By Jenifer L. Henderson, MD, FACS
As days grow shorter and much of the country welcomes cooler weather, Americans find themselves shifting their habits—from what they wear and eat to when and how they exercise and more. Though it’s frequently overlooked, skincare should also shift with the seasons. As the air grows drier and indoor heaters kick on, the skin becomes less hydrated, and patients face a different set of environmental insults. It’s worth emphasizing that, while there may be fewer hours of sunlight, UV exposure remains a concern through the winter months. Patients may need to tweak their daily skincare regimens in the weeks and months ahead to support their skin health in the face of changing exposures.
When it comes to integrated skincare, seasonal adjustments can be essential to optimizing outcomes. Patients should use products formulated to protect and moisturize the skin before, during, and after procedures. At SkinCeuticals, we formulate products with patients’ changing needs in mind. So when it comes to moisturizers and SPF, you and your patients can find the right balance of ingredients in the ideal formulation base to optimize the user experience.
Of course, there are some constants, like the antioxidants that are essential to skin health every day, all year long. We are proud of our leadership in the antioxidant space, with recognized formulations like CE Ferulic, Phloretin CF, and more recently, Silymarin CF. As noted by Dr. Jenifer Henderson, these formulations deliver the proven efficacy of our stable L-ascorbic acid in combination with other potent antioxidants to help protect the skin from environmental insults and optimize recovery in the wake of procedures.
Patients make a significant monetary investment when they choose aesthetic procedures—from injectables to surgery. Proper skin care is a simple, accessible, and affordable way to protect and maximize that investment for the long-term. SkinCeuticals is honored to partner with you and your patients in optimizing skin health. — Alison A. Murakami, PhD
VP, Medical Affairs
Why are antioxidant products beneficial in skincare, especially in integrated skincare?
Jenifer Henderson, MD: Antioxidants are important in skincare because they help to minimize oxidative stress on the skin caused by environmental insults.
Antioxidants are important in integrated skincare, because it’s important to get the skin in good condition prior to any procedure or surgery. When patients are in a routine of using antioxidants before surgery, they’re going to continue their use during the recovery period and afterwards. They start to see improvements in the skin—minimizing fine lines, improving firmness and elasticity of the skin—before the procedure.
Antioxidants help optimize results and support recovery. They neutralize free radicals and therefore may help decrease inflammation. Also, it is well known by aesthetic physicians that L-ascorbic acid is involved in all phases of the wound healing.
In our practice, we have patients use antioxidants right away after surgery. And in fact, we put the first application on after ablative laser procedures while they’re still under anesthesia.
Ultimately, patients want to maintain results for as long as they can, and topical antioxidants help there, too.
Every time we do a surgery, we include a skincare surgery kit in the cost of the procedure. For example, for a face lift, we provide a gentle cream cleanser, CE Ferulic, Epidermal Repair, sunscreen—usually Light Moisture UV Defense SPF 50. We also include Antioxidant Lip Repair, because lips become very dry after surgery. We give the kit to the patient at their pre-operative appointment, which is usually two weeks before the surgery, so they can start using the products.
Which antioxidants ingredients do you prefer for integrated skincare?
Dr. Henderson: I use CE Ferulic for most everything ablative or non-ablative, because CE Ferulic is 15% L-ascorbic acid, and I prefer that patient use the highest percentage of vitamin C topically that they can tolerate. If patients can’t tolerate CE Ferulic after fully ablative, we’ll switch to Phloretin CF, with a slightly lower percentage of L-ascorbic acid.
CE Ferulic also has the benefit of vitamin E, which is also an antioxidant that works together with vitamin C to support recovery.
For men especially, we like Phloretin CF gel. It tends to work well post shaving. As opposed to a serum, many men seem to prefer the gel formulation. I also prefer the Phloretin CF for oily skin and for patients that have hyperpigmentation.
For acne-prone skin, I like new Silymarin CF, which helps prevent lipid peroxidation in the sebum, which is a factor in acne production. It’s also very good for oily skin.
Is it important to moisturize?
Dr. Henderson: We know that skin heals better in a moist environment, so we like to have the skin hydrated post any procedure. Certainly, getting the skin in optimum quality before we create an injury or an insult to the skin improves the post healing outcome.
Especially for ablative laser procedures, which I do quite a few of, I like Hydra Balm from SkinCeuticals. It creates a really good occlusive barrier and helps the patient with some itching and discomfort. It’s great for patients with severe dry or compromised skin. I use Hydra Balm until the patient re-epithelializes, and then we usually switch to a product that helps reinforce the skin barrier. This is also a good option for any patient with very dry skin.
We may modify our recommendations seasonally. In summertime, when it’s hot and patients sweat a bit, most people prefer a lighter formulation. Daily Moisture is a lighter formulation that is good for all skin types. If that’s not enough for the patient, typically we’ll add additional hydration with Hydrating B5 Gel; they use that first and put the daily moisturizer on top of it.
In winter months and in aged skin, we tend to like Emollience. They can also use Triple Lipid Restore 2:4:2, which helps improve barrier function. It’s got ceramides, cholesterol, and fatty acids, and it’s good for all skin types. That tends to be a really good product for winter time.
What is the role of topical hyaluronic acid in integrative skincare?
Dr. Henderson: I love topical hyaluronic acid year-round. It’s a great plumper of the skin and lips, and it promotes elasticity and firmness of the skin. We use it following most of the procedures that we do. I like it especially for patients who have had injectables; it adds plumpness and hydration to the skin. It’s a good surface hydrator.
What about UV protection? Why is it important even in the fall and winter when patients may perceive that it’s not as necessary?
Dr. Henderson: UV protection is so important. Post procedure, you want to prevent re-pigmentation of skin that you’ve just treated. We use it right after any procedure that we do in the office, for the most part.
It also is important to protect scars from the sun, since scar remodeling and reformation after an injury can be affected by sun exposure.
You want to maintain results after any procedures. UV protection is important to maintain the results after we’ve achieved a good outcome from whatever procedure we’re doing.
We recommend patients use SPF every day. Patients that tend to have oily skin or don’t want to do a lot of additional skincare or use a lot of additional skincare products can use their sunscreen as a daily moisturizer.
And even in the winter when we don’t have a lot of sun, SPF is important because UV is still present.
Jenifer L. Henderson, MD, FACS
Facial plastic surgeon, Cavalon Aesthetics, Silverdale, WA Associate Clinical Professor, Uniformed Services University of the Health Sciences
