Okay, buckle up, here’s a lot of information!

Your skin is the largest organ in your body, and also the most visible, so changes with the aging and stresses are directly visible on the skin.

Skin is a barrier to all the external stress like heat, cold, UV rays. But in the face skin also feels internal stress through contraction of expressing muscles.

It also feels the pull of gravity, and as we age the duration of this pull is increasing so as the lengthening of the ligaments. These effects get accentuated  when the underlying support is less form loss of fat and bone. We see these changes as jowels begin to form.

As we age the production of the collagen also declines reducing the repair process.

The changes appear externally early as rough uneven skin, dry, lack of glow, uneven skin tone, then progress to fine lines and with addition of loss of volume and gravity develop wrinkles. As the skin sees more changes more aggressive treatments are required.

One of the main ways we treat issues here at Nourished is with Collagen Induction Therapy. Most of our treatments are geared toward growing new collagen to plump your skin and make you look healthier and younger. We suggest taking a Collagen Powder supplement daily. Don’t take the capsules, though, use the powder that requires a scooper. In consultations, I’ve explained that it’s like being at a construction site trying to build a house. If you don’t have bricks and lumber at the site, you can’t start building the house. Somewhat similarly, while your body will eventually make the building blocks for the collagen, if you already have some of the raw materials available, the process of rebuilding is much quicker.

We tell people all the time that dealing with skincare issues (wrinkles, loose skin, texture, spots, etc..) starts with good daily skin care. That is the basis of everything we do in aesthetics to make good changes to the skin. It’s the 80/20 rule. The results are 80% from your daily skin routine and the other 20% are the professional treatments we perform. If there isn’t a good medical-grade daily skin care system to go hand-in-hand with the antiwrinkle injections, fillers, lasers, microneedling, etc., then you’re not maximizing all the resources that aesthetics has to offer. There are many different things that we do to address the issue of wrinkles and skin texture. The most successful patients I have seen don’t rely on just one thing to make their skin better. 

When it comes to healthy skin, ZO Skin Health by the Beverly Hills Dermatologist Dr. Obagi is clinically shown to be the best of the best, that’s why we at Nourished MedSpa are a ZO Skin Health Center of Excellence. Whether your issues are oily/acneic skin, rosacea, spots or wrinkles, we have a treatment plan for you.

THE 80%

Before your treatment begins, you need to “Get Your Skin Ready.” This involves:

1. Washing your face

2. Physically Exfoliating

3. Using a toner to readjust the pH of your skin

That’s it. A three-step process to get your skin ready for your treatment. Then, depending on what condition we’re treating, you apply the products for that particular treatment. Your treatment plan might include anti-aging, pigment, redness or acne—with products like Growth Factor, Brightalive, Rozatrol and Acne Control that are used in the plan.

There are two products that deserve special mention. The first is Daily Power Defense. When I first heard the term “Daily Power Defense” I thought it sounded gimmicky. Why would I need daily power? Then ZO HealthCare sent a representative from Houston as part of our certifying courses and she discussed a very important layer of the skin called the Dermal-Epidermal Junction (DEJ). This very thin layer of the skin is responsible for keeping in moisture and protecting the deeper layers of skin from damage. When the DEJ is “sick” that’s when we see issues like worsening wrinkles, dry and scaly patches in the skin and inability to hold in moisture. Then what do we do? We reach for a moisturizer. The problem with that is, that moisturizers are typically very emollient or heavy and oil-based. That heavy layer of emollient, while it feels good, actually slows down the rate at which the skin turns over. So, in effect, a moisturizer “helps” only on the layer of the skin that’s dead and should actually be exfoliated instead of moisturized. Daily Power Defense is a product designed to specifically treat the DEJ. When the Houston rep showed us the data on this product, I was amazed. It’s not a moisturizer, it’s a hydrater, and incidentally, the one product I can hardly keep in stock on the shelf!

The other product deserving special mention is one of the most important things we use to increase the cellular turnover of the skin. It’s Vitamin A. In the aesthetics world, it’s called Retinoic Acid or Retinol. If you’re serious about having younger, healthier skin, you’ll be absolutely certain to include a Retinol.

THE 20%

• An excellent starter treatment would be the ZO Glow Express facial. Our 30-minute Express Facial Treatment is great for patients with any skin type. Our unique, process of crystal-free microdermabrasion and Dermabuilder Peptide Serum work together for radiant skin. Before the treatment begins the licensed esthetician will apply ZO Hydrating Cleanser to remove any superficial impurities. This specially designed formula is made with panthenol and allantoin that effectively works to cleanse the skin without causing any dryness or irritation. After cleansing, Exfoliating Polish will be gently massaged into the surface of your skin. The polish is made with ultra-fine magnesium crystals for gentle yet powerful exfoliation. Once the polish has been applied, it will be activated with Exfoliating Polish Activator. Then, between one to three layers of the Stimulator Peel will be applied, followed by ZO’s Peel Neutralizer to balance and restore your skin’s pH. Growth Factor Serum is used next to rejuvenate your skin, encourage cellular function and collagen production. Simultaneously, the growth factor serum will actively reduce degradation, increase density, and work to restore skin elasticity. An Express Facial is performed in 30 minutes without a mask or extraction included. There is no downtime and no peeling.

• To take your skin care to the next level, you would consider a full facial. We would customize the facial to your skin needs such as acne clarifying, anti-aging or brightening.

• Dermaplaning is a process of carefully removing the very top layers of dead skin. Secondarily, it also removes all the fine hairs (peach fuzz) on the face, leaving the face smooth and soft. When you combine dermaplaning with a treatment, the skin is prepped and ready to fully maximize whatever treatment that follows.

• The next progression is into chemical peels. We can remove deeper and deeper layers of skin based on the kind and strength of acid applied. We use glycolic acid, salicylic acid, TCA, Jessner’s Peel and Retinoic acid. Peels are classified as superficial,  medium depth and deep peels. Peels can be used to target uneven tone, fine lines, pigment, acne prevention and treatment.

• ZO 3-step Peel is a moderate chemical peel. It is a highly effective treatment for the many signs of skin aging. This peel is ideal for treating Melasma, sun damage, fine lines, uneven texture, large pores, dull skin and even acne! Suitable for any skin type or color. Step 1 of the system is the application of the peel solution to exfoliate the skin. Step 2 is the application of the Stimulating Retinol Creme that works to stimulate cellular function at a deep level for collagen enhancement, firming, and wrinkle reduction. Step 3 is the application of the Calming Creme that works to minimize inflammation and irritation that may result from the first two steps as well as restore the moisture balance of the skin. Skin peels often achieve instant, glowing results and tighter, smoother, brighter-looking skin after just one peel, although a series of treatments can be repeated every 3-4 weeks for deeper repair. You will have one to two days that your skin will be red and feel dry. The third and fourth days following your peel, your dead skin will begin to slough off. Total time for peeling is 5-7 days.

• A Hydrafacial is one of our most popular treatments! It’s a hydro-dermabrasion. Our licensed medical aesthetician will pamper you in our Audrey Hepburn treatment room. There are three steps to the procedure, the first is a cleanse and light peel. A new layer of skin is gently exfoliated and the mixture of glycolic and salicylic acids loosens dead skin cells and is light enough to not cause post-peel scaling. The second step is suctioning debris from the pores with painless vortex suction tips. The skin is saturated in this step with exclusive Beta-HD serum and Antiox + serum which protects with antioxidants, peptides and hyaluronic acid. The final step is nourishing the skin with targeted, proprietary skin solutions delivered to address specific skin concerns. The Hydrafacial can be upgraded to a Deluxe by adding boosters which can be customized for patients experiencing pigment issues, rosacea, wrinkles and aging. There are different tips which can provide up to 4 different strengths of exfoliation. Also, prescription strength peel solutions can be substituted for a more robust effect.

• Intense Pulsed Light (IPL) treatments use high-intensity pulsed light to break down skin pigments and lighten or remove spots on the skin, improve the look of scars and broken blood vessels.

• We also have an ablative laser (Erbium Laser) that removes the top layers of the skin. I say that it does the same thing as a chemical peel, but uses light energy instead of chemicals.

• Microneedling is the use of sterile tiny needles to create microchannels into the skin. Collagen is made of long strings of proteins which are braided together in the deeper layer of the skin. When these microchannels are made in the skin, the collagen fibers become somewhat deformed. When the body senses that the collagen is deformed, it sends in repair mechanisms to build new collagen. This is why it’s important to be taking the collagen supplement daily.

• Platelet Rich Plasma (PRP) is when we are using your body’s own growth factors to grow collagen. Your blood is drawn and spun down in a centrifuge. The white blood cells and red blood cells are not used. The concentrated platelets are left suspended in the plasma. When the plasma is reinjected into the tissue, the growth factors in the platelets are released. PRP can be microneedled into the skin. PRP can also be injected into joints to help with symptoms of arthritis. We use it in the hair restoration protocol to stimulate hair follicles to grow hair.

• Radiofrequency is when we use high frequency radio waves to create very short bursts of heat to the tissue. These radio waves also deform the collagen and cause the body to send in repair mechanisms to build new collagen. Superficially, the heat from radiofrequency energy can cause tightening of the skin as well. One of the machines we use is called a Vanquish machine. This radiofrequency machine is tuned to focus on superficial fat cells in areas such as the abdomen and thighs. When these fat cells are heated to a certain degree, they will begin a process called apoptosis or cell death. The body then clears them out over the next few weeks.

• 24-karat Nourishing Hydraneedle Treatment. We use a gold-tipped microneedling mesoneedle with a unique recipe of hyaluronic acid for collagen plumping, Xeomin for skin tightening, and ZO SkinHealth Accelerator. Pick the accelerator for your skin needs from one of the following: Firming, Redness and Pigment. This provides immediate skin tightening, glow, reduction in size of pores.

• Botox® or Xeomin® are anti-wrinkle treatments. They both have the same active ingredient that relaxes the muscle for up to three months. When the muscle is relaxed, it does not crinkle the skin and cause wrinkles.

• Dermal fillers are made of hyaluronic acid. Hyaluronic acid is a type of carbohydrate that keeps body tissues hydrated and lubricated. It’s a naturally occurring compound found in high amounts within the skin, joints and eyes. Studies have shown that it can hold up to 1000 times its weight in water. On a cellular level, when it is present within the skin it can have an ultra hydrating effect and give it a fresh hydrated + plump look as a result. As you age, your hyaluronic acid levels decrease. The hyaluronic acid fillers that we use are manufactured to have different levels of thickness. These various levels of thickness are used in different areas of the face. For instance, you would not want to use a very thick filler in the lips, a better choice would be one that is softer and more pliable. However, a better choice for the cheeks would be a thicker filler that holds its shape and can better replace the loss of volume in the facial fat pad.

TL;DR

1. Take powdered Collagen supplement daily

2. Use ZO SkinHealth products to “Get Skin Ready”

3. Then, use the ZO SkinHealth products unique to your skin condition we’re treating

4. For beginners, start with a ZO Glow, then move to Facials, then Chemical Peels

5. The list of treatments available include dermaplaning, Hydrafacial, IPL, Erbium Laser, Microneedling, PRP, Radiofrequency, Hydraneedle treatment, Botox®/Xeomin® and Dermal Fillers.

I realize this is somewhat of an exhaustive list, but as you can see, there are many options available to treat the many skin conditions that concern people.

We’re always excited to share what we know about taking care of your skin! You can schedule a consultation with us and learn how your particular skin care concerns can be addressed. We look forward to seeing you and answering your questions! Make an appointment by accessing our online booking 24/7.

Dr. Carter