How I'm Upping My Skincare Game Now That I'm A Grown-up (or something)

Hello at last! It feels like it's been forever as I've been fighting off jet lag that seems to have hit me pretty hard this week. I'm back in Ireland for the long haul and over the last two days have slept something like thirty hours. It's bizarre but my friends are remarkably understanding and for that I have to thank them.

Traveling, stress, and caffeine are well-known enemies of the perfect complexion and over the last month or so I've been doing battle with all three. While I was home in Seattle last week I stopped in to H-Mart, an Asian megastore, to see what kinds of therapies our lovely Asian friends could recommend. While I was there I stocked up on all my favourite Asian foods, candies, and teas to bring back to Dublin and then popped into Amore, a sort of Korean version of Sephora. I've heard of their luxury line Amore Pacific (available at Sephora and here) but never actually played with any of their products before. The shop was an adorable little place with about a million different girly and colorful products just waiting for me to play with.

I've been wanting to play around with Asian skincare products for awhile, at least since my first order with Kollection K, but didn't know where to start and I wasn't willing to risk ordering something online that could potentially be irritating or just not the best choice for me. Luckily, a lovely skincare consultant in Amore (who, incidentally, had fabulous skin herself) had useful advice. She examined my skin using a strange bit of paper and some blue lights and then fed the results into a computer which spit out my skin analysis. It was bizarre and kind of gimmicky but surprisingly more accurate than the Dermalogica skin mapping analysis that I had last fall. As I suspected my skin is actually very dehydrated, causing it to overproduce sebum in the T-zone. This explains why my skin has always been the obnoxious combination of dry and oily at the same time and why I've had difficulties finding the right balance of products in the past.

The new regimen. Thanks, Laneige!

I left the shop with a few products from a company called Laneige (literally "the snow" in France). See more about the brand and please enjoy the poorly translated story. It very much reminds me of this scene from Zoolander

 and yet I'm still a sucker enough to buy into the marketing. The products from Laneige didn't come cheap (each product was around $30) but the packages are a good size and I expect I won't run out for at least 6 months, maybe even a year for the Yogurt Peeling Mask!

So far I've used the Water Sleeping Pack twice and the Gel Cream almost every day. I haven't had a chance to try the Yogurt Peeling Mask but when I do I'll be sure to report back. The Water Sleeping Pack is a very cool overnight mask that I use on nights when I skip my retinol product. It leaves a weird sticky feeling behind (it is quite a bit heavier than your standard night cream) but I always wake up the next morning with plump, moisturized skin. The Gel Cream is also fabulous and is quite like my old favourite, Chanel Hydramax Gel Creme, but at a fraction of the cost. The only downside is that it lacks SPF. Otherwise it keeps my skin feeling hydrated but never oily and makeup glides on like a dream.

Water Sleeping Pack - ultra fancy night cream, basically

Sidebar: I also left with approximately a zillion sheet masks. They were $1 each!

I look forward to scaring neighborhood children with these

Now that I've got my anti-aging and moisture game on lock I've been exploring a few new avenues for the last of my skin troubles. The most important thing with starting new products is to take them one at a time in case something causes breakouts or rashes. I tend to be a bit impulsive and in my life I don't think I've ever added one product at a time. I'm trying so hard to resist the urge to jumpstart my new skincare obsession NOW, so why don't I share my woes first?

Problem 1: Congestion. I have a few closed comedones on my forehead that bug me. The skin there isn't covered with red cystic acne but it's not exactly smooth. Hours spent on r/skincareaddiction lead me to believe I most likely need an AHA or BHA exfoliating product. I'm a little reluctant to dive in with a chemical exfoliant when I'm using a retinol, though. I've had no adverse effects from my current anti-aging product (La Roche Posay Redermic R) and I don't want to tempt fate by irritating the crap out of my skin. Thoughts? Recommendations? American ladies are partial to Stridex pads in the red box but we can't get those in this part of the world.

Problem 2: Makeup Removal. Ugh. I love Benefit's They're Real mascara (it is my one true ride-or-die eye makeup I think) but it is such a bitch to take off at night. It's not waterproof but seems to be highly resistant to all my efforts to gently remove it. Almost every night I'm convinced I'm pulling out several eyelashes at once plus likely damaging my delicate skin around the eyes. I tried coconut oil but kept getting that in my eyes. I'm tempted to try a micellar water. Bioderma is the makeup industry gold standard but difficult to access in Dublin. I saw several good options at Boots though, including this Garnier one which was on offer and a few by La Roche Posay, Avene, Vichy, and L'Oreal. The number of options is slightly overwhelming and they all seem pretty much the same. Probably by this time tomorrow I'll have purchased the Garnier one.

(Update: I did! It was 6 euros and they had 3 for 2 on skincare. I do what I want. Also I got Avene Cleanance K, an AHA/BHA product, and La Roche Posay's Physiologic Toner)

Can't wait to try these out. Updates to follow

How often do you update your skincare regimen? Do you gradually introduce products or go for it at once like me?

xo Caitlin

Retinoids: A Case Study

I love talking dermatology more than almost any other subject. It combines my passion for Evidence Based Medicine with my...er...passion for beauty? There is no way to phrase that sentence without sounding like a geeky ditz. Anyway in my ongoing quest to learn about the products I put on my skin and in my body I've been turning a lot to resources like UpToDate and PubMed to get a feel for the safest and most effective options to make my skin look prettier without unwanted side effects (unnecessary expenditures count as a side effect, too). Up to now I've mostly played it safe with my skincare routine, sticking to gentle cleansers and moisturizers that don't irritate my skin but also don't make any promises. Now that I'm in my mid-twenties (*gasp*) I've seen the light! It's 2014, I should be using products that actually have active, hardworking ingredients. I love buying foundations and BB creams and playing with makeup, but I want my skin to be so amazing that I never ever hear the dreaded phrase "you look tired" ever again. I want to glow, like a cute little baby or something.

Gratuitous photo of a famous baby with great skin. I want skin like his but maybe more hair and teeth. 

Now, to abruptly change the topic. Last summer in Atlanta I worked with a large group of extremely attractive female doctors all in their late 20s to early 30s. Every single one of them was brilliant, compassionate, and excellent at their jobs obviously but at the end of my rotation my burning question was, "how do you all have such amazing skin?" The Georgia humidity was wreaking havoc on my face, I was in a constant battle of new blemishes and random dry patches that wouldn't resolve no matter what. The very sweet attending who was clearly wearing no makeup at all apart from mascara and lipgloss, informed that her dermatology colleagues prescribe everyone Retin-A long before any wrinkles appear.

The Science Bit

"Retinoids" is a generic term for any product derived from Vitamin A. It encompasses Retin-A (available by prescription only, also called tretinoin), retinol, retinoic acid, and retinyl palmitate. Those of you who suffered from severe acne as teenagers may remember taking Accutane (isotretinoin), an oral formulation also derived from Vitamin A. All Vitamin A-derived products work in a similar way to exfoliate skin (keratolysis) and stimulate collagen production (collagenesis). This means the skin will feel softer, hyperpigmentation will be reduced, and wrinkles will disappear. Retinoids have been used for decades in dermatology for conditions like severe acne, psoriasis, and keratosis pilaris. In fact, their use as antiaging products was only investigated in last 20 or so years when dermatologists noticed that their acne patients had very youthful skin.

When choosing a retinoid product everything boils down to potency. Tretinoin is available by prescription from your doctor and is about 10 times more potent than retinol, the over the counter equivalent that is present in many anti-aging serums. Tretinoin's potency means that its effects will be evident more quickly but this is associated with an increased risk of side effects. Some patients note that their skin becomes sensitive, dry, and flaky when they start using tretinoin. Depending on your tolerance for pain and the "severity" of your skin's "condition" (sarcastic quotes because normal aging isn't a pathological process in my mind) it may be worthwhile to discuss a prescription with your doctor.

Retinol is a lower potency because after application it has to be converted to retinoic acid by the body, so it's a less efficient delivery system of active ingredients. It's present in a lot of over the counter formulations up to a maximum concentration of 2%.

It is also important to note that high dose Vitamin A is a known teratogen. Please discuss it with your doctor first if you are planning to get pregnant. Also retinoids are delicate little molecules so are packaged in foil containers and if exposed to sunlight will be deactivated. Apply them at night time before your moisturizer. It's a common misconception that retinoids cause an increased risk of sunburn but they definitely don't. Every single woman (and man, but I guarantee there are no men reading here) should wear SPF on the daily. There's no point fighting the first signs of aging all night with your hard working retinoid and then causing more photo damage during the day.

Fun fact: high dose Vitamin A is also used as a treatment for certain lymphomas and is being investigated as a potential treatment for malignant melanoma as well. Is there anything this humble vitamin can't do?

Picking A Retinoid

I'm going to focus on the over the counter retinoids at this stage, since Retin A/tretinoin is only available by prescription. I personally opted to start with an over the counter retinoid since I'm young and my "problem areas" don't bother me too much. I'm saving the tretinoin/big guns for when I'm a bit older and need something more aggressive.

The number of anti-aging products on the market are truly mind-boggling and it can be difficult to sift through the marketing mumbo-jumbo to arrive at something resembling the truth. Lots of products use vaguely science-y words ("Nanotechnology! Proteoglycans!") accompanied by photographs of attractive people in lab coats. I'm sure in a few years one of these companies will emerge the triumphant winner but in the meantime I'm sticking with retinols because the data is there to back it. Plus I feel a little better knowing that the FDA has approved tretinoin as a pharmaceutical, rather than a cosmetic. My feelings about cosmetic labeling is a completely different rant though so I will spare you the details.
When hunting for an anti-aging product in my opinion simple is better. As products start offering more and more benefits such as moisturizing, antioxidants, and sunscreen the whole thing becomes a little more dicey. Complex serums that claim to multitask are more likely to contain irritating fragrances or frustratingly low concentrations of their active ingredients. Right now the maximum that any non-prescription retinoid can contain is 2% retinol, so I set out to find a product that was exactly that and nothing more.

Perhaps unsurprisingly, retinoids are expensive! I presume this is a conspiracy to keep us all either youthful and poor or haggard and wealthy. My feeling is that if your skin looks flawless you save money on foundations and concealers, so justification of the price is easily had.

The Contestants

My first Glossybox arrived, containing a sample of Vichy's newest anti-aging product called "LiftActiv Advanced Filler." The website doesn't list the concentration of retinol and mentions some proprietary product called "LR2412" which is also present in Lancome's Visionnaire serum but must be an industry secret because I can't find any information about what it is. At 37 EU for 30 mL, this Vichy serum is a little more expensive than I'd like. Also I don't like the idea of investing in a product that I don't know enough about, so when my sample runs out I might hold off on repurchasing. I've used it for a few nights now and I'm happy to report no side effects at all. I also had a few nasty little stress-induced blemishes on my chin and this cleared them right up within a few days.

Pros: available at your local Boots, contains retinol, non-irritating, cleared up blemishes
Cons: $$ what am I, an heiress?

In two weeks my darling little brother is coming to visit all the way from New Orleans! Obviously this means I'll be using him as a mule and demanding that he bring me some Sephora products because this trip isn't about family, it's about skincare. I'm having him bring me Dr Brandt Overnight Resurfacing Serum and Philosophy Help Me. Both contain 2% retinol and very little else. I'm also glad to see they are formulated without parabens and phthalates, though I haven't done enough research about those ingredients to really make my mind up about them. Still, safe rather than sorry, etc etc. I chose these 2 from Sephora because I was happy with the cost:benefit ratio and I've used products from each brand before with no problems.

Two Retinols enter...

...this metaphor doesn't work

Since retinoids can take several weeks, if not months, to have a visible effect I won't likely be able to do any kind of review of their efficacy for awhile. The scientist in me is tempted to do one side of my face with the Dr Brandt product and the other side with the Philosophy product, sort of a cosmoceutical Hunger Games where the arena is my face. I probably won't, though. As much as I love a controlled trial I'm kind of worried that the difference will be dramatic and the phrase "this is my good side" is going to take on a scary and literal new meaning.

The Before

So what's my starting point? I'm tempted to upload a photo wearing zero makeup in the name of science but that is quite frankly kind of scary and you never know what handsome millionaire might stumble across it and decide not to marry me. I took a "before" photo for posterity with my cell phone though, so stay tuned in a few months and we can track progress together. By then I'll have convinced the millionaire to marry me and I can expose my scary face to the Internet. At the moment I'm dealing with some hyperpigmentation around my mouth, some post-inflammatory hyperpigmentation (fancy talk for acne-related dark spots) on my chin, and a bit of redness on my nostrils and cheeks. I don't have any wrinkles and my skin is in pretty good condition. I've been breaking out quite a bit, likely because of stress, and I'm glad the retinols will take care of that too. Ain't nobody got time for the ravages of time and the problems of puberty, right?

Stay tuned for updates on my retinol experience! Share your grown-up skincare secrets too, I'm all ears.

xo Caitlin