3 Top Tips To Save Your Skin This Winter

Winter is approaching and for most of us that means it is time to tackle our changing skin needs. As the air outside gets colder and the humidity decreases, indoor heat gets hotter and drier, which can lead to skin that is parched from moisture as the air around us, indoor and out, selfishly steals our reserves. Rosacea, which is commonly triggered by extremes in temperature, can flare more easily.  Eczema and psoriasis can flare too, and those with acne-prone skin may even start to see an increase in breakout.

Another tricky aspect we are presented with these days is that while winter weather may be imminently approaching, temperatures can range widely from day to day or week to week. One day it can be cold and blustery and the very next temperatures can soar into the 60’s, making it difficult to know what coat to wear let alone which moisturizer to use.  Wool and coarse fabrics can irritate your skin and add to the problem. Here is the solution to your winter skin woes:

1. Listen to your skin: It will always tell you what it needs, and what it doesn’t like. If your rosacea is flaring or you’re breaking out like you haven’t in a while, there is still hope. Try to pinpoint any triggers, avoid them when possible and be sure to stick to your skin care routine especially when you’re under stress. Perhaps you are overdue for a maintenance treatment or a visit to your dermatologist for a peel or skin care assessment? Did you run out of a skincare product that you love? Your skin will need different ingredients and products as weeks, months and years go by, but a common thread of consistency in your daily routine- cleansing, hydrating and sun protection- is important to prevent flares and keep your skin looking it’s most beautiful radiant best.

2. Check the weather: Just like you think ahead for seasonal weather changes, you should also prepare for the effects the changes in season will have on your skin. Learning to layer the right products and adding or subtracting ingredients throughout the year will lead to happier, healthier, more beautiful skin. Warmer days tend to be a bit more humid, so layers of antioxidant serums, hyaluronic acid serums and lightweight sunscreens may do the trick for you. Colder days, especially when it is dry and windy, may require a moisturizer designed to help seal in precious moisture. The body is drier than the face, and all skin loses water as you sleep and your body repairs damage from the day, so be sure to add a richer layer of hydration at night and find an easy to maintain humidifier to use in your bedroom as you sleep, allowing your skin to protect, replenish and restore its moisture bank.

3. Have the right skin care products ready in your arsenal: Key pieces are critical. Once you know which products you love and what works best for you,  make sure you have them supplied and available to use on the fly as needed. Once you learn to listen to your skin and remember to routinely think of your daily skincare as you would your outfit selection for the day, you will start feeling and seeing more consistency in your skin health. See below to learn how to select the best products for your skin needs.

If all your efforts still only get you so far, trust the experts- after all it is what we are here for!

Skincare products that help you cope:

Facial Serums with Hyaluronic Acid

Depending on how prone to dryness your skin is,  the cold air will quickly steal moisture from your skin. Layering serums, thinnest to thickest, under lotions and creams, helps to infuse your skin with deeper hydration. Topping off with the right lotion or cream will seal in all the good stuff so you’ll be best prepared for blustery, cold days.

I like to think of using Hyaluronic acid, which is a humectant, helping to pull in and hold water in the skin, as an ingredient that helps to fill the well. HA attracts water from the air around you and holds onto it, up to 1,000 times its weight, and is part of how your skin hydrates itself naturally. After a week or so of consistent HA use your skin’s moisture well will be replenished so you have better defense against dryness. As we age, we lose our reserves of naturally occurring HA so it’s important to supplement with it topically. Not only will it help you feel less dry but your skin will also plump up and the appearance of fine lines and wrinkles will soften.

A few favorites: SkinCeuticals H.A. Intensifier, Skin Medica HA5 and PCA Hydrating Serum

Facial Antioxidant Serums

Using antioxidant serums year round is a must. In the summer, we tote antioxidants for their protective qualities when layered with sunscreens and the same is true in the winter months. Some of us can upgrade to more emollient formulas in the winter for an extra boost of hydration. If you don’t already have a facial antioxidant you love, Alastin Skin Nectar, SkinBetter Alto, SkinCeuticals CE Ferulic and Skin Medica TNS Essential Serum are all highly recommended!

Super Gentle Exfoliants

You might notice that treatment ingredients and acne medications  suddenly begin to irritate your skin as the weather gets colder. This is because as your skin loses moisture and naturally occurring protective oils, active ingredients penetrate more deeply. To counter this, use actives less often and sandwich them between serums and moisturizers. If they still irritate you, switch it up and try these clever products from RestorSea, which exfoliate without any irritation and help to enhance skin function and barrier repair. RestorSea Intensive Treatment 10x is a safe and non-irritating alternative to retinols. Apply RestorSea Rebalancing Lotion on top for additional hydration.

Facial Moisturizers

Your moisturizers will never work better than they do when layered over your favorite Hyaluronic Acid and Antioxidant Serums. And for some of us, these layers of serums might be enough, especially when topped in the day with a protective sunscreen. For those who need a bit more, we recommend finding a formulation designed for your specific skin needs. Drier skin types can use moisturizers morning and night. For combination-to-normal-to-dry skins, we say sleep in one that you love, remembering to slather your neck and chest too.

Dry Skin: Skin Medica Dermal Repair, MD Rejuvena Ultra-Rich Hydration, Neutrogena Hydro Boost Gel-Cream (for extra-dry skin)

Normal-to-Dry Skin: Epionce Medical Barrier Repair, SkinCeuticals Triple Lipid Restore, Sente Dermal Repair Cream, Skin Medica Total Defense and Repair SPF

Oily or Combination Skin: SkinCeuticals Physical Fusion SPF 50, NeoCutis MicroDay

Hydrating Masks

1-2 nights a week you can apply a hydrating mask. For very dry skin, apply a cream or gel based mask like SkinCeuticals Phyto Corrective Masque  for 10-20 minutes, tissue the mask off and then apply your regular nightly routine. For normal to dry skin, apply your evening skincare and then a sheet mask over the products, wearing the sheet mask, like SkinCeuticals Biocellulose Restorative Masque for up to an hour or even overnight. Make sure you’ve got a good humidifier going while you sleep, too. Certain essential oil diffusers also infuse the air with moisture with the adding bonus of sleep-enhancing essential oils like Lavender or Chamomile. In a pinch, take a tip from our grandmothers and great grandmothers and place a bowl of water by your bed- it doesn’t work nearly as well as the other options but it’s certainly better than nothing.

Lips, Hands, Feet, Body

Dry, chapped skin can start to appear on the hands, legs and body as soon as the weather starts to change. Keep a bottle of liquid coconut oil (Nutiva Organic Cold-Pressed Liquid Coconut Oil) in the bathtub and apply it to your whole body while the water is still running. A little coconut oil goes a long way and the warm shower water helps you spread it evenly over your whole body (do not apply to feet while standing in the shower and be especially careful not to slip getting in or out!). Before drying off, try applying 1-2 pumps of an exfoliating, hydrating body lotion. Some of my favorites are: PCA Body Therapy, AmLactin Hydrating Body Lotion, SkinFix Extra Strength Soothing Body Cream and Theraplex Emollient for Severely Dry Skin.

Replace hand soaps with richer moisturizing formulas and keep hand lotions next to your sink in the bathroom and kitchen and apply after every hand wash and in your purse for when you’re on the go. Pro tip: If you don’t like your hands to feel greasy, just apply the formula to the back of your hands from time to time. Keep your hands covered with gloves or mittens on especially cold days to protect them from cold, dry air.

To better manage dry cracked feet, begin by exfoliating regularly. Most of us get pedicures less frequently in the winter but when you do, skip the exfoliating callus remover and more aggressive exfoliation methods offered at spas as they can go wrong, making you more prone to cracked heels. Instead, when you step out of the shower, apply an exfoliating serum designed specifically for the feet, then apply something rich like Aquaphor and put on your socks. For less dry feet use a milder exfoliating and hydrating formula when you get out of the shower and before you go to bed.

Lips need love too! Physically exfoliate them gently with your toothbrush then apply a hydrating lip serum. Top off with something more occlusive and reapply it throughout the day. Keep it easy by having a travel version in your bag at all times.

Hands- Dr. Day’s Handle With Care, Neutrogena Norwegian Formula Hand Cream, Aquaphor

Feet– Clarisonic Pedi-System, Clarisonic Pedi Boost Renewing Peel, Isdin Podos

Lips-RestorSea Lip Magic, EpiCeram Lipcare, Aquaphor

For questions about how to best treat your skin, please call us. We can help answer your questions over the phone or in person during a consultation with Dr. Day or myself (Holly Montgomery).

Many of these products are available on our online store! If you’re not yet signed up for access please call us at (212) 772-0740 and we will happily register you! Access allows you to store our recommendations and other favorites so you can order them as needed or have them shipped automatically, making life that much easier.

 

The following in-office treatments are some our favorite skin savers in maintaining glowing skin during the winter months:

 

Hydrating Facial Peels

Dermaplaning

Clear and Brilliant

Fraxel

Hyaluronic Acid-based Filler

Botox

Dr. Day’s Top 6: Best Treatments Available for Hair Growth

Thick, lush, healthy, silky smooth and shiny hair – it’s every woman’s dream. For men, it’s simpler but the same idea- a thick full head of hair. Hair thinning and loss is one of the most emotionally difficult concerns patients present with and it’s anything but superficial. Hair is deeply tied to our self-esteem. I wrote an article on hair loss for LVBX Magazine that reviews the common causes and facts – this post is devoted to the best treatments available to grow hair.  There are many options from over-the-counter products to in-office treatments and home-use lasers:

1. Over the counter

These are options available at your drugstore or online. They often contain the FDA approved active minoxidil, alone or in combination with other ingredients. Your dermatologist may also custom-make a formulation adding in prescription-strength ingredients not otherwise available.

  • Minoxidil: at 5% is FDA approved to grow hair in both men and women and is available in various concentrations from lots of companies from your local drug store, online, department store or dermatologist. The ones dermatologists carry typically also include other supporting ingredients. I have one in my hair growth program that also contains niacinamide and caffeine to minimize irritation, improve absorption and also optimize the anti-aging effects to the skin and follicles.
  • Antioxidants: are helpful in creating healthier scalp skin and hair follicles, improved circulation and stronger hair. They work well with other components of a hair growth program to support and optimize results.
  • Julien Farel Magnifique serum: contains an excellent cocktail of antioxidants including resveratrol in a formulation that leaves the scalp rejuvenated. I’ve even seen it help with patients who have itching, scaling and redness of the scalp with or without hair loss. It works well alone and even better with Julien Farel Restore shampoo.
  • Esteem botanical hair loss solution: is one I created and has a mix of natural actives (biomimetic peptide combined with a red clover extract rich in Bochanin A) to help support hair growth as part of my hair growth kit consisting of a specially formulated shampoo and conditioner to complement the botanical solution.

2. Low Level Laser Therapy

This is an area where I’ve seen excellent advances in quality, efficacy and ease of use. There are over 2,000 investigations from over 80 countries on the effect of Low Level Laser Therapy (LLLT) on humans and animals published in the medical literature.

The early hair combs are now also offered in versions that look like baseball hats that cover a broader surface area of the scalp, leaving your hands free and making treatments easier and more efficient. They also have better diodes, providing excellent energy while covering a broad area of the scalp at one time. It’s still not fully understood how they work but the idea is that they:

  • Influence hair growth in 3 stages
    1. Stops hair loss
    2. Current hair becomes thicker and fuller
    3. Regrowth of new hair (hair follicle grows terminal (thicker) hair in place of very thin “peach fuzz” (vellus) hair)
  • Almost 100% of patients using a Hair Growth Laser go through stages 1 and 2
  • 70% of patients using the Hair Growth Laser experience stage 3 (regrowth)

Low level laser therapy caps allow for flexibility within your schedule as it can be done in the comfort of your own home and can absolutely be used in conjunction with other hair growth procedures and prescriptions. Brands I’ve researched that stand out as superior include:

Theradome

Capillus

Laser Cap

3. Cortisone Injections

This is done by your dermatologist and, in my view, works well for all types of hair loss including the genetic male and female types. I do low concentration injections at monthly intervals for 5 months and then switch to treatment every 3 months. Using topical cortisone is not effective since the follicles are deep and the medication will be carried away by the bloodstream before reaching the follicle if applied topically. At the concentrations and volumes I use I have never seen any systemic side effects or atrophy (thinning of the skin of the scalp).

4. Supplements

There are two supplements I believe have the greatest amount of data for hair growth:

  • Viviscal Professional: this is a 100% drug-free way to nourish thinning hair and promote existing hair growth and has excellent clinical data. The formulation includes:  
    • 50% more of revolutionary AminoMar ingredient. Exclusive and Patented AminoMar Marine Complex provides the essential proteins needed to nourish thinning hair and encourage growth of existing hair
    • Horsetail Extract, an organic form of silica which increases the strength of the hair and revitalizes lifeless hair
    • Vitamin C derived from the Acerola Cherry (one of the richest sources of Vitamin C available)
    • Fish and shellfish, making it not appropriate for those allergic to these ingredients or for those with celiac disease
  • Nutrafol: This is a super-supplement that addresses the critical stages of hair health, helping to combat the effects of hair-damaging hormones, free radicals, inflammation, and stress – addressing the causes of unhealthy hair and empowering follicles to absorb nutrients and grow fuller, healthier hair. Key ingredients include:
    • Tocomax 20%™, a form of Vitamin E extracted from Tocomin® palm oil, that’s been shown in a clinical study to increase hair growth on average by 34%
    • Sensoril® Ashwagandha, clinically proven to decrease the levels of hair damaging stress hormone Cortisol by up to 30.5%, reduce inflammatory C-reactive protein (CRP) by 35.2% and improve resistance to stress
    • BCM-95® BioCurcumin, a potent anti-inflammatory and antioxidant clinically proven to lower inflammatory biomarkers, like CRP.  Extracted from turmeric, curcumin optimizes the immune system + fights many inflammatory molecules that slow hair growth
    • Cynantine® HNS, a solubilized, more bioavailable and bioactive keratin provides the building blocks of hair – amino acids like cysteine and proline; proven to improve hair strength and brightness
    • Hydrolyzed Marine Collagen & Hyaluronic Acid, rebuild the structural integrity of the hair follicle environment, improve moisture, and promote diffusion of nutrients. Hydrolyzed to a low molecular weight for better bioavailability
    • Bioperine®, a natural thermonutrient that synergistically increases the body’s absorption of other phytonutrients and key ingredients
    • It does not contain: Gluten, Wheat, Shellfish, Binders, Fillers

5. Prescription Medications

These include Propecia which is FDA approved for men and Avodart. I offer these to my male patients with male pattern hair loss alone or along with my hair growth program. If I use both medications, I have them take Propecia for 5 days and Avodart for 2 days of the week since Avodart stays in the blood longer and has more side effects (your dermatologist can review side effects and treatment options with you).  I recommend that patients alternate between the two medications, such as taking Avodart on tuesdays and fridays and Propecia the the remaining days.

Some doctors also prescribe these for women as well but it’s not something I’m comfortable with. For women with a hormonal pattern and who are not planning pregnancy, I sometimes offer Spironolactone, an off label use of Avodart, usually prescribed as a diuretic but also has effects of blocking androgen hormone receptors so it has some use in hair thinning. We need to use high doses and there can be side effects of irregular periods, dizziness, high blood potassium levels and breast swelling and tenderness. It can also take a full year or so before seeing results.

6. Platelet Rich Plasma (PRP) Injections

I spent years researching and reviewing data and devices for PRP for the scalp before deciding to add it to my hair growth program. The hair promoting effects of PRP are supported by studies showing a faster transition to the growing (anagen) phase of hair cycling back from the resting and transitional phases, and also an increase in the number of newly formed follicles and earlier hair formation.

The process is an in-office treatment which starts with gentle tapping into a vein in the arm to extract a small amount of blood, the equivalent of about 1.5 tablespoons, which is drawn into a specialized test tube. The test tube is actually the key to the process and is what separates one system from another. It contains filters that when placed in a centrifuge and spun at rapid speeds, separates out and concentrates the platelet-rich plasma. There is no FDA approved process or protocol so each office determines their own program.

Who is a good candidate? This is something I recommend for my patients with male or female pattern hair loss or for rejuvenation of the scalp and follicles to recover from the changes of loss of volume and density that comes with age even for those without male or female pattern hair loss. I do not recommend it for those with the autoimmune form of hair loss such as alopecia areata, alopecia totalis, universalis, or for scarring forms of hair loss.

Based on the data, I created a schedule for treatment as follows:

Active Phase:

  • 4 treatment sessions at 1 month intervals
  • Hair Growth supplements
  • Esteem Hair Growth Kit
  • Hair Growth Laser
  • Esteem Active Drops

Year One Maintenance Phase:

  • One Treatment every 3 months
  • Hair Growth supplements
  • Esteem Hair Growth Kit
  • Hair Growth Laser
  • Esteem Daily Drops

Year Two Maintenance Phase:

  • One treatment every 4 months
  • Hair Growth supplements
  • Esteem Hair Growth Kit
  • Hair Growth Laser
  • Esteem Daily Drops

Follow up Maintenance:

  • One treatment every 6 months
  • Hair Growth supplements
  • Esteem Hair Growth Kit
  • Hair Growth Laser
  • Esteem Daily Drops

BEFORE & AFTER

Bottom Line

Hair growth is complicated. We don’t understand all the mechanisms of loss so it’s difficult to come up with a precise single mode of treatment. For every patient I recommend managing stress and diet along with using one or a combination of hair growth treatments to help maintain and grow the healthiest most beautiful hair possible. Not all dermatologists are comfortable treating hair loss so it’s important to find one who can properly assess your condition and review the best treatments for you.