in females. And a very very common problem, severe acne. It has been linked with low levels of Vitamin D. Now as dermatologists we don’t want our patients getting a lot of sun because of the risk of skin cancers. The UVB light is what produces Vitamin D in our skin. So in order to prevent our patients who are using sunscreens as we wish them to use to prevent them from getting Vitamin D deficiency, we stress the importance of taking oral Vitamin D daily. Be sure to get your Vitamin D level checked especially if you have any inflammatory skin diseases such as Rosacea, Psoriasis, severe acne and always be sure that yur Vitamin D level is normal.

I am a big fan of mineral based chemical free sunscreens, and a lot of people don’t like to use them because they feel it gives them a pasty look, so I like to tell my patients how I like them to apply this mineral sunscreen. The one I am demonstrating today is the Isdin Eryfotona Actinica which has been proven to prevent skin cancers. So the way to use it is to actually use it almost like a makeup. Put it in the palm of your hand and then take your finger and put it in little dots, on your face, and then as you pat it in, you spread it so you get good even coverage and then you blend it in, until you lose that whitish tint. And then you just go ahead and put your make up on top of it. Men also like this product, especially if they have a history of actinic Keratoses

Down in New Orleans we have a large group of patients who are mixed race and therefore have darker skin tones, so having practiced here for more than 35 years I have learned a thing or two about how to properly treat darker skin tones. The most important thing is use a sunscreen every day, this will prevent irregular pigmentation, decrease your risk of skin cancer and actually decrease inflammation in your skin, that accelerates ageing. I particularly like the Alta MD 46 Clear because it is a sunscreen that does not give that ashy tint to my patients’ skin. Finacea can be used to improve pigmentation, from inflammation or from acne. Azelaic acid is a known treatment that is very gentle and is very acceptable for people who perhaps can’t use hydroquinone. Taseract is a retinoid, Tretinoid is another. These particular groups of medicines are particularly effective from increasing epidermal turnover and brightening the skin. They also improve the quality of the pores and decrease acne. This new C plus correcting serum from Revision is particularly good for all skin types who are trying to improve conditions of redness and pigmentation plus vitamin C is an excellent adjunctive treatment to prevent sun damage that goes beyond what your sunscreens alone can do. Finally the use of specific kits that have hydroquinone retinoid, anti-oxidants and brighteners can be particularly beneficial for people who have a condition called Melasma. Melasma is seen in many different skin types but it is particularly a problem in Asian, Hispanic and African American patients.

There has been a lot of news about the use of testosterone at wellness and rejuvenation clinics, and I would like to give you my take on testosterone as a dermatologist. First of all you should always make sure that before you are given testosterone that your testosterone levels are abnormally low. That is the most important thing; excess testosterone is not good for your overall health. The other thing you need to be aware is that testosterone has effects on the skin and hair that you may not like. For example, when you get testosterone you may notice and increase in acne, you may notice a decrease in your hair, on your head or what we call Alopecia, androgenetic alopecia and then finally it can cause facial hair to get thicker and courser, so before you get into that testosterone treatment – to feel better, more energetic and perhaps loose a little weight, make sure you have done your homework and talk to your doctor about these issues.

There are many, many good skin care products on the market that do things to make our skin smoother and brighter, and a lot of times we have to use more than 1 product in the morning and more than 1 product in the evening, so a lot of people get confused as to which product they should use first. So let me give you some rules of thumb. You should always put the thinner product on first, so that usually means serums before gels, gels before lotions and lotions before creams, and remember the sunscreen should always be the last product you put on so it can best protect you from the ultra violet light.

I am going to be doing a series of posts about skin care pairings of products with procedures, so today I am going to start off by mentioning that the use of sunscreens both before and after a procedure is extremely important. The reason is because most of what we are trying to correct, is sun damage and hyper pigmentation – sometimes the hyper pigmentation can be from acne and sometimes it can be from general sun damage, so the use of sunscreens is extremely important, to make your skin look better faster. So I want to talk about the 3 that we recommend most frequently and the reason we recommend these is because they are chemical free. We use zinc oxide and sometimes also titanium dioxide so let me talk about my 3 favorites, True Physical is a great sunscreen from Revision, this product is an SPF 45, and in addition to the chemical free sun ingredient Zinc Oxide, it has a combination of some antioxidants which can also help fight pigmentation – another great product is the Eryfotona ageless. This is an spf 50 that contains a high level of Zinc oxide, but in addition it has an ingredient that helps to repair DNA damage from sun damage. Both of these products as well as the third product have a lovely light tint, which can help camouflage some of the redness that you may experience after a procedure. This one is my favorite from Alta MD is the SPF 44, that has Zinc and Titanium dioxide. These products are very good and it is a matter of personal preference and your dermatologist’s choice, as to which one you should use both pre and post procedure.

So we are going to talk a little bit more today about products that compliment procedures. One of my favorite products is an oral supplement called Lumity. Lumity has a day and a night time formula that helps to stimulate collagen production in your skin and protect it from photo damage. I particularly like Lumity when I am doing collagen simulation procedures, such as Fraxel, Sculptra and Radiesse. In addition to Lumity those procedures really require root of skin MD. This is my favorite compliment to collagen stimulating procedures, because it has stem cells deriving growth factors that help up regulate the collagen production in your skin. If you have redness and brown in your skin, then you probably are going to get either a vascular laser such as Excel V or perhaps an intense pulse light therapy treatment with the M22. For that I like the revision C plus correcting lotion. The reason is, is that this is sort of the IPL of skin care products because it addresses both red and brown. Finally Revox 7 is my go to product to pair, with neuromodulators such as Botox, Jeuveau, Dysport and Xeomin. It has 7 peptides, several of which simulate collagen repair but there are also peptides in here that help diminish the neuro-stimulation of your muscles.

So the Intellishade TruPhysical is really one of our new favorites at the Lupo Centre, we have been carrying it now for about a year. The reason we like it - it’s a gumbo of ingredients that gives good sun protection and there are some anti-oxidants and some other peptides that help with the ageing process, But even in tele-shade it is not always convenient to reapply during the day. So we recommend one of 2 other products. If you want a matt finish we like the colour side’s powder and if you want more of a creamy dewy finish, we like the Avene. Now we are having a special to promote the idea of reapplication of sunscreen this month and with a purchase of Intellishade you get 25 percent off one of these 2 reapplication products!

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Skin Care
Dr. Mary Lupo
Lupo Center for Aesthetic and General Dermatology

As a board certified dermatologist I think I am uniquely qualified to identify skin problems and treat them with a spectrum of treatments! For example, some people come to me, and they think they need a chemical peel or they think they need laser, when all they really need is a good comprehensive skin care programme. I will use both prescription as well as physician dispense products and even over the counter recommendations, to design a skin care programme that will give you the best and brightest and healthiest looking skin that you can have!

145 Robert E. Lee
Suite, 302
New Orleans, LA 70124
504-288-2381

Dr. Mary Lupo
Lupo Center for Aesthetic and General Dermatology

Healthy skin depends on basic daily care! Hi, I am Dr. Mary Lupo. Here are some steps to ensure healthy skin at any age. First always use sun protection. It filters out both UVA and UVB rays. Remember UVA rays are present all day and occur year round. Over time they can cause wrinkles brown spots, loss of volume and even skin cancer. Use a good topical antioxidant as a second line of defense against sun and environmental damage. Cleansers are specific to your skin type and can enhance your skin’s natural beauty. Moisturizers contain emollients or exfoliants to keep your skin hydrated and fresh. Ingredients that promote collagen production are important for wrinkle prevention and reversal. Caring for your skin just 10 minutes a day, can pay off with a life time of healthy radiant skin. Our professional staff at the Lupo Centre can help you create your own personal skin care regime, to help keep your natural skin beautiful for a lifetime. Thank you!