About: Dr. Papantoniou

See Dr. Papantoniou’s recent interview by Glamour Magazine: see below the interview questions, and visit the site for more information: http://www.glamour.com/lipstick/blogs/girls-in-the-beauty-department/2015/06/can-you-over-moisturize-in-the

Is it possible to over moisturize your face in humidity? (and how to know if you are)

An optimal skin care regimen should be flexible and climate should really be taken into account when choosing the right products to use and how much to put on. We frequently discuss how to take care of skin during periods of cold weather and low humidity, but we often dismiss the management of skincare in humid climates. High humidity can provide a moisture rich environment for your skin, but can be challenging for patients with oily skin types and for those with acne prone skin. The extra hydration on the skin and lack of evaporation can lead to a residue build up on the skin which can result in clogged pores. It can also cause makeup to run and look shiny or dewy.

I often recommend changing up creams that were being used in colder and drier climates and switching to lighter lotions or serums, which are non-comedogenic. A good example of a very nice light lotion with SPF 30 is Cerave AM Lotion. The amount that should be applied will be different for each person, you want to have enough so that the lotion easily rubs into the skin and disappears. Powder makeup or light lotion based makeup that is oil free will perform well in high humidity. A good finishing makeup setting spray can be used to help prevent makeup from running as well.

Are you using the right anti-aging products?

There are so many options available when it comes to anti-aging creams, lotions, serums and cleansers. I am asked on a daily basis by my patients what really works and what do I recommend. As a Dermatologist I have found through my experience and extensive research that you should be looking for several key basic elements and ingredients when selecting a product to help reverse and prevent the signs of aging. Ask yourself if your regimen and creams provide:

1.  Broad Spectrum SPF 30 – 50 daily moisturizer.

This will help prevent sun spots, discoloration, melasma, fine lines and wrinkles from collagen and elastin break down, and prevent DNA damage and risk for skin cancers.

2.  Retinol or Retinoic Acid 2-3 times per week, or nightly as tolerated.

This will promote your skin cells to produce more collagen, even out skin tone, and is clinically proven to improve fine lines and wrinkles. This is the gold standard in skin care for rejuvenation and prevention.

3. Vitamin C: can be used in the morning or evening.

A strong antioxidant, and skin brightener, this can help reverse daily damage from free readicals and even out skin tone. May also help with the appearance of fine lines and wrinkles.

4. Hyaluronic acid serums or creams.

This may be used alone or in combination with the other recommended ingredients listed to super hydrate your skin cells, and instantly improve the appearance of fine lines and wrinkles. Some studies have also linked Hyaluronic acids with skin regeneration and increased collagen production.

5. Green Tea Polyphenols, Resveratrol, Edelweiss

These are powerful antioxidants and free radical scavengers that are anti-inflammatory, and help to promote cellular health. They have the potential to increase your skins ability to heal and repair from photo-damage as well.

If your regimen does not include the top 2 important elements: sunscreen and retinol/retinoic acid you may want to consider adding these. I will mention that there are some people, especially those who are rosacea prone or have eczema, that may have flare ups of their conditions with a retinol/retinoic acid cream and so should omit this from their regimen if they note worsening. 

What about growth factors?

Well, there is a new wave of cosmetics for anti-aging purposes that contain growth factors, some of which are plant derived, and some derived from living cells. These growth factor aim at specifically stimulating cell growth and production of collagen. I won’t get into the controversy over the use and origin of these growth factor containing ingredients, but I will mention my hesitation with recommending these products. In order for an ingredient to have an effect on the cells in your skin, it must first be able to cross your skin barrier and be able to migrate across cellular membranes, I am not sure that all these growth factor creams/serums are truly able to accomplish this and are truly effective. And as a precaution if you have a history of skin cancer or are at a high risk for skin cancer I would reconsider using these products on your skin, a growth factor has the potential to increase the growth and turn-over of many cell types and may pose a theoretical risk. On the other hand, the use of topical Retinol/Retinoic acid is beneficial for reducing the risk of developing certain types of skin cancers.

Décolletage, “the scoop” —

Looking to prevent or treat a leathery appearing chest? Read here…

So maybe you yourself have, or maybe you know somebody who has the telltale sign of aging on the chest…you know: age spots, sun spots, red blotchy patches, and a crinkled appearance to the skin on the chest extending down into the cleavage, the so-called “décolletage.” Well, if this has become an area your are beginning to notice more, especially when you are wearing more summery attire or dresses and lower cut shirts, you are not alone. I am treating this routinely for women who come in seeking rejuvenation to this area. I am able to accomplish this very simply with laser treatments and careful assessment of the topical regimens that are being used. I am using the Fraxel dual laser for resurfacing of the crepiness and discoloration and brown spots, I use the Ulthera to tighten lax skin and also firm crepiness, and I use Pulse Dye Lasers to assist in reversing damage to blood vessels and eliminate red blotchy patches if they are present. For some patients I am able to use a combination of these laser treatments when all 3 are necessary, and the results are phenomenal.

Tips: Key to prevention is Sunscreen and minimizing sun exposure to these areas. Using a topical retinoid can help with the appearance and help prevent signs of aging. Keeping the skin hydrated with a delicate moisturizer will also help plump up skin cells and create a smoother firmer look to the skin.

How to both reverse and prevent age spots on hands!

How did these get here? You may be wondering. Well, it may not be from your vacation over the winter, or even what you did last summer, these “age spots” or solar lentigos are really a product of sun exposure and possible sun burns that occurred from childhood and young adulthood. To prevent further development and help fade the spots present daily sunscreen with minimum SPF 30 uva/uvb spectrum is necessary. Using a retinoid topically can long-term prevent the formation and help to fade marks that are already present. In my practice I am using the Fraxel to help treat these “sun spots” on the face, neck, chest, arms, shoulders, upper back, and backs of the hands. The Fraxel is a resurfacing laser with minimal downtime, and patients have the ability to cover the areas treated with make-up shortly after a treatment. This laser takes 2-5 sessions depending on the extent of sun damage present, but the results are incomparable to any other laser that I have seen.

Tips: Keep sunscreen in your car, possibly a spray for the backs of your hands, or you can invest in a pair of SPF driving gloves that you keep in the car. When we are driving the windshield does not eliminate all the harmful rays from the sun so protect your hands. And if you are active with outdoor sports (tennis, jogging, etc.) apply sunscreen to the backs of your hands and reapply every 2 hours. At night put a small amount of retinoic acid containing cream to the backs of your hands, neck and chest and face to help rejuvenate the skin.

For a lip you can bite into. All the information you need to know about getting fuller lips!

It seems these days that everyone is talking about lips, I get many patients who request “Kim Kardashian’s lips”.  I find that there is really a balance, between improving the shape, contour and volume of the lips, and at the same time maintaining a natural look that does not look fake. Indeed with the use of fillers women can now have lips that they never had, and help to regain lips that they lost with aging and sun damage. When filling the lips if the cupids bow or philtrum is weak, recreating this feature can help attain a beautiful look. The lower lip is usually fuller naturally than the upper lip, so we try to maintain these proportions when correcting lips with fillers. The lips are a very sensitive and delicate area, they tend to swell after fillers for 1-2 days, but this does go down and can be sped up with cool compresses. For most patients I will apply topical numbing ointment prior to starting, or even applying an ice pack to the area can help for the discomfort of the injections. But overall, most people do just fine with lip fillers, and the fillers often have numbing medication already premixed so the areas become numb. There are instances when people may be tempted to overfill the lips, but at the hand of an experienced injector this can be avoided. Overall, I enjoy rejuvenating and volumizing lips with fillers and highly recommend it for anyone interested in improving their lips.

Now you can finally banish those fine lines and “smoker’s lines” around the mouth!

I am seeing more and more patients who want the lines around their mouths treated. Many of these patients have never been smokers, and are confused about why they are developing wrinkles. The answer is that there are many factors that contribute to the development of “smokers lines”: genetics, sun damage, repetitive drinking from water bottles and drinking from straws are all contributing factors.

To prevent the formation of lines daily sunscreen use is important with a minimum SPF of 30, and regular application of a topical retinoid can help stimulate collagen production in your skin, you also want to avoid drinking from straws and water bottles. In addition if we can help prevent the perioral muscles from contracting strongly with Botox we can help soften the lines and even prevent lines from becoming deeper.

Fillers such as Belotero, Restylane, and Juvederm Ultra are all helpful for treating lines around the lips. My personal product of choice out of the fillers for the fine lines around the mouth is Belotero. Belotero is a great product because it is specialized to treat very fine lines and is safe to use very superficially in the skin and really looks seamless, and lasts around 6 – 9 months depending on the patient.