What is acne?

Acne vulgaris (commonly called Acne) is a genetic skin disease caused by changes in the pilosebaceous units at puberty or later. If both parents had acne, three out of four children may have acne. Severe acne is inflammatory, but acne can also manifest in non-inflammatory forms. Acne lesions are commonly referred to as pimples, spots, or zits. The typical acne lesions are comedones and inflammatory papules, pustules, and nodules. Some of the large nodules are called "cysts" and the term nodulocystic has been used to describe severe cases of inflammatory acne.

Acne moves across the face like a wave, and remission (growing out of acne) occurs when each defective follicle has been involved. So does treating acne simply prolong and delay remission?

If you stop birth control pills the acne will come back because the progression across the face is not complete. However, this does not appear to happen with topical therapies like benzoyl peroxide. If we keep the acne in remission with topical therapies like benzoyl peroxide, the pore matures and doesn’t flare up.

Will the sun help acne?

There is no scientific evidence that the sun helps acne. If you feel that the sun improves your acne and you have blue eyes or blond hair, please keep in mind that the ultraviolet light increases your risk of skin cancer. Medications like tetracycline and some acne treatments may even increase your sensitivity to the sun. We recommend if you go into the sun to use Day Treatment Lotion SPF 15 Lotion and avoid any sunburn.

How do you treat neonatal acne?

Start with Green Tea Antioxidant Cleanser and Derm-A-Gel® conditioning lotion. Wash with Green Tea Antioxidant Cleanser, then, apply a pea-sized amount of Derm-A-Gel to the affected area once a day. If the area becomes too dry, decrease Derm-A-Gel to every other day. You should continue this routine for about 3-6 months or until all the closed comedones are gone.

What regimen would you suggest for someone with acne and very oily skin?

With very oily skin you can progress rapidly. In the AM wash with BP 3% Exfoliating Cleanser, tone with 9% Mandelic Acid 3-in-1 Toner and apply Spin Trap® Antioxidant Serum. In the PM wash with BP Cleanser 3%, cleanse with 9% Mandelic Acid 3-in-1 Toner and apply Exfol-A™. Later on, if needed, apply the BP 10% Gel Medication on top of the Exfol-A as a booster. Use the BP 10% Gel Medication Monday, Wednesday and Friday and leave on between 30 minutes to two hours depending on skin tolerance; then, wash it off. Eventually, the BP 10% Gel Medication may be left on all night. When you apply the BP 10% Gel Medication over the Exfol-A there is a synergistic benefit.

Is there any way to avoid the initial acne flare-up while on vitamin A therapy?

10% of the clients who start on vitamin A therapy will notice a “flare-up” as the vitamin begins to work by flushing out all the pores. Some of them may become inflamed. If therapy is combined with the BP Cleansers and Mandelic Acid Toners there is less of an opportunity for a flare-up since the bacteria are controlled.

Is vitamin A equally good for inflamed acne?

The vitamin A works best on the comedonal type of acne as it opens up the pore and flushes out the impactions. However, vitamin A is also a useful addition for inflamed acne. For inflamed acne take advantage of the BP Cleansers and the Tonics and Toners which reduce the bacteria and inflammation and allow the vitamin A to flush out the pores. With either type of acne the problem goes into remission when all the pores are flushed out.

What kinds of cosmetics should you recommend your clients to use if they have acne?

Avoid heavy foundation make-up and use loose iron oxide pigments instead. If you use a foundation, read the label carefully and to be certain that it doesn't contain comedogenic ingredients. Foundation should also be oil-free and water based. If you notice flare-ups occur when you use a certain cosmetic, discontinue its use. To make your own light foundation put a nickel size amount of the Day Treatment Lotion SPF 15 Lotion in your hand and mix in a small amount of the mineral make-up ( do not use talc powder. It doesn't combine well). A darker or lighter foundation can be made depending on the amount of pigment that you add.

I put a client with acne on the Clear Complexion System and the acne got worse, why is that?

Acne will appear to get worse, but it is actually getting better. In fact, the Vivant Skin Care program is flushing out the 10,000 pores on the face. As some of the pores are impacted, the follicular wall may break as the comedones are forced to the surface. The white blood cells rush in and inflammation develops. Once all the pores open, the white blood cells leave and the complexion clears up. Make sure you read Dr. Fulton’s book, Acne Rx, for full details.

If a client has an old cyst that flares up from time to time, what is the best way to get rid of it permanently?

Eventually, the comedone has to come out. So, heal up the flare-up with the ice compresses and use the Vivant Clear Complexion Starter System to work the comedone to the surface. Then, extract it out. The cyst will disappear once the pore is clear.

What do you tell people who have red macules? Is there a way to diminish them more rapidly than Mother Nature might?

Some people get red macules after their acne lesions heal up. These red macules will naturally heal and fade, but it may take a while. Use Totaloe twice daily and the red LED light to heal the red macules faster.

There is a 17 yr old Asian patient at my office with type II, non-inflamed, acne. She is very frustrated about her acne. She has been coming in consistently for facials/extractions and peels. At her last appointment we prescribed to her Tretin-X®, but she still has no results. Our office just started using Vivant products and I was wondering what would be the best regimen for her?

I would not use Tretin-X® as this is a generic Retin A® cream that contains isopropyl myristate. This ingredient is an acneogen which may flare-up her acne. I would recommend the following in the morning, BP 3% Exfoliating Cleanser, 3% or 9% Mandelic Acid 3-in-1 Toner (depending on her skin sensitivity), then topical vitamin C called Spin Trap® Antioxidant Serum. In the evening, use the BP 3% Exfoliating Cleanser again, then, Derm-A-Gel or Exfol-A (depending on her skin sensitivity). If necessary add the BP 10% Gel Medication fifteen minutes after Exfol-A, once or twice a week as a booster. Then, wash off the BP 10% Gel Medication after 1 or 2 hours or in the morning.

What is the best new treatment for rosacea to eliminate redness?

Rosacea is a unique condition causing a defect in the skin’s barrier. This results in very sensitive skin that flushes easily. A special Vivant product, Rejuv Rx, contains oligopeptides which suppress the body’s production of inflammatory prostaglandins. Within two weeks of using Rejuv Rx daily, the redness is suppressed and the skin’s barrier is repaired. For best results use Green Tea Antioxidant Cleanser for normal/combination skin or Cleansing Milk for more dry, sensitive skin, apply Rejuv Rx to entire area, and finally apply Day Treatment Lotion SPF15. The use of a blue LED Light at night also helps resolve the problem. With daily use of this program the rosacea improves. More aggressive Vivant programs, like the use of the Mandelic Acid 3-in-1 Toners, may be started after the skin has been repaired with Rejuv Rx.

What is melasma and how do we treat it?

Melasma, also called the Mask of Pregnancy, is a condition of defective melanocytes. In regions of the face the melanocytes, usually in Spanish clients, have estrogen receptors and whenever the blood level of estrogen increases these melanocytes are activated so they produce more pigment and the blotchy brown spots appear. When the estrogens decrease again (like after a pregnancy) the brown spots lighten but usually do not disappear completely. With each pregnancy or the use of Birth Control Pills the melasma is aggravated again. The treatment is to avoid extra estrogen and sun exposure. Vivant's Mandelic Acid and Hydroquinone products will help diminish the appearance of melasma, hyperpigmentation and uneven color.

Does Hydrocortisone thin the skin if used for long periods of time?

Only the strong steroids like – fluorocinolone thin the skin. The added fluorine group makes it stronger, but more damaging. Hydrocortisone – is strong enough to help a mild rash, but not strong enough to cause thinning of the skin. It can be used forever.

Is bismuth oxychloride acneogenic or an irritant?

Bismuth oxychloride (also called Blanc de Perle or Pearl White) is a completely inert (not soluble in either water or alcohol) white powder. The fine powder is used in face powders as a filler. It is not acneogenic or an irritant.

Can you replace glycolic acid with mandelic acid in every circumstance?

Mandelic is good for blotchy-brown type of acne. Not only does it flush out the pores, but it lifts the pigment. However, glycolic acid is the stronger acid and is quite useful in cases of persistent closed comedones that do not have pigment problems.

How does salicylic acid compare to vitamin A or mandelic acid in the treatment of acne?

Vitamin A and mandelic acid both peel off the surface of the skin and inside the pore. Salicylic acid peels just the surface of the skin leaving the comedones tight in the pore. So, they will not extract as well. We prefer the vitamin A or an alpha hydroxy acid like mandelic acid.

Can you use Mandelic Acid 3-in-1 Cleanser to control body odor?

Yes, it is a good body soap as it kills the bacteria, yeasts and molds on scalp, face, axilla, and groin. In the shower, start with rubbing the cleanser into the scalp and create suds. Leave it on while you shampoo the rest of the body, putting emphasis on the axilla and groin. Rinse off the body; then, the scalp. Repeat twice daily if you have dandruff or folliculitis. The cleanser is also good before shaving or waxing.

How do I know if I need to use the Normalizing Tonic or if I need to use a Mandelic Acid 3-in-1 Toner? What is the difference in the two?

The word Tonic and Toner are interchangeable and they are both part of Vivant®’s skincare programs. You use the cleaners to clean the skin and the tonic or toner to remove the skin of dead cells which allows the subsequent conditioners to penetrate better. The Tonic is mainly a glycolic acid toner which works very well to remove the dead skin cells on the skin and in the pore. Mandelic toner is better for dark skin patients because it absorbs slower preventing reactive hyperpigmentation, and it helps to lift off dark spots.

Is BP 10% Gel Medication as effective as a wash as it is as a leave-on?

BP is quite effective in suppressing the acne bacteria. When used as a wash or cleanser it will suppress the bacteria, but not as effectively as BP 10% Gel Medication left on the skin. For more severe acne the BP 10% Gel Medication is needed as a booster to compliment the twice daily BP cleansing. However, when the acne is clear and in remission, the BP cleansing should be continued to maintain the remission and the BP 10% Gel Medication maybe discontinued.

Should I prescribe the Vivant® Even Color System to patients who may have reactive hyperpigmentation after laser treatment?

Yes, this system can be used after a peel or laser treatment to avoid reactive hyperpigmentation. Patients start a month ahead of time with the Even Color System to condition the skin and, then, discontinue the system and switch to Vivant®’s Recovery Ointment for the first 5-6 days after the ProPeel® or laser treatment. Then recommence the Bleaching Cream around day 7-8 to suppress any reactive hyperpigmentation.

What types of skin (Fitzpatrick Skin Types I to VI) does the ProPeel® improve?

The ProPeel® improves all skin types. The safest to peel are the lighter skin types (redheads, blondes and brunettes – Fitzpatrick Skin Types I, II, and III). Always precondition the skin before the ProPeel® – use the appropriate Vivant® skincare program for the condition of the client’s skin. Precondition the clients with the darker skin types longer. For example, the Skin Types I – III precondition for one month; whereas, the darker Skin Types IV - VI precondition for two months. Also, when peeling the darker skin types for the first time, use ProPeel® I, II and skip III, and finish with ProPeel® IV. If the peel goes well, add all four steps of the ProPeel® in the next session. The ProPeel® can be repeated in 4 to 8 weeks.

How often can I do a ProPeel® on a client and what clients does it work best on?

A ProPeel® can be used on all clients. Each client is different so you can tailor the ProPeel® to their needs. The best results are obtained when the client’s skin has been preconditioned with one of the Vivant® systems for six to eight weeks prior to the ProPeel®.

To make the peel more effective dip the wooden end of the swab into the ProPeel® III and apply it to crow’s feet or other lines on the face and in acne scars. The new collagen generated by this treatment will puff out the fine lines and acne valleys. ProPeels® can be performed as frequently as once a month depending on the condition you are trying to correct. The information below is a guideline.

In our medical office we would ProPeel® an acne patient and, then, several weeks later put on just two or three coats of ProPeel® II to keep the impactions peeling out and to help prevent scarring.

For hyperpigmentation use the ProPeel® six times a year. Ten days after the peel, have the client resume using the Even Color System to suppress the action of the melanocytes.

Aged and photo damaged skin can benefit from the use of a ProPeel® six times a year.

Where is the TCA used in Vivant®’s ProPeels® derived from? Why is it so effective to peel the skin?

The trichloroacetic acid (TCA) comes from adding chlorine to acetic acid. When you add a hydroxide to acetic acid (which is vinegar) you generate glycolic acid. So, TCA is modified vinegar and a more effective peeler than glycolic acid. The chlorine makes the molecule stable and more potent. The TCA causes the white blanch on the surface of the skin. This is the denaturation of the keratin on the top layers of the skin. The skin rapidly proliferates to generate new skin cells and discards the old cells. As these new cells come to the surface the old cells are peeled off. This gives the appearance of scaling skin on days 3, 4 and 5 and new smoother skin within 6 to 7 days. The peel can be repeated every 6-8 weeks to keep generating new skin. This peel helps discard old sun damaged cells and blotchy pigment. It also clears up impacted pores.

What is the difference between the crystal and crystal free microdermabrasion machines?

All the original machines used aluminum crystals from Florence, Italy. They were quite useful to remove surface dead skin cells. However, the crystals clogged in the machine if there was high humidity (like doing a steam facial in the same room). The crystals ended up on the floor and in the client’s eyes. Also, one had to buy new crystals all the time. The diamond tips solve all these problems. However, both machines work well if everything is functioning.

What skin conditions are LED lights most effective on?

In combination with Vivant® skincare products the LED lights are helpful. The blue light reduces the bacteria and red light suppresses the sebum. The combination of the two helps improve the acne complexion. The LED therapy is also helpful in reducing the redness in rosacea and inflamed cysts in severe acne. However, they are only an aide and must be used with Vivant®’s Clear Complexion System.

Can the client use benzoyl peroxide, glycolic acid, mandelic acid and vitamin A skincare products/medications if they are pregnant or breast feeding?

The client should always check with their health care provider before using any products/medications while pregnant or breastfeeding. There may be circumstances that are unique to their pregnancy and baby that may affect whether or not they should use these products/medications.

Benzoyl Peroxide: Benzoyl peroxide has been proven in clinical studies to be safe to use during pregnancy. We do not have any studies regarding breast feeding.

Glycolic Acid:Glycolic acid has been shown to be safe used topically during pregnancy. We do not have any studies regarding breast feeding.

Mandelic Acid: Mandelic acid has been shown to be safe used topically during pregnancy. We do not have any studies regarding breast feeding.

These medications are not safe to use during pregnancy or breast feeding:

Tetracycline, Salicylic Acid, Tretinon, Isotretinoin and other products/medications containing vitamin A that either are known to be harmful during pregnancy or have not been fully tested as to their effects on pregnant and lactating women.

While using these products/medications the client who may become pregnant should use an effective method of birth control. If the client becomes pregnant while using these products/medications, have the client stop using these and contact their doctor.

It is not known if vitamin A passes into breast milk. If the client is breast-feeding and is taking these products/medications, it may affect their baby. They need to talk to their doctor about whether they should be using these products/medications while breast feeding.

Are Vivant® products tested on animals?

Our products have not been tested on animals. However, some of the raw materials that are in the products were tested on animals back in the 70’s/80’s. You would be hard pressed to find any skincare product that does not contain raw materials that were tested on animals up to the 1980’s. Many skincare companies will say that their products are not tested on animals. That is probably true, but the raw materials that they are using most likely were.