Most people know that using sunscreen protection is essential for healthy summer skin, but there are other important steps that you should take to make sure that you look your best this summer. Below are my top 10 tips:

1. Reduce Appearance of Cellulite with Injectable Fillers I usually see an increase in cosmetic procedures pre-summer for things like injectable fillers (Restylane, Juvederm, Radiesse, Sculptra) and Botox. This only makes sense because Spring/Summer beauty trends lean toward natural looks and beautiful skin. Injectable fillers are a great way to enhance certain features on your face, and even help correct dimples caused by liposuction or irregular distribution of cellulite. If done correctly by an experienced dermatologist, your results should look very natural.
2. Protect Your Lips! Always apply sunscreen or a lip balm with a minimum SPF 15 to your lips BEFORE applying your lip-gloss/lipstick. Many lip products contain castor oils and petroleum jelly. These oils coat the lip and actually increase the amount of sunlight that penetrates the skin on your lips.  This will increase the lip wrinkles and the risk of skin cancer on your lips.
3. Know your SPF. Some things most people don’t know about Sunscreen:
4. The Latest in Laser Hair Removal. A popular pre-spring/pre-summer procedure I perform in my office is laser hair removal in the underarm and bikini areas of women and backs for men. Remember, it takes anywhere from 2 to 5 treatments for the best results, so begin your treatments early. To make an online appointment, please visit Skindoc.net.



5. Reduce Ingrown Hairs. To get rid of unsightly shaving bumps or ingrown hairs in the bikini area, your dermatologist can inject the area with a dilute anti-inflammatory. The inflammation of the pimple will recede within a 1 to 2 days.
6. Botox Can Reduce Sweating. For women who love wearing tank tops but are concerned about underarm sweating, know that Botox® has been FDA approved to treat excess underarm sweating, also called hyperhydrosis.  It is very effective, and lasts approximately 8 months. For more information, visit Skindoc.net.
7. Remove Spider Veins. Again, with spring/summer beauty trends leaning toward au natural make-up and more time in the sun, consider getting laser vein removal for those pesky red spider veins around the corners of your nose. There is virtually no down time and the results are immediate.
8. Remove Varicose Veins. New lasers, as well as the standard sclerotherapy, can treat unsightly spider and varicose veins on your legs. Results are immediate and long lasting.
9. Scrub Away. How to get the beautiful after winter, summer skin glow? Exfoliate with a mild scrub 2 to 3 times a week. I recommend scrubs that contain date seed power or pineapple and papaya enzymes. These are all natural, botanical ingredients that are mild yet effective.
10. Use A Clay Mask. Increased humidity and high temperatures in the summer lead us to sweat more, and cause more oil and buildup on our face. To refine skin, remove dead skin cells, and tighten pores, I recommend using a clay mask 1 or 2 times a week. I do not recommend exfoliating and using a scrub on the same day, as this may dry out your skin.

It should be applied 30 minutes before you go out in the sun to give the product time to penetrate your skin. If you apply sunscreen while you are outside in the sun, you are basically exposing your skin to UV radiation for the first 30 minutes.
For the absolute highest sun protection, use a sunscreen that contains physical sunscreens such as titanium dioxide and/or zinc oxide. These particles lay on top of your skin and actually deflect light away from your skin.  The higher concentrations work better at blocking the sun, but also can leave a slight residue discoloration on the skin.  This is particularly an issue for people who want to wear sunscreen on their face, but don’t like the white residue or skin discoloration. Try the kaplanMD Day Cream SPF 15 (www.kaplanMD.com), which contains a highly micronized titanium dioxide, along with 9 other active ingredients. An anti-wrinkle cream, moisturizer, and SPF 15 all in one, the kaplanMD Day Cream SPF 15 leaves no messy white residue while providing long-lasting sun protection.
Most people don’t apply enough sunscreen. To get the full benefit of a sunscreen, it must be applied liberally.
Use at least an SPF 15.  Higher concentrations give only marginal improvement in sun protection, but can also irritate your skin.
Re-apply your sunscreen every 3 hours.  There is no such thing as a water-proof sunscreen.  Some are water-resistant, but you should still re-apply your sunscreen often.
Don’t forget to wear a hat to protect your scalp (even for women) and sunglasses to protect your eyes.

Dr. Stuart Kaplan has been in private practice in Beverly Hills for more than 20 years, as well as an Assistant Clinical Professor at UCLA Medical Center and Attending Physician for Skin Cancer Surgery at the Wadsworth VA for more than 18 years. For more information, please visit Skindoc.net.

It is important to understand the difference between Botox, a muscle relaxer, and Juvederm, Restylane, Collagen, etc. which are fillers.The easiest way to visualize the difference is to think of a crease as a valley between two mountains. Botox prevents the mountains from being pushed together, and fillers fill in the valley.

Botox® Cosmetic
If someone has a crease that is apparent only when frowning or squinting, Botox should be all that is necessary. Botox is most often used on the forehead, crows feet, and frown lines. It can also be used to treat neck bands. (Its most recent FDA approval is for armpit sweating and sweaty hands. For these conditions, results can last 6 months or longer.) Botox works on creases in two ways. First, it weakens the muscles that cause the creases. Second, and even more important, as the muscles get weaker, the patient gets out of the habit of creasing and using those muscles. In this way, Botox actually prevents the progression and deepening of creases:

Injectable Wrinkle Fillers
The differences between fillers has to do with thickness and longevity. In general, the thicker the filler, the better it will fill creases, but the greater the chance of possible bumps. Bumps are more likely in thinner skin such as the lower eyelids, and crows feet. Zyderm (a type of Collagen), and Restylane Fine Line are the least thick and can be used around the eyes, but they are also the shortest lasting. Juvederm Ultra Plus is one of the longer lasting hyaluronic acid fillers. It can be used for deeper creases. Juvederm Ultra Plus can last between 3 and 6 months.

Fillers can also be used to improve or enhance facial structures such as:

• Filling in acne scars
• Enhancing cheek bones to make them fuller and more defined
• Enlarging lips for a fuller, softer pout
• Correcting lip deformities or asymmetry
• Non-surgical nose-job to fill in dips and valleys in the nose bridge
• Filling in hollows under the eyes that contribute to dark circles

Other new trends include:

• Nipple enhancement
• Vaginal rejuvenation
• Injecting into the soles of the feet to make wearing high heeled shoes more comfortable

Four other fillers deserve mention:

Radiesse is considered the longest lasting filler, It is made from a similar material that bone is made from. Although it is not permanent, it can last up to one year in many cases. It is ideal for the nasolabial folds that get deeper as we get older:

Sculptra is a volumizer, and fills larger areas of the face, such as sunken cheeks. It requires more than one treatment, each about one month apart. It is also an injectable filler, but its effect is is more like a tissue expander, filling in larger areas. Imagine a balloon being blown up under the skin. It is not a balloon of course. It is made from the same material that dissolvable sutures are made, and is not permanent.

Silikon 2000 (Silicone) and Artefill (polymethyl methacrylate aka PMMA) are permanent synthetic products that the body cannot metabolize or remove. While they have unique benefits, they also have unique risks in that once injected, they are permanent, and cannot be removed.

Botox vs. Fillers
In summary, as we get older, our creases also age. They become deeper and deeper, even when we are not frowning, squinting, or using facial muscles. If creases are only apparent when we squint, only Botox is needed. If creases are visible at rest, and not made worse by squinting, then fillers are necessary. If creases are present at rest, and get worse with facial expressions, then Botox AND fillers will be necessary.

For more information, visit Dr. Kaplan’s medical website at Skindoc.Net.

There are 3 types of skin aging:

Chronologic Aging - As we get older, so does our skin. We do not have
control over this type of skin aging.

Environmental Aging - Pollutants and UV radiation (sun and tanning
booths) accelerate skin aging. We DO have control over this type of
skin aging.

Hormonal Imbalances - Our bodies peak in all aspects (physically,
hormonally, etc) in our late 20’s and early 30’s. Although we cannot
stop hormonal imbalances, there are treatments which can help slow this
type of progressive aging.

We have always understood how time and sun age our skin. However, skin
aging due to hormonal imbalances is an exciting new concept in
understanding how our skin ages. Our body’s hormones are responsible
for coordinating and regulating millions of complex process that keep
our body, including our skin, functioning optimally.

For both men and women, the hormone estrogen is responsible for
maintaining and regulating 3 key skin components: Collagen, Elastin,
and Hyaluronic Acid. Collagen gives our skin its strength and
structure. Elastin makes our skin elastic, flexible, and bounce back.
Hyaluronic acid gives our skin plumpness, water retention and
hydration, These three skin components are what keep our skin plump
and youthful.

As we age, the gradual decrease of estrogen also decreases the
production of these 3 key skin components. A decrease in elastic
fibers causes our skin to loss elasticity and firmness. As hyaluronic
acid decreases, the epidermis and dermis thins, loses hydration and
plumpness, and becomes translucent. Thin skin means blood vessels are
more obvious, making flushing and redness more apparent. Also, less
hyaluronic acid means decreased water retention, which causes dry,
flaky, dehydrated skin. Decreased collagen also causes our skin to
become thinner, fragile, and more sensitive. These factors combine
together and cause wrinkling and fine lines to worsen over time.

In future blog entries, I will discuss the 12 skin symptoms associated
with hormonal imblances, as well as treatment options for all 3 types
of skin aging.

For more information about Dr. Stuart Kaplan and kaplanMD Skincare, please visit kaplanMD.com.