“Dermatologist-approved”; “dermatologist-tested”; “dermatologist-recommended”; “preferred by more dermatologists”; “listed by the American Academy of Dermatology”, “doctor-brands”–what does it all mean? A lot of companies are using those words, and I want you to be smart, educated consumers, so let’s face the facts.
A skincare product that is labeled “dermatologist-approved” (or tested, or recommended) only means that at least one dermatologist says that he likes it. Not the majority of physicians, not the best ones, not licensed ones; not independent ones, not even a panel. Just one. Of course, some dermatologists are more than willing to accept the generous checks proffered by unscrupulous skin care companies to “test” their products. They like to euphemistically call it an “honorarium”, in fact, sometimes it’s nothing more than payola.
I was offered $25,000 recently by a skincare company who wanted me to “approve” their new product. They didn’t want me to study, review, or test it. Just approve it. I not-so-graciously declined.
Even some of the biggest and best pharmaceutical companies can be unethical and deceptive. Case in point: just a few months ago Pfizer featured Robert Jarvik, the inventor of the Jarvik artificial heart, on their ads for Lipitor. You surely saw their commercial— Pfizer spent more than $200 million promoting their blockbuster cholesterol drug. Dr. Jarvik is neither a cardiologist nor a licensed medical doctor, and he can’t prescribe pharmaceuticals. He was shown in the ads vigorously rowing across a mountain lake— but they used a body double—Dr. Jarvik doesn’t actually row. Due to criticism from Congress, Pfizer pulled the ads in February. Pfizer admitted that they were deceptive.
Another anecdote—remember when Johnson & Johnson claimed that “more hospitals trust Tylenol”. That’s because they had massive give-aways to hospitals. All the hospitals gave out Tylenol because they had so many free samples. J&J knew that people would be more likely to buy Tylenol if it was dispensed by the hospital. And of course they were right. But does it mean that hospitals trust Tylenol? Maybe. I think it means that hospitals give out free samples.
Be wary of all of the claims about skincare products that purport to be backed by a doctor. You need to make decisions for yourself. Skincare products are complicated, and their marketing is pretty slick. Ask questions about the safety, effectiveness and potential side effects. Read labels. It’s a little bit harder that way, but it’s a better decision-making process.
Zein Obagi, MD
Hello – I have been following your posts on this blog for a while and I must say, you’ve come to garner my respect. Although I’ve always been wary of dermatologists (and especially estheticians) who comes out with their own skincare line – because I, perhaps unfairly, believe they can use their “M.D.” status as a way of gaining consumers) I am interested in your skincare line.
I am 100% Korean and am currently using Finacea & Differin – are there any products that you recommend I take out? Or do you think I can still use your entire line while using these two prescription topicals?
Hi, Saku:
You’re so right; being an MD (or esthetician) is not a good qualifier for a developer of skincare products. No dermatologist was taught in medical school how to formulate; we were taught about the physiology of skin and disease; and the word “cosmeceutical” was never even mentioned. In fact, we weren’t taught about healthy skin at all–only about skin pathology. Many of the doctors who are behind doctor-brands of skincare don’t practice at all. I know of a plastic surgeon in Beverly Hills who is great with butts and noses, but he doesn’t know anything about skincare; yet he has his own line of skincare products.
Anyhow… let’s talk about you.
There’s no contraindication for ZO Skin Health and Differin or Finacea; you can certainly use them together. You don’t need the entire line, though!! Just a few selected products, and I’m sure you’d be fine! If your rosacea and acne are under control, you may not need any ZO products designed for oily skin (for example, the TE pads may not be necessary).
Thanks for your nice words.
Zein Obagi, MD
What products from your line would you recommend, then? Fortunately, I do have my acne & rosacea under control – I’m now interested in preventing aging and in trying to alleviate the oiliness on my face (if this is possible to do with skincare products).
Saku:
You can alleviate the oiliness, you can’t eliminate it. Oily skin is due to a lot of multifarious factors, so there generally is no quick or easy fix.
You may want to try:
AM
Exfoliating Cleanser (wash no more than twice a day, with lukewarm water)
Exfoliating Polish (2-3 times a week). More frequently is OK but may not be necessary. It’s good at deep-cleaning pores. Use it in the shower.
TE pads (one pad, over your whole face, do not rinse off). Wait until completely absorbed (less than a minute)
Daily Power Defense
Oclipse Sunscreen
PM
Exfoliating Cleanser (other cleansers will also work, BTW, but you want something that’s not too harsh, as it can increase oiliness)
Ossential Growth Factor Serum
If you need medical treatment for anti-aging, you may want to ask your physician.
Thanks.
Zein Obagi, MD
Dear Dr. Obagi,
I found your comments on “Doctor Who?” very reaffirming. I just this week, had a facial by one of the aetheticians at my new dermatologists office. Although I totally enjoyed the facial, I have not had one in years to my dismay at the conclusion of it came the “up-sell” of the products she used.
She is aware that I am now on NuDerm maintenance and I have minor rosacea on my cheeks and nose, she termed it “typical butterfly pattern”. She wrote down her prescribed regimen for me incorporating
MuDerm maintenance along with some of the “Dermaware” products she used
and sent me home with a few samples. One sample is Vitamin K serum for my rosacea (Willow Herb, which I know is already in your Ommerse Daily Renwal Creme that I already use).
Bottomline, I enjoyed the facial and found it rejuvenating, to further enhance my skin’s response to your products.My disappointment came in the sales job I received at the close of the session. I probably should not have been surprised but by her own admittance, she is not that familiar with NuDerm Obagi. Lesson learned… Guess I should have seen this train coming…
I believe in you, your credentials, dedication to your profession and your research into the products within your skin care lines. NuDerm and the ZO Skin Health products I have incorporated as part of my maintenance regimen are working wonderfully. Why mess with success?
I have an appointment with my new dermatologist at the end of this month, it’s time for my skin cancer screening (previous actinic keratosis spots).
Thank you for your honest and open words of encouragement. I greatly appreciate the care you take with all of your patients.
Anne
Hi, Anne:
Thanks for your nice words. I understand and agree with your sentiments on having aestheticians recommend products. It can be annoying and often is not appreciated. But there are many aestheticians who do love skin, believe in their products, and recommend products because they genuinely care about your skin. After all, they just spent an hour looking at your face, sometimes using a magnifying glass–whoever gets so upclose and personal with your pores! I’m sure they also meet many people who think that they can have a facial once or twice a year, and expect that one facial can compensate for months of neglect. As you know, it doesn’t work that way.
It’s great to hear that you’re continuing to get good results by combining ZO and Obagi NuDerm. Keep up the good work, and thanks for taking your skin cancer screenings seriously.
Zein Obagi, MD
Dear Dr. Obagi,
Referring to my previous blog, I am rethinking my choice of dermatologists to see soon. There is one who is an Obagi Diamond Club physician, well versed I assuming with your regimens and how best to guide my skin renewal using NuDerm Obagi.
I am having second thoughts about seeing this other dermatologist whose aesthetician performed my facial. My instincts are beginning to tell me that there has the potential to exist a bit too much self promoting of the “Spa” image, including a personal line of face cream(s)ie. retinoids.
Since I have been on maintenance a month now, my fce is still uncomfortably dry, especially peri-orally even though I am using the Daily Renewal Creme after the application of the Obagi 20% Vitamin C and I am using the Night Recovery Creme in the evening after I use the Growth Factor Serum. When I use the 0.05%/Blender in the PM, I do not use a moisturizer on top of that. I am still using Clear on M/W/F, followed by the Vitamin C and the DRC. On the alternate days, I only use the ZO Skin Health.
Please tell me if my dryness normal still at this point. As for the change in dermatologist, it’s a matter of going to someone who I think maybe better versed with your proceedures and skin care line. Like I said, I may well be incorrect in my thinking but I think I will feel more comfortable following my instincts.
Thank you for your quick response, I only wish I lived close enough to see you.
Anne
Hi, Anne:
As for your dermatologist pushing their own brand of skincare–that’s not unusual. Many of them do now. Even some of the biggest and best physicians have diversified their practices to cosmetic dermatology, offering facials, aesthetic procedures, etc.. I have an aesthetician who works in my own practice. So please don’t assume that just because they offer facials, or they have their own private-label line diminishes their credentials.
I am not encouraged, though, by the quality of anti-aging skincare products that many of these doctors can offer. Many come from companies that just do private labeling for you-name-it-doctor, or they buy stuff off-the-shelf from a local lab. They’re not necessarily “bad”. I don’t believe that anybody intentionally makes bad products. But are they effective???
Note that I’m not claiming that only products that have Obagi on the label are good. There are functions that we don’t offer, and that can be good accessories to an Obagi/ZO program. There are also conditions that we don’t treat.
Now, let’s talk about you. I don’t understand what would be causing the peri-oral dryness. You should not be experiencing continued dryness at this point. We will mail you some samples of Ommerse Daily Renewal Creme. Are you using that in the morning? Apply the Ommerse Overnight Recovery Creme on top of the tretinoin and Blender. If that doesn’t resolve the problem, there’s something that we’re missing.
If that doesn’t relieve the problems, please advise. Let me know how you do.
Zein Obagi, MD
Dr. Obagi,
I am so glad to receive your response of July 14 and I do apologize for not having replied sooner.
I did receive your generous gift of Ommerse Daily Renewal Creme and I have been using it every morning following Obagi 20% Vitamin C and Clear (M,W,F only). I had purchased the Ommerse Overnight Recovery Creme as part of the “Girl’s Night Out” and have been using it but only following Ossential Growth Factor but not following Tretinoin/Blender (M,W,F only). On the weekends, I have been strictly using ZO Skin Health, avoiding the HQ. With the NuDerm maintenance, a moisturizer is not mentioned following the Tretinoin/Blender so I have not been doing it.
I have had a problem with dryness in the “T-Zone” area for a number of years now, probably after the hysterectomy even though I use HRT. This is true regardless of what skin care line I used, especially peri-orally I needed additional moisture. There is a “new” wrinkle that has made its longtime presence known to me right in the middle of my chin, spanning almost the entire length of my bottom lip. Now I have since learned from your Obagi Inner Circle group that as the skin renewal progresses, things such as wrinkles that “you did not know existed” will be revealed. this particular wrinkle is also in the “area” of concern and I want it minimized or better yet gone. Actually it is more of a crinkle, not a deep wrinkle but it’s new to my looking at my face in the mirror.
Right now, this is where I am experiencing the most flaking/peeling. This is also where the first AK appeared above my upper lip. I am confused too, very much so. I have Tretinoin 0.1%( under this other dermatologist’s private label) which I concur with you completely. It’s not to say that it is necessarily inferior but I also do not know what is in it. Not to throw anyone under a bus but it comes in a jar as well which exposes more of the product to air everytime I use it or that is when I use his 0.1%. I have been a bit hesitant as I do not know what is in it and it’s use in conjunction with Blender.
I still have some Tretinoin 0.05% to mix in equal parts with Blender and follow with Ommerse Overnight Recovery Creme. I am so grateful to have you to help guide me. I aknowledge the fact that you can not see me face to face which places us at somewhat of a deficit however, no one knows your skin care lines better than their creator so I greatly appreciate your advise.
I have an appointment on July 27th with a Obagi Diamond Club Member Dermatologist and it is my hope that she will be more knowledgable with your protocols than the one whose aesthetician I saw.
I welcome and desire your input with the full understanding as well as appreciation of the fact that she will have the benefit of actually seeing me face to face. I like being knowledgable so I can make informed decisions. I want to do what is best for my skin safely with the right method in order to achieve the best, maximum results.
I look forward to hearing from you when you have an opportunity to respondand thank you so much for your deligence and concern.
Sincerely,
Anne
Hi, Anne:
As for the regimen you describe in your second paragraph: perfect!!!
As for new wrinkles “emerging”–as you heard. Yes, it’s true, that damage that has not yet surfaced will become more apparent–particularly hyperpigmentation and wrinkles. As you slough off the dead, dull, dry epidermis, the “next generation” of skin will become more visible. It’s only part of the regenerative process, however, and as that damage begins to surface, it too will be repaired.
As for your third paragraph: tretinoin in a jar? Never heard of that! Yes, you’re right, the retinoic acid will deactivate when exposed to light (more so than being exposed to air). This process is called photodegradation. That’s why Retin-A is normally produced and packaged in a metal tube or a plastic tube that has an extra liner (so it’s twice as thick). I’d like to see a photo of the tretinoin in a jar. Would you mind sending one to me?
OK to use the .05 in combination with the Blender, but use that and the Ommerse Overnight Recovery Creme on alternate nights–unless you really need it for the peri-oral dryness.
Thanks, and I’m sorry that I didn’t respond quicker. Hope you like your new dermatologist!
Zein Obagi, MD
Dear Dr. Obagi,
Thank you for your reply and I have been to the “new” derm, had a few AK spots frozen, which I didn’t this visit because now I have 5 blisters on my face (normal rx for me, wherever liq. Nitro is sprayed result in 2nd degree burns requiring silverdene cream) and my birthday is on the 29th. Now I have to figure out how to camoflague these things for dinner out with my husband. But I digress…
Before I proceed, I am not going to throw anyone under a bus and I highly respect you for your integrity as to not to malign nor second guess your colleagues. I am very appreciative of your input, which right now I need to know the right course for me to resolve the issues I am currently experiencing (emergence of the hiding wrinkles and the facial dryness).
Yesterday’s appt. was to accomplish 3 things:
Annual skin cancer check up (done)
Address a couple of AK spots (done, however painfully so)
Address my current skin issues (peri-oral dryness and chin wrinkle)
I had seen this derm, more so her aesthetician a number of yrs ago. In 01/05, I was introduced to Obagi NuDerm the 1st time and after the recommended 18 weeks were complete I was counselled to continue using the Healthy Skin Protection but begin using a different MD’s moisturizer,eye cream and went “cold turkey” on HQ or retinoids, although there is some Retinyl Palmitate in the moisturizer. I was recommended to folow up with a series of 5 IPL treatments and after only two IPL treatments, the end results did not justify the cost, in my opinion and I did not pursue anymore. I did not care for the “sale pitch” feeling I exited the doors with rather than the quality of treatment I should have.
I continued using the above mentioned,recommended products but was
becoming increasingly dissappointed in the appearance of my skin. I then switched completely to a different skin care line after having a mini-facial by the regional skin care rep for that line. I still have some of the hydrating gel mask left and it’s a refreshing, hydrating which I have used just by itself after cleansing, of course.
So, 4 years had gone by since I 1st used NuDerm and my face was showing it’s age, which up until 2003 people always thought I looked younger than I was but in 2008 no one did, especially me. So I took action, came across a derm on the net whose aesthetician started me on the Vivite with the TriLuma, 08/08 and then Obagi NuDerm with Tretinoin 0.05%,02/09.
This long journey brought me to you and ZO Skin Health. My general MD is in partnership with a derm as part of a overall general health and SPA/Derm concept. It was one of their aetheticians who initially recommended my NuDerm Maintenance Protocol and where I had my facial performed. I was introduced and encouraged to purchase the products used with a different maintenance protocol, incorporating NuDerm and this other skin care line. It was at this MD’s office that I purchased the Tretinoin 0.1% in a jar, I later found out we are caring our own line. My husband has seen this derm and liked him. He is listed on the website Obagi.com and so by the way is my OB/GYN although in ALL fairness, as you previously mentioned quite a number of MDs, clinics are broadening their practices in order to cater to their patient’s varying needs.
The “new” derm I saw was the one I initially saw back in 2005 and I am sorry to say I was greatly disappointed with what I was told and the product recommendations/follow up protocols. Once again here comes products from the west coast, same as before. I can read ingredients and I know what to look for, I am interested in the quality and performance of the product. I am not interested nor impressed in pretty, attractive packaging.
I was also surprised by something I was told when I commented on my prior “cold turkey” NuDerm experience. I thought, giving them the benefit of the doubt that perhaps protocols had changed over the years. Well, the answer to that question was that they have patients go off of HQ for 2-3 months because patients can build up a “HQ Tolerance” but as a Maintenance Protocol they recommend switching to Obagi-C Rx System.
Well, I wonder why that was not recommended as my maintnance protocol in 2005? Perhaps it was not developed back then and of course you would certainly know but I was under the impression that Obagi C-Rx was primarily designed more for skin not yet effected by sun damage. To your credit, she did comment that she did not see any evidence of age spots so perhaps that is why she said I did not need HQ?
Everyone is entitaled to their own opinion and to make a living but what I heard was another IPL treatment (for my broken capillaries)and another skin care line’s serum (which I was told would take care of the wrinkles on my chin) and moisturizer. Suffice it to say I did come away with one thing I wanted, Obagi Tretinoin 0.1% in a tube,the rest of the recommended items remained there.
I apologize for being long-winded, please you are a busy man so please do take your time in responding as I vented a great deal of information. My only goal is to not cause my skin harm and to do things right. I am not going anywhere, although after the length of this email you may wish I did. My promise to you is that I will stay the course with what you recommend and I will provide short, brief updates only as needed. So, all of this being said…
Here are the products I have:
NuDerm Obagi:
Cleanser (I find my skin is taut and dry after this)
Toner
Vitamin C 20%
Clear
Tretinoin 0.05% (1/3-1/4 of a tube left)
Tretinoin 0.1% (full tube, brand new)
Blender
Exfoderm (not in use, per your recommendation)
ZO Skin Health:
Hydrating Cleanser
Exfoliating Polish
Daily Power Defense
Growth Factor Serum
Daily Renewal Creme
Overnight Recovery Creme
Olluminate Intense Eye Repair
Oclipse Sunscreen + Primer
I feel like quoting a line from the first “Star Wars” when Princess Leah sent a message which said “Help me Obi Wan Kanoubi, you’re my only hope”…
Thank you for your much appreciated patience, guidance and recommendations. Your loyal client,
Anne
P.S. I’ll send you a photo of the Tretinoin in a jar too!
Dear Dr. Obagi,
Happy Birthday and may you enjoy many, many more!!! Your skin’s appearance is a living example of your skin health philosophy and skin renewal regimens.
I am pleased to say my skin’s dryness dilemma(peri-oral)has seen some improvement. When you have the the opportunity and more particularily, the time available I look forward to receiving your recommendations for my skin care regimen (referring to my reply of July 28th).
It is my hope that given time, patience and proper skin care the “new” wrinkle that appeared on my chin will diminish in appearance.
Again, my sincerest best wishes for your birthday!
Best regards,
Anne
Dear Dr. Obagi,
I replied to your email of July 14 to me on July 21 and when I last looked my reply was still “in moderation”. Now, July 27 “in moderation” no longer shows up but I do not see your reply either and prehaps I am looking in the wrong place.
I realize that you keep a busy schedule and yet remarkably you still find time to reply to emails as well. If you have had the opportunity to reply to my latest email on July 21 and I just do not see it I apologize.
It is just that I am seeing my new dermatologist today and I had hoped to have your most recent reply beforehand. No problem, things will work out as they should and I will let you know her evaluation of the cuurent condition of my skin.
Thank you,
Anne
Hi, Anne:
I apologize for not responding. There was a problem with the blog monitor (this relates to something technical, something to do with social media actionable items, none of which I understand). Now I think it has been fixed.
I will respond to your message of 7/21 separately (and immediately!)
Zein Obagi, MD
I’m curious as to why you use retinol in your Ossential Daily Power Defense product. I heard that retinol is broken down by the sunlight, which is why my dermatologist recommends me to use the retinoid Differin at night, not in the morning.
You are correct, retinol is broken down by sunlight (this process is called photodegradation). The retinol we use in Ossential Daily Power Defense is entrapped in a liposomal system which was specifically designed to significantly reduce the photodegradation profile of retinol, thus making it a fairly unique product – a retinol product for day time use.
Dr. Obagi is a great proponent of giving the skin a steady supply of vitamin A (aka retinol, retinoic acid, etc.), because the skin can’t get enough of it.
Justin Morgan
Vice President
Research & Development
ZO Skin Health
Dr. Obagi:
I live and work in Las Vegas where I am outside all day in the heat and need to know what products I should use. I try to use sunscreen but I am noticing that I am tanning but am getting white spots in some areas that don’t tan. I am 31, so I want to take care of my skin, but am not sure what I should be doing to improve my skin state.
Hi, Stef:
Are you wearing an SPF30 or 35??? Less than that gives you inadequate protection; more than than that gives people a false sense of security that the sunscreen doesn’t need to be reapplied. It also requires the manufacturer to put in an inordinate amount of chemicals. So stick with something like SPF 30, or 35 or 40.
Apply products that are rich in anti-oxidants. It helps provide natural protection from UV damage. Especially for your face, the two in combination provide the best UV protection.
Are you reapplying every two hours? Las Vegas is a scorcher in the summer with lots of direct sunlight. If you’re sweating or rubbing it off, you may need to apply more often.
Hopefully you’re putting on sunscreen–not moisturizer with sunscreen added, or make up with sunscreen added. The problem with these products is that you don’t apply a sufficient amount to get adequate protection. And you don’t reapply them.
As for the white spots. That condition is called depigmentation. Sounds like you have damaged melanocytes (the cells that produce melanin–that give your skin color). They may have been damaged by excessive UV exposure years earlier, and in fact are there year-around, but become more visible when the skin has tanned. They’re harmless, but not easily repaired. Try to avoid getting a tan, and then they won’t be easily visible. It’s the easiest way to make them “disappear”.
Stay cool.
Zein Obagi, MD
Dr. Obagi:
Is there a product that will tighten the area around the upper eye and the neck area that is natural? Because of age, my eye and neck area are the trouble spots. My neck is very long. I have girlfriends that have had plastic surgery on their eyes because of the excess looseness of skin. They, of course, look great, but I prefer to go out gracefully without intervention such as this. I look more like I’m in my 40′s, but I am in my 60′s. I don’t mind the aging, I just would like it to be much smoother.
Claudia
Hi, Claudia:
Hi, Claudia:
I wish I could tell you of some great over-the-counter products that would help tighten eyelids and necks, but I’d be fibbing. In fact, I don’t believe that there are any medical (Rx) products either.
For your neck, I recommend doing facial exercises every morning and evening. Tilt your head back, then open your mouth wide, and then shut. Repeat 25 times. By doing so, you’ll be able to strengthen the lax muscles in your neck, which in turn will tighten them. The problem is, we don’t use these muscles often enough, so you need to make them exercise to firm and tone them. I call them “exaggerated facial expressions”–and they work.
Zein Obagi, MD
Dr. Obagi:
I normally have pretty clear skin, but when I do break out it’s always on one side of my face. Typically, it’s the right side, my left side never breaks out. Is there a reason for this?
Kendra
Hi, Kendra:
Which side of your face do you sleep on? Is that the side that is affected? It could be that sebum and bacteria are accumulating. Try washing your pillowcase every night, or sleeping on your back.
Do you talk a phone a lot during the day, and hold the cell phone or handpiece next to your face? That could be causing contamination.
Is your hair touching your forehead or face? Hair and hair products are sometimes the culprit. Many, many products are comedogenic (meaning they clog the pores). Look for products that are labelled non-comedogenic.
Hope you find a solution!
Zein Obagi, MD
Let me know; I’m curious!
In the past few weeks (about 4-6) I’ve noticed that my body has started breaking out in very small, very itchy bumps at various times throughout the day. Sometimes, it happens at night. They are very tiny bumps and usually go away within 10-20 minutes. If I scratch them, they leave a scratch mark but that also fades quickly. I think it may have to do with my stress levels but since they, seemingly, show up randomly, there isn’t any way to know. Any advice would be helpful.
Hi, Christy:
Is it the same area that becomes irritated, or is it random?
You already know this but it bears repeating. You shouldn’t scratch your skin. Doing so could create microscopic wounds that would allow bacteria or pathogens to enter and lead to infection. I appreciate your honesty, but that’s not something that any dermatologist wants to hear!
If it’s affecting the same part of your body consistently, you should try to determine the trigger, so that you can avoid that. Is it affecting your hands? That’s not at all uncommon, because your hands come in contact with so many different foreign objects. Don’t wear clothing that could be tight. It’s important to allow your skin to breathe (cotton), which is sometimes difficult during the summer, when it’s already hot.
Use mild soaps, without added fragrance.
Apply a lotion to keep your body hydrated, and drink plenty of water.
You may want to apply a hydrocortisone cream (available at drug stores) which is an anti-inflammatory and will help heal your skin.
Hope that helps. Let me know if you have continued problems. Or better yet, if the problem continues, see a local doctor.
Zein Obagi, MD
I use Tazorac every night for my acne. I peel but it keeps my skin clear from “bumps”. I used to use Nuderm (worked fine) but have no skin discolorations now. I just keep using the Taz and would like to know how to incorporate these products (Zo skincare) at this point. thanks
Hello Marianne,
Tazorac is a Retinoid (like a generic for Retin-A/Tretinoin) to treat and prevent acne. It’s a great product, but fails to provide other products necessary to protect and enhance skin. Regardless, of whether you are applying this product daily or on a maintenance basis (2-3 times a week) all of the ZO products can be used in conjunction and will greatly enhance its effects and benefits.
First, ideally you are using the cream form of Tazorac and not the gel form. If you are using the gel from, finish up that tube and then have your MD switch your RX to a cream form. That form always mixes and works better with other skin care than the gel delivery.
You can definitely use the Exfoliating Cleanser twice a day for one minute to cleanse your skin. The Oclipse is an excellent sunscreen to protect your skin against UVA and UVB rays (remember, you are more sensitive to the sun on a Retinoid) and the primer (natural melanin) will help to reduce the appearance of redness from the Tazorac.
The DNA kit is an excellent choice to provide you with all of the components mentioned above and 2 other products that are excellent for use with Tazorac. Remember, the Growth Factor Serum, is applied AFTER the Tazorac on the evenings you use that product.
Thank you,
Dr. Zein E. Obagi
Now that I am approaching 35 I notice that I have more wrinkles than ever!! I also lost 170 lbs and I have some sagging skin on my face. I think I need a face lift but I have been told I am too young by friends and family. I also have very dark circles under my eyes because of being anemic. What do you think??
Hello Angi,
Congratulations on the major milestone of losing 170 pounds. Did you know that beyond the age of 28, one loses collagen at a rate of 1% a year? Further, since at this age skin cells (including collagen and elastin cells) are no longer active or regenerate at the rate they used to, the aging process in the face begins to kick into high gear…This is the reason no one begins to “look younger” or have “firmer and smoother skin” as they age. The good news is that skin cells are one of the only cells (other than gastrointestinal cells) that are capable of being regenerated. Retinoic acid and it’s derivative retinol (which converts into Retinoic acid) can regenerate cells. Therefore, in terms of the wrinkles you are noticing more, it is possible to stimulate collagen and elastin and correct your skin. ZO Skin Health products all contain high concentrations of potent retinol and other potent anti-aging ingredients to restore healthy skin. You can and speak to a member of our trained ZO Staff about starting on the most effective system for your skin type.
With respect to your second question regarding a facelift, friends and family are great sources for support, but it should stop at that and not transcend into providing “medical” advice. The need for a facelift depends on the extent of the skin laxity that has occurred. A mild to slightly moderate amount of skin laxity can be non-surgically corrected with the Obagi Blue Peel or certain lasers such as the C02 Fraxel Laser (skin type highly dependent with this laser). On the other hand, more severe skin laxity is only correctable via surgery, regardless of one’s age. It is best for you to seek the advice of 2-3 plastic surgeons. I would recommend that you go to obagi.com and utilize the physician locator on that site. Call several of the plastic surgeons listed on the site in your area and inquire if they perform the Blue Peel (not all Obagi doctors perform the Blue Peel). Obtain a consultation from 2-3 of these plastic surgeons, as the have the wide scope of knowledge to recommend a skin tightening procedure or surgery.
The Olluminate Eye Cream is an excellent treatment for reducing fine lines and wrinkles, as well as dark circles and puffiness. You can easily begin to implement this into your regimen twice a day. In addition, to dietary changes and supplements to treat your anemia, sleeping on your back propped up with 2 pillows, will help to reduce fluid accumulation and allow you to see a difference in your dark circles.
Thank you,
Zein E. Obagi, MD
Dear Dr. Obagi,
Thank you so much for your very learned advice in your recommendation of my NuDerm / ZO Skin Health Maintenance Protocol. I am certainly thankful that you know your life’s gift so well and I am also thankful that I found you and your highly competent staff.
The peri-oral dryness I was having such an issue with has subsided and now I only have to deal with an amount of significant flaking around the 20th of every month, my skin’s surface life cycle. I solve that by being more diligent with the exfoliation. This is the ONE part of the process my husband, David does not like seeing and always asks me if I am “burning” myself again. But I am committed to the regimen so he will just have to live with it.
Just curious about ZO Skin Health following two products and who they are
designed to benefit: It’s the Exfoliating Cleanser and TE- Acne Pads,are they for people other than myself. That is those of the for people other than myself:dry skin,small pore, no breakouts, acne or T-zone oilness?
Thank you to you and everyone on your staff,
Anne
Dear Anne,
I certainly appreciate your passion for the Obagi products. I think David will appreciate your due diligence with exfoliating and continuously stimulating collagen cells, when your skin still looks as great as it does today- 10 years from now. Remember, as I previously blogged, skin cells are one of the ONLY cells that can be regenerated, and it is documented that Retinols and Tretinoin (ZO Skin Heath/Obagi Nu-Derm) are capable of doing this. No one ever correctly guesses that I am 66 years-old, thanks to practicing what I preach.
The Tepads are NOT indicated for dry skin. This is one product that you would not need for your specific skin type, given that you have no visible pores, no enlarged oil-glands, and no signs of acne. If a male patient I was treating had dry skin, no acne, etc., but suffered from in-grown hairs as a result of shaving, I would recommend the use of the Tepads after shaving. They are excellent at reducing in-grown hair and other related forms of irritation that can occur as a result of shaving regardless of whether skin is oily or dry.
The Exfoliating Cleanser is perfectly fine for you to use. It is pH balanced and doesn’t induce artificial drying or strip the skin of its natural lipid barrier. Other cleansers designed for oily skin are very alkaline. At first, skin feels very clean when it is cleansed. A few hours later, skin is even oilier than it was prior to cleansing. The reason, skin will compensate for being over-stripped by producing more oil.
The Exfoliating Cleanser has Vitamin-E infused blue-beads that dissolve after approximately one minute, and after skin is thoroughly cleansed. Vitamin-E nourishes the skin and is an excellent anti-oxidant. The white-beads in the cleanser, are round and smooth and do NOT irritate skin. These do not dissolve, and assist in gently removing dead skin cells. The base effectively cleanses and dissolves both sebum and dead skin cells. The cleansers are interchangeable, so feel free to give the Exfoliating Cleanser a go and see which one you prefer. Remember, to give your skin about one-week to adjust to the new cleanser before judging its effects. Also, you can use one in the AM and the other in the PM. Thank you,
Zein E. Obagi, MD
Dr. Obagi,
You confirmed my thoughts regarding TE Pads not designed for my skin. My husband likes to kiddingly “brag” that he married an “older” woman. He just turned 55 on 08/29 and I was 58 on 07/29 so with your help, I love a challenge so let’s make that a “brag’ that will be hard for people to believe. Gee, I look forward to that!
Question: with regards to Elastiderm for the Neck and Decolletage. Concerning the HQ contained in the kit,after having used it (well into my second kit)what is recommended once the second container of HQ is finished?
I do apply Obagi Vitamin C Serum and ZO Skin Health Body Emulsion, in particular on my decolletage as well as everywhere else because of the Retinol. As I still have sun damage (brown spots/freckles)on my upper chest and shoulders I would like to continue to improve the overall skin’s appearance.
I do however, have to figure out what I am applying or the specific layering of products that my neckline doesn’t like. On at least two occasions I have experienced an itching,on the right side of my neck at the collar line, which of course I make worse by scratching.
Either I am accidently layering some products that I obviously shouldn’t or something I am using is too strong in strength for my neck area. Right now everything is fine, I applied cortaid and avoided applying anything else apart from using cleanser. I do not apply Clear,Tretinoin or Blender on my neck.
To avoid causing this same reaction again, what would recommend I apply to from jawline to neckline? FYI: the skin on my neck is pretty clear of sun spots (3 faint little ones), sun damage still remains on the decolletage but I am content with a “work in progress” approach there.
I know this mystery can easily be resolved, we just rather me not repeat whatever it is that I inadvertently did besides “no scratching”!
Take care and warmest recards,
Anne
Hello Anne,
The kit you are using for your neck and chest consists of 4% hydroquinone, the same active ingredient present in the Clear, with an evening product designed to “stimulate” collagen and elastin. Once you are satisfied with the correction on your neck and chest, you can reduce application of this kit to 2-3 times a week for maintenance.
The epidermis on the neck and chest is far thinner than it is on the face. It takes a lot less product to induce a reaction (and correction). Think of the skin around your eyes and mouth and how much more sensitive it is in comparison to your cheeks and forehead.
The source of your irritation (temporary of course) may be the retinol in the Body Emulsion or the L-Ascorbic Acid that is present in the Obagi Vitamin-C. If you are using the 20% concentration, make sure you are only applying this once a day in the AM. Also, begin easy by using the Obagi-C product after cleansing and about every other day. As you gradually build tolerance to the program on your neck and chest, you can increase the number of days you apply it.
If you are using the Elastiderm kit, apply the hydroquinone product after the Vitamin-C, and the Body Emulsion last (on some days, you will go from the hydroquinone product straight to the Body Emulsion and skip the Obagi Pro-C. Apply less Body Emulsion than you have been applying to reduce the amount of retinol you are applying to your skin. In the evenings, you will use your Elastiderm stimulator product, followed by the Body Emulsion. Don’t forget that you should be using sunscreen during the day on your neck and chest. It’s about trial and error. Use less product, less frequently, build tolerance for about 2-3 weeks, than increase application. You know your own tolerance the best and it will vary by person. If your skin continues to burn and itch, then I would replace the Body Emulsion use on neck and chest with one of the Ommerse hydrating products. Keep the Body Emulsion for other parts of the body such as the legs and arms, which tend to be less sensitive.
Thank you,
Zein E. Obagi, MD
Dear Dr. Obagi,
Thank you so much for your recommendations, they are a tremendous help. I had a feeling that I was inadvertently overlaping active ingredients in the transitional area of my neck to the top of my shoulders.
I knew that the neck skin was thin and therefore, more sensitive than facial skin. It’s also an area that I caught a glimpse of in a mirror while simultaneously lifting my chin up. I gasped(to myself)as I witnessed the skin pulling taut in tiny lateral folds… My first thought(after I quickly lowered my chin) was “I have GOT to do something about this!” This was long before I began using Elastiderm and of course, Zo Skin Health. Thank you as this is no lnger an issue!
Is it all right to apply Growth Factor Serum and Night Recovery Creme on my neck on the same evenings (T,Th and weekends)that I am also using them on my face if these are the only two products being applied?
I neglected to ask you about the use of GFS on my neck before.
Have a pleasant and Happy Labor Day holiday!
Warmest Regards,
Anne
Hello Anne,
Yes, it is perfectly fine to apply the Growth Factor Serum to your neck. It is an epidermal growth factor, minimally irritating, and will aid in correcting damage on your neck. For hydration and to reduce irritation you may encounter from the Nu-Derm products you are using on your neck, the Ommerse Overnight Recovery Creme is an excellent choice.
Thank you,
Zein E. Obagi, MD
I saw my question from aug 31 above, wondered when a reply would come.
thanks
My questions are about this product line in general. I started the Nu-Derm regimen about two weeks ago. In researching online, I came across the ZO line. I was surprised to see it, as I had never heard of it before and my dermatologist doesn’t have it. From what I’ve read, I am gathering that this line, as opposed to the Nu-Derm line, is more over-the-counter. Am I understanding that correctly?
I am concerned about acne, anti-aging, and age spots.
I was wondering what the percentage of retinol is in these products. Would it be beneficial for me to use any of these products? I was specifically interested in the TE pads, as I have some acne, but mostly lots of blackheads and whiteheads, especially on cheeks and nose.
I would appreciate your advice. Thank you!
Kelley D.
Hello Kelley D.,
Yes, you are correct… The ZO Skin Health line by Dr. Zein E. Obagi is an over-the-counter (OTC) system. As of yet, it is not available through any doctors’ offices. Distribution is limited to flagship Nordstrom stores, Dr. Obagi’s two clinics, and a few other exclusive locations. The locations link has a list of all of our distributors. You are also able to purchase it online through this site.
The ZO system contains several high quality, potent, and effective OTC active ingredients, including Retinol (a derivative of Retinoic Acid – Retin-A® cream), Anti-oxidants such as, vitamins A, C, & E, CoQ10, and other DNA generating support ingredients.
The Obagi Nu-Derm system, on the other hand, is a prescription based program utilizing a combination of 4% hydroquinone, retinoic acid, phytic acid, and alphahydroxy acids. It is far stronger and more potent and requires physician supervision and monitoring during use.
Dr. Obagi likes to refer to both systems as a circle of “Skin Health.” One line always supports the other and concurrent use is fine to enhance results. All of our Obagi Nu-Derm acne patients utilize the “Tepads” after the Toner (step 2 in Obagi Nu-Derm). The Tepads dramatically improve and reduce whiteheads, blackheads, large pores, and control sebum production. Mild stinging for a few minutes after using the Tepads is normal for the first 2-4 weeks of using the Obagi Nu-Derm system.
The Oclipse sunscreen tends to be favored by many of my personal acne patients and those of Dr. Obagi. It does an excellent job at keeping oil under control (absorbed) all day and at reducing the redness that temporarily results from use of the Obagi Nu-Derm system. It is a physical block, without the white film conventional sunscreens leave behind. I also have my patients apply Ommerse Day (for more oily skin types) and Ommerse Night (for more dry skin types) every night on top of the Retin-A® &Blender step, or on its own on “off nights” from Retin-A® & Blender. Ommerse is NOT your ordinary moisturizer. It will NOT slow down the effects and benefits of Retin-A® the way conventional moisturizers do. It provides hydration, comfort, and reduces the temporary side effects of Retin-A® cream, without slowing down the benefits. It contains Retinol, to keep skin cells stimulated and Candian Willowherb and Oat, to reduce inflammation and redness. I.e., makes the system far more tolerable.
Once you have gone through the 12-18 weeks of daily Obagi Nu-Derm use and are on maintenance, you can incorporate the rest of the ZO Skin Health products. Nu-Derm is used 2-3 times a week during maintenance. One your “off” days you can ensure the use of complementary and great products by using the ZO Skin Health system. You can write me back at that point, and I can recommend a program for you.
Best,
Sandra Obagi
After I turned 24 my skin just started to become dry. It’s started in a small patch on my check and gradually spread to the whole bottom part of the face and partially my neck. I was given a cream to help it temporarily but it has a steroid in it that makes my face sensitive to the sun. Just by looking at my face you can not tell it’s dry, only when you touch it. I am unsure of a daily routine that I can do to help me with my skin care.
I’m currently using Boots No.7 toner and day cream and Aveeno foaming face wash.
I also am starting to show some sun spots on my forehead (can’t really see in the picture) and wrinkles around my eyes. I currently use sunblock sometimes but would like the sun spots to not get any darker.
Thank you.
KL
Hello KL,
I am assuming you have some eczema or contact dermatitis, which is the reason you were given a topical steroid cream? Hopefully, you obtained the topical steroid from your dermatologist so he or she can monitor and ensure you only use it when you have a flare-up. Steroids can cause atrophy in skin (thinning), which can result in photo-sensitivity. That is why you feel sensitive to the sun.
You are not generating healthy skin cells, which is a common reason someone young like yourself would be experiencing dryness (the eczema set aside). Exfoliating dead skin cells to promote the growth of healthy cells a great way to relieve dryness over the long-run. Try using the Exfoliating Polish (without pressure), about 2-3 times a week, while in the shower. Apply to wet skin and gently massage for about 1 minute prior to washing your face. To effectively cleanse your skin, the Exfoliating cleanser should be used two times a day for 1-2 minutes. One days you utilize the polish, cleanse skin after the polish.
The Ommerse Crème AM is a great hydrating cream, as in as anti-inflammatory properties, and contains Retinol to stimulate the growth of healthy skin cells. It will also hydrate and relieve the dryness that you have. This can be used 2 times a day after washing your face.
The Olluminate Eye Cream can be incorporated into your program twice a day after the Ommerse Crème to reverse and correct the fine lines and wrinkles around your eyes. The stimulation of collagen induced from the Retinol and will also prevent the formation of new wrinkles.
Finally, you should use the Oclipse sunscreen daily to prevent pigmentation, sun damage, and to protect your skin. Someone, with truly sensitive skin as you, needs the benefits of a broad spectrum sunscreen. The added natural melanin, gives you additional protection, prevents spots from forming, and will provide you with a primer (one even color in your skin).
If you must use a topical steroid as a result of a flare-up, only apply to affected areas, to a clean surface (after washing your skin), and for no more than 2-3 days. Your topical steroid cream is used prior to Ommerse Crème, Olluminate, and Oclipse.
Try this routine for about 1 month, than email me again to see if your skin is strong enough at this point to add in other great items, such as Growth Factor Serum, to really provide you with anti-aging benefits.
Best,
Sandra Obagi
I am African American and have been using Obagi Nu Derm for approx. 10 years. (didn’t know that was too long!). Still love the product, but now experiencing more hyperpigmentation (loss of pigmentation–too light around eye area and darkening at the cheeks). Should I switch to the maintenance routine with the Nu Derm products and incorporate the Obagi Zo Daily Power Defense and Ossential Growth Factor Serum? I don’t want to stop using the product because nothing gives me the same clarity as Obagi. Please help!
Hello Teresa,
There is no maximum or minimum time frame for using the Obagi® Nu-Derm system. The program can safely be used indefinitely. After you have achieved your desired results, the Obagi Nu-Derm system should be used on a “Maintenance Routine” (2-3 times a week) with daily use resumed every 3 months for 2 weeks to “shock” skin. Cleanser, Toner, Eye Cream, & Sunscreen (Obagi Pro-C if this is in your original program) are used DAILY on Maintenance. Clear, Exfoderm (if in your orig. program) and the Retin-A® & Blender steps are reduced to 2-3 times a week.
Dr. Obagi, developed the ZO Skin Health products with “Maintenance” patients in mind. He wanted a system of creams that are high quality and highly effective so that patients don’t negate the benefits and effects of the Obagi Nu-Derm system by using inferior products during their off days, or to prevent the incorrect mix and matching of products.
Let’s begin with your program and skin type. For darker skin types such as yourself, Dr. Obagi and I limit the use of the Clear to 1 gram ONCE a day instead of two – Usually, with application taking place in the morning. You need to evenly apply the Clear to the entire face, including under the eyes and eyelids. In the evening, you only apply the CLEAR to the darker areas. In your case, this would be just your cheeks. Your Retin-A® cream (Tretinoin cream 0.1% or 0.05%) must be used with Blender, as this promotes an even color tone to skin. You should be using Clear, Blender & Tretinoin 3 times a week (especially, since you still have pigmentation).
The Growth Factor Serum (GFS) would be applied every evening as your last step. On the nights you apply the Blender & Tretinoin, 1-2 pumps of GFS can be used on top. You will have enhanced results, and less irritation. On evenings you don’t apply the Blender routine, just apply the GFS on its own.
The Daily Power Defense should be incorporated into your morning routine daily after your Toner (Step #2) routine. This would be followed by the Clear, etc., on the days you are applying the full system.
I would highly recommend that someone with your skin type incorporate the Oclipse sunscreen. It reduces the white film that is more evident on darker skin types when physical blocks are used and will provide you with excellent protection.
Best,
Sandra Obagi, MBA
Medical Esthetician
Please help me!
I’ve been using Obagi NuDerm for about 4 months. I am using gel cleanser, toner, clear, exfoderm, sun protection in the morning all over my face and at night i use gel cleanser, toner, clear all over my face and I use the blender/ tretinoin only on my chin area…. I am mostly experiencing breaking out in my chin area on a continuous basis ( i feel like it’s not stopping in that area) but just this past week i got a couple extra ones on my forehead… which was unsettling because i thought i was almost done…
Is this normal? When will it stop? Please, please help i am so disappointed that I am getting new acne breakouts….
Thank you.
Laila
Hello Laila,
I need a little more information. You can email me to sandrao@obagiskin.com. For the four months that you used the Obagi Nu-Derm system, did you ONLY apply the Retin-A® & Blender to your chin area the whole period? What concentration and form of Retin-A® did you use? Did you originally have acne as the primary reason your doctor prescribed the Obagi system? If you can send me an email with a little more information, I can better advise you. No need to be disappointed.. I think with a few adjustments and clarification we can reverse this problem. Thank you.
Best,
Sandra Obagi, MBA
Medical Esthetician
Hi,
I am using the Obagi skin care system. 1-5 (cleanser, toner, skin bleaching, exfoliator, and tretinoin with blender.) At first, I couldn’t figure out how to close my tretinoin tube. Turns out that once you opened it for the first time, the cap would only screw back on if you turned it over and put it on that way. For the first week or so I was just leaving the cap on covering the opening, but it wouldn’t securely fasten, and twice when I took the cream with me on a trip, it opened up on the journey. A bit of cream leaked out into the bag the tube was in, and I scooped it up and put it back in the tube. Do you think the air would have deactivated the retinoic acid? It really wasn’t exposed to light. Also- about a week ago I used a bit of tretinoic acid near my eyes, thinking that it would get rid of fine lines. (My main problem is acne though.) About 36 hours later I went to the beach and probably got too much sun, although I was wearing plenty of sunblock. (I was out there pretty exposed from about 1:30-3:30.) An area near my eye became red/irritated, but it got better the next day. I’m hoping that this wasn’t enough sun exposure to cause the exact opposite of what I was going for-wrinkles and sun spots!
Hello Caitlin,
The retinoid will not lose its potency and will not become deactivated. Just squeeze out the first part of the exposed cream and do not use it.You may continue use of the unexposed cream. It is best to keep the tube closed and sealed, if possible, however it shouldn’t lose its efficacy.
It is very important not to use tretinoin around the eyes, corners of the nose and mouth. The skin on and around the mentioned areas tend to be more sensitive. I’m happy to hear that the area has healed since, however I would not recommend continued use of the tretinoin around the eyes and to only apply a pea-sized amount on the face at night. Having used it and getting a sensitive reaction will not significantly cause fine lines and wrinkles or make it worse. If you would like to use an eye treatment that has a stabilized retinol- I would recommmend ZO’s intense eye repair. The stabilized retinol and peptides will help decrease the fine lines and won’t cause irritation. I hope this helps-Remember to use proper sun protection with an SPF 30!
Thank you,
Tiffany C., LVN
Medical Aesthetician
Thank you for your reply. I can still see the mark near my eye where the skin seemed burned. However, it is hardly noticeable and I´m hoping it goes away soon and doesn´t cause any “sunspots.” I also forgot to mention in my comment that I am using the Obagi Nu Derm system following a low level laser treatment I got on my face about two weeks ago. But that probably doesn´t change your answer, right?
Hello,
I´m using the Nuderm system 1-5 with tretinoin .5% as a follow-up to a low level laser procedure which I got for some marks on my face. I am in Spain right now and my toner is about to run out so I was wondering if I should just use the rest of the products and skin toner, or if there is a toner I could use until I can get a new Obagi toner.
Thanks,
Caitlin
correction- I meant to say should I use the rest of the products WITHOUT the skin toner for now, or is there another toner I can buy that would be useful?
Thank you.
Hi, Caitlin:
ZO Skin Health is separate from Obagi Medical Products, but we are familiar with the products and work closely with Dr. Obagi. That being said, here is our recommendation:
Have fun in Spain, and don’t worry about the toner. Resume using it when you get back home. Be sure to wear good sun protection!