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Do Peels Scare You?

Do Peels Scare You? on Belle Belle Beauty

By now, most of you know that Gabriel Horn is my trusted source of medical spa services. In fact, he’s known as the Tulsa Skin Guru. And it goes without saying that I trust him implicitly. We have been working together for almost a year now, with much success, in the battle against my hyper-pigmentation and sun damage. Our approach has been moderate strength chemical peels (you can read more about them here). While these peels are both my and Gabe’s choice to reverse sun damage, their aggressive nature isn’t always right given the person or time. So, what do you do if aggressive peels scare you or are inconvenient?

I had a couple things going on in my life last time I visited Gabe (side note: Gabe is also a wealth of advice, wisdom and laughter during my visits). Between a hot date, a Mardi Gras ball and a television appearance, I knew that the regular chemical peel just wasn’t going to work for me. I suddenly found myself in the shoes of some of you readers who have told me peels scare them. The pain, side effects, dry skin and redness just sometimes don’t fit into our lives.

Gabe curated a different treatment that was productive but left my skin radiant, even and supple the following day. He started with a heavy microdermabrasion. Then a 30% Glycolic peel was applied for a short period of time. Thanks to a couple lazy evenings, I had two breakouts on my chin. Gabe spot treated these with salicylic acid. I experienced no tingling or pain. That being said, we must emphasize that these steps require a medical aesthetician. These are not run-of-the-mill spa services. I left the office with a little bit of redness which dissipated throughout the evening.

These types of treatments can lead to dramatic and satisfying results. The difference is that peels like these are like baby steps as opposed to rapid results with more aggressive approaches. But for many people, they just can’t afford the downtime. While the required frequency of more gentle peels might cost slightly more, the lack of side effects might be worth it. Additionally, a more moderate approach might be ideal for summer months. Skin under aggressive treatment can be at greater risk from the damaging sun.

The real takeaway from my last visit is that peels come in a huge spectrum. When we hear “chemical peel” we think of the frightening Sex In The City episode with Samantha’s peeling, red face. But there is a huge range of options and customization available. With proper analysis, a medical aesthetician can design a proper and balanced approach. Even microdermabrasion, a zero downtime treatment, can boost collagen, reverse sun damage and improve skin texture.

The plan for me for now is to ramp up my use of hydroquinone and Retin-A to prep my skin once again for the slightly more aggressive treatment. We are in the home stretch here with maybe only two or three more peels necessary. But I know the time will come again when I just can’t afford the downtime. And it is a comfort to know that there are steps I can take that mitigate the side effects and still make progress against that darn sun damage!

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AN EDITORIAL SAMPLE MAY HAVE BEEN PROVIDED BY THE COMPANY AND EVALUATED TO DETERMINE OUR OPINION OF THE PRODUCT IN THIS POST. PLEASE SEE THE DISCLOSURES PAGE FOR FURTHER INFORMATION REGARDING OUR POLICIES FOR USING EDITORIAL SAMPLES.

The Quest For Even Skin

gabe peel

Ever since this interview with Gabriel Horn, I knew I wanted to up my game battling this stubborn hyperpigmentation. I’ve confessed to indulging in the sun this summer (obviously safely, always with sunscreen), so my sun damage and dark spots have gotten even worse. Even with my SPF 50 on my face, my hyperpigmentation-prone skin was affected.

Now that the cooler days have arrived, I knew I could safely go after the damage with strong, medical grade formulas. I stopped in to see my favorite Tulsa Skincare Guru, Gabriel Horn. He has recommended incorporating Tretinoin (aka Retin-A) along with hydraquinone (at 4% strength). I’ve been loyal to that combo since early September. And I have made tremendous progress against those darn spots. But I knew I needed more to eradicate them totally.

Last week, I went in to see Gabriel for a peel. While it can sound scary, my prep work actually made it much less traumatic. Skin that is used to and being treated with Tretinoin can handle chemical peels much better. I have had a peel with Gabriel before, so I knew what to expect. We started with acetone (which sounds gross and scary), but it helps for effective and even absorption of the chemicals. He then applied a modified Jessner peel with a formula developed by Dr. Manduano (the doctor he works with). This usually consists of salicylic acid, lactic acid, and resorcinol. From what I understand, it is a very gentle peel alone but can work in conjunction with other peels to raise efficacy. Gabriel then upped the game and spot treated the really dark spots with Trichloroacetic acid (TCA). This is a much more aggressive type of peel.

Next up was a Retinoic acid peel applied all over the face. This is deeper than a Glycolic acid, Alpha hydroxy acid or Beta hydroxy acid peels, but not as strong as the TCA. Along with pigmentation, Retinoic acid also works against scars and wrinkles. While there was a tingle and discomfort but it certainly wasn’t intense pain. I held a fan in front of my face for about 10 minutes which provided a lot of relief.

The areas that Gabriel spot treated got very dark and then peeled for a full week. But gosh darn it… those dark spots are GONE. My face peeled on Friday (approximately 48 hours after my peel). Other than the spot-treated areas, I was done with peeling by Sunday evening. I had no pain after the actual application of the peel. And my skin looks radiant, healthier and more even. I am going to follow up with more peels and will be keeping you posted on my progress!

If you are in the Tulsa area, I highly recommend Gabriel. He works out of Dr. Joey Manduano’s office (also highly recommended) at 2219 East 21st Street. Their phone number is: 918.749.5522.

AN EDITORIAL SAMPLE MAY HAVE BEEN PROVIDED BY THE COMPANY AND EVALUATED TO DETERMINE OUR OPINION OF THE PRODUCT IN THIS POST. PLEASE SEE THE DISCLOSURES PAGE FOR FURTHER INFORMATION REGARDING OUR POLICIES FOR USING EDITORIAL SAMPLES.

Fighting Back Against Summer Sun Damage

Fighting Back Against Summer Sun Damage // Belle Belle Beauty

I started off this summer with a little irresponsibility. I hit the pool with sunscreen – but definitely not enough and in such a short time, I had my dreaded sun spots and hyper-pigmentation on my forehead and cheeks. I vowed to fight back! I knew I couldn’t be too aggressive with treatments as some make you too sensitive to any sun exposure. But I did come up with a routine that has made some pretty darn wonderful strides against those dreaded dark spots.

Mario Badescu Glycolic Foaming Cleanser // Belle Belle Beauty

First, I have been washing my face with my beloved Clarisonic. My cleanser of choice has been Mario Badescu Glycolic Foaming Cleanser. My skin is gently primed and exfoliated for application of serums and treatments, but not irritated in the least.

A-TEAM // Belle Belle Beauty

Second up, I knew I wanted to work in a retinol, but also new my beloved Rx Retin-A would be too strong for my pool-heavy summer. So I turned to mybody. This line, now available online, has wooed me with gentle and effective products and the most fun packaging and names. A-TEAM provides 0.3% Retinol that you can use in the AM and PM safely. Also in the formula, mySBP 189, Actiwhite and Chromabright can help tighten and recondition skin. So, say goodbye to rough patches and redness.

MELAMIX // Belle Belle Beauty

Next up, one of my skin care staples, albeit a controversial one: Hydroquinone. Banned in certain types of the world, many find it to be unsafe. But I trust my doctors here that say it is really the only effective way to reverse sun damage. While there are versions of this skin lightener in the drugstores, they are usually at 2% or below. So turn to your doctor for a 4% version. I use ZO Skin Health MELAMIX from Gabriel Horn at Dr. Joey Manduano’s office here in Tulsa (Gabe truly is the Tulsa Skin Guru if you are local). I use this both morning and night. During the day, not only does it correct dark spots, but it also works to prevent formation of new ones.

Super Nourishing Cream SPF 50 from Zensation // Belle Belle Beauty

Lastly, I am all about extreme sun protection. I used to dally around with a SPF 15 or 20, but for those blazing summer days, especially when you are outdoors, make sure to up the ante. Super Nourishing Cream SPF 50 from Zensation has been a summer favorite. On the richer side for my dry skin, it is perfect for those with aging skin or craving hydration. And I love the high sun protection. It is creamy, soft and absorbs well. It also works beautifully under makeup.

Kiehl's Super Fluid UV Defense SPF 50+ // Belle Belle Beauty

Another favorite is Kiehl’s Super Fluid UV Defense SPF 50+. It is totally lightweight, non-irritating and even works as a wonderful primer.

So that is the story! If you are like me and paying for some summer sins, try these steps to get that skin looking more even.

AN EDITORIAL SAMPLE MAY HAVE BEEN PROVIDED BY THE COMPANY AND EVALUATED TO DETERMINE OUR OPINION OF THE PRODUCT IN THIS POST. PLEASE SEE THE DISCLOSURES PAGE FOR FURTHER INFORMATION REGARDING OUR POLICIES FOR USING EDITORIAL SAMPLES.

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Summertime Medical Skin Care

Summertime Medical Skin Care // Belle Belle Beauty

Yesterday marked the moment of truth. While I have been on a quest to finally nip this hyper-pigmentation, I have come to the realization that I am a bit of a pool bunny. While I wear SPF 50 at least and reapply every hour, my forehead is just really prone to these dark spots. So, I visited my favorite Tulsa Skin Guru, Gabriel Horn, and we made a plan on action.

I already knew that summertime required a bit of a different approach to skin care. I have set aside my beloved retinol because, primarily, it makes us more susceptible to the sun. I, along with Gabe, will return to the heavy duty retinol/hydroquinone 1-2 punch in the fall. But all is not lost for these months I might spend a little more time by the pool.

First, don’t give up on your hydroquinone. It still helps block the body’s ability to make more melanin, preventing some of those dark spots. In fact, I learned today that it is often used post peel or procedure to keep that melanin suppressed. But as a note, results have shown it takes a 4% dose, twice daily. And for that, you need to see your doctor. Over the counter hydroquinone is at most 2%.

So, that’s what to do on the home front. During my office visit, we went after things in a more medical and aggressive format. But fear not: the biggest bonus of Gabriel’s DNA Reparative Brightening Treatment is you are left with glowy, healthy looking skin. No down time. (Tulsa folks, get more info here).

First, we cleaned things up with a eyebrow tweeze and extractions. Apparently, I was looking “bushy”. Ha, not anymore. Next, we did my favorite, microdermabrasion. The microdermabrasion clears out pores and gives skin a fresh start. Next, Gabriel applied ZO Skin Health ‘Ossential’ Growth Factor Serum.

ZO Skin Health 'Ossential' Growth Factor Serum // Belle Belle Beauty

Growth Factor Serum contains lab-developed growth factor that works to replicate healthy skin cells and repair damage or anything that ails the skin. The water-free gel was soothing and left my skin insanely soft. Over the Growth Factor Serum, Gabriel applied the Ossential Skin Brightening Sheet Masque (found only at doctor’s offices). This deposited much needed antioxidants, stabilized Vitamin C and a mega-dose of hydroquinone to brighten the skin.

Ossential Skin Brightening Sheet Masque // Belle Belle Beauty

After 15 minutes of mask time, my skin was revealed to be softer, brighter and glowing. While I still have to work on my sun damage in a couple months, the DNA Reparative Brightening Treatment is a great way to go after tired and dull skin in the summer.

ZO Skin Health™ 'Ossential™' Daily Power Defense // Belle Belle Beauty

Lastly, Gabriel applied with Dr. Obagi calls “the one product every patient has to have”. (note: Dr. Obagi left his namesake line, Obagi, to start ZO Skin Health). ZO Skin Health™ ‘Ossential™’ Daily Power Defense is a DNA repair lotion that also protects cells from future damage. Stimulating cellular activity, skin cells are encouraged to rejuvinate. This second line of defense is used under SPF.

Tulsa folks, I highly encourage you to stop by for Gabriel’s DNA Reparative Brightening Treatment. You can reach his office at 918.749.5522 or find more information on his Facebook page. Also, make sure to follow him on Twitter. And alert French Bulldog fans: his Instagram cannot be missed.

ZO Medical and ZO Skin Health products can be found at a dermatologist’s office near you. Find your closest here. ZO Skin Health products can be found at Nordstrom as well.

Shop my favorite ZO Skin Health products here:

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Taking Skincare Up a Notch – Interview with Gabriel Horn

Taking Skincare Up a Notch - Interview with Gabriel Horn // Belle Belle Beauty

So many times, when asked about the most important skin care product, I rattle off that most everyone should be using a retinoid. I’ve said it until I am blue in the face. But to be honest, this often requires taking a medical approach to skin. So, today, I’ve asked my skin guru and friend to talk a little about the medical approach to skin care.

My fight against hyperpigmentation and early signs of aging just stepped up big time. I’ve already done one peel with Gabriel and will be blogging about my journey as it continues over the next couple of months (more on that later). But today, we have a little introduction about taking skin care up another notch. Take it away, Gabe!

1. What kinds of problems require a medical approach to skin care?

Most people find themselves in my chair when they have exhausted most all other options. As collagen depletes and the effects of sun exposure [earlier in life] start to appear, we get restless. We begin searching for what works…. and what works is what we want. Often what leads people to increase strength in their skincare is the awareness that what they have been doing isn’t keeping up with the pace of aging.

There are many wonderful products on the market for all skin types… they clean, hydrate, nourish and protect the skin as much as they are able. But the environment, in which we live, is drastically changing and not for the better. The UV rays are stronger, the air we breathe is full of toxins and pollution, that not only our bodies have to filter… but our skin as well.

Hyper-pigmentation (sun spots) are, in my opinion, one of the most noticeable (and usually the first) signs of the aging process… much like a banana peel, we start to show pigment with “ripening”….LOL. Lets call it “ripening” hence forth, shall we? Secondly, the weight of excess dead tissue causes crevassing/wrinkling in the skin, which tend to appear more quickly in thinner tissue… around the eyes in particular. These issues require ingredients, or should we say “strength of ingredients” that you won’t find in over-the-counter products. THAT is when we should seek a medical approach to skin care.

2. How do peels work and what kind of results can patients/clients expect over the course of treatment?

Chemical peels originated in burn centers… when patients recovered from a “burn”, their skin would repair itself by sending collagen and elastin to the area rebuilding what had been damaged. Unlike sun damage, a “burn” not caused by UV exposure, can be healing in the long run. It caught on… they knew if they could control the level of “burn” to the skin, they could induce collagen production and basically help rebuild the damaged tissue.

The process of “peeling” skin doesn’t always involve a physical peel. That’s a common misconception. There is only so much dead tissue to remove, at any given time. We use acidic compounds that are designed to affect certain portions of the skin. We can target pigment at different levels of the skin. We can cause collagen production that not only replenishes the healthy skin but also removes the tired, grey, lifeless tissue as well if the skin is in need of deep exfoliation. The collagen building is the MOST important part. The flaking and peeling of the skin becomes less and less with regular treatment and attention. Home care is a vital part of this process.

The best news is that in the over 20 years I’ve been in this field….. the way we utilize these agents has changed. More and more, patients/clients having seen people go through “Samantha from Sex and the City” responses to strong chemicals, want to treat the skin issues as they arise… people are much more aware of what healthy skin looks like, so they are starting sooner.

If you pay attention to small changes.. they are much easier to reverse than years of neglect and over exposed skin left to try and protect itself. The skins’ only choice in prevention is melanin… Melanin is the brown pigment we see popping up as we age. Uneven tone and texture = less attractive skin.

The Peel experience depends on several components… the issue(s) being treated, the pre-conditioning of the skin prior to treatment, the level of treatment necessary and the patients compliance in regard to aftercare. Now a days, you can effectively rectify most “ripening” issues with peels that will fit into your life without much “downtime.”

Downtime is a very individual experience. Some people consider flaking “downtime” while others think nothing of that. It depends on your daily activities during the time of “healing.” The healing of procedures range from just pink, flushed tissue to rather inflamed and “burnt looking” skin that usually takes a week to peel away. All of these factors, mixed with the condition of the skin on each patient, make it hard to make a blanket statement in regard to “downtime.”

Some of these treatments will induce a collagen production that will take a couple of months to see the result, others work by speeding up the cellular turnover and exfoliating dead cells revealing a much more healthy glow to the skin. All of that being said, you should consult with someone when embarking on this journey. It’s important to get to know them and how they approach your issues. If it sounds too good to be true… it probably is. Tragically cliché… but true.

3. Why is using an at-home retinol so important? And at what age should we start using one? Do you always recommend a prescription version?

You know, there are new reports coming out constantly about retinoids and their place in skincare. It’s super exciting to a skin geek like myself but the effects of just about any level of retinoid in your routine, are positive.

Basically, in order to correct damaged tissue, we use full strength Retin-A, sometimes, depending on the patient and the doctors recommendation, there may not be a need to discontinue use. Retin-A is, to my knowledge, the most effective collagen producing product on the market and should have a place in your routine. Again, inquire with a medical skin professional to determine what level is most appropriate for you.

4. What is your approach to treating hyper pigmentation?

There are a few different methods of treating hyper pigmentation, my favorite is the use of a “pulse therapy” method of using Retinoids and Hydroquinone at 4% twice daily until the pigment is suppressed and the skin has evened in tone and texture. Once we achieve that level of correction (usually about 6 months), there isn’t a need for continual hydroquinone use.

As long as you protect the skin (faithfully), and avoid sun exposure you can maintain that even tone with regular skin maintenance and continual retinoid use. If you become hyper pigmented because of over exposure or hormonal imbalances etc., the use of hydroquinone can easily be brought back in. Chemical peels assist this process by keeping the skin exfoliated and collagen production flowing, allowing the skin to remain healthy and vibrant for years to come. Unnecessary pigment is such an individual, case by case, issue… consultation and medical direction are paramount, in my opinion, to ensure a safe and effective treatment.

If you’d like to learn more about Gabriel, please check out his Facebook page here. I encourage everyone in Tulsa to go see him for a consultation!

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