Val Answers Your Top 20 Skincare Questions

Q: Is it more effective to use products from only one skincare line than to mix different brands? 

A: If you're like most women, you probably use products that contain active ingredients (alpha hydroxy acids to treat aging skin, for example). Typically the ingredients and products in a skincare line are formulated to work synergistically to maximize results and minimize side effects, says Jennifer Linder, MD, assistant clinical professor of dermatology at the University of California, San Francisco. But many of Linder's patients make the mistake of mixing the strongest products from several lines, which irritates their skin. It's especially important to be careful with retinoids, alpha hydroxy acids, hydroquinone and salicylic acid; the skin can become overstimulated if these ingredients are used simultaneously.

Bottom line: If you use only a gentle nonsoap cleanser, moisturizer and sunscreen, you can mix brands with abandon. But if you're trying to target specific skin conditions, it's better to stick with only one line.

Keep reading: Should you apply sunscreen before or after moisturizer?

Q: How can I get rid of spider veins on my legs? 

A: Among the many useless, inane things I've often wondered about: Wouldn't those intricate patterns of blood vessels be more appropriately called spiderweb veins? Anyway, if they're large enough to be threaded with a tiny needle, sclerotherapy—the injection of various chemical solutions into the blood vessels—is the best option, says Tina Alster, MD, clinical professor of dermatology at Georgetown University Medical Center in Washington, D.C. The solution irritates the vein's lining; tissue inflammation results, which causes the blood vessel to collapse and fade.
The procedure used to sting because of the nature of the solutions; now that there are better ones, it's nearly painless, says Alster. Most people experience temporary mild redness and swelling along the course of the treated veins. The treatment takes 10 to 30 minutes, depending on the number of veins; often both legs can be done in a single session. If you hate needles, you could try vascular laser treatments instead, though they're a little more uncomfortable because they zap the veins with heat, Alster says.

Bottom line: The best time to treat spider veins is in winter, when your legs are covered and more easily protected from the sun. (Tanned skin reduces visibility of the veins during the procedures and increases the risk of posttreatment hyperpigmentation.) Avoid sclerotherapy immediately before or during menstruation because of heightened sensitivity. You can expect to pay $350 to $1,000 for either procedure.

Keep reading: 15 treatments for more beautiful skin

Q: Help! I have turkey neck! Short of surgery, is there anything I can do? 

A: Another reader recently wrote to me complaining of chicken legs; we seem to be having a moment of poultry-related beauty issues. The problem with turkey neck is that you can't get dramatic results without taking dramatic action. Think of your neck as a skirt that needs hemming, suggests (the metaphorically gifted) Alan Matarasso, MD, clinical professor of plastic surgery at the Albert Einstein College of Medicine of Yeshiva University in New York City. You can iron the skirt (meaning treat it with various lasers, which can help smooth the skin) and reinforce the fabric of the skirt (meaning apply creams like retinoids that will encourage production of collagen and elastin), but unless you hem the skirt, you won't lose the excess fabric. You follow? And what does "hemming" entail? An incision behind the earlobes, suctioned fat, lifted and tightened muscles, and a small scar from behind the ears into the hairline. (Not to mention a recovery time of 10 to 14 days, and a cost of about $10,000.)

Bottom line: If your turkey neck is in full swing, neither lasers nor creams will make an appreciable difference. But before you send your neck to the tailor, think long and hard about what people see when they look at you. Your magnificent eyes and delicious smile may render your neck way less noticeable than you think.

Keep reading: What products to use on your neck

Q: When I get a bikini wax, the technician dips the wooden applicator into the pot of wax repeatedly. Could I catch anything? 

A: How are you feeling right now—good? I hope so, because if the technician isn't changing the pot of wax for each new client (ask her; she may not be), you could catch a lot of stuff you'd be a whole lot better off without. Infection in the vaginal area can be quite severe; you could be exposed to group A strep, staph, human papillomavirus and herpes, says Jennifer Linder, MD, assistant clinical professor of dermatology at the University of California, San Francisco. Waxing induces areas of microtrauma to the skin, making cross-contamination from client to client more likely, she says.

Bottom line: The technician should never double-dip the application stick; she should wear gloves during the treatment and use new paper or sheets for each client. If you're concerned about the cleanliness of a facility, take your waxable parts elsewhere.

Keep reading: How to prevent breakouts when waxing

Q: How can I keep my hands looking youthful? 

A: I love the look of mature hands; they seem to have earned the right to wear good jewelry. But there's lots you can do if you want youthful hands, says Deborah Sarnoff, MD, clinical professor of dermatology at New York University Medical Center. Hyperpigmentation (brown spots) can be eradicated with one treatment of a pigment-specific laser, like the Q-switched ruby or alexandrite. (A bleaching cream takes longer to work but will fade spots in about six weeks.) At night, apply a vitamin A prescription cream like Renova, or an over-the-counter retinol cream. Always remember to use an SPF 30 sunscreen on your hands to prevent new spots. If veins are your bugaboo, they can be diminished by injections of a filler like Radiesse or Sculptra.

Keep in mind: Wear cotton-lined or rubber gloves when you're working around the house and leather gloves when you're outside. And moisturize like crazy.

Keep reading: The secret to beautiful, line-free hands

Q: Since I turned 40, I've noticed that though my skin is dry, my eyelids have gotten oily. What's up with that? 

A: Some of the things you write to me about, my friends, would terrify a lesser woman. (Or maybe just a younger woman.) As for oily lids: First, if you have blurry vision, you should consult a doctor to rule out a couple of conditions that might cause oil on the lids, says Sapna Westley, MD, clinical instructor in dermatology at St. Vincent's Hospital and Medical Center in New York City. Though oil glands usually become less active during perimenopause and menopause, in some women hormonal fluctuations can cause overactivity of those glands, which can lead to oily skin around the eyes and nose, she says.

Or—I'm sure you've thought of this—you may be using too much eye cream. If you're finding it hard to wear eyeshadow or liner because it migrates off your lids, try an eyeshadow primer, which lays down a base that keeps your eye makeup in place.

Bottom line: Hormonal fluctuations can cause various changes in your skin; oily eyelids is one of them.

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