One constant I hear again and again from friends and other women I know in their 40s is that want to take care of their skin, but they are afraid of fillers. So am I. I’m ok with a little Botox now and then, and for those Botox virgins out there, no you don’t end up looking like Nicole Kidman (unless you have an over zealous dermatologist). In fact, it’s a lot more natural looking than you think. I’ve also had a few Clear & Brilliant treatments and should probably get more on a regular basis. But fillers, no thank you. Still, I want clear glowing skin, or the closest approximation to that I can achieve. So I asked my dermatologist, Dr. Gervaise Gerstner, a global ambassador for L’Oreal, who runs her practice from her Park Avenue office what can be done. Luckily she’s agreed to be TFI’s dermatologist/skin guru, and hopefully this will the be first of many topics she covers. (If you need a dermatologist, I highly recommend her, especially for those who are afraid you’ll be coerced into trying procedures you’re not comfortable with. She is not that kind of doctor.) Here, her tips for better skin without fillers.
SUPPLEMENT YOUR DIET
One simple thing is to increase the internal fat that you’re taking in. Loss of volume in the face is loss of fat. We were such a fat-free nation for so long, but I think now people are returning to including fats in our diets. Personally, I do a shot of high-grade fish oil every morning that I keep it in the refrigerator. Fish oils have that good omega boost. I do eat fish but I’m not great about eating tons of it. Plus there can be mercury. My own mercury levels got really high from eating tuna twice a week. Then, include the good fats in your diet–avocados, nuts, those really do help.
As we get older, we lose bone in the face and we lose fat in the face. What can you do for bone loss in the face? Take an oral bone supplement. It can be something like Citracal. I like the Citracal with magnesium because magnesium naturally helps with constipation, plus it’s a relaxant. Taking a calcium at night can potentially help your muscles relax and help you sleep better.
IMPROVE YOUR SKIN’S TEXTURE
AT HOME: Treatments should include glycolic peels, a vitamin A/retinol treatment, hyaluronic acid and sunscreen. You want to start working on your skin’s texture because a facelift is just cutting and re-draping what I call dirty skin. So make sure that your homework is onboard. Use a glycolic at home. Use a vitamin A/retinol at home. If I was on a desert island those are the two products I would have. As for glycolic peels at the office, they’re pretty light and babyish.
Topically, one thing that can help boost the skin that has gotten much better over the past year is hyaluronic acid, which is a hydrator that’s going to make the skin retain more water. I put it on people right after I do filler. I put it on my own skin on an airplane just to make my skin look plump and beautiful. Studies show not only am I getting a short-term fix, but at six weeks elastin and the collagen has been boosted. My favorite is Skin Medica HA5. It’s a good layering agent, you can wear it under or over makeup. I don’t believe in having multiple products. If you have HA5 you could use it as your primer and/or as your night serum.
Also, know it’s easier for me to treat a wrinkle than a brown spot. Brown spots have memory and they come right back. If you’re going to spend money on lasers [see next] to get rid of brown spots, you want to maintain your results. Wear sunscreen, not just to prevent skin cancer, but also so your brown spots don’t come back.
IN THE DOCTOR’S OFFICE: Lasers. Texture for one person may be brown spots, another broken capillaries and another may be pores. Really working on a regime to help with your texture is good. Now that usually involves a laser, that’s why I have eight different lasers. Clear and Brilliant is still the mainstay. Many of my patients think Clear and Brilliant’s old is because I was the first person in the country to get one. (The head of the company was in a taxi accident on the West Side, and he came to my office with glass in his head which I got out. As a present he sent me the first Clear and Brilliant.) I’ve had it for four years and I love it and still embrace it. You can also alternate Clear and Brilliant with the Fraxel, which is the big sister of the laser. I was at Mount Sinai all weekend at a dermatology meeting and, really, there are not any new lasers pushing texture right now.
Botox. We know the classic areas people do Botox, the glabella (the area between the eyes above the nose) and around the eyes but we use Botox in other areas too to reshape the face. I think that’s something that people are less scared of sometimes than filler. There are competitors to Botox now, but consistently, everyone’s still using Botox, because it lasts the longest and is the best.
Microneedling. It’s very popular with millennials and is another option to Clear & Brilliant. Clear and Brilliant is making micro cuts with a laser. Microneedling is making micro cuts with actual little needles. It’s like two ways to skin a cat. Microneedling is making physical little holes which I can then infuse with growth factor that helps with skin texture and repair. Again, is it a game changer? No. I think microneedling does much more than microdermabrasion. I think Clear and Brilliant’s a little bit better, but usually for patients in their 30s and 40s, I’ll alternate. For my own skin, I’ll do Clear and Brilliant, three weeks later I’ll do another Clear and Brilliant, three weeks later I’ll do a microneedling. Whereas, I have many patients do microneedling, then microneedling, then Clear and Brilliant. They just get into a regime that’s good for them.
Wear sunglasses. I think a good pair of sunglasses is still really the mainstay in terms of preventing the crow’s feet, and that repetitive movement around the eyes. Invest in UV window guards in your car, if you really are in the car a lot.
No yo-yo dieting. Keep your weight stable. Yo-yo dieting is the worst thing you can do for your face, and that sunkeness in the face, because every time you lose weight you’re losing fat in your face and you’re not gaining it back.
Watch what you eat. I think inflammation is key, especially for women, and I think inflammatory foods in our diet really affect how our skin looks. But it’s very personal. Sugar, dairy, and gluten really play into this. For me, dairy plays into it and sugar plays into it, gluten less so. I find if my patients eliminate the inflammatory foods in their diet it can help their skin.
top photo courtesy Vogue