Mirror, Mirror on the wall, OMG! Who do I need to call?

Are you avoiding your reflection because of wrinkles, deep furrows and creases, dark spots and sun damage?  If so, you’re not alone. After we hit our 40’s the person staring back at us in the mirror may look our true age, but not reflect what we feel inside, usually 10 -15 years younger.

Blame it on decreasing levels of estrogen!  That’s right, estrogen helps retain collagen in the skin and in our joints. 

Everyone wants to look younger, but not like we’ve had “obvious work” done. Most of us want to look better, more well-rested and leave everyone guessing at our secret to the fountain of youth. 

Reducing wrinkles, dark spots and sagging skin is just a visit to a dermatologist visit away. Here’s my Gold-i-locks advice: Consider the middle road; just enough, not too much, and not too little. 

2 Essential Questions

There are 2 main questions to ask yourself to help you decide what you may decide to do.

#1  What do I want to change about my appearance?

#2  What is my budget?

1. For wrinkles: There are injections of Botulinum toxin (Botox and Dysport) that freeze facial muscles to prevent wrinkles for worsening. If used repeatedly on an on-going basis, deep creases and fine lines will fill in gradually and be less visible.

These can be used to treat the fine and deep lines in the forehead that make us look constantly worried or angry. It’s a great treatment for the lines between the brows that telegraph anger even when we’re resting. These injections help with the laugh lines between the corners of the eyes and the hairline. In tiny amounts, they’re even effective for the fine lines on the upper lip. 

The injections usually last 3-6 months. The length of time depends on how each person reacts to the injections.

The cost ranges from $300 – $750 per site injected. Each provider claims that their injections are better, but the data indicate that the effectiveness is about the same. There is no downtime for these injections.

In addition to treating wrinkles, these injections can be used in the forehead to prevent migraines and headaches. 

2. For Deeper Creases: Fillers and some of the pulsed and intermittent laser treatments work well. 

Here’s my advice: Whatever you do, please Do Not use permanent fillers. These don’t dissolve over time and can leave the skin with large and small bumps and an uneven look. Fillers that dissolve over time are injections that get reabsorbed after several months and fill in the deeper creases. There is no downtime and the results are immediate.

The cost $500 – $1500 depending upon the number of areas injected

For a more lasting result, laser treatments work well. This will remove some of the surface layer of the skin, which creates a smoother appearance. For this, you will have 1 week of downtime, when your skin becomes red and then the surface layer peels off, revealing a much softer, smoother appearance. 

The cost ranges from $3,000 – $5,000.

For both of these results are improved with ongoing microdermabrasion every 2-3 months and continuous use of sunscreen.

3. For dark spots and sun damage: 

There are various creams that contain Hydroquinone that help lighten the skin over time. Retinol creams will also help the skin turn over or exfoliate, slowly reducing the appearance of dark spots. The cost ranges from $100- $200 per tube, which can last 1-3 months.

Pulsed laser treatments and chemical peels both do the same thing, which is to help remove the surface layer of the skin which has dark spots. This leads to smoother, lighter skin tones and are very effective. There is at least 1 week of downtime for each.

The cost ranges from $1800 – $5000

For both of these, the results are improved with ongoing microdermabrasion every 2-3 months and continuous use of sunscreen.


It’s important to be realistic about the downtime after laser or chemical peels. Your provider may minimize what you’re likely to experience. 

I had a TCA chemical peel about 2 years ago to help prevent some of my dark spots from becoming cancerous. I can tell you that the downtime was not what I expected. After 2 days, my skin became so tight that it started to crack, it was very red and peeling in small and larger sheets. When a friend stopped by the house unexpectedly and saw me, she burst into tears. 

I didn’t feel comfortable leaving the house for about 5 days. The benefit was that once the skin healed my face did and still does look years younger.

Yes, I’d recommend it, but be aware of the side effects.

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