Not to worry. There was actually less discomfort than usual and the dental technician was thrilled with the state of my teeth and gums. Turns out that the plastic aligners that cover the teeth dramatically reduce plaque build-up and kept the teeth super white. She also was so happy to see the progress in my bite. Pulling out earlier pix of my mouth , she pointed out that the overlap in both the top and bottom teeth have practically vanished.

When I got home, I pulled out my set of “befores” from Dr Jacquie and took some homemade versions of “afters”. Check out the difference in the flare of the bottom teeth in the before ( left) and after ( below) pix. When I started Invisalign, I would have been happy with modest improvements. This change far exceeded my expectations and I’m not even half done.

When I began Invisalign  I found the idea of wearing  an aligner 22 out of 24 hours a day a bit daunting.  But IRL  it was no  big deal.  And wearing the aligners kept  me from snacking and I’ve dropped a whole dress size of the past four  months.  However I do find it hard to cook while wearing aligners.  I’m such a foodie and I taste and season as I work.  I find myself automatically taking out my aligners   as I tie on an apron.

One final thought:  In the past few weeks, several people have casually remarked that I had a beautiful smile.  Just  to be clear, other than my  mom, no one has ever said  I had a beautiful smile.  Great hair  or a  cool bag, but never a great smile.   Its certainly a great confidence builder.

Question:

Answer:  This is one  of my favorite topics!  We ( consumers) have all  experienced this.  We fall in love with a new skin care  product only to see the once wonderful benefits seem to twindle away.  Doctors and other skin experts have a boatload of different reasons as to the cause:

1. When  we first use a product it provides fresh new benefits, as it supplies what the skin needs.  Over time, other problems and isssues develop and the once new serum or lotion  cannot  meet the new needs.

2. Some dermatologists believe that the products still continue to work , but we’ve forgotten  how bad   our skin looked before.  In other words the original improvements are still there, but now we want more.

3.  Then there  is the phenomenon of “New User Benefits’.  For  example, if you’ve never used  an exfoliating scrub, the first time results are remarkable.  You have just taken off  layers of dead dry skin and your skin just glows.  Regular exfoliation will continue  to clarify your skin but the shock and awe of the first time will not be repeated.

4. If  you’ve purchased a second bottle of  a favorite  product only to be disappointed at the results, its possible that there’s been a “Change in Formula”.   One  or more of the key ingredients  had become too expensive, was in short supply  or even deemed unsafe.  Different ingredients, different results.

All of these are pretty subjective reasons for a products decline, but  in at least one case clinical studies have shown that skin cells do become resistant to an ingredient.  Researchers have found that after about six months skin cells no longer respond as enthusiastically to alpha hydroxy acids like glycolic acid.   The benefits  continue, but not as dramatically  as  when they were first introduced to the  skin. 

To bottom line it, there are numerous reasons that products seem to become less effective over time.  The question is what to do about it.  People report that rotating products seem to slow the loss of power, but jumping around too frequently will not allow the skin to get full benefits from a forumla.   Try using each  product for two- three weeks at a time to allow the skin cells  go  through  a full growth cycle before switching to another option.

Have you found that skin or hair care  product seem to deliver less and and less benefits?  How did you handle it?

There are two  main  forms of rosacea:

1– The most common and mildest form consists primarily of bright red skin and numerous small broken blood vessels on the skin’s surface.  Why this happens  is not clear ( genetics?)  but certain triggers seems to bring trigger flare-ups.  Sunlight is the biggest culprit, followed closely by alcohol, spicy foods, stress,  chocolate, coffee and hot showers.

2– The second form of rosacea has similar redness but now the skin also  has pimple  like breakouts that don’t respond to traditional care.  There is some evidence that bacteria and yeast  microorganisms  are part of the problem.  Sunlight and the other well-known rosacea trigger also  contribute to outbreaks of this  type of rosacea.

Treatment of Rosacea 

Treatment starts with trying to avoid  factors  which provoke flushing.   Rosacea  prone skin is very suseptible to cosmetics  and should avoid  irritating ingredients  including alcohol, witch hazel, fragrance, and menthol.  Many experts advise against exfoliating agents such as scrubbing grains, glycolic acid  and complexion brushes.  Effective sun protection is key.  Use an oil-free  physical  sunscreen with  zinc or titanium oxide like Sensitive Skin SPF30 by Neutrogena.  As good as they are, chemical sunscreens can be  too irritating for rosacea-prone skin. To reduce  inflammation, bathing the skin with fresh milk and oatmeal solutions can  provide relief.   Lasers, especially IPL,  have proved to be extremely helpful for rosacea.  They close off the tiny blood vessels in the skin,shutting off the source of the flushing.

There are  additional treatment options for  the acne like form of rosacea.  Topical antibiotics like  MetroGel or anti-inflammatory lotions like Finacea can reduce  break-outs.  Cleansing pads with sulfa   like Prascion will also get to the micro-organisms that can be part of the problem.  For  severe rosacea, doctors can prescribe low-dose oral antibiotics like Oracea.

One final word:  Cortisone creams which are used for  so successfully for so many  skin problems   actually make  rosacea worse. They  have actually been known to provoke its  own type of rosacea.  While steroids can temorarily  improve the rosacea, the  problems rebound when  they are stopped 

For   more information on  rosacea visit  the National Rosacea Society  http://www.rosacea.org.

Next  post– Just because its red doesn’t mean its rosacea.

I was also excited to learn that Beauty Bash, the health and beauty expo created by Fab Over Fifty is coming back this year in September  and will be accompanied by Beauty Bash week in NYC. More on Beauty Bash as  the program develops.

May is National Smile Month  and it  seems like karma that  the book of the week is Smile! by the dentist  who invented GoSmile, Jonathan Levine.  Its  basically a  no-nonsense approach to  caring  for  your teeth and is packed with wonderful information. For example  it explains the differences between  whitening, desensitzening  and tartar control toothpastes including which ingredients to look for and which to avoid. I was surprised to learn that  about 60% of Americans have tooth   sensitivity issues  because the tiny tubules in the teeth  transmit messages to the nerves.  Potassium nitrate seals up tubules and prevents  pain transmissions.  However  Dr Levine points out that  to be effective  a toothpaste needs to have 5% potassium nitrate  and not all that make sensitivity claims  have that formulation. FYI   Dr Levine recommends Sensodyne  if  you have sensitive teeth.

The chapter on tooth whitening  alone is worth the  price of the book.  I was  fascinated  by the science behind tooth whitening and the way the different  techniques can work together.  Dr Levine writes about who should  and  should not get tooth whitening-  during pregnancy,  while breast feeding and under age 14. He also includes a tooth whitening spread sheet that  I will take with next time I  buy a whitening product.  Smile! by Joanthan Levine  has  earned a permanent place on my beauty bookshelf.

I was psyched to learn that  for such a tastie veggie, green  beans had a very respectable anti-aging  profile.  One cup  clocks in at  just 31 calories .  While they are not high in fiber, the folacin and  skin friendly vitamin C levels are impressive.  Add about 20%  the RDA for vitamin A  and a daily serving of green beans  adds genuine anti-aging nutrition to any  diet.

I was  also intrigued to find out that green beans are actually immature versions of true beans.  In fact,  when they are mature and dry, they are higher in  protein, calories and carbohydrates that young green bean pods.  In the US, green snap beans are the  most popular form.  Italian broad beans, chinese long beans and skinnyFrench haricot vert have similar nutritional profiles, while yellow beans   have much lower levels of beta carotene.

I think of green beans as the chicken of vegetables in that  they can be used in so  many different dishes.  I love this anti-aging Greek style recipe that also contains tomatoes, onions and garlic– all of which add their own nutritional pay-off. Do you have a favorite  way of eating  them?

Greek Style Green Beans ( from the Mediterranean Diet Cookbook by Nancy  Jenkins)

Ingredients: 1 pound cleaned green beans, 1/3 cup chopped onions. small clove of garlic, chopped, 2 tbs. olive oil, 2/3 cup drained, canned whole tomatoes, chopped coarsely, 1 packet Equal or 1 teaspoon sugar, I teasp. lemon juice

Directions: In a saucepan large enough to hold  the beans, saute the onions and garlic on  medium heat until the onion is soft and starting to brown; Rinse the beans and toss into the onions; Stir, cover and cook  on  medium heat for 5 minutes; Uncover  the pan and add tomatoes andEqual ( or sugar).  Cover and cook on low heat for 35-40 minutes; Check every 10 minutes to  stir and make sure that the beans are not too dry;  When they are soft and  the  tomates dissolved into a sauce, add the lemon juice.  These beans can be served hot or room temperature.

Causes of Sensitive Skin

The first thing I learned about these red spots is that they  are driven by different  factors.  Sensitive skin is  a kind of umbrella term for skin problems that produce red, flaky sometimes itchy skin.  There are basically six, count ‘em, six different types and its important to identify the true  cause to select the right  treatments and prevent them from returning.

1. True Allergic Reactions

An allergy is  an overreaction of the body to something that it identifies as threatening.  Like a defending army, white blood cells rush to protect the area and the skin becomes inflamed, itchy and sometimes even  painfully sore.  During this struggle, blood vessels in the area become clogged with debris.  As a result, the skin begins to die  producing flaking and scaling skin.

Allergies to   personal care  products is so common that it even has a name– cosmetic dermatitis.  About half the time its the fragrance that’s driving the problem, so fragrance-free is a great start if you are like  me and tend to get red splotches.  Other well-known culprits in beauty care  products include alcohol, lanolin, parabens, detergents and chemical sunscreens like benzophenone.  Often irritating chemicals are genuinely effective and useful, but  for some they can cause unwanted irritation.

Caring for Cosmetic Dermatitis

There is no shortage of products offered for sensitive skin.  If they are free of common triggers like fragrance and lanolin then you’re  off to a good start.   For cleansing,  look for soap-free  formulations and avoid exfoliants like scrubbing grains and pads.  Colloidal oatmeal stabilizes white blood cells and calms down edgy skin and its a great ingredients in cleansers, moisturizers and face masks. Sensitive  skin is especially vulnerable  to sun damage,  but chemical sunscreens can provoke problems.  Rely instead on physical sunscreens  like Titanium and/or  Zinc Oxide to block UV rays.

Hypoallergenic products suggest that have less potential for problems and if they avoid common triggers (eg fragrance, lanolin and alcohol) they are definately on the right track.  Unfortunately there are no federal standards for the term” hypoallergenic” so just because its labeled hypoallergenic doesn’t mean its so.   I always check the labels and buy  products at stores like Sephora, Bath and Body Works and CVS  that have  consumer friendly return policies.  Its hard enough to  have sensitive skin– but its adding insult to injury when you waste  money on  products that make it worse.

Next week:  Rosacea– the never-ending redness

I guess I’ve got a bad case of travel fever since my book of the week   turns out to be Passport to Beauty by Shalini Vadhera.   Its a collection of beauty tips  and secrets from around the world, most of  which are made from local ingredients.    I loved trying a mix of olive  oil and salt for winter-dry feet and was  intrigued by a yogurt and tumeric  paste to reduce cellulite on stomach and waist.  Brazil,   which has made its  beauty rep  with   hair straightening  and body  waxing techniques  provided  a  more natural sugar and lemon scrub to soften winter-dry  hands.

My favorite parts of Passport to Beauty focused on natural ways to treat dark spots and patches.  A common problem in Sosuth America, India and Asia, the book offers  a wide selection of homemade recipes to deal  with hyperpigmentation.  For example  a forumla from Japan adds  a few drops of camilla oil to a tablespoon of  sake to rub on the skin at night.   From Indonesia  comes a recipes of a lightening  scrub   based on coffee grounds.  But  to prevent  unwanted pigmentation,  author Shalini frequently reminds the reader to use  at least a 30SPF sunscreen every day.

Shalini  Vadhera is a celebrity make -up artist and has  her own line of products called Global Goddess.  I was very impressed that,  unlike some doctors, she did not  use her  book as a shameless self  promotion for her products.  She mentioned her   products  a  few times and  just where it was appropriate. Nice.

Retin A  was actually originally  developed and approved for acne  management.  This vitamin A derivative helps the skin to empty  pores clogged with debris, shuts down overactive oil glands and helps skin turnover to reduce discolorations from old acne eruptions.   This process includes flaking off old dry keratin that is contributing to blocked pores and breakouts. Some peeling and flaking is necessary and actually good.  However   you need to keep it under control to avoid too much redness and irritation.

The  solution  is to allow  Retin A to do what it does best. Twice a day use an extremely gentle  oil-free cleanser such as Cetaphil Gentle Skin Cleanser and apply with damp cotton pads. Rinse off with handfuls of lukewarm water. Even a washcloth can be too rough in the first months of Retin A treatment   Start by using Retin A every other night and gradually, over three weeks, work up to an every night routinue.  

 In the early months of using Retin A  its very import ant to avoid additional irritants such as scrubbing grains or pads, toners and even alpha hydroxy acids ingredients  such as glycolic acid.  It certainly takes  a leap of faith to abandon these tried and true acne aids and simply   trust Retin A to clear your skin– but  that’s the best way to succeed.  These products and ingredients  are  simply too irritating to be used at the beginning of Retin A therapy and can make the skin so red and sore that  people abandon Retin A treatment. 

Using a moisturizer  to control the peeling  can actually  lead to additional breakouts.  If your skin becomes too irritated and flaky,  use a tiny dab of oil-free moisturizer and take a two day Retin A holiday.  In the morning make sure  to use an light fragrance-free oil  sunscreen such as  Aveeno Ultra Calming Daily Moisturizer SPF 30.  Retin A  increases sensitivity to sun damage and its ESSENTIAL to use a sunscreen each and every day– even when its cloudy.    

After six months, you skin will  become comfortable, even bored with Retin A.   At this point you can amp  up the impact by adding exfoliators such as 3M Buf Puf Pads or  my beloved Clarisonic cleanser.  Toners and peels with glycolic acid can   provide additional  benefits  for acne-prone skin.   But if irritation and flaking  reappear,  cut back on the extras and focus on Retin A.

And I am so proud of two  Fashion Flash  friends– Jojami Tyler of Fab After 40 is featured in a full page  ad in More magazine.  She is an Aveeno Brand Ambassador for their new Active Naturals campaign to award eight, $10,000  grants to  people in the community who are making a beautiful difference in the lives of their friends and neighbors.  For  more information on this program,  visit  Aveeno on Facebook.

And  before you  spend a day in the sun, be sure to  pick up the May issue of Redbook and read about Dr Ellen Marmur’s  own experience  with skin cancer.  She shares her before and after pix of skin cancer surgery and it is a vivid reminder to wear sunscreen each and every day.   Dr Marmur is not only a dermatologist, she is vice chair of cosmetic and dermatologic surgery  at Mount Sinai Medical Center where she is THE expert on skin cancer surgery.  Her story has a happy ending and  her scar is now virtually invisible. But her message is clear and strong– WEAR SUNSCREEN every day throughout the year.   Dr Marmur and her whole family  also wears  hats and sun protective clothing   to  lower  skin skin cancer risk.  Reading her story,  I think  you will be inspired to   crank up your  sun protection strategies.