Chances are Dr. Graf's name sounds familiar. She is well-known for her expertise in skincare as a board certified clinical and research Dermatologist. Not only do her clients and others rely on her extensive knowledge about the science of skincare, but also her ability to blend nutrition and lifestyle counseling into an overall prescription for beauty inside and out.

DeLush thanks Dr. Graf for her generous time!

DeLush Asks: Obviously one of the biggest agressors against healthy skin is the sun. At this point, what SPF do you truly recommend daily? Does this differentiate based on skin coloring or should we all take similar precautions?

Dr. Graf Says: The sun is indeed a major aggressor against all skin types. Skin does have a natural UV absorber called melanin. This pigment is found most abundantly in darker skin types. The darker the skin tone the more melanin it contains and the more widely distributed in the epidermis. I recommend wearing a daily broad spectrum UVA and UVB sunscreen with an SPF of 30 to all of my patients regardless of skin color. During the summer months I recommend even higher SPF levels of 55 with frequent reapplication if outdoors. The differences may be based on the type of sunblock used. For example, light skin may do quite well with a titanium dioxide-containing block while the same product often leaves a bluish caste on African American skin.

Even though lighter skin is more vulnerable to the sun’s damaging rays and has a greater chance of developing skin cancer, no one is immune to skin cancer. In addition, darker skin tones are often very sun sensitive and can burn easily. Certain medications and medical conditions can also increase skin sensitivity to the sun resulting in skin which burns quickly upon exposure.

Finally, there is also a cosmetic consideration which is the tendency of darker skins to develop pigmentary changes. In African American skin which develops large pores and T-zone oil with age as well as blemishes, it is not unusual for drying acne medications to irritate the skin as well as post-inflammatory hyperpigmentation from the acne blemishes. Asian, East Indian and Hispanic skin types have pigmentary changes as their number one cosmetic concern. For all of these reasons I do not differentiate based on skin color - instead, I urge all patients to take similar precautions.

DeLush Asks: What is your opinion of the surge of recent over-the-counter versions of typically dermatologist or spa-applied treatments? (microdermabrasion, peels, etc.)

Dr. Graf Says: There have been an increasing number of over-the-counter at-home treatments available such as microdermabrasion and chemical peels which, though not dermatology strength, have nonetheless provided consumers with an opportunity to perform effective treatments in the privacy of their home at a great cost savings. If a treatment sold by a reputable company is used in exactly the way it is meant to be - these treatments can provide excellent results.

The downside of all of these at-home treatments is that there is an increased risk of skin complications such as irritation - often severe - from misuse and/or overuse of these products. The common tendency of 'more must be better' can result in 'over-exfoliation' of the skin which is damaging to the skin and at its worst can be severe enough to cause scarring and pigmentary changes.

In order to safely use these very well-made and effective treatments with success, I recommend the following rules:

• Use a brand from a reputable company so you can trust the research behind it.
  
• Do not use more than one type of treatment at a time. For example, if you choose an at-home chemical peel - do not buy a microdermabrasion kit to use in between treatments.
  
• Follow the instructions carefully and do not deviate from them.
  
• If you are under the care of a dermatologist, check to make sure that it is safe for you to use them. I have many patients who use these treatments at home but I may vary the way they are used based on their skin's needs. Also, certain medications such as Retin-A can cause a strong peeling reaction as can having certain skin conditions such as rosacea.
  
• Remember that exfoliation should be gentle for best results and too much exfoliating will hurt the skin.

DeLush Asks: You talk about “mechanical aging” and how we have some control over its effects on our skin by realizing when we are frowning, furrowing our brows, squinting, etc. and attempting to eliminate those habits. I notice that my worst habit is scrunching my brows together a bit while I’m concentrating, and when I catch myself I very often try to ease up and relax that area. But I often still feel a tension in between my brows that will lead them right back into that bad position. Is there something we should do to not only stop the action but release the tension in that area as well, to decrease the chances of returning to the habit automatically? (i.e. facial massage, etc.)

Dr. Graf Says: Mechanical aging is the term used to describe wrinkles and furrows that occur over time from repetitive wrinkle forming movements such as frowning and drawing the brow together. It is very difficult to stop oneself from from these types of movements since they are so much a part of our normal expression and we often frown while we are sleeping, however, it is not impossible. If Botox treatments are not in your radar than I suggest trying a number of different methods - preferable at the same time so they overlap and have additive results.

First, find a way that you have a constant reminder that you're frowning so when you are aware of it you can consciously relax the muscle. Try wearing an adhesive patch (made for sensitive skin if possible to avoid tape irritation) which can provide enough resistance to make you aware. This can be helpful even while sleeping providing enough resistance that the muscle will relax without waking you up.

Facials and regularly performed facial massage with lymphatic drainage by a skilled aesthetician can help muscles relax and decrease habitual frowning. Also, electrical stimulation treatments performed by a skilled professional can strengthen facial muscles that counteract the frowning muscles over time. Other relaxation techniques including acupuncture treatments can be helpful.

Use a good anti-wrinkle serum or cream with ingredients designed to lessen wrinkles and use it regularly, paying close attention to treating you lines. Your treatment in addition to helping the line lessen will also provide a massage and special care and attention to the area.

Finally, the new generation of temporary wrinkle relaxers through the use of GABA inhibitors can help by lessening the frequency and strength of muscle contraction to the frown lines.

DeLush Asks: What do you feel is the best first step toward reversing sun damage?

Dr. Graf Says: The best first step toward reversing sun damage is to prevent it. The earlier you start sun prevention, the less sun damage you will cause. The daily application of a broad spectrum UVA/UVB sunblock is a must for everyone - rain or shine. I also recommend wearing a mineral foundation over sunblock for enhanced UVA/UVB protection since most have an SPF of 15 - 20.

Preventing further sun damage also means that smoking cigarettes must stop since smoking increases sun damage.

Skin care to help reverse sun damage starts with retinol which is non-prescription Retin-A or the next best thing. Gently exfoliating the skin on a monthly basis can help the skin's appearance as well as allow treatment products to better penetrate the skin.

Using an anti-wrinkle product with retinol which contain anti-wrinkle peptides can be helpful in reducing the wrinkling that has accumulated and a topical anti-oxidant containing Vitamins E and C as well as green tea and other natural extracts can add more protection to the skin and enhance the action of sunblock.

Use a product to moisturize and hydrate the skin which also contains lipids for the moisture barrier. Many of these moisturizers also contain ingredients to 'brighten ' and revitalize the skin.

That's a start - finally, use a gentle pH balanced facial cleanser so as not to strip precious lipids off the skin and most of all - 'be patient and be good to yourselves."

DeLush Asks: Your skin looks absolutely lovely. It’s clear that you are a good example of proper skincare. If you don’t mind sharing, what is your personal skincare routine?

Dr. Graf Says: Thanks for the compliment. In a word, I employ everything that has been discussed and more. As part skin care junkie and part mad scientist I can tell you that life can be interesting. I am constantly trying new formulations with new ingredients and/or improved ingredients; I'm always first to try them since I have to love them in every sense before I'll continue to research them. I also use treatment products with skin respiratory factors which create energy within the skin cells making them better oxygenated and resulting in brighter skin. I use PHA's rather than AHA's as exfoliants since they are far less irritating and yield so many benefits including smooth, even-toned skin with enhanced radiance. Radiance is my goal and it is achieved by taking care of both inner and outer care. Everyone is capable of achieving radiance.

DeLush Asks: You have your own line of skincare products available on the Home Shopping Network right now. Will they soon be available through other venues?

Dr. Graf Says: Yes, my products have been available through my office and soon they will be available through my website, askdrgraf.com.

DeLush Asks: What would you consider one of the best low-budget skincare products? Luxury product?

Dr. Graf Says: That is a tough one! There are so many and it depends on what you are looking for as a benefit.

If you're on a budget:

• Retinol – Roc
  
• Lightening and Evening Skin Tone – Aveeno Positively Radiant and Neutrogena Visibly firm
  
• At-Home Exfoliation – Neutrogena
  
• Sunblock – Neutrogena Dry Sheer SPF 55

• Microdermabrasion – Lancome
  
• Wrinkle Treatment – Chanel Precision (very expensive but lovely)

DeLush Asks: What product from your own line are you most proud of?

Dr. Graf Says: Another tough question since I’m proud of all of them...I would have to say my Skin Deep Wrinkle products and my retinol resurfacing product as well as my retinol line.