Each year, we highlight new ways of approaching beauty and making ourselves look better without draconian measures. For 2018, our special section on new approaches to beauty goes to … (envelope, please) … the skin! And to start it off, we present you with the hottest thing in Tinseltown: the Red Carpet Facial.

red carpet facial
Turns out, a Hollywood dermatologist has trademarked the name Runway Facial and is selling the treatment to the Hollywood elite for crazy amounts of money.

You can skip the plane ride—and movie star price tag—and get your own version right here. “The purpose of this multi-step facial is to get rid of dead skin and make you positively glow for a special event,” says Dr. Joseph Muccini of MidAmerica Skin Health & Vitality Center. “How we do that is up to you. The four components we offer can be mixed and matched.” He says that while the components are not new, their combination is a fresh take on achieving specific results.

1. Radiofrequency (RF) treatment to the skin is usually done first or it can be skipped, depending on your time allotment, how close the event is and your budget. Muccini uses RF because it goes a little deeper than the surface, creates collagen remodeling (particularly if you do a series of treatments), and heats the skin to increase blood flow and make it look softer and plumper.

2. Microdermabrasion involves mild buffing with a hand-held, Dremel-type device to polish and exfoliate the skin, removing dead skin cells.

3. A cutera surface laser can be used next and is not as deep as RF, but it does improve texture and glow. Over time, if done in a series of treatments, it also smooths pigment irregularities.

4. The last step is a gentle chemical peel that removes any dead skin cells microdermabrasion might have missed, giving a smooth, shiny finish. As with the other steps, the depth of the peel depends on how much time there is before the event. If you have two weeks, a deeper peel will produce even better results, but it requires a few days of down time.

“The microdermabrasion and chemical peel get rid of the stuff that keeps your skin from looking its best: dead skin cells and surface irregularities,” Muccini explains. “The RF and laser increase blood flow and water to the skin, making it glow and have a youthful radiance, so you are ready for the carpet.”

ditch the harsh retinol
Ideally, a skincare regimen should work with your skin type, diminish encroaching fine lines, reverse sun damage and increase the thickness of the dermis. However, prescription Retin-A comes with a price beyond the cost: redness, itching and skin peeling.

But it’s not necessary. Dr. Michele Koo, a plastic surgeon in private practice and creator of Dr. Koo Premier Skincare, has developed Rejuvenate, a medical-strength retinol with additional antioxidants to stimulate skin cells to regenerate more rapidly and replace damaged skin with younger, healthier cells.

A unique feature of Dr. Koo’s product is that it comes in different strengths:
>> Rejuvenate Gentle is for sensitive skin that cannot tolerate any retinol due to irritation. Koo says this is a lifesaver for the redhead or fair-skinned individual who desperately needs damage prevention, wrinkle reduction and skin revitalization.
>> Rejuvenate Moderate is designed for the next level of intervention for skin with mid-level
wrinkles and damage.
>> Rejuvenate Advanced may be needed for skin with deeper wrinkles and advanced sun and age damage.
>> Rejuvenate Ultra, the highest strength retinol, is for skin with deep wrinkles and severe sun and age damage.

Koo explains that the gentler solution with antioxidants requires four to six months before improvements are noticeable rather than the typical six weeks. “You will achieve astounding results with consistent use of a simple, pH-balanced system of skin care,” she says.

the chin is in
Many of us first recogize the signs of aging around the jaw with development of a ‘second chin’ or a softer appearance. Firming up calls for a combination approach, says Mary McKaig, RN, a cosmetic nurse with Laser & Dermatologic Surgery Center.

“Many of our clients have a laxity to the jaw area and some fat under the chin, but they aren’t ready for a face-lift,” she says. “I use a combination approach that sometimes can be done in one treatment or multiple ones over time, depending on budget and desired results and downtime.”

McKaig has several tools in her toolbox that, when matched to the individual, can achieve striking results:
>> Thermage under the chin and along the jaw line: This one-time, noninvasive radiofrequency therapy can achieve mild lifting and skin tightening and stimulate collagen growth. It is a combination of heat energy to treat deep tissue and cooling effects to protect the skin surface and deliver better patient comfort.

>> Kybella: An injection of synthetic deoxycholic acid under the chin that destroys fat cells so they no longer can store or accumulate fat. On average, three treatments will produce noticeable results.

>> Dermal filler along the jaw: This can give further lift and contour to the jaw. Fillers like Radiesse, Juvederm Voluma or Restylane Lyft last one to two years.

>> Topical firming cream: Nectifirm by Revision helps with lifting and tightening of the skin. Nectifirm is a specialized cream containing peptides, vitamins and plant extracts to tighten the neck and relieve the ‘crepe-like’ or leathery epidermis of the neck and décolletage. McKaig says it should be applied twice a day for best results.

from adolescent acne to adult rosacea
Rosacea is the scourge of of middle age. It’s a common skin condition that causes redness, visible blood vessels and sometimes small, red bumps on the face. These signs and symptoms may flare up for a period of weeks to months and then diminish.

The FDA recently approved a topical treatment for the flushing of rosacea, Rhofade cream 1%. Dr. Natalie Semchyshyn, a SLUCare dermatologist, explains how rosacea acts: “Skin that flushes in response to triggers like heat, spicy foods, red wine, embarrassment or cold can develop a permanent redness over the cheeks, nose and chin. That’s what Rhofade addresses.”

She says the cream acts as a vasoconstrictor, causing the blood vessels under the skin that dilate in response to triggers to constrict and become less noticeable. It takes 30 to 60 minutes for the  effect of the cream to kick in, but it lasts for 12 hours. It disappears into the skin, and you can apply makeup or sunscreen over it.

Broken blood vessels under the skin caused by sun damage and pimple-like eruptions need additional treatment. Semchyshyn says a good skin care program will attack rosacea on all fornts: Use Rhofade for red flushing. Apply sunscreen with zinc oxide daily because it protects best against UVA rays that stimulate rosacea. Use topical antioxidants like Vitamin C to strengthen the skin after UV damage. Take oral antioxidant supplements to prevent DNA damage from sun exposure. Avoid the triggers that cause flushing. Get laser treatment to get rid of broken blood vessels.

a special place for men
First there was the lifestyle center, which mostly caters to women. But medical director Dr. Richard Moore wanted a place geared toward his male clients, so he opened The Edge for Men next door in Clayton. “It has a private entrance and separate areas for men,” he says. Here, he offers a wide variety of medical and cosmetic services: hormone therapy for low testosterone and erectile dysfunction, hair replacement, laser hair removal, body sculpting, and anti-aging treatments such as Botox and dermal fillers. Turns out, men want to look good too, just discreetly.

Not surprisingly, the hormone therapy has attracted many clients. “When men are in their 40s through 60s, their hormone levels drop,” Moore says. “They start having mood changes, trouble in bed and fat deposits around the middle. Some men treat low T by giving themselves weekly injections, which cause peaks and valleys of effect. We use bio-identical hormone pellets, which take 5 minutes or so to inject and last four to six months with a more steady release to reverse or stabilize hormone levels. It’s a much nicer way to live.”

For hair replacement, Moore has found NeoGraft the most reliable and natural looking way to replace hair. It uses an automated punch to score the follicles to be harvested. The tiny grafts are extracted from the lower areas of thick hair and implanted in the sparse areas, resulting in a fuller, more natural-looking hairline and increased hair density where loss has occurred. Laser hair removal is also popular, especially on the back and neck. Body sculpting with gentle liposuction can get rid of love handles and other stubborn fat deposits in men who are at or near their ideal weight.

new skin: just a few needles away
Who needs crows’ feet, acne scars skin laxity and texture issues? If those are your concerns, you need to get needled. Infini high-intensity focused radiofrequency microneedling, to be exact.

Carol Anderson, a board-certified nurse and owner of Nouveau Medspa, explains how it works. “Infini has a small head that delivers fractionated radiofrequency energy through 49 gold plated, polarized microneedles,” she says. “They are very thin, and the gold plating protects the skin as it goes in. RF energy is conducted across the needles, generating heat below the skin’s surface.”

Earlier RF machines delivered energy to a plate on the surface, but later models evolved to achieve deeper results, and healthy skin is interspersed with the skin treated by the needles. The depth of needle penetration depends on what is being done; deeper lines need deeper treatment. Overall skin tightening and collagen remodeling are the deepest. Acne scar treatment depends on the depth of the problem and if you’ve had any prior treatments.

The operator establishes the depth, amount of heat and length of time the RF is delivered by carefully assessing the problem. “It depends on how much perfection you want,” Anderson says. “With fine lines, one treatment will make a difference, but it will be even better with two or three. With folds and skin laxity, one treatment gets you started, but it will take two or three to make more dramatic changes.”

She says treatment results are enhanced when they use PRP (platelet-rich plasma) after microneedling. PRP uses your own cells to rejuvenate the skin, and when the channels are opened by needles, it gets in much more effectively. Downtime is about three days with mild swelling, pinkness, and sometimes tiny needle marks, but after that, the skin looks totally normal—only better.

old memories, be gone!
Nothing says beauty like an old tattoo from a past relationship. Sometimes the biggest skin blemish is a bad decision made years ago. But there are ways to fix it. The Cutera Enlighten Laser not only removes age and sun spots, it also does a bang-up job taking off tattoos. Heather Faupel is a certified laser technician with St. Louis Vein Specialties and the office of Dr. Norman Bein. They can treat all colors of tattoos or skin spots using the laser’s three different wavelengths.

“Tattoo lasers have been around since people have wanted them removed, but some don’t break up ink as well, or can cause scarring,” Faupel says. “We tested a lot before deciding on the Cutera.” With it, she sees significant fading within a week, and anesthestics make it pain-free. While it might take four to six treatments to totally remove an unwanted tattoo, clients can see significant results after one.

How long it takes to remove a tattoo depends on its size and the type of ink used. Aqua colors and metallic inks are the hardest; black and red are the easiest. But they all can be removed. Faupel says for large tattoos, they work with one small area at a time. Some people stop treatment when the image is small enough to conceal under clothing. “We want clients to be happy with the outcome,” she says.

beautiful skin from the inside out
A discussion of beauty advances wouldn’t be complete without the latest in supplements, which can be taken internally or used topically. And in this case, new is actually very old, says Afua Bromley of Acupuncture St. Louis & Wellness Center. “There are several preparations I’m using in my practice now, some of which are ancient, that are just getting the research confirmation to back up what many of us have known for years,” she says.

Bromley has several things she’s excited about:
1. Astragalus (Huang Qi): You can find it at health food stores and on Amazon. The herb comes powdered or in capsules in the U.S. Internally, Bromley says it helps cells and DNA replication, lengthens telomeres (the caps at the end of each DNA strand that protect our chromosomes), and protects against mutations, including cancer. It has no taste and no known risks, and the powder can be added to food. It also can be mixed with skin creams or toners to treat skin issues. “It’s a mild but effective herb,” Bromley says. “In China, they give it post-operatively through an IV to speed recovery and reduce complications. We’re starting to see it in beauty magazines.”

2. Franincense (Boswellia): Bromley uses this in her practice, and its anti-inflammatory benefits are getting a lot of publicity. It can be taken as a supplement, and Whole Foods sells twice-daily capsules. It also is used as an essential oil to help treat basal cell skin cancer. As a prevention, particularly if you are prone to skin cancers, she recommends adding one drop to an ounce of facial moisturizer to use daily under sunscreen.

3. Goji berries: These are known for their antioxidant qualities. Many women drink goji berry tea, made with five or six cut berries placed in boiling water, after menopause to help skin retain its moisture. You also can put them in the bottom of your water bottle, refill throughout the day and then eat them.

4. Black sesame: Add black sesame seeds to food or make them into a paste to keep your hair dark. It is known to combat graying or thinning hair and hair loss if eaten on a regular basis.