Thursday, June 30, 2016

But I thought I was here to talk about wrinkles and face creams?

So remember when I wrote this post from early April asking about skincare? A friend of mine who happens to be a nurse and maybe the first Democrat I met in Fort Worth highly recommended that I visit with a local dermatologist who specializes in cosmetic as well as medical dermatology. Knowing that Cayce is always right (she is also the woman responsible for bringing me to try Orangetheory), I called up Dr. R immediately, only to be told the first available appointment was June 29th. It was a lifetime away, but I made the appointment and hoped I wouldn't find any new wrinkles while I waited for the day to arrive.

And then it did! Somehow we're already at the end of June. I did yoga at lunch (I can do a modified Hurdler pose! (my top leg stays bent) - arm balances are my JAM right now and it's making class SO FUN) and then had to take a shower because I was so sweaty. I kept my face makeup-free since I was going straight to the dermatologist and figured she might as well see me at my worst. I exited the studio into 102 degree heat and wondered why I'd bothered with the shower.

Once at the dermatologist I was shown back to a room right on time. I told the nurse I wanted to talk about skincare and oh by-the-way I have this little mark on my chest that I treated with a dermatologist-prescribed cream a year ago but now it's back and maybe Dr. R can look at it. Dr. R came in 30 seconds later (by far the most timely medical appointment experience I've ever had), looked at my chest, and said, "okay, this looks like skin cancer, we'll be doing a biopsy today, please lie back on the table." Next thing I know my dress is pulled down and the doctor whose hand I shook ten seconds ago has two needles in her hands and is talking to me about radiation and surgery and ways she'll try to minimize the scar.

She was very kind and professional, filling me in with all the facts while stabbing me with needles, and I have no complaints about her bedside manner, I was just... I was still holding the little notepad I'd so excitedly brought to fill with skincare tips. For the wrinkles and the elasticity and other things that aren't fucking cancer.


Dr. R believes the spot is a basal cell carcinoma, which is a cancer that pretty much never metastasizes beyond the original tumor site. It still needs to be treated- I've had it for a long time (2.5+ years under the care of another dermatologist I will not be recommending) and the tumor can grow larger and deeper and be more disfiguring to remove, but it's not a particularly bad or scary cancer to have. My mom has had one and my grandma has had many. I'll get the biopsy results back next week to make it official, but the doctor was pretty confident in her diagnosis.

So I'm laying back on the table, now with a slice of skin removed from my chest, getting a handout on "wound care" and hearing I'll have to wear a band-aid for 2-3 weeks and talking about a possible radiation schedule... and my first hazy thought is "now I'll get a weird band-aid tan line at the lake this weekend." My next is, "is it inappropriate to ask about wrinkle creams now?" And in the back of my mind something is screaming over and over "I'm 33 and I have cancer. My skin is damaged enough and my genetics suck enough that I have cancer. And I can get more. I'll probably get more. I'm 33 and I have cancer."


After my new "wound" was properly covered and my slice of skin was packaged to be sent to the lab, the doctor asked if I had anything else I wanted to talk about. "Skincare?" I asked in a small voice, pulling my hopeful little notepad back in my lap after I had dangled it off the side of the table so no one would see it while I was getting biopsied.

"Of course!" she replied and we talked. Basically, she said there are a ton of skin products out there, but the only things that really do anything special are retinol and antioxidants. You need to cleanse and you need to moisturize- they have some they sell in the lobby that are great, but you can also use CeraVe or others. Where you want to spend your money is on a good, pure retinol (not mixed in with a lotion because it's hard to know how much retinol you're really putting on your face) and a good antioxidant. The retinol is just for aesthetics- it helps fine lines, wrinkles, and redness. The antioxidants are aesthetic as well, but they actually go a bit beyond that. She explained that skin cancer is caused by 3 things: (1) genetics (I'm screwed there); (2) sun damage (my past history is really bad, but from my 20's on I've been pretty on top of it and will remain so going forward); and (3) free radicals- UV, pollutants, and other junk in the air that soaks into and damages your skin. Antoxidants actually soak into your skin and create a protective barrier against UV and free radicals. It's like another type of sunscreen and more. They can also do a limited amount of healing in your skin. She recommended the Skinceuticals brand and off I went to the lobby skincare section, wound care packet in hand and highly visible biopsy bandaid in place.

Feeling vulnerable, I was ready to just hand the skincare managers my credit card and tell them to load me up, but they were gentle. They told me Dr. R had recommended the SkinMedica 0.25 Retinol Complex and the SkinCeutical C E Ferulic antioxidant oil. She also suggested an optional nighttime antioxidant, given that I was basically asking for product and I already had some damage, and recommended the SkinCeuticals Resveratrol B E serum. Skinceuticals makes an Anti-Aging Kit that includes the a.m. and p.m. antioxidants and their A.G.E. Interrupter moisturizer for only $10 more than buying the 2 products on their own (and the moisturizer retails for $161), so I just got the kit.

I also asked for a recommended sunscreen. Currently I have sunscreen in my morning lotion (that I don't love) and my makeup (that I don't always wear and I never reapply). I wanted one that was good and light and that I would put on again throughout the day over my makeup without ruining it. They recommended the Elta MD UV Clear SPF 46. It has zinc oxide which is by far the most effective sun blocker, but it's broken down by magic/science into tiny tiny pieces that don't look white on your skin. It's like rubbing on creamy fluffy lotion. I LOVE it. And at $28 it's not that much more than the Aveeno stuff I was buying that always felt thick when I put it on.

So that's my new routine. Here's the order, as scribbled in my little notebook:

1) Cleanse (I'm still using my CeraVe hydrating cleanser though they gave me samples of the SkinCeuticals one and I must say it feels amazing)
2) Antioxidant (3-4 drops on back of hand, dab on face, neck, and chest)
3) Moisturize (if needed, particularly after a night using retinol)
4) Sunscreen
5) Makeup

1) Cleanse
2) Retinol
(only 2x per week; pea sized amount)
3) Evening antixoidant (2 pumps, put on face, neck, and chest)
4) Moisturize

I've only used it for 24 hours but I do love how each of the products feels. I spent a lot and could have spent less but I wanted to wipe the slate clean and start over with my haphazard skincare. I wanted to invest in something an authority figure told me to use and the women I talked to in the skincare section said the products last them between 9-12 months, so I'm comfortable with the investment. And I have no doubt this is at least 50% because of the tiny place in the back of my mind screaming that I am 33 and have skin cancer.


Then, just to make this endless skincare story extra exciting, I did Orangetheory this morning and carefully packed my new skincare items to use before work. And so this morning, post workout and shower, I set my new glass bottle of antioxidant oil on the sink counter, turned away, and heard a SMASH. It had slipped off the ledge, down to the ground, and broken into a million pieces. And there I was- naked, in a small poorly lit bathroom with glass and oil everywhere. I had just shattered one hundred and sixty dollars into tiny pieces. And I'm naked. And it's oil and glass EVERYWHERE and I'm naked and I have cancer. And so the first thing I do is bend down to find a few drops without obvious glass shards and rub them off the floor and onto my face. Priorities. 

I pulled myself together, cleaned up the mess with a million paper towels, got dressed, and headed to work, recomposed and talking myself through a long list of things I haven't broken or lost in my life (my iPhone! any of my expensive jewelry! the iPads we don't even own!) to remind myself I'm not a failure and it's okay. It's okay to break one expensive thing. I'm okay. I'm sure the oil I rubbed off the floor is going to make my face look magnificent today and it's all going to be fine.

I'd already decided to replace the bottle. I was invested at this point and I just wanted to get on with my new program. I took a deep breath and called the dermatologist office to make sure they were open until I got off work and also to see if there was maybe any discount or special or anything I could use to help justify this repurchase. The woman I'd spoken to in the skincare department remembered me and said she'd call the office manager. The office manager was at home, but she got in touch with her anyway and then the office manager called their SkinCeutical rep, told her my story, told her I was a new customer, told her my investment, and the SkinCeutical rep said to replace my bottle for free. "Thank you!" I cried, almost literally, and I drove over to pick it up this afternoon. She also gave me a smaller sample glass bottle I could refill to take with me to work out so I wouldn't have to risk my larger one. I know you can find things cheaper online, and goodness knows I almost always do, but sometimes it really does pay to have that in person relationship and contact. This was definitely one of those times.

And so that's my update on skincare. I'll post another in 6-8 weeks when I can have a real review on the products themselves, but I am happy to have them and happy to have a new routine to follow. And obviously I'll keep you posted on the biopsy results and treatment. In the meantime, wear your sunscreen and don't put glass bottles on sloped surfaces. 


  1. Wow - really sorry to hear about your skin cancer, and hooray for the fact that you had the appointment!

    We have skin cancers in the family too - Dad had a nasty one removed 12 years ago and had no recurrence - didn't need any kind of follow up therapy either, hope you'll be the same.

    My sister had a cancer detected before it presented major symptoms (not skin cancer) and had surgery this week - there are some great treatments out there now - and getting even mild/strange symptoms that are "really not a big deal" checked is so worth it.

    Will send up a prayer or two for you and yours!

  2. Oh, honey. So much love to you.

  3. Good luck on your biopsy- hopefully that did the trick and no follow up is needed. Another recommendation if you can handle it-Peter Thomas Roth makes this AWESOME powder sunscreen that comes loaded into a fluffy brush so you can just dust it on (it is translucent). I keep it in my bag for mid-day sunscreen application and it is perfect for dusting in your scalp when you don't have a hat and don't want to fry or grease up your hair. Maybe I also use it on my daughter when I realize I missed her ears.....

    1. I use the Roth sunscreen too! It's great for applying in the afternoon!

  4. I'm 39 and after many years of abnormal moles I had my first basal cell cancer removed a couple months ago. Even though they're totally curable it I'd really unnerving to cross that line. I chose to gave a wide area excision done. It's on my chest but I don't really care about scars and I wanted the treatment that had the lowest recurrence rate.

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  6. I had a basal cell removed from my face when I was 30, just after I had my second of three children. I seriously had it on my face for probably 8 years before I didn't anything about it. Probably because I was in medical school and internship and residency and took care of everyone on earth but myself. By then, I had already buried my father from the ravages of metastatic melanoma three years previously, and have been a rabid skin protection enthusiast ever since. Fast forward 16 years, and I still wear sunscreen 365 days a year. My absolute favorite facial sunscreen is Elta md uv clear. There truly is no equal and I wear it every day under makeup or not no matter how much, or not, I will be outside. I highly second the C E ferulic and the retinol recommendation as well. When I use the combination of those two religiously my skin never looks better. Your derm is spot on with the advice. It's ok, you can get another bottle. Is your skin not more important than $$? I highly recommend sun protection clothing, rash guards, and hats are a must. Coolibar and other companies makes some great stuff. Oh, and I am a radiologist at a cancer center so.... doctors orders!

  7. Oh man, that's scary! Please do keep us updated!

    I'm sorry your bottle broke - that is something that would happen to me. I'm glad they replaced it for you!

  8. I am so sorry. I hope that all goes well.


  9. Oh man, I'm so sorry! That's a really crappy string of happenings, in the midst of your other current worries. Hang in there and please keep us posted. Glad, at the least, you're not out $160.

  10. I'm so sorry about the BCC. I can identify with this (same age, same genetics) only mine was a melanoma. Thankfully it seems like it was caught early but I had a three week old at the time so you know, there were feelings. Thanks for the skincare recs!

  11. XOXO Happy that you're taking such good care of yourself, and sorry that something so scary happened to you.