A Top Dermatologist Shares Her Secret for Looking 30 in Her 40s

For 44-year-old Louisville, KY, dermatologist Tami Buss Cassis, MD, there’s one go-to treatment that she personally relies on to keep her skin looking youthful and fresh. “Just like everyone else, I have the normal aging skin worries: fine lines, wrinkles, brown spots, larger pore sizes and sunken eyes.” As a skin care expert, Dr. Cassis has access to a multitude of noninvasive options for facial rejuvenation. To treat her own skin, she chooses microneedling as an easy and effective way to treat the common signs of aging, leaving her with a complexion that makes her look more than a decade younger than her actual age.


Before the Treatment

Using a small, roller-like device with tiny needles, microneedling works by making miniscule holes spaced apart in a given area of your skin. This creates a controlled skin injury that your body will respond to by sending collagen and elastin to heal the entire area. “When the trauma happens to the skin, it is forcing collagen remodeling,” says Dr. Cassis. “There is some slight pain associated with it, so we make patients sit with numbing cream about 20-30 minutes before the procedure. But beyond that, it’s a very safe, effective and fast treatment. The procedure takes about 30 minutes. Afterward your skin is very raw, swollen and a little bloody. You will have very specific skin care instructions to follow after the procedure. Sun avoidance is an absolute must!”

Immediately After the Microneedling Treatment

The collagen and elastin heals the damaged area and smooths out minor scars, flattens out fine lines and wrinkles, and promotes elasticity in the skin. “I love the glow it gives my skin,” adds Dr. Cassis. “My brown spots have diminished, and under the layers of skin that peeled off after my treatment, I can see an improvement in my fine lines.”

8 Days Post-Procedure

“My after picture was taken eight days after the procedure, and I am very happy with results,” says Dr. Cassis. “Most people will need a series of three treatments about a month apart. Results are ongoing and it really depends on what you are trying to treat. It’s a great option for acne scars, wrinkles and hyperpigmentation.”

The cost for a microneedling treatment varies by the physician, geographic region and the complexity of the procedure (some use radio frequency, platelet-rich plasma and special serums). “In Kentucky, the cost is about $300, plus the cost of the post-op care, which is about $100,” says Dr. Cassis. “Everyone will react differently, so make sure you are having this done in a board-certified dermatologist or plastic surgeon’s office.”




How to keep skin looking young? We asked the experts

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The beauty market is awash with anti-aging products, and the lists of ingredients in serums and creams that promise to slow down or reverse that process can be confounding.

Take a look at the fine print and you might encounter Vitamin C or green tea extract or alpha-hydroxy acids. Can anything make a difference?

We checked in with a handful of experts, including Dr. Gregory Henderson, a dermatologist and clinical instructor in dermatology at UCLA, in our search for answers.

By the way, cosmetics companies test their products extensively. The Food and Drug Administration does not test products, but can take action against a manufacturer if it has concerns over product safety.


Activated charcoal, which can absorb some toxins, has been used to treat alcohol and drug poisoning in emergency rooms for decades. But in the last few years, the beauty industry has embraced it, touting its ability to absorb dirt and oil. Can it be effective?

“When used as part of a mask or strip,” Henderson says, “the charcoal may help remove sebum and keratinous debris from skin pores.”

Clay and mud

Mud is sometimes used in masks that are used to hydrate the skin and is acknowledged by many in the medical community for its potential to help with skin issues. “Mud therapy,” says Henderson, “is an ancient tradition and historically has been used for inflammatory skin conditions such as eczema and psoriasis.”

Clay is one of the most common ingredients found in beauty products, and experts tend to agree that it can serve a useful purpose, if used according to directions. Clay masks, designed to remove oil, dirt and dead skin cells, can be used as a delivery mechanism for ingredients — oils and emollients, for example — to ease dry skin.

Sodium hyaluronate

Sodium hyaluronate, which is used in all sorts of wrinkle and skin-repair products, is a “cousin of hyaluronic acid, a naturally occurring substance in the skin which helps hang on to water and helps give the skin a younger appearance,” says UCLA dermatologist Dr. Hayley Goldbach.

“Dermatologists often inject hyaluronic acid fillers into skin, resulting in more volume and a reduction in fine lines.” Sodium hyaluronate, designed to be applied to the skin, “has not been shown to have the same anti-aging or collagen-boosting properties as injectable hyaluronic acid.” But it continues to be included in various medical studies and papers that are focused on the efficacy of various anti-aging products.

Alpha hydroxy acids

According to Medscape, an online reference source used by medical professionals, AHAs (including glycolic and citric acids) “improve skin texture and reduce the signs of aging by promoting cell shedding” in the outer layers of the skin. But “the mechanism of the action is not completely understood.”


Caffeine is used in cosmetics and cosmeceuticals to counter a number of skin conditions, including the appearance of cellulite. It works, in theory, “by stimulating lipolysis — the breaking down of fat — in the skin and by improving the microcirculation,” Henderson says.

Caffeine is also found in some eye creams, promoted by cosmetic lines for its ability to shrink blood vessels under the eyes, although “its role has not been well studied.”

Green tea extract

In the last few years, there’s been a surge in the use of green tea extract in beauty products. WebMD reports that “the ingredients in tea can reduce sun damage and may protect you from skin cancer when you put it on your skin.” Henderson says that “a study combining green tree extract, caffeine and resveratrol showed reduced facial redness.”

Vitamin C

Vitamin C is one of the most popular ingredients in anti-aging products, promoted as something that can protect cells from free radicals, which can damage cell DNA, increase signs of aging and lead to cancer.

Some experts say the antioxidants found in vitamin C can assist the body’s production of collagen. But Henderson cautions: “While limited studies have shown that topical vitamin C may limit photoaging, many current preparations … are not formulated to allow the vitamin C to effectively penetrate the skin. Also unless protected from the air, most preparation became inactive without hours of opening.”


Peptides, formed from amino acids, are “cellular messengers” of sorts and are commonly used in beauty products. According to Henderson, signal peptides may stimulate collagen production. Carrier peptides “may aid in the delivery of copper to the skin and promote smoother skin.” (Copper is said to help develop collagen and elastin.)


Many of us associate algae with unpleasant encounters in the water (seaweed, pond scum, etc.), but algae have been used in traditional diets and folk medicine for centuries.

In the beauty world, you might read about ingredients such as blue marine algae or brown algae extract. You won’t find universal agreement on their effectiveness in cosmeceuticals, but an article in the Journal of Cosmetic Dermatology suggests brown seaweed “could be used as a potential cosmetic ingredient to make skin firmer and smoother.”

The bottom line?

Some of the ingredients listed in the fine print on cosmetics and cosmeceuticals may actually help your skin. But what the experts really hope you’ll indulge in are rest, exercise, a healthy diet and sunscreen.


Wall Street is looking for a big rebound from what’s been a bad year

After six turbulent months, there’s good news for Wall Street banks, and there’s bad news.

The good news first: it’s likely getting better. Of course, that comes as big banks try to rebound from the bad news: It’s been the worst start to a year, on a number of metrics, since the global financial crisis.

Bankers say that despite the shock Brexit vote in late June, there are more corporate buyers weighing big M&A deals and more companies eyeing the IPO window after seeing signs of life in the U.S. market. Now, some market watchers have become hopeful that there will be more public offerings in the back half of 2016, and more big deals to prop up big banks’ top lines.

LeBron James

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LeBron James

If investor wariness is pushing cash out of international markets, there’s hope that an influx of investment into the U.S. will foster more IPOs.

“It is easier for companies to get public when mutual funds have positive cash flows,” said Lise Buyer, partner with Class V Group, which works with pre-initial public offering start-ups. “You don’t have to be profitable, you have to paint a compelling picture of why you will be.”

The bad news is that IPO revenue for big banks is down to a level not seen since 2009, coming in the wake of the global financial crisis, according to data from Dealogic.

But that said, revenue to big banks on IPOs more than doubled from the first quarter to the second quarter of this year, Dealogic data indicates, rising from $405 million to $1 billion. And, recently, some market bulls have pointed to upbeat metrics, despite the turmoil that closed out the second quarter.

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And all of a sudden, there seems to be a big turning of the tide in terms of private companies’ sentiments regarding public markets. On Tuesday, snack maker Hostess charted its ambitions to complete its post-bankruptcy turnaround, announcing plans to make a public market debut through a reverse merger with a listed acquisition company. Also this week, the Wall Street Journal reported that iPhone production company Foxconn Interconnect Technology is aiming to raise up to $1 billion in an offering of its own.

All of this comes on the heels of the runaway success of software company Twilo’s initial public offering, which saw shares shoot up after its late June market debut.

Separately, there are signs that M&A may finally take off. After seeing a record number of transactions busted up by Washington regulators, big banks are probably reassured to see more mega-deals being considered by corporate boards. Blockbuster M&A deals includingBayer’s bid to buy out Monsanto could be followed by other large-scale mergers in sectors including pharmaceuticals, one banker said.

Part of what might be pushing corporate boards to weigh big purchases is the cheap debt expected to proliferate in the 2016 market, thanks to central bankers’ unease with raising rates in the immediate wake of June’s Brexit vote. And, elsewhere in the deal marketplace, bankers think that stalling Silicon Valley valuations could also push once-hot start-ups to consider selling out if the right offer arrives.

“In a post-Brexit world and a better but still discerning IPO market, you will see seller capitulation that results in accelerating tech M&A, including a few unicorns,” said Elgin Thompson, managing director at Digital Capital Advisors.