January 2021 / Quarter 1
How to Achieve the Real Filtered Skin Look
Double board-certified Plastic Surgeon
Even skin tone is one of the primary functions of filters & is one of the highest yield treatments you can do to your skin to make you look younger. Internationally, even skin tone is an obsession and is not always the primary focus of beauty treatments here in the U.S. Hyperpigmentation is the number one culprit in blotchy appearing skin. There are a number of ways in which we can treat pigment using technology however, your skin type plays a huge role in what technology is best for you. Skin types range from 1-6 (1 is light skin and 6 is dark skin)
Pale white skin blue/green eyes blond/red hair
Always burns, does not tan
Fair skin, blue eyes
Burns easily, tans poorly
Darker white skin
Tans after initial burn
Light brown skin
Burns minimally, tans easily
Rarely burns, tans dark easily
Understanding your skin type is an important part in your treatment approach. Why you ask? With technology we are creating heat which, in darker skin types, can actually create MORE pigment if the heat is not delivered with control, precision, and a gentle approach. This is why I always say it is not just the technology but rather the correct technician that yields the best results. The first step in treating pigment for all skin types is a proper skin analysis and understanding of the root cause of pigmentation (see Heather’s content below). At CBRx our pigment protocol is to start all of our patients with a skin analysis with Heather. She takes a detailed history to help us understanding how to approach the pigment. For example, if acne is causing hyperpigmentation then treating the acne is the first step. However, if pregnancy is causing hyperpigmentation then you are limited in treatments and products that can be used and we take a staged approach to managing hormonal pigmentation. Proper documentation of pigment using our SkinScope machine reveals deeper damage that is not apparent on gross inspection. This is followed by priming your skin with treatments in the office to prepare you for a proper home regimen and/or technology. We will talk more about our favorite spa machines in upcoming blogs. We then review your case as a team to create a treatment plan to respects your budget and skin type. One of our big philosophies at CBRx is that we are in it for the long-haul with your beauty journey. The skin has on average a 5 week life cycle and meaningful, long-lasting changes to your skin take time! Patience and commitment to the process along with all our toys and knowledge is what gives us consistent results!
Understanding your skin type is an important part in your treatment approach. Why you ask? With technology we are creating heat which, in darker skin types, can actually create MORE pigment if the heat is not delivered with control, precision, and a gentle approach.
Heather Bennett / Master Aesthetician
I know many of you have been struggling with some kind of hyperpigmentation and I am here to help. Whether your blotches stem from the sun, post breakout or skin trauma, it can be difficult to navigate which combination of treatments and active ingredients yield the greatest outcome. Result driven skincare regimens are only effective if done consistently and properly. Skincare is not a one-size-fits-all strategy but certain products and ingredients will help guide you towards your goals. Before starting with any brightening, lightening or depigmenting treatment I recommend “skin priming”. What is skin priming you ask? Trust me, it has nothing to do with makeup primer. Priming your skin is an essential way to optimize the outcome with lasers, chemical peels and other depigmenting treatments. Preparing the skin involves the application of topical skin brightening agents prior to the peeling procedure with the goal of enhancing the effect of the treatment and
decreasing the risk of post-inflammatory hyperpigmentation. The last thing anyone needs is MORE pigmented lesions right!?! Skin priming and treatment products I love can include not only ingredients to brighten, but also those that increase skin health and re-texturization. Ideally everyone would have a cleanser, antioxidant, brightening product, retinol or tretinoin, moisturizer, and sunscreen. Does that seem like a lot to you? That is actually a minimalistic regimen for the average person wanting quantifiable results. Obviously adding in more products during different seasons and/or stages of life vary a lot.
Firstly, let’s talk about vitamin C related antioxidant serums. You want them. You LOVE them. You just might not be sure which ones are tried and true. Our top selling antioxidants are also backed by science and rigorous testing. Skinceuticals C & E Ferulic and Phloretin CF have been flying off the shelves since we opened. Three to five drops on clean skin in the morning is all you need for amazing results. Along with antioxidants you will be prepping your skin with topical treatments to aid in the brightening of the hyperpigmentation. Ingredients like azelaic acid, kojic acid, tranexamic acid, hydroquinone, and niacinamide are all very helpful. My current favorites include products like SkinMedica’s Lytera, PCA’s Pigment Bar, Skinceutical’s Discoloration Defense, ZO’s BrightAlive or their Pigment Control Creme. Keep in mind any hydroquinone has very strict usage regulations and should be consulted by with a professional before starting. Pairing a brightening product with a retinol or tretinoin will create a transformational and synergistic approach to evening out the discoloration of the skin. The results are compounded and give way to faster and more impressive skin texture and improved tone.
A retinol that I am fond of for beginners is SkinMedica’s Retinol .25%. This low percentage allows you to use it more consistently without the harsh side effects of dryness or peeling. Start out a few nights a week and progress to nightly use. Your moisturizer will closely follow this step and go on after to seal the deal. Nightly routine complete. Moderate retinol users might enjoy PCAs .5% Intensive Brightening Treatment. Think of it as retinol with an extra hit of added nutrients. It contains retinol, resveratrol, niacinamide and hexylresorcinol to rev up cellular turnover as well as combat discoloration. Experienced retinol users, I am so proud of you! Congrats on starting early. Now let’s refine your choices. You may be interested in 1% retinol or going to a prescription tretinoin for advanced renewal. ZO and SkinMedica make phenomenal and highly effective retinol for the experienced user. Tretinoin will require a prescription from a doctor and can offer a person that might of plateaued with their retinol usage a great replacement. If you are one of the few that cannot tolerate retinol or tretinoin, you are in luck! SkinMedica’s AHA/BHA Cream or SkinCeutical’s Glycolic Renew Overnight, are a lovely alternative. Both are nightly treatments that promote turnover and increased radiance in the skin. Now everyone has an option that works for their sensitivity level and skin type. Let the brightening begin!!**Mild irritation may initially be experience when starting a new retinol, tretinoin, AHA/BHA protocol and is not a sign of a negative complication. Remember: It is important to wear a broad- spectrum sunscreen during the day when using these products at night. Keep that newly spotless skin protected!
What is the BEST technology for treating pigment?
Dr. Moore / Board-eligible Plastic Surgeon
My top 2 technologies that we use at CBRx for managing pigment are:
1) Mixto’s Fractionated CO2 and
2) PicoSure by Cyanosure
CO2 treatments can be scary and an understanding of the technology is so important in effectively treating pigment. I will generally use this technology on the lighter skin types and love it because it also improves texture and tightens (a winning combo and high-yield technology in the right patient). Unlike many CO2 treatments, at CBRx we believe in not over using settings or technology as it poses unnecessary risks, creates more downtime, and in the long-term can create a “over-processed skin” look that we do not like. The Mixto CO2 is unique in that it delivers a fractionated (broken up) light energy (laser) in a short burst so as not to over heat the skin and allows results without as much downtime. Proper prep for this treatment is important as light energy can be absorbed incorrectly, penetrate too deep, or bounce off the skin if for example, you have had recent sun exposure making results unpredictable. In addition, the right skin type is important as this does generate some form of heat and Heather will often put patients on a pre-treatment pigment suppression protocol in advance.
My current number 1 treatment for pigment however is the Lamborghini of pigment technology weighing-in at 300 lbs, with a device cost of 200K, and only has a single energy wave length (and that’s all you need). The PicoSure laser is an unparalleled breakthrough in laser technology that delivers ultra-short bursts of energy to the skin in trillionths of a second to gently target and eliminate pigment without harming the surrounding skin. We invested in this technology because it is the best on the market specially for pigment in ethnic skin.
Unlike other lasers that rely on intense heat energy which can cause problems as discussed above, this gentler treatment reduces unwanted pigment with minimal to no discomfort or downtime. Due to its elegant form of energy delivery, PicoSure is also unique in that it can be safely used to treat pigment in ALL skin types. It is an obsession in Asia for good reason & we are obsessed with it at CBRx! In addition, adding an extra filter to our laser improves texture and stimulates collagen so you really can accomplished the “filtered look.”