Thank you for your reply and your advise regarding the correct use of Growth Factor, my favorite! as well as the incorporating RNR-Plus into my daily skin care routine.

I thank you for giving me pause to consider after reading some of your
articles on the possible overuse of moisturizers which can result in skin sensitivity that, unknowingly this could be my problem at time too.
Well, it was true! I was over-moisturizing, too many years of the ten plus step progams, which is why I left them in the first place!

I look forward to placing my next ZO Skin Health order which will include the RNR-Plus, which I am excitied to experience. Thank you
for your time and gifted talent in the world of dermatology.

Sincerely,
Anne

I am so happy to here that you caught your lesions at such an early stage and I am certain you will heal just fine. The Growth Factor Serum stimulates collagen and elastin and is an effective epidermal growth factor (makes your skin thicker and stronger). The great thing is that it also hydrates and soothes skin. There are certain skin types that experience dryness and exfoliation from it as a result of the retinol… You should only apply the Ommerse on top of it if your skin is truly dry or sensitive. You should not apply the Growth Factor Serum on top of your Radical Night Repair Plus. If you feel like you are too dry or sensitive the next morning – the evening you do apply RNR, you can apply Ommerse on top. Also, you can apply Ommerse the next day in the AM. Using the Growth Factor Serum on top of the RNR-Plus is not recommended–the Growth Factor Serum has ingredients that cause the time-released retinol to suddenly downpour–which can be irritating. On maintenance, apply Tretinoin Cream and Blender two days a week at night (GFS on top is fine). 2 days a week apply the RNR-Plus and Ommerse. The other 3 days a week you can use the Growth Factor Serum as your collagen boosting step at night. If you think you can boost the RNR plus to 3 days a week after about a month, do so. However, the protocol outlined above is sufficient for your skin type. Yes, the Tretinoin will certainly help you to accelerate healing. You can begin to use the products on your face – minus the Polish about 5 days after your procedure. For now, the Hydrating Cleanser, Clear, Ommerse, and Sunscreen are fine. Hope this helps.

Best,
Zein E. Obagi, MD

Thank you for your advice regarding my incorporating RNR-Plus into my NU Derm /ZO Maintenance protocol and your kind words regarding my “anniversary”.

Clarification needed here: on the nights I use Tretinoin/Blender, is it preferable to follow with the Growth Factor, applying the Ommerse in addition ONLY if I am experiencing dryness? I am referring to what you stated when I am using the Tretinoin/Blender and I just want to be sure I am using the products correctly.

The dermatologist found 6 actinic “spots” to freeze, only 3 were on my face which did not blister too badly but I applied Sulfadene ointment right away as I immediately begin to develop a second degree burn. You referred to the tretinoins and retinoids helping heal faster. Can I return to my usual daily routine (short of exfoliating polishing the blisters)or anything I can do to hep them heal better?

I am so pleased with where my skin is today and so pleased with the discovery of ZO Skin Health for it has helped to round out my skin care maintenance regimen. I find such benefit from all of the products, I enjoy them all especially the Growth Factor Serum for one.

I am very interested in incorporating the RNR-Plus into my Maintenance program. With doing so, I may need an expert to break it down for me but I am not going to trouble you to do that.

Thank you and fondest regards,
Anne

The RNR is an excellent product that you can use at night 2 days a week, instead of the Growth Factor Serum. Basically then 2 nights a week, you apply the Tretinoin Cream & Blender mixture, with the Growth Factor Serum or Ommerse on top. 2 nights a week you will apply the RNR-Plus cream, with OUT applying the Growth Factor. Otherwise, you release the micro spheres too quickly. The other one day a week, you can use your Growth Factor Serum. Since you are using Tretinoin Cream & Blender, you do not need to apply the RNR-Plus more than the 2 days a week recommended. The RNR-Plus may induce more exfoliation and dryness the first 3 weeks. You can use the Ommerse AM cream the next day OR right on top if you are sensitive to it alone. Thank you for your kind remarks again. I am sure you look fabulous for your 15th anniversary of turning 43 years-old.
Sincerely,
Dr. Zein E. Obagi

As always I highly value your recommendations and learned dermatological insight.

I long since shelved a very popular handheld brush head device used for cleansing as well as exfoliatiating your face and exclusively use the ZO Skin Health Exfoliating Polish. I found I like this immensely hand down over the other method!

The primary reason that I bring up my exfoliating is currently I only peform it 2 X a week and perhaps I need to increse the number of times a week I exfoliate, hence eliminating the dryness that I falsly have been attributing to the retinoids.Also, I have heeded your warnings regarding the over-dependence on moisturizers and I am now more aware of my use of them on a regular basis.

At 58, I believe in maximizing my efforts. This July I will be 59 but I certainly do not feel nor do I want to look it! If you and I can possibly help it so keep up the good work!

I have my annual skin cancer check up tomorrow (04/21) and I have what I think are two actinic keratosis spots that need to be frozen. I wish I was in Beverly Hills and could see you in person but I am very grateful for having this much access to you from afar.

Come this June I will have been on this same Maintenance Protocol for a year and not to say that it needs tweaking, but with RNR now available perhaps it may be a good idea to make sure that I am still staying the course. Fighting Harder!

Thank you for everything and all the best to you for all that you give us.

Anne

Thank you so much for your questions and your feedback. You are supposed to build tolerance to the overall program- Nu-Derm/ZO Skin Health or combination, where you no longer have a reaction, but continue to have correction. Retinoic Acid (Tretinoin Cream) and Retinol (the active ingredient in ZO Skin Health) stimulate the growth of healthy skin cells.

Radical Night Repair Plus:
This is by far the most superior and advanced Retinol product on the market. It doesn’t induce the photo-sensitivity and irritation that Tretinoin can. The RNR is 10-times the potency, concentration, and effectiveness of conventional retinol products. To incorporate this into your existing program, use it twice a week after cleansing (no Clear before) and toner (or Tepads). You can apply the Ommerse Day or Ommerse Night on top. If you choose to incorporate RNR plus into your program, then reduce your application of Tretinoin & Blender to 1-2 days a week. If you are happy with your Tretinoin Cream, you don’t have to incorporate since you already use the stronger Retinoic Acid (Tretinoin Cream) and Growth Factor Serum.

Thanks for asking, Anne.

It’s been awhile and I am very happy with the NuDerm and ZO Skin Health Maintenance Program you recommended for my skin. The peri-oral dryness/peeling issue is a non-issue. I am still using 3X a week Obagi 0.1% Tretinoin/Blender as well as the NuDerm Clear.

As I alternate the NuDerm with the ZO Skin Health including the Overnight Recovery Creme, I am intrigued by your addition of the Radical Overnight Recovery Creme which contains 0.1% Retinol. I sometimes, as needed apply a thin layer of the Overnight Recovery Creme on top of the 0.1% Tretinoin since I have a tendency towards being feeling dry and tight.

When you have the opportunity, would you educate me on your new ZO product(s).

Also, I use ZO Exfoliating Polish 2X a week, I shelved the Clarisonic as I found that whenever I used it my skin became highly irritated to just about everything I put on my face. At the risk of sounding like a malcontent, is it all right that I am not seeing any visable peeling? As long as I am sticking with the maintenance program, is healthy skin cell renewal still being generated? Granted, I realize this maybe hard for you to answer without seeing me but I can tell you, my skin is not regressing! thank you for your all of your good works.

Fondest Regards,
Anne