Not seeing skin care results?

It has happened to us all. You get a new skin care product that you are excited to use, only to find months after starting it that you are not getting the results it had promised. Most of the time it is because you have not used it long enough, but get this: it may be because of the way you are layering your products! Many people don’t think about it, but product layering truly does affect product efficacy and results. 

Just as any medication, skin care product ingredients interact with each other and are easily altered by temperature, pH, humidity, and the skin in which they are in contact. Each product is produced with this in mind, and you should keep this in mind when applying the products. 

Science backs the careful thought process that goes into creating each skin care product. For example, waxy ceramics and cholesterol require heat to liquify and mix with other ingredients. Too much heat could damage useful fatty acids or even inactivate some ingredients such as Vitamins C. For this reason, waxy ceramics and cholesterol are integrated first allowing them to be properly mixed and then cooled before adding any more ingredients. 

In the same way the order of adding ingredients into the formulas affects the final product, the order of product placement on the skin affects product efficacy. Important products that interact with each other have ingredients such as benzoyl peroxide, retinoids, hydroxy acids, hydroquinone, vitamin C, and peptides. We recommend that you consult a professional to clarify the order in which the products are applied to improve outcomes!

Caring for the skin around the eyes. Photo closeup.

Lets talk specifics!

Cleansers

  • Cleansers can alter the pH of the skin and influence the penetrability of the skin. Therefore, they should be selected based on the products that will follow in your regimen. For example if you use a foaming cleanser, that will increase penetration and disrupt the skin barrier. You need to make sure that whatever you put on your face directly after you wash with a foam cleaner is gentle and not super drying. 

  • We recommend foaming cleanser for those suffering with acne, so that the prescription medicines applied after washing will penetrate the skin.

  • For people who are dealing with dry, sensitive and eczema prone skin, we recommend creamy cleansers that will not disrupt the water content of the skin.

Eye Products

  • Eye products have many uses. They treat dryness and puffiness around the eye, treat fine lines and dark circles, but they also protect the delicate area. While you sleep your face products get all over your pillow. Applying an eye product before bed will protect your eyes from these products to eliminate any extra eye irritation and redness. 

Moisturizers

  • Like eye products, moisturizers have multiple benefits. They hydrate the skin, deliver important ingredients to the skin, and also protect it. Another thing moisturizers do that people don’t talk about is improve the efficacy of the product that is applied before it. Moisturizers contain ingredients such as hyaluronic acid and oleic acid that can increase penetration of the other skin care ingredients on the skin. Another major benefit of moisturizers is that they prevent the underlying products from getting wiped off. They seal in all the previous product you applied! 

  • Moisturizers can be used after professional grade serums and prescription medicines to provide added benefits in many conditions.

Retinoids

  • Retinoids penetrate easily into the deeper layer of the epidermis. We recommend first time users to apply them on top of the moisturizer to reduce the side effects and increase compliance. If you are experiencing irritation, applying them on top of the moisturizer will slow their absorption rate and reduce irritation. As you build tolerance, you can begin to apply the retinoid first before the moisturizer.

  • You also have to think about the suns UV rays when using retinoids. They should always be applied at night, because they are easily broken down by ultraviolet light. 

Finding the correct way to layer your products in your skin care regimen can be confusing. Schedule a consultation with one of our professionals to confirm what products are most effective and how they should be applied!

Baumann, Leslie S. “Skin Care Product Layering Affects Efficacy and Outcomes.” Dermatology News, May 2018, pp. 22–23.

Skin Protection Controversies and SPF Selection

Recently, people have been worrying about the safety of sunscreens and their ingredients. We are here to debunk the myths and controversies about sun protection and make sure you have the facts!


One thing’s for sure, sun causes most skin cancers which can be deadly. You can talk about the risks of sunscreen and their alleged harmful ingredients, but the bottom line is that they protect you from the potentially deadly risk from the sun’s UV rays. And if you love the outdoors, it is absolutely necessary! A study done in Australia showed that for people who wore sunscreen daily, melanoma was reduced by half and squamous cell carcinoma by 40 percent. That’s such a large amount! This and several other studies have proven time and time again that sunscreen helps to prevent skin cancer.

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While sunscreen is an important sun protectant, you also need to think beyond the creams. The safest method to reduce your skin’s exposure to the sun is to wear clothing and hats and seek shelter.  Sun protective clothing and sun hats are very popular and look trendy for 2019! During the hours of 10 and 2, it is best to avoid direct sunlight, or protect yourself if you cannot.

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When talking about sun protection, we must talk about the common misconception that people don’t have to wear sunscreen if they are in the shade. The truth is that indirect sunlight and reflected exposure can be just as harmful as direct sunlight! (Ever been skiing on a sunny day?) A study done in 2017 showed that 78 percent of participants who stayed in a shaded area outside got sunburned over a 3 ½ hour period, while only 25 percent of those wearing sunscreen did.  Sunscreen alone is not going to prevent sunburn 100%. It is important to combine methods to ensure the best protection. 

There are many brands of sunscreen and each one has slightly different ingredients. Many people worry about chemicals in their sunscreen and seek out the “most natural” one. It’s best to think about all sunscreen ingredients as chemicals, which they are. Yes, there are different kinds of chemicals and they each can act in different ways, but a molecule is a chemical. A better way to look at sunscreen ingredients would be to ask if they are organic or inorganic, and not in the way you are thinking. Organic ingredients are carbon-based molecules, such as oxybenzone. Inorganic ingredients are the minerals zinc oxide and titanium dioxide. A lot of focus has been placed on the ingredient oxybenzone recently worrying about it being a hormone disruptor. A study was done that did show uterine growth in rats eating oxybenzone, but you have to look at the details. During that study those rats were fed huge amounts of this chemical over 4 days. Such huge amounts, that to duplicate that amount in humans, it would take applying sunscreen all over the entire body every single day for 70 years. So, take that as you will, and if it still worries you just use sunscreens that are zinc or titanium based!

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Finding the perfect sunscreen is largely a personal choice. It should say “broad spectrum” so that it protects from both types of harmful UV rays, but other than that you need to find one that works best for your lifestyle. For some people the texture is important, for others is the smell, some parents just want to be able to apply it to their constantly moving toddler. Find one that you love and stick with it! No matter which one you choose the application is extremely important. It is imperative that you apply a thick (like really think) coat on your skin. Most people only apply a quarter of the thickness needed to provide the protection it claims to on the bottle. It is also important to note that sunscreen becomes less effective after about two hours. That means reapplication every two hours is a must! If you are using a spray, make sure to spray in on the body until it glistens in the sun, then rub it in.

Our dermatologists recommend mineral sunscreens and mineral powders. Minerals have broad UV protection and are less likely to cause reactions on the skin. Also, mineral SPF products are safe for babies and children. Have you tried the powders and foams? They totally will change the way you think about having to apply sunscreen… and reapply! Come check out our range of products or visit our online store for our doctor recommended products.

Radiofrequency Microneedling: the Latest in Skin Tightening

There is a relatively new technique that dermatologists are using to tighten your skin. Its called RF microneedling, and Legacy Dermatology Group is proud to offer this groundbreaking treatment!

RF stands for radio-frequency. RF microneedling affects the skin in two ways. You get the physical injury from the microneedling device, along with the simultaneous radiofrequency which adds a heat effect in the dermis (the deep layer of your skin where collagen is formed and rests). This forces your skin to create an abundance of collagen for many months after your treatment. That’s one reason why you see such amazing results.

On top of tightening your skin, this treatment helps with acne, scars, stretch marks, axillary hyperhidrosis (excessive sweating in your underarms), and even the vertical lines some women develop on their chest.

The best part? There is very minimal downtime! The treated areas may experience redness that may last for about 48 hours, but that’s it! Stacked treatments about a month apart will lead to a gradual tightening and rejuvenation effect. You can get this treatment and get back to you routines without missing a beat. Now that’s lifestyle dermatology!

This is Dr. Legacy’s actual patient who can given written consent to have her treatment photos used for our media. Please do not use or reproduce these without permission. Photos are property of Michelle S Legacy, DO.

This is Dr. Legacy’s actual patient who can given written consent to have her treatment photos used for our media. Please do not use or reproduce these without permission. Photos are property of Michelle S Legacy, DO.



Hilton, Lisette. “RF Microneedling Applications.” 19 Jan. 2017.

Can you treat your acne with the right diet?

Acne is a very common skin issue in people of all ages. If you have ever struggled with acne, you may have heard of a few foods to stay away from. You might now avoid grabbing a greasy burger because you believe it will cause a new pimple to pop up, and you might not be wrong. Recent studies do show a correlation between diet and acne, but I bet it’s not for the reasons you think. Let’s take a look at what components of your diet truly cause your breakouts.

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High-glycemic foods

High-glycemic foods are foods that are easy for your body to turn into sugar. American culture has conditioned us to crave lots of high-glycemic foods and beverages, unfortunately. These foods include white bread, doughnuts, potato chips, fries, white rice, and sugary drinks just to name a few. Researchers have found that when people made the switch to a low glycemic diet they had less acne. A study was done placing 2,258 patients on a low-glycemic diet originally to just lose weight, little did they know they would learn something more. Along with losing weight, 87% of them said they had less acne, while 91% of them said they needed less acne medication than before. 

Why do high-glycemic foods increase your acne?

  • High-glycemic foods cause your blood sugar to spike, which causes inflammation throughout your entire body. These spikes also cause your body to create more sebum, an oily substance in your skin. If you can lessen your bodies inflammation and excess sebum, it will lead to less acne!

What’s the best way to change your diet to avoid this?

  • Adding low-glycemic foods to your daily routine is the best way to make the change. These foods include fresh vegetables, some fresh fruits, steel-cut oats and most beans. If you can find a way to incorporate these types of foods into your diet, while eliminating the french fries and milkshakes, your skin will thank you. 

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Milk

Some studies are suggesting a milk to an increase in acne breakouts. Although it is a low-glycemic beverage, a few studies found that all types of milk (whole, low-fat, and skim) have been leading to acne. One study looked at patients aged 10 to 24, who were all seeing a dermatologist for moderate to severe acne, along side patients in the same age group seeing a dermatologist for a different skin condition. They were all asked what they ate and drank on a daily basis. The only difference in diet they found, was the patients being seen for acne drank significantly more milk than the patients with little to no acne at all. 

Why does drinking milk increase your acne?

  • As with many medical conditions, more research is needed to uncover the exact reasoning behind this. One theory is that the hormones in milk cause inflammation in your body which can clog your pores and lead to breakouts. 

What’s the best way to change your diet to avoid this?

  • With all the milk alternatives out there, it makes it easy to swap out the 2% milk in your fridge for perhaps almond milk instead. Maybe try getting coconut milk in your next Starbucks coffee. This change will not have the same effects on each and every person, but as someone who has struggled with acne for longer than they want to admit, anything that could possibly get rid of acne breakouts is worth a try!

What does all this mean for you?

As talked about above, each person will see different results when changing their diet. One thing that dermatologists recommend is that you pay attention to your breakouts and take note if certain foods or beverages seem to trigger them. If you do find a trigger item, what happens if you don’t have that food or beverage for a day, a week, or a month?

If you have questions, or are wondering if you are a good candidate for professional acne treatment, call to schedule a consultation with our Board Certified Dermatologists Dr Michelle Legacy and Dr Lynn Sikorski.

“Can the Right Diet Get Rid of Acne?” American Academy of Dermatology, 14 Dec. 2018, www.aad.org/public/diseases/acne-and-rosacea/can-the-right-diet-get-rid-of-acne.

Everything you need to know about microneedling

What is microneedling? 

  • Microneedling, or collagen induction therapy, uses a powered pen like device with 36 fine-gauge needles at the end. These needles vibrate in and out of the skin, up to three millimeters deep, causing the skin to produce more collagen.

    • The depth the needles penetrate and the speed at which they move is adjustable. Your dermatologist will determine those factors based on the treatment surface area and skin type.

What can I expect during the procedure?

  • First you will put a numbing cream over the entire area to make the procedure more comfortable. 

  • A sufficient amount of hyaluronic acid gel or Platelet Rich Plasma is applied on the treatment area surface to facilitate the gliding of the device.

  • Your dermatologist will then begin the microneedling process by rolling the device over the treatment area making a few passes in all directions over each section.

    • The total time this takes will vary on the size of the surface area and the type of skin being treated. Thicker skin may take a few more passes to achieve the best results.

  • Pinpoint bleeding will occur (nothing crazy, don’t let that freak you out), so after the procedure, cold/wet gaze will be used to clean the surface area.

  • You can expect the skin to stay slightly pink anywhere from three days to one week after microneedling. Nothing to worry about as it is very easy to cover up with make up, which can be used as early as two days following the procedure. 

  • Expect a rough and vibrating sensation during the procedure but very little pain.

What are the benefits of microneedling?

  • The goal of microneedling is to produce more collagen in the skin to rejuvenate it and in some cases get rid of scars. 

    • Skin rejuvenation

      • This is becoming the most popular way to get rid of wrinkles and create a smooth complexion. 

      • Microneedling can also be used to get rid of stretch marks on the stomach, hips or thighs. 

    • Clearing acne and surgical scars 

      • The needles of the device can reach deep scar tissue without the heat production of a laser treatment. 

      • Microneedling can be used on a small surface area when treating a small scar because unlike laser treatments, there is no fear of discoloration.

When will I see results?

  • The ideal results are best seen after the third treatment at intervals of two to four weeks apart. However, some patients will opt to only have microneedling done once or twice a year to maintain their cosmetic outcomes.

  • It takes a little time for the collagen to be produced and remodeled, but this lag time varies for each patient. 

I’ve seen at home microneedling kits on Instagram, do those do the same thing?

  • There have been many at home microneedling kits circulating social media. The bottom line is, they are not safe! And moreover, you are not going to get the results that you will achieve with an in-office microneedling treatment by using one of those at home.

  • There are a few problems with them. 1) There is not a good way to clean these devices at home, so spreading infections you didn’t even know you had is very common. 2) There is no way to sharpen/interchange the needles. Needles dull after just 1 treatment. In-office treatments require the needles to be changed with each treatment to achieve the desired results.

  • Bottom Line: skip the at-home microneedling and contact Legacy Dermatology Group to make an in-office appointment. 

If you are craving a smooth complexion with little to no down time, Consult Dr. Legacy about how microneedling can work for you!

Margosian, Emily. “The Many Uses of Microneedling”. Dermatology World, September 2018: 44-49. Print.

PRP: The New Way to Treat Hair Loss

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80 Million Americans

suffer from hair loss according to the American Academy of Dermatology.

Using platelet-rich plasma (PRP) is not a new phenomenon. It has been used for years as a way to repair joint damage. The most recent use for it however, is to reverse hair loss. PRP has been found to stimulate the hair follicle promoting thick, healthy hair to grow fairly quickly. Injected deep into the scalp, the solution then tends to diffuse into the dermis where it works its magic! The 15 minute procedure, where the PRP is injected in a grid like pattern in and around the affected area, may require an anesthetic numbing cream to make the procedure more comfortable. In some types of hair loss, PRP spawns new hair growth in six to 12 months, with many doctors seeing initial results in as little as three months!

Because there are so many types of hair loss, it is imperative that you see a board certified dermatologist to rule out causes that may indicate other health issues. You may require a biopsy or further evaluation before initiating PRP treatments.

If you are interest in getting a PRP treatment on your scalp, schedule your consultation with our Dr. Legacy to see what PRP can do for you!

“Hair Loss Solutions”. New Beauty summer-fall 2018: 114. Print.