Q:

​“How do I get rid of the tiny white bumps under my eyes?” - Rebecca Bishop

A:

This particular question was asked by quite a few people. I also have these tiny white bumps, normally on the side of my nose or near the eye area. 

I thought I would go straight to my professional source, Dr. Katherine Lane of Ophthalmic Consultants, here in South Burlington, Vermont. Dr. Lane is a Cosmetic, Oculofacial Plastic & Reconstructive surgeon, who also does my injectables. 

If you would like to find out more information about injections such as botox and fillers you can check out my video “Watch Me Get Botox! Plus Q&A with Dr. Lane” on my youtube channel.

According to Dr. Lane:

These tiny white bumps are called Milia.

What are Milia?

Milia are small, pearly-white, or yellowish cysts that can occur on your face (including on your eyelids and under your eyes).

They occur when dead skin cells get trapped under the surface of the skin, forming a raised white bump, looking similar to a whitehead. 

Why this happens is not completely understood, although sun damage is a risk factor. Sun will make the skin rough, which in turn makes it more difficult for the dead skin cells to rise to the surface and be shed normally. There is probably some genetic predisposition as well.

Treatment:

Milia will often disappear without treatment. Milia that are bothersome to a patient can be drained easily in your doctor’s office; other options include chemical peels.

Regular exfoliation can improve skin turnover and resolve milia and prevent recurrences. Additionally, home glycolic peels are safe to try. But if it is close to the eye region I wouldn’t suggest using a face peel.

Retin-A products increase the skin turnover rate, as well. This is why it also helps with skin texture and dark spots. When using Retin-A near the eye, it should be a low concentration, and moisturizers should be used to combat associated skin dryness.

Prevention:

First and foremost, sun protection!! You should be wearing sunscreen every day, even if you are wearing a full face of makeup. I know some makeup products claim to have a certain amount of SPF, but to guarantee full protection you would have to use a lot more of the makeup product than you would typically use. 

Now, as for the treatment products I mentioned above, there is a number you can purchase to achieve all of these results. Many of them I have talked about in previous blog posts and use daily, or at least keep in the rotation of my skincare routine. 

You can also ask your doctor for prescription-strength Retin-A, which I also use but much less frequently. Prescription-strength Retin-A can have a drying effect on the skin and should be used sparingly and followed by a hydrating moisturizer.

Below I will list some of the top products that I use to help with skin cell turnover and keep my skin looking healthy and smooth.

Q:

"I would love to try this (The Tata Harper Giveaway from last months Column). I am 56 years young and I have spent the last 20 years taking care of everyone else but me and it is definitely showing now. I am struggling with all the different products out there and how to use them correctly for the best results. I would love to have a consistent skincare routine but I am at a loss as how to start and which products to use. You are beautiful and I would appreciate any advice on where to start."  ~ Cory

A:

Hi Cory! Thanks so much for the great question. I think this is something most of us women are going through today. We do tend to take care of everyone else first and at times put ourselves last. As we mature, our skin changes, and sometimes it feels like overnight.
 
I follow a morning and night skin care routine. Some ingredients and products work best at night, while your skin renews itself. Also, some ingredients are not meant to be exposed to the sun, so it’s important to know when and in what order to use your products.
 
Certain ingredients are a must to make sure we achieve that glowing skin that we are all after. In my experience, Retinol, Vitamin C and Hyaluronic Acid are ingredients that will help your skin achieve that goal. 
 
So here are my recommendations for a simple skin care routine:

"Mrs. Stafford, could you please suggest what Fillers are best for me. I'm 78 years old and I have some lines and wrinkles from sun exposure. Creams do not work except to moisturize. I love your skin."  ~ Willa White
 

Hi Willa,
​
Thank you so much for the compliment on my skin! I definitely do a lot of work taking care of it and skincare has kind of become a hobby for me:)

It is true that at some point creams and serums only deal with the surface skin. At some point in time, creams really won't do the job and that's when you need to get out the big guns. Some women are still opposed to getting injections because they don't want to look unnatural but with the right doctor, this won't happen. 

Products such as Botox and Dysport help with lines and wrinkles. These are brand names for the injectables that are used to primarily freeze the muscles and prevent them from moving. This will minimize the lines and wrinkles caused by aging. I do get Botox around my eyes (crowfeet) and on my forehead. Also in between my eyebrows right above the nose, this is what is referred to as the "11 lines". I have been doing this for quite a number of years now. I am very happy with the results, and as my Doctor notes, a little goes a long way. What we strive to do is a natural look, so yes, I still have a few wrinkles around my eyes, which is normal. I don't want to look plastic! This product will last for about 3 to 4 months.

Another treatment I receive is fillers. These products bring back the volume and fullness to your face. My Doctor places filler in my cheek area and the lines called "Marionette lines" which are right above the mouth on either side. Filler last longer than Botox or Dysport, normally between 6 to 9 months. Again, for this, you will need an experienced doctor to know where exactly to place the filler. It's all about the muscles and knowing the general anatomy of the face. My doctor is really the only person I would trust with this. 

I have a video that I'll attach which will give you so much more information. I filmed this with my doctor, Katherine Lane, to answer all the questions women normally have concerning this issue. You can also see me actually getting injections in the second half of the video. 

If you are unsure of going directly for the Botox I understand! If you are uncomfortable or wary of getting a substance injected into your skin (even though Botox, when done by a proper physician is completely safe) there are other solutions as well. One other procedure I had done at a medical spa that really helps with wrinkles is called the CO2RE laser. This can treat multiple skin problems including wrinkles, scars, and sun damage. It resurfaces the skin at superficial and deep levels. The downtime is about 7 days and you should stay out of the sun during this time. 

I will say that Botox and Fillers have really made a difference with how my skin looks, but don't expect Botox to be the cure-all. Obviously, you still have to be mindful and take care of your skin in other ways such as having a daily regime and not baking in the sun. If you have sun-damage already such as dark spots, I wrote a great answer for that in my August Column of Glowing with Mrs. Stafford. There are various things you can do such as face peels or lasers. 

Finally, I must stress again it is to know your doctor. Word of mouth is really the best way to find someone who will be right for you. I would not go to someone just because you saw a commercial or an ad. Ask for referrals and also a consultation before doing anything.  This is a standard procedure for any qualified doctor to do for you. Ask your friends if they are seeing someone that works for them. You'll be surprised how many people nowadays, men and women, who are getting injectables.

So I hope this is helpful for you and please keep me posted on your search!
​

OK, hold on Jen, I've got you covered! I went through exactly what you are going through right now. I know it can be very frustrating but there is a light at the end of the tunnel:) 

First of all, your skin is reacting to hormonal issues, which you probably already know. We women are so lucky, it never seems to end does it!? But I digress, the key here is to start slow with a light skincare regimen and try to get your skin to a healthy, happy place again. Using products that are kind to your skin will help. By this, I mean nothing abrasive. No scrubs or treatments that will dry out your skin even more. You need to calm your skin with GENTLE products. 

1. To start, one of my first posts I did on my blog was specifically for a simple Acne Treatment which I'm attaching here to help clear up those breakouts. It’s a quick six-step process in which all of the products are great for helping calm the skin. Most people tend to over-treat their breakouts. Either they use too many products at once not allowing time for any of them to work, or they overuse a harsh product that irritates the skin even more. I know it can be tempting to do these things since breakouts are no fun, but my advice is to take a step back and take a deep breath. If you stick to a simple regimen like the one above, with products that are gentle enough, while also treating problem areas, then you should start to see results.

If all of these are new products for you though make sure to use one product at a time, to test out how your skin reacts to each. This way if you do have a reaction you can pinpoint the product and take that out of your regimen. I do this with all the new products I try because I have extremely sensitive skin. I have a feeling this won’t happen with any of these products, but it’s always better to be safe than sorry. Everyone’s skin is unique and something that is fine for me might not work with you. But again all these products are extremely well made, highly reviewed, and meant to calm the skin. 

​2. To address your second issue of extremely dry skin I wrote a blog listing my Top 5 Favorite Moisturizers, linked here. All of these all miracle workers and should do the job! Once you get your breakouts under control it’s essential to find a great moisturizer to keep your skin glowing and hydrated! A lot of women, especially younger women, don’t understand the importance of moisturizing your skin every day. If your skin is prone to acne then your most likely using spot treatments, which is a step in the Acne Regime I linked above. It’s important to balance that out with a good moisturizer so you're not dealing with dry skin that inflames your problem areas even more.

3. Once your skin is healthy and feeling back to normal you can move on to the next step in skincare. There are so many products that are available over the counter and things can become very confusing. So many different ingredients and what do they all mean!

Well, one ingredient that I feel is a must in my skin regimen is Alpha Hydroxy Acids (AHAs). As your skin ages, it is necessary to start using products that contain (AHA). Products such as Drunk Elephant’s T.L.C. Sukari Babyfacial Mask (with 25% AHA + 2% BHA) or First Aid Beauty’s Facial Radiance Pads have the ingredient AHA. These products gently exfoliate the skin and will leave you with radiant looking skin. Glycolic Acid, which is a form of AHA, will improve discoloration and enlarged pores. Lactic Acid, another form of AHA, which is a very gentle AHA and is great for sensitive skin.

I know that got a little scientific but believe me I did my research. If you’re still confused just comment and I will try to clarify. 

​4. Finally, add a Vitamin C product to your routine. It works wonders! This month we are including the Glow Recipe's Pineapple-C Brightening Serum for the Glowing with Mrs. Stafford Giveaway. I love this product for brightening the skin and delivering antioxidants to protect the skin.

In Short: 
1. So start slow and easy.

2. Be consistent in your routine. 
​
3. ​Add in one new product at a time, such as a Retinol, Vitamin C, or AHA.
​

​I hope this helps. Jen, keep me posted on your progress and remember we're all in this together!
​

​"Hello Mrs. Stafford, 
I am currently 60 years old. My skincare question is “how should I take care of hyperpigmentation or dark spots from sun damage? I don’t like wearing too much makeup, so being able to clear up this issue will help me with that. I love your pretty face and how young you look. Hopefully, you can give me advice on what would be best for my skin. Thanks a lot!" ~ Shirley Navarro 

​Hi Shirley! Thanks for the great question! I know that so many women can relate to this particular issue.

There are 3 different ways you can deal with dark spots or what is called hyperpigmentation. This is a natural result of your skin being exposed to the sun. 

1. The first step I would take would be to purchase over the counter products.

• There are so many options on the market today that contain retinol, which is a key ingredient in helping sun-damaged skin.
• When looking for a retinol product, start with a lower percentage, 1% being a good starting point.
• Use only in the evening, beginning with twice a week.
• See how your skin reacts over a few weeks. If all goes well you can increase to three times per week.
• A product that I have used and found incredibly effective is Drunk Elephant A-Passioni Retinol Cream.
• A little goes a long way with retinol and this product is no exception. Use only a pea size for your face. It is a bit expensive but since you use only a very small amount it will last for quite some time.

Not only have I used this but my husband has also. He’s been using it for over 4 months now and very dark spots he had on the side of his face have faded and mostly disappeared. The extra benefits of retinol are that it helps with fine lines and wrinkles. 

2. If you feel that this is not working for you another option is to speak with your doctor or go to see a dermatologist.

• Talk with your doctor and try a prescription-strength retinol cream.
• Just be aware that when using any of these creams it’s a must that you wear sunscreen on your face at all times, even with over the counter products.
• Since you are trying to rid yourself of damaged skin, your skin cells will be turning over at a faster rate, thus exfoliating itself. That beautiful new skin will burn much faster if exposed to the sun, so don’t forget the sunscreen!

3. Your final option would be medical lasers.

• If all else fails this is a way to go but there are downsides to lasers that you should be aware of.
• First, treatments can be quite expensive.
• There can also be discomfort and some major downtime associated with lasers. But they do work!
• Look for a medical spa in your area to see what is offered. Make sure that they have good recommendations before making an appointment. Usually, they will have a website that you can check out to see reviews.
• Also, ask friends that have had laser treatments done. Do your homework to make sure that the person you choose is qualified and knows what they are doing.

I’ve had Fraxel laser done and while it took at least a week for my skin to heal and it was uncomfortable the results were incredible. No pain no gain as they say!

Hope this helps and let me know how you make out!