It’s Indian Summer in the redwoods. This is my favorite time of year here in Coastal Northern California. The redwoods are bathed in golden sun instead of shrouded in fog. There’s a spacious stillness to the air and it's the most magical season here. Plus, it's the time I turn my dermatology focus to helping people remove the ‘foot prints of summer’ on their skin.
The health promoting outdoor activities of summer have a negative cosmetic impact on our skin; they're leathering and they darkens age spots and uneven pigmentation. Most of us also have rough feet after months in sandals and flip flops. Both of these dermatologic summer remnants need an exfoliation program. For the age spots, we need pigment lightening therapy as well, which is best done between early fall and late spring.
In my practice, patients know it's time to get down to work rejuvenating their skin after summer. Most of my patients have been with me for years. They know that in the summer we just try to keep the age spots from getting too much darker. We use a good sunscreen, hats, and clothing to keep the sun off our skin as much as possible. Many of my patients have to stop using the powerful skin lightener Retin A (tretinoin) because it makes the skin more sun sensitive and requires really strict sun protection. People often slack off on glycolic acid products in the summer as well because they too create a little extra sun sensitivity, or they just don’t want to be bothered.
As summer winds down, my patients start back on their skin care regimes; they exfoliate, they lighten uneven skin pigment and age spots, they restart their wrinkle treatments. They also come in for cosmetic procedures that work best when they are out of the sun. Here’s some of what we do:
Anti Aging Skin Care Treatment Options for Early Fall to Late Spring in my Dermatology Office
- Restart Retin A/Renova (tretinoin) therapy on the face, neck and chest. Sometimes even on the back of the hands
- Use glycolic acid facial care products either with tretinoin (for the rare few who can handle the combination), or instead of the tretinoin.
- Use hydroquinoin products if they have a lot of uneven pigmentation and pigmented age spots. These products are practical for use on the face, neck and chest and the back of the hands. The most effective are prescription 4% products and include the Obagi Nu Derm system (available in my office by consultation with my aesthetician). I typically don’t like hydroquinone products used more than 6 months at a time and so late fall, winter and early spring is the most effective time to really lighten pigment with hydroquinone here in California.
- Consider a monthly microdermabraision program or glycolic acid peel program with my aesthetician.
- Consider a deeper TCA peel.
- Start IPL (intense pulsed light) treatments with my Sciton BBL. These are usually done in a series of 3 to 5 at monthly intervals or a treatment or two for maintenance. These can only be done if a person is not tan. For darker skinned patients, being on a good pigment lightening skin care treatment first is really important to maximizing their results with IPL.
- Do a single Pro Fractional laser treatment or a series of treatments (2 or 3 treatments at 2 month intervals to really maximize wrinkle improvement). The Sciton Pro Fractional laser is state of the art fractionated laser technology to reduce wrinkles and treat acne scars. Patients have to stay out of the sun after having Pro Fractional treatment, and darker skinned patient get better results if they are on a pigment lightening skin care treatment, so fall, winter and spring are the best times for Pro Fractional laser treatments.
- For the body, using my Glycolic Acid Body Skin Care Kit at least twice a week helps to soften skin and lighten age spots. Many of the lumpy age spots called seborrheic keratosis are also treated with this kit. For stubborn age spots we can also freeze them with liquid nitrogen. We can lighten flat pigmented age spots with IPL treatments or liquid nitrogen.
- Rough feet and scaly feet can be treated with Glytone Heel and Elbow Cream if they are really bad. For feet that aren’t so rough, Glycolic Body Lotion may be enough to remove the thick scale (along with using a pumice stone).
So for me, the Indian Summer means getting ready for the busiest time of year in my office. The schedule gets pretty tight and we don’t have much wiggle room. But it’s also a really satisfying time because I get a chance to neaten up peoples skin and I make real headway keeping their skin soft and attractive.