P. acnes, an anaerobic bacterium, die when exposed to oxygen.  Your natural oil or other oils in topical products can clog the pores, which blocks this natural process. These oils also serve as a source of energy for the bacteria.  They emit an enzyme that breaks down the oil so they can digest an essential fatty acid from your skin.  Once nourished, they multiply.  The enzyme that P. Acnes emits is irritating to the wall of your pore (follicular wall). The more released enzyme;   the more irritated the pore. 

Local inflammation is bad but it slowly moves into your bloodstream: inflammation occurs when P. Acnes enters the blood stream.  The body’s immune system kicks in and deploys the white blood cells to create redness, swelling and even a pustule (white head).  Once the blemish is clean and clear, the body begins to repair the damaged skin area and the pore. 

Your Acne Products may be Making Your Acne Worse!

Beware: some acne products on the market are actually causing the pores to clog. If you are experiencing acne breakouts, and any of the following ingredients are in your skin/body products, makeup, shampoo or conditioner, simply switching products may make a dramatic difference.  These ingredients are highly comedogenic, meaning they clog the pores:

• Myristate
• Amodimethicone           
• Dimethicone
• Cyclomethicone
• Trimethicone
• Simethicone

If a product says its “oil-free,” be cautious.  According to the FDA, the “oil-free” claim can be made if the product does not contain any natural oils.  But, the product can contain fine grade machine oils and still be considered “oil-free.” 

How to Treat Acne

• Maintain a regular skin care program at home
• Augment your home care with microdermabrasion, extractions and glycolic peel by an aesthetician who works in conjunction with a doctor
• Don’t touch your face. “Popping zits” on your own, while tempting, is not recommended because you can cause more skin tissue damage than you think 

Your Home Care Program Should Include:

• Exfoliating cleanser: apply to your dry skin, leave on for 30 seconds
• Use the Clarisonic brush in circular fashion on your skin. The sonic energy clean pores without traumatizing your skin.
• Apply an antiseptic (Clarifying + Ferula) product that won’t dry your skin out and will protect against the hyperpigmentation that worsens the appearance of acne scars.
• Follow with an SPF product (Active Day Crème + SPF 30) that doesn’t clog your pores. Augment this with iS Clinical micronized zinc brush every two hours if you are having issues with hyperpigmentation.
• At bedtime, use KCMD  Triple Pumpkin + Ferula exfoliating  mask for 20 minutes and then sleep in an overnight exfoliant (Overnight Triple Peel)
• Epiduo is an excellent prescriptive that contains benzoyl peroxide and a retinol. It can be used as a spot treatment for stubborn regions that tend to break out. This medication can be drying so is best used on nights that you don’t use the triple peel.

Use these products at home correctly and consistently, and you will see a noticeable difference in your skin.

To set up a Reset Facial contact skin@CockerhamMD.com  
I hope you found this blog helpful; be sure to check the ingredients on your products as the first step toward clearer skin.   

J: I haven’t had a facial in a while but the promise of a triple-action reset facial intrigued me.  Aleks provided me with what to expect…but my thoughts are provided to help you understand the process.

A: This is a safe and effective facial peel and mask treatment for every skin type even sensitive but really geared for acne, scarring, hyperpigmentation and anti-aging. First a peel prep is applied to prepare the skin for the treatment; this ensures that the active ingredients don’t get neutralized by any alkaline mineral deposits from water or make up. Once the skin is prepared, a layer of four acids: glycolic, lactic, malic and salycilic, is applied.  In this solution there is also a very high level of vitamin C, ferulic acid, grape skin extract and vitamin K from spinach to deliver antioxidants and also to keep the skin calm.

J: This anti-acne treatment was welcome given my bout of post-holiday, stress and sugar-induced break out. The sensation was a growing tingle–just enough to know it’s effective yet keep me totally at ease.

A: The neutralizer was then applied; it delivers chamomile, green tea, vitamin C and E along with ferulic acid to help soothe the skin.

J: I felt a subtle heating sensation and my skin just felt hydrated.

A:  The next step was the C 20 FERULIC with Resveratrol, which makes the skin cells resist UV damage and provides a glow that last for days.  You are able to absorb your topical products more effectively, which enables make-up to go on smoother and it also prevents hyper-pigmentation.

J: Sounds like the fountain of youth…bring it on.

A: Apple C Tightening Mask is the next step, which lasts for 15 minutes. This is where the triple-stage reset gets its name.  The mask is in an organic apple sauce base and it really does smell like apple sauce. 

J: The sensation is tingling at first and then somewhat of a heat sensation.  I love to feel the treatment at work, so the tingling is quite welcome.   I’m relaxed and thinking of how good it feels to give back to my skin after years of putting up with my youthful sun-worshipping.

A: The DNA/RNA, ferulic acid and vitamin C are all hard at work.  The warming stimulating sensation is to increase blood flow to the surface of the skin for optimal absorption of the key ingredients.

J: After about 5 minutes I felt the tingling sensation start to subside on its own.  A few minutes later as my skin continued to calm, there was a cooling sensation that is calming.  After another five minutes, the cooling feeling subsided and I felt my skin  tightening.

A: The mask was then carefully removed with distilled water and Jennifer’s face was patted dry. KCMD Peptide Smoothing Complex, which contains hyaluranic acid microspheres and a natural muscle relaxer was massaged into the skin.

J: Sounds like a natural version of Botox® from the description, but it felt wonderful–and no needles!  It felt like a creamy light lotion but it’s really just a light serum.

A: The final step was complete tension removal: a combination of peppermint, eucalyptus, evening primrose, ginger and lavender to enhance your neck massage.

J: All of the scents combined were amazing and relaxing.  The back of my neck tingled—but in a good way. As relaxed as I felt, I was actually invigorated by the cooling sensation.

My skin had a flush, youthful dewy glow that I haven’t seen in quite a while.  My skin still looked visibly radiant for several days following the treatment…even my husband noticed !

Combat winter’s drying effects & look terrific for the holidays and 2011!

1.    Use KCMD Illuminating cleanser and your clarisonic brush to remove make-up, pollution and dead skin cells. Put the cleanser onto dry skin for 30 seconds or so for added exfoliation before using the brush (not a good idea for dry or sensitive winter skin)
2.    Use KCMD anti-inflammation toner after showering or washing your face.  But be sure to wipe it off with a dry cotton ball after applying. The toner is critical to remove the drying mineral deposits from the water and will re-acidify your skin to the proper pH of 5.5, which will prevent skin cells from drying out.  You can do this over your entire body to prevent dry and itchy legs and arms.
3.    Apply your KCMD eye cream or gel onto your eyelids with a patting motion – do not rub.  Ideally you will apply effective treatments in the morning and evening.  In the morning you want to make sure that your eyes are protected throughout the day from ultra violet rays (UV) that break down the collagen and elastin around the eye area EVEN IN THE WINTER.

4.    Beware of eye makeup and eye makeup remover, it can pull moisture from the eyes making fine lines that much more visible.

• Cleanser of choice: KCMD illuminating cleanser for the entire face and neck…but don’t forget your eyelids! If you have sensitive skin or allergies use the anti-inflammation cleanser for gentle exfoliation.
• The Clarisonic Brush is a wonderful way to gently exfoliate your skin – including your eyelids. Use it in the morning as a horizontal sonic medial to lateral way to get rid of tired puffy morning eyes.
• Next apply the KCMD Eye Illuminator – a super rich and buttery formula will protect against moisture loss, and the 23 karat mica diffuses and reflects UV light away from the eyes.  This diminishes fine lines, dark circles and puffiness.
• For those with thicker, more oily skin who want to focus on dark circles and puffiness, KCMD BioComplex Eye Renewal Gel is your choice. Wonderful gift for your husband !
• If you have sensitive skin – especially issues with allergies and sinus disease – KCMD Anti-Inflammation Eye cream delivers calming ingredients that reduce swelling, redness and puffiness – it is designed for ultra sensitive eyes.
• At bedtime… after you cleanse and tone, apply KCMD Time-Reversal Eye Treatment. This serum delivers high levels of anti-aging antioxidants that firm the skin around the eyes, help reduce puffiness and diminish dark circles due to fluid accumulation. Apply after your Retin A cream. If you are very dry, use the Time reversal cream instead.

And as a special holiday bonus, all four of the above-mentioned eye products are available in an elegant 50-ml jar—for the same price as the original 15 ml demo packaging and size!  That’s more than triple the savings!  But hurry, it’s just a limited-time holiday special.  Log on to www.YourSkinSpace.com now and get the right eye product for you.

A patient shares her experiences with Botox and Dermal Filler injections done by Dr. Kimberly Cockerham, MD, to reduce wrinkles and smile lines.

A patient shares her experiences and gets post-op tips for Botox injections done by Dr. Kimberly Cockerham, MD, to relax muscles and reduce wrinkles.

Watch Dr. Kimberly Cockerham inject Artefill dermal filler to reduce smile lines and wrinkles for a patient in her surgery suite. Warning: Shows needle injections and some blood.

A patient shares her experiences with Artefill Dermal Filler injections done by Dr. Kimberly Cockerham, MD, to reduce wrinkles and smile lines.

Have you ever had any of these procedures done, or questions about the treatments? Please leave a comment!

For more information, see also http://www.cockerhammd.com

We hear the term “anti-aging” all the time.  It’s used on skin care products, services, and treatments to imply there is some kind of magical age preventative effect that will occur.  Not to mention that the word “anti-aging” is also used to increase the price of whatever product, service or treatment it placed on.  So, is there any truth to the term or is it just a marketing gimmick?

There is only one way to find out if a product(s) is really “anti-aging.”  You will need to use the “anti-aging” products on just one side of the face and neck for the next 10 years and then make a conclusion if there is a difference between the “anti-aging” side verses the side that received no care or very little care.  God help you if there is a difference.  Can you imagine actually having one side of your face that looks 10 year younger and the other side looking 10 years older?

But, the term does have some true implications to it with a condition.  The condition is that the person using the products needs to actually use them in a specific program on a regular daily schedule.  Studies show that when people are instructed to use products in a prescribed program that they only follow through the prescription maybe by 50%.  That means that at least half of the benefit is never gained.  Just imagine what a difference it would make if the prescription would be followed to the letter. 

The way anti-aging products work is primarily in two phases.  The first phase is to exfoliate away all the skin cells that are dead.  With exfoliation skin cell energy is increased, which gradually drops during the course of aging, and uneven skin tone (hyperpigmentation) is brought to the surface to also be exfoliated away.  So there is continual exfoliating that is performed either on a daily basis or every other day.  The second phase of anti-aging is to keep the new skin cells performing at high levels for maximum performance.  Keeping free-radicals neutralized as much as possible and preventing damage caused by UV rays.  Introducing high levels of super anti-oxidants that are absorbed by the newly exposed skin cells after exfoliation.  But, with all aging there comes a wall that anti-aging products just can’t jump over.  That’s where the fancy laser resurfacing, injectables, and surgery take over.  With more advanced medical treatments there is still the maintenance that has to occur and you guest it, the maintenance program is “anti-aging.”

Will anti-aging products prevent our skin from aging, probably not if the person is smoking, sun bathing, consuming excess alcohol, eating junk food, and experiencing high levels of stress.  The honest answer is that the product will have a positive effect but it’s a lot to ask of a topical product to reverse everything else that’s not healthy.  On the other hand anti-aging products will perform at their potential when the person is taking care of himself/herself and being good to their body.   

To really define anti-aging it comes down to life style.  A life style of eating healthy, exercising regularly, keeping stress levels from extreme highs, and absolutely taking care of our largest organ, the skin.  The skin is the only organ that we can see.  It tells a lot about a person and when taken care of, the story can be beautiful. 

Let’s face it, every product on the market will do something when applied to skin.  So what makes some products better than others and how much can they really do before we need to do something medical.

Products sold on the mass markets that can be picked up by anyone can not contain high concentrations of active ingredients for the simple reason that customers will miss-prescribe themselves a product that will cause some kind of undesired result.  If enough customers return certain products the store will no longer carry them.  That is exactly why over the counter (OTC) products cannot be too active.  Not to mention that some of those products have to sit on the shelf for who knows how long and therefore must contain paraben preservatives in order to keep them from spoiling.  But, yes, even the OTC products will do something; it just won’t be enough of a result that most customers are looking for.

Then there are products that have higher levels of active ingredients that can only be purchased at Spas or MedSpas.  These products are usually recommended by a trained professional that can accurately prescribe the correct product for the proper skin type and/or condition.  These professional grade products usually have higher concentrations of active ingredients.  An example of this is when a product contains over 2% of Alpha Lipoic Acid (a super/uneriversal antioxidant) instead of 1% or less in OTC products.  Once the Alpha Lipoic Acid begins to exceed 2% the chances of a skin irritation or reaction increases and therefore requires a trained professional to monitor a patients/clients skin reaction.

But, perhaps the best and way to be able to explain the true limits of skin care products would be to use an example.  If a person that is not fit and has never worked out just begins to walk regularly that person will see amazing results.  On the other hand if a person who is super fit wants to take their fitness to the next level they have to work out a lot harder and longer to be able to get to that next level.  The same is true with skin care.  If a person does not take care of their skin at all and they begin just using one product they will see amazing results.  On the other hand if a person has a complete skin care program and is doing everything possible and using every single product in the regimen (cleanser, toner, serum, eye crème, moisturize, and SPF) that has both AM and PM regimens that next level of better looking skin will be almost impossible to achieve without medical esthetic intervention.

Bottom line, the products are only as good as they are affective.  You should have higher levels of active ingredients for your skin and not just OTC products. Once you begin to plateau in your results you may want to consider the next step by seeing Dr. Cockerham.  A complete home skin care program is key to beautiful and healthy skin and to maintain any medical esthetic intervention.

Ever watch the Emmy’s or the Grammy’s and noticed the glowing skin of the celebrities, only to wish and wonder what their secret is and what did they have done to get it.  Well, I’m about to spill the beans on this secret and it’s not that big of a secret.

First of all, it helps to have young and flawless skin.  But, even flawless skin needs TLC.  The secret to the amazing glow is in two easy steps, exfoliate and load with anti-oxidants! 

You may have heard by now that exfoliation is a really good idea. Now let me explain why and what methods are ideal.  Most of us are familiar with “scrubs”, some kind of abrasive material that we rub around and move over our skin so that the dead skin cells are removed.  If that’s the only kind of exfoliant you have, great, use it.  But, these kinds of exfoliants are random.  Random in the sense that we hope the abrasive material will remove the dead skin cells that we want to have removed.  Abrasive scrubs only work where you manipulate them and even then how do you know when all the skin cells you want removed have been scrubbed off?   Sometimes this very thought of not being sure if all the dead skin cells have been removed can created a feeling to keep scrubbing even more, which can cause skin irritations due to over exfoliation. 

The solution is a proper exfoliant, for your skin type, that works uniformly.  Uniformly means, putting on a serum or exfoliating treatment mask and leaving it on for a duration of time.  Every area you’ve applied the serum or mask will be exfoliated.  It leaves no guesswork.  Dr. Cockerham has developed three different kinds of exfoliants that do just that.  The Overnight Mini Peel, Overnight Triple Peel and the Triple Pumpkin + Ferula are perfect examples of uniform exfoliants.

Once you’ve exfoliated correctly you’ll then need to make sure that the new skin cells are going to perform at their top performance.  This means they will be alive longer, adsorb your high-end products better and the most important part, reflect light in a way that makes your skin glow.  The glow comes from a smoother skin surface once the dead skin cells have been removed.  It’s like flashing a light at a mirror.  If you flash a light at a mirror that is titled sideways, as dead skin cells are, it will deflect the light elsewhere.  But, if you have a mirror that is flat, facing you directly, like newly exfoliated skin, the light will bounce directly back at you.  This is the exact effect that correctly exfoliated skin will have, hence the glow.

The next step is to make sure that your newly exposed skin cells will perform at their optimum level for as long as possible before you exfoliate them again.  The best way to do ensure cell’s high performance is by introducing high levels of anti-oxidants right after exfoliating.  Anti-oxidants like Alpha Lipoic Acid (universal anti-oxidant), Vitamin C (packed with extra valence electrons), DMAE (proven firmer) and CoEnzyme Q10 (increases ATP cell energy).  It’s like putting lime juice on a freshly peeled avocado.  The juice helps to preserve the avocado from oxidizing (turning brown) quickly.

The goal is to keep newly exposed skin cells performing at their optimum level for as long as possible.  Once they begin to oxidize it time to exfoliate again.  Usually, even with strong anti-oxidants, the best results are achieved by gently exfoliating on a daily basis with an active enzyme like the Triple Pumpkin + Ferula or every other day with either of the two Overnight Peels. 

Do these two simple steps and you too will enjoy constantly glowing skin.

What is real ?
Topical Botox – Is It Possible?

For those of you that like details……… here they are……
Acetyl Hexapeptide-3 (Argirilene) is an Amino acid that helps relax muscular tension.
Argireline is manufactured by a Spanish company Lipotec based in Barcelona. It’s a hexapeptide (a chain of 6 amino acids) attached to the acetic acid residue. It works by inhibiting the release of acetylcholine – a neurotransmitter – just like injected botox.

When applied to the skin, Argireline relaxes your superficial muscles.. leading to the reduction in facial lines and wrinkles with regular use.

Visible proof ???

Pictures below are skin treated with Acetyl Hexapeptide-3 after 30 days.

Hey sceptics we plan to do a photographic comparison with Visia skin assessment for you to see…give us a month..
This key ingredient can also be found in KCMD’s Peptide Smoothing Complex that also includes hyaluronic micro-spheres, GABA, two mushroom extracts, white tea, and tri-peptides that mimic collagen and elastin synthesis. A must to compliment any Botox or Dysport injections.

Realistically, no topical is going to do what Botox or Dysport (European Botox) do because its not being injected directly in to the muscles. At the moment Acetyl Hexapeptide-3 is the closest topical that has similar effects of Botox.

What is wrong ?
Allergan aka big gorilla in industry with its Botox monopoly would like you to believe that Botox is the only effective "Botox out there". Thank god for competitiion, Medicis now sells Dysport a sexy smaller molecule that is also a Botulinium A product. After 18 years in Europe – this slick competitor now available here !!!

After six months of using this on us, our staff and our patients — total thumbs up for the Europa Botox.
Just a side note on Dysport…it takes less Dysport to achieve what Botox does and it begins to work faster and lasts longer. So a mercedes has now joined the cadillac of facial rejuvenation.

What is more wrong ? Allergan refuses to provide Latisse price reduction to cancer victims despite my spending 180k on their products last year – see www.CockerhamMD.com for more info on Lashes for Life and the Katz center.

What might be ?
Does titanium cause lung fibrosis – well our colleagues at Osmosis think so…more to follow on our next blog…..