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The World of S+R

5 FAVORITES: SUN SPOTS

5 FAVORITES: SUN SPOTS

When speckles go beyond freckles, brightening treatments will restore an even skin tone. Sun spots develop due to a combination of genetic tendency and environmental exposure, and best results require a synergistic approach of topical active ingredients. Dermatologist Dr. Noëlle Sherber addresses causes of hyperpigmentation, from sun spots to melasma, with customized combinations of skincare and in-office procedures, and here shares tips along with some of our favorite products to treat uneven skin tone and to maintain your results over time as you enjoy fun in the sun.

SkinMedica Lytera 2.0
While new brightening products launch frequently, it's rare that one has solid science to back it up. Lytera 2.0 is a state of the art brightening serum that demonstrated improvement in dark spots and uneven pigmentation as soon as 2 weeks in clinical studies, with benefits becoming more dramatic at 12 weeks.  It features tranexamic acid, a non-hydroquinone non-retinoid active ingredient that has been garnering global interest as a topical brightener after improvement was noted in patients who received it systemically to stop bleeding due to surgery or trauma. This formula combines it with phytic acid and niacinamide for a synergistic pigment lightening effect, and has the added advantage of incorporating ingredients that are considered to be in pregnancy-safe teratogenicity categories so this is a good option for those looking for a treatment option for melasma or sun spots while pregnant. Dr. Sherber is glad that this has now launched: "Tranexamic acid has been appearing in the dermatologic literature in recent years, and I have been waiting for a clinically-proven and gentle formulation to be available in the U.S. so that I can now add it to my customized brightening regimens for patients." Lytera was tested with twice-daily full face application and we recommend this for best results, in combination with broad spectrum sun protection, although this can also be applied in combination with other skin brighteners once your skin acclimates to your regimen.

Tranexamic acid has been appearing in the dermatologic literature in recent years, and I have been waiting for a clinically-proven and gentle formulation to be available in the U.S. so that I can now add it to my customized brightening regimens for patients.

Elure Advanced Brightening Lotion

Elure's standout product is their Advanced Brightening Lotion, which has, in additional to performing strongly in clinical studies, won numerous awards from AllureInStyleEssence, and other national publications for its dramatic results and gentle hydroquinone-free formulation. The active ingredient, lignin peroxidase which they term "Melanozyme," is derived from tree bark, and breaks up uneven pigmentation gently within a few weeks.  In a 28-day study, 82% of the subjects demonstrated a significant decrease in their melanin index, and 91% of the subjects showed an overall improvement in pigmentation and skin tone.  Dr. Sherber advises, "I often recommends this as an adjunct to laser treatments targeting unwanted pigmentation, or sometimes as a companion product to prescription pigment lightening creams because it is so gentle: when skin is prone to post-inflammatory hyperpigmentation it's critically important not to inflame the skin and because this isn't an acidic product it is exceptionally mild."

Caudalie Vinoperfect Radiance Serum

This serum is Caudalie's most popular product internationally for good reason.  In a study Caudalie conducted of 60 patients over 3 months, dark spot intensity improved by 83%. Its alcohol-free antioxidant-rich blend is powerfully soothing, making it an ideal addition to a brightening regimen to prevent irritation and possible inflammation.  Dr. Sherber explains, "skin that is prone to dark spot formation is often prone to post-inflammatory hyperpigmentation, so I like my patients to use anti-inflammatory topical treatments consistently to counteract any possible irritant effect of other active treatments we pursue, from topical exfoliants and brighteners to in-office peels and lasers, to ensure consistent improvement. This French beauty secret not only really works, but it is a joy to apply." Sometimes we advise mixing this serum into Elure or Lytera for a super-serum cocktail.

This French beauty secret not only really works, but it is a joy to apply.

Natura Bissé Glyco Extreme Peel
This is the only at-home peel that Dr. Sherber has found to deliver results that are close to those of an in-office peel. The formulation blends 5 alpha hydroxy acids, a beta hydroxy acid for synergistic effect, and a proprietary peptide that ensures even depth of delivery. Glycolic acid has been proven with skin biopsy studies to stimulate collagen production, making it a gold standard anti-aging ingredient, and it also works to break up clumps of uneven pigmentation. It allows all other skincare products to absorb more deeply by dissolving the dead skin cells on the skin's surface, which is one reason why regular exfoliation is key to a brightening regimen. This product is ideal for protecting your investment of in-office peels, but also works well on its own, and, delivers value at $10 per face treatment ($20 if treating face, neck and chest). As your skin acclimates to the potency of this product, applying in a warm shower will delivery an even more powerful treatment.

Thank You Farmer Water Sun Cream Broad Spectrum SPF50 PA+++

Absolutely essential to achieving a more even skin tone is daily application of a broad spectrum sunscreen with mineral filters. This SPF50 PA+++ sunscreen from South Korea is the most lightweight mineral-containing sunscreen that we have found, and Dr. Sherber contacted the company after reading reviews citing its featherweight finish and tenacious protection. We are one of the first to bring this product into the U.S. and have been barely able to keep it in stock.  With an average of 11 steps in a Korean skincare regimen, there is intense demand for lightweight sun protection and this product delivers: a mix of mineral and chemical sunscreens makes this formula powerful, yet it manages to provide the highest degree of UVA and UVB protection with airy coverage. Dr. Sherber sourced the primary documentation submitted to the FDA for approval for U.S. sale of the product because she wanted to ensure that it wasn't too good to be true, and it has passed all the requisite tests. The mineral component of a sunscreen is important for those with hyperpigmentation because it provides physical protection, like wearing a tee-shirt, and this product avoids the common pitfall of a chalky finish no matter your skin tone.

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5 FAVORITES: BRIDAL BEAUTY

5 FAVORITES: BRIDAL BEAUTY
Summer is the most popular time of year to get married, and we love getting our brides ready for their idyllic summer weddings.  Here are five of our favorite skincare and makeup "do"s that are perfect prep before "I do"s, along with expert dermatologist and makeup artist tips for looking your best on the big day. Continue reading

5 FAVORITES: MEN'S GROOMING

5 FAVORITES: MEN'S GROOMING
Blind Barber Watermint Gin Shave Cream
Shaving cream is a staple in many men's routine, and choosing one with top quality hydrating and moisturizing ingredients both ensures a close shave and prevents skin irritation.  This barbershop brand originated in Manhattan and has developed an intensely loyal following due to the its cutting edge formulations.  This contains hydrating glycerin and moisturizing shea butter, as well as allow to soothe.  Plastic surgeon Dr. Ariel Rad shaves daily with this cream and shares this tip: "I recommend applying this product immediately after a shower.  The heat, steam, and shave cream work together to has soften skin and stubble to ensure a smooth shave without razor burn."

SK-II Facial Treatment Essence
Men's skin differs from women's because it is thicker, and it has more oil production due to higher oil gland density and testosterone activation of oil production.  This can mean that skin is be more prone to breakouts and shaving bumps, and that it develops shine throughout the day.  SK-II's famed Treatment Essence contains 90% Pitera, which is the ingredient they found addresses these these issues, making it popular with men since it delivers rapid results with a water-light texture.   Makeup artist Enrique Valentino recommends this product for post-shaving application and explains, “after shaving I gently press a few drops of the SK-II Essence into my skin, I love how this lightweight fluid instantly hydrates and soothes. It also keeps future shaving bumps at bay by increasing skin cell turnover with Pitera, SK-II’s legendary proprietary ingredient sourced from sake fermentation in Japan.” 

Thank You Farmer Light Sun Essence Broad Spectrum SPF50 PA+++
Daily sunscreen is essential to skin protecting against skin cancer, and to preventing skin aging from UV exposure.  A recent study demonstrated that 100% of subjects showed improvement in skin texture and pigmentation after a year of daily sunscreen use, in the absence of any other anti-aging treatments, so shielding your skin from environmental damage will make a significant impact.  Dermatologist Dr. Noëlle Sherber advises,"men often find heavy sunscreen texture to be a deterrent, and so this vanishingly light fluid sunscreen is popular with my patients who want to be able to forget that they applied their SPF.  I discovered this product from a South Korean company, and it's no surprise that this innovation is coming from a country in which the average skincare regimen is 11 steps, putting a premium on light textures: you can streamline and apply on its own or on top of moisturizer."

TOM FORD Hydrating Lip Balm
One of the quickest ways to look well-groomed is to have smooth lips, and most lip balms geared towards men (i.e. not overly glossy) are wax-based and don't confer meaningful moisture.  Some also have camphor and actually worsen chapped lips and rough texture.  This blend of natural oils and vitamin-rich butters conditions lips to improve smoothness, and seals in moisture in any weather conditions.  True to Tom Ford's style, the packaging is designed to be stashed in a suit pocket or jeans pocket for on the go reapplication.

TOM FORD Vert D'Encens
Winner of the 2017 Fragrance Foundation Award in the Men's Luxury category, this scent is a new classic.  Inspired by the coast of Corsica, known as "the perfumed isle" for its aromatic air, it is a versatile fragrance owing to its sophisticated and rugged balance which we see men appreciating in their increasingly multifacetedly lives.  It blends smoky notes of incense, woody notes of pine resin and fir balsam, and fresh notes of lavender and lemon into a blend that Tom Ford describes as at once "distinguished" and "delectable." Continue reading

5 FAVORITES: ACNE-PRONE SKIN

5 FAVORITES: ACNE-PRONE SKIN

Acne is the most common skin concern, but clear skin is achievable for everyone. Here are some tips on how to choose active ingredients in your skincare regimen that will gently, but effectively, help by addressing several root causes of breakouts.

EVE LOM Morning Time Cleanser

Thorough cleansing is fundamental to both treating and preventing breakouts. Harsh cleansers are not the best choice because dehydrating the skin's surface with aggressive detergents can trigger more oil production to compensate. Oil-based cleansers are often an excellent choice because oil dissolves readily in oil (think about how oil and water separate out in salad dressing). This means that the oil down deep in the pores will dissolve readily in a balm cleanser. This version from the U.K. is enriched with fruit enzymes to soften dead skin cells plugging pores, which is the first step to achieving a clear complexion since one of the essential elements of acne formation is dead cell accumulation in the pores.

Natura Bissé Stabilizing Cleansing Mask

Beta hydroxy acids dissolve in oil to penetrate into pores to break up congestion. They also have an anti-inflammatory effect which makes them excellent for treating red bumps. This mask from Spain incorporates kaolin clay which has a wicking action to draw oil out of the pores without overly drying the surface of the skin. The large size of the tube makes this excellent for both face and body breakouts. This is best applied after cleansing when skin is patted dry, and can be left on for 1-5 minutes depending on the intensity of the treatment desired. Hormonal changes (whether stress hormones or estrogen/angrogen hormones) make oil produced by the skin stickier, so a decongesting mask like this is a good skincare step to include when treating hormonal acne.

La Mer The Moisturizing Gel Cream

Gel cream is a new category of moisturizer that is more hydrating (water-rich) than classically moisturizing (oil-rich), making it a great choice for acne-prone skin. Skin that is inadequately hydrated not only will overproduce oil but is less able to tolerate targeted acne treatments since it is more prone to irritation, so finding a gentle moisturizer is an important skincare step. "Non-comedogenic" is the labeling term indicating that the moisturizer didn't cause acne in clinical testing. This gel cream from La Mer has proprietary seawater minerals that are renowned for their soothing properties. Because the redness and bumpiness of acne breakouts are the result of inflammation, antioxidant-rich treatments such as this are beneficial because they reduce the inflammation associated with the acne and therefore reduce the appearance of the acne bumps themselves. Whereas acne used to be considered a predominantly bacterial process and was treated with antibiotics, newer science has shown that it is driven by inflammation in the skin directed at dead skin cells mixed into the oil built up in the pores, and so newer treatments are driven at reducing this inflammation.

Indie Lee Blemish Stick

A multi-ingredient spot treatment is a mainstay of a gentle-but-effective acne regimen. Rather than relying on a high concentration of any one ingredient, this spot treatment by natural U.S. skincare brand Indie Lee employs a synergy of several ingredients: salicylic acid, glycolic acid, zinc, and witch hazel. A conventional ingredient for many blemish treatments is benzoyl peroxide, but this pro-oxidant can be pro-inflammatory for many skin types, and so this is a good alternative if spot treatments have previously caused red peeling skin (which can be more attention-grabbing than a blemish itself). For mild occasional acne, sometimes a good spot treatment is all that is needed to keep skin clear. For moderate acne, a spot treatment can up the intensity of a preventative treatment regimen by layering extra active ingredients over breakout-prone areas.

Verso Super Facial Serum

The gold standard ingredient to include in your regimen for preventing acne is a retinoid. This retinol serum from Stokholm-based Verso, has added antioxidant polyphenols: this anti-inflammatory ingredient has been shown in European studies to be effective in calming inflammatory acne, so it makes an excellent addition to a retinol product not only for its skin-calming effects but also for its acne-fighting benefits. Retinoids work by improving skin cell turnover so that pores don't become so readily clogged, and also help to fade marks left behind by prior acne. Whereas older formulations were harsh and left skin chapped and raw, this retinol is gentle enough to be used every night (sensitive skin types should start with every other night and work up to this). Retinol has the added benefit of stimulating collagen production to smooth the skin, so it is ideal for more mature skin that is dealing with both acne and aging concerns at the same time.

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5 FAVORITES: ENRIQUE'S HARSH WEATHER ESSENTIALS

5 FAVORITES: ENRIQUE'S HARSH WEATHER ESSENTIALS

Few things are worse than taking the time to do your makeup only to have it ruined by harsh weather. Here are some of my tips to keep your makeup fresh and flawless in any forecast.

 

Tom Ford Waterproof Foundation/Concealer is the perfect multitasking product to have in your foundation wardrobe for those days mother nature puts you to the test. This foundation is comfortable and breathable with a flawless finish that withstands harsh weather including heat, humidity and water.

 

Be sure to moisturize and prime the skin well before applying any long wearing formulations, since along with their extended wear comes minimal play time before they set. My suggestion to counter this situation is to apply a small amount of the La Mer Renewal Oil under your foundation: not only does this allow the foundation to glide on with ease, it also increases the amount of time you have to manipulate the product onto the skin before it sets.

 

We've all seen our favorite actress get caught in the rain with running mascara on the silver screen. We all love a little drama, but you probably don't have a personal makeup artist waiting for you at your office. I don’t recommend it for everyday wear, but waterproof mascara is the perfect tool for rainy days and inclement weather and Tom Ford’s Waterproof Extreme Mascara will give you pitch black high impact lashes.

 

Long wearing and waterproof makeup formulations require thorough cleansing, and I recommend a double cleanse to ensure that you have a clean slate for the skincare that follows. First, start with the legendary cleansing balm by Eve Lom. This oil-based cleanser dissolves all makeup and brings your skin into balance with its proprietary blend of oils.

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5 FAVORITES: IN-FLIGHT ESSENTIALS

5 FAVORITES: IN-FLIGHT ESSENTIALS

Dry airplane air and traveling between climates can be a recipe for skin that's out of sorts. Here are some travel skincare tips I share with patients, as well as product picks to keep with you in your carry-on. These essentials include gentle but effective hand sanitizer and blemish spot treatments, as well as solid cleansers and moisturizers which not only won't spill in transit and make a mess of your luggage but also won't count towards the infamous TSA "ziplock" baggie of liquids.

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Eve Lom Cleanser

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This cleanser, described by Anna Wintour, Editor in Chief of Vogue, as "probably the best cleanser in the world," is remarkably effective. The proprietary blend of oils (Egyptian chamomile, eucalyptus, clove, and hops) cleanses deeply because oil dissolves best in oil: this melts away even waterproof sunscreens, which is great for active vacations. The formulation emulsifies and turns milky when removed with the accompanying muslin cloth and warm water, leaving skin feeling soft and perfectly clean. One of the common post-travel skin concerns I see among patients is skin irritation from hotel towels, so I suggest traveling with these muslin cloths or your own washcloths if you have sensitive skin since hotel detergents can be harsh and cause eczema from the commercial-grade chemical residue.

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Frais Everyday

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Hand sanitizer is a must when traveling, since saying healthy needs to be a priority. The FDA has now banned antibacterial ingredient triclosan from rinse-off hand soaps, but, interestingly, not from leave-on hand sanitizers. Triclosan can cause hand eczema and I recommend that it be avoided. This Australian formula is triclosan-free, and instead relies on sugarcane alcohol. To balance out the drying effects of the alcohol, it incorporates a blend of natural essential oils (ginger, tangerine, lemon myrtle, niaouli, orange, basil, grapefruit, and cardamom), which make it pleasant to use without lessening its efficacy.

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May Lindstrom The Blue Cocoon

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This unique product is a facial oil in solid form so it is another great carry-on product that won't count as a liquid in your carry-on. It is handmade in L.A. without preservatives or synthetic fragrance, and so is excellent for sensitive skin types, and derives its distinctive color from blue tansy oil which has renowned soothing properties. In an interview with SHERBER+RAD, May Lindstrom said that The Blue Cocoon "was the formula I dreamed about my whole life and the one I am most proud of and personally attached to" and it has garnered an intensely loyal following based on the intensely nourishing results it delivers. You can apply it anywhere that needs extra moisture, such as hands, cuticles, or lips, and can reapply throughout the flight if skin feels parched. It is also an excellent vacation companion to soothe chapped skin whether from skiing or jetskiing.

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Indie Lee Blemish Stick

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The airplane restroom has such notoriously harsh light and can make it tempting to attempt self-surgery on nonexistent blemishes that appear in the mirror there. This spot treatment is a much better idea. It's an invisible quick-drying clear gel with a wand applicator that can be dotted on spots, and the formula is so sheer that it can be applied over or under makeup. The potent blend of salicylic and glycolic acids, along with natural acne-fighters zinc, camphor, witch hazel, and sulfur, shrinks acne quickly and effectively without over-drying the skin and causing a peeling spot which can be more unsightly than the blemish itself. It's always good to have a spot treatment on hand while you're traveling in case a blemish arises as an unwelcome visitor, and this one is discrete enough to keep with you: just be sure not to confuse the chic packaging with a lip gloss!

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Crème de La Mer

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This moisturizer has a legendary following due to its skin-soothing properties, and, since it's a solid texture at room temperature it's an ideal choice for your carry-on. Sea water minerals are very calming to the skin, and this formula combines them with a blend of oils - including sesame seed oil and eucalyptus leaf oil - which is renowned for its ability to repair the skin's barrier, so this is good for cushioning the skin against arid airplane cabin air. To apply, be sure to warm the product between your fingers until it becomes translucent and then press gently into the skin. You can apply a generous additional layer mid-flight if skin feels dry and you'll be amazed how much skin will absorb before landing.

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5 FAVORITES: WINTER SKINCARE

5 FAVORITES: WINTER SKINCARE

In winter, skin becomes more prone to dryness and irritation due to cold temperatures and low humidity. Here are some tips to keep skin looking its best when there's a chill in the air... or even major wind chill.

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La Mer Revitalizing Hydrating Serum

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Cold air is also dry air, and so hydration (meaning adding water to the skin) is key to winter skincare. One of the ways to help hydrating products work best in the winter is to place a humidifier near your bed so that they can bind water to the skin overnight. Similarly, seal off your bathroom door while showering or bathing and apply your skincare in the steamy air to harness the humidity. This serum uses new technology to deliver small beads of hydration into the skin effectively with a light texture that layers well with other products, and soothes dry skin with La Mer's proprietary complex of seawater minerals.

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Natura Bissé Diamond Extreme Oil

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One of the best ways to transition your skincare into the winter if you don't want to revamp your products entirely with the change of season is to mix oil into your cream or lotion moisturizer to make it more nourishing. Blending in a few drops of this lightweight mix of chia, carrot, calendula, and amaranth oils from Spain will make any moisturizer more winter-appropriate. This can also be applied as a serum layered under your moisturizer, or patted on dry areas midday if skin becomes chapped from the cold.

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Caudalie Divine Body Oil

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This French blend of grape, sesame, hibiscus, and argan oils with a lovely warm scent can be applied to body, cuticles, and even hair. Clinical studies comparing vegetable-based oils to mineral oil (as is found in baby oil) show that vegetable oils are more effective moisturizers for eczema-prone skin, so if your skin is persistently dry or itchy look for vegetable oils on the ingredient list. Apply body moisturizer while skin is still damp from the shower to trap water next to the skin for best results, and you can use this as a body oil or cocktail it by mixing it into body cream.

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La Mer The Body Crème

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A good rule when shopping for body treatments for dry winter skin is to pass by any products in a pump, and to go straight for those packaged in a tube or a jar. This is because, in order to pass through a pump, lotions will have a high water content to thin the formula which makes them generally insufficiently rich in oil to soothe really dry skin. The formulation of this pudding-textured cream was inspired by in-spa seaweed wrap treatments that leave skin deeply hydrated and moisturized and has earned a loyal following for calming even super dry skin.

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Caudalie Premier Cru The Elixir

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Harsh weather isn't incompatible with active skincare ingredients, but skin can be sensitized by overly aggressive products in harsh weather. In particular, avoid serums containing alcohol since these can dehydrate the skin at a time of year when skin is already prone to dryness from the low humidity in the air. Also, serums with heavy silicones (apply them to the back of your hand and see if water beads up) will form a film that prevents optimal absorption of moisturizer that you layer on top. This fast absorbing oil-based serum incorporates antioxidants viniferine, resveratrol, and grapeseed polyphenols which defend against free radical damage from UV exposure and pollution.

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5 FAVORITES: POST-PROCEDURAL PRODUCTS

5 FAVORITES: POST-PROCEDURAL PRODUCTS

The holidays are a very popular time for cosmetic procedures, whether a skin brightening laser treatment to get party-ready or surgery to take advantage of time off to recover - here are dermatologist Dr. Noëlle Sherber's recommendations to soothe healing skin.

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La Mer The Concentrate

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The Concentrate has become a top selling La Mer product in South Korea, the country leading the world with the most plastic surgeries per capita. It is enriched with seawater minerals, and since blood and seawater have very similar mineral composition this may account for La Mer's renowned healing properties. This is a silky serum enriched with high quality silicones which I find calms redness post-laser and helps scars fade post-surgery. The rich texture wears beautifully like a primer under makeup and is suitable for delicate skin on the eyelids as well as the face.

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Biocorneum+

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Topical silicones are proven through numerous studies to improve scar healing, resulting in flatter, softer, and smoother scars. Biocorneum+ is an FDA-cleared liquid that dries to form a thin clear sheet of flexible silicone over a healing scar to keep the area hydrated while protecting it from UV exposure with SPF30. When Angelina Jolie underwent bilateral mastectomies, she shared that she applied this twice daily for 12 weeks to optimize scar healing. My husband, plastic surgeon Dr. Ariel Rad, often recommends a similar protocol to his breast reconstruction and aesthetic surgery patients.

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Natura Bisse S.O.S. Instant Rescue

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Natura Bissé developed this powerfully soothing serum to fight inflammation in the skin, incorporating natural calming ingredients such as calendula, arnica, propolis, and aloe vera. I often apply this in my treatment room after laser or injectable procedures since it calms redness rapidly, and this is a great at-home companion to these procedures. Men often prefer the lightweight texture of this sheer gel to richer post-procedural balms

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Caudalie Vinosource S.O.S. Thirst-Quenching Serum

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In clinical studies, this combination of polyphenol-rich grape water and hydrating hyaluronic acid reduced skin redness rapidly as compared to untreated skin following exposure to lactic acid. I often apply this to patients' skin following chemical peels or laser, and particularly recommend it to those with oily skin who want an oil-free product, and also suggest it after surgery when skin can feel dry and irritated from the prep solution used to sanitize skin pre-operatively.

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SK-II Facial Treatment Mask

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This sheet mask has the highest concentration of Pitera™ of any product in the SK-II line. Its mix of vitamins and minerals derived from the sake fermentation process is deeply hydrating and visibly reduces redness, which is why I recommend it after laser treatments to many patients who need redness to fade quickly so that they can be event-ready. For post-surgery patients, the masks can be chilled in the refrigerator and applied cold to help reduce swelling.

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