Vitiligo

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Our skin may have its share of challenges--dark spots, stretch marks, cellulite, unsightly veins--but know that there's always a solution. We asked the experts for their favorite tried, true and new treatments, sure to leave you feeling 100-percent beautiful in your own skin

TRIED AND TRUE Dark spots can appear just about anywhere on our bodies--as remnants of old mosquito bites, acne scars or just tough, dark-pigmented skin on knuckles, elbows or knees. How best to combat them? "Topical bleaching solutions do work--you just have to find the right formulation, stick with it, and wear sunblock," says dermatologist Frederic Brandt. Some prescription products Brandt recommends include Tri-Luma, a type of Retin-A mixed with a bleaching agent and a little cortisone that he says is good for both the face and body, and Epiquin, which has an effective time-released formula of 4 percent hydroquinone and is usually prescribed for the face.

You can also find over-the-counter bleaching agents with up to 2 percent hydroquinone, but they may not be as effective. "Once in a while I'll find a patient of color who is responsive to 2 percent, but we usually need a higher dosage," says Heather Woolery-Lloyd, M.D., director of ethnic skin care at the University of Miami. Over-the-counter cosmeceuticals, which offer both cosmetic and pharmaceutical benefits, are another option. Two to try: Exuviance Essential Skin Lightening Gel 2 percent and Dr. Brandt's Lightening Gel with 2 percent hydroquinone.

THE NEXT LEVEL For more severe dark marks, consider microdermabrasion and acid peels. Microdermabrasion uses a combination of suction and small crystals to remove dead skin cells. Acid peels--salicylic and glycolic are the most common--remove these cells chemically. "These exfoliators can hasten the improvement of dark areas when used in conjunction with bleaching agents," says Woolery-Lloyd. But, she adds, it's imperative that you consult a dermatologist or aesthetician who's experienced with our skin.

A number of at-home peeling systems mimic in-office procedures. Though not as strong as professional treatments, they can still be effective. A caveat: If you're using a topical retinoid such as Differin, Tazorac or Retin-A, check in with your doctor before using at-home chemical peels; the combination can be too aggressive.

ZONE: CELLULITE

TRIED AND TRUE Mesotherapy, in which a solution is injected into the skin's deepest layer to help shrink fat cells, has long been used to fight cellulite.

R&B legend Roberta Flack, who undergoes the procedure, claims that mesotherapy has dramatically reduced her cellulite, from her saddlebags to her waistline. "It eliminates cellulite over a period of time," she says, although she believes healthy eating habits and exercise also contributed to her results. "You can't have the treatment, then stop off at Krispy Kreme," she says. About 60 percent of patients will need a numbing medication such as a topical anesthetic or laughing gas prior to the procedure, says Lionel Bissoon, M.D., of New York City. Ten to 15 treatments or more may be required.

And don't forget the seaweed, says aesthetician, spa owner and natural-health expert Susan Ciminelli. Despite a diet rich in fat, sugar and alcohol, the French have had their cellulite under control for years, and it's all about seaweed, both inside and out, she says. "The cellulite-conscious French regularly include it in their baths and body treatments and consume it, either through taking supplements or by drinking liquefied seaweed," Ciminelli explains. She developed her own seaweed treatments years ago. Visit susanciminelli.com for information.

THE NEXT LEVEL Renowned dermatologist Howard Murad, M.D., has written a comprehensive book on the subject, The Cellulite Solution (St. Martin's Press, March 2005). He has also created a line of internationally patented anticellulite treatments, Firm and Tone Serum and Firm and Tone Dietary Supplements, which he says get to the root of cellulite by strengthening blood vessels.

If you're plagued by cellulite in your thighs and derriere, you may be an ideal candidate for stringcision, a same-day surgical procedure in which fibrous connective tissue is cut to smooth the skin's surface and create "instant gratification," Bissoon says. The process takes from 30 minutes to two hours, depending on the number of dimples you have. You can return to work the next day, although swelling may last for a week and bruising for from two to six weeks, depending on your particular skin tone. Hairstylist Ellin LaVar of LaVar Hair Designs in New York City tried it out in the spring of 2004 and says she has no regrets. "I love it, my thongs love it, and my Lycra pants love it," she says.

ZONE: STRETCH MARKS

TRIED AND TRUE Stretch marks are microscopic collagen "runs" that occur when the dermal, or top, layer of skin is stretched rapidly, such as during pregnancy or after rapid weight gain. "But if you act quickly, you may be able to minimize their appearance," says plastic surgeon Emily F. Pollard.

Ask your doctor if you're a candidate for StriVectin-SD, a cream that laboratory tests show can decrease the length and depth of marks, improve skin color and texture, and smooth the skin. Also ask about products containing retinoids--the active ingredient in Retin-A. "They can make stretch marks less noticeable," says dermatologist Susan C. Taylor, M.D., author of Brown Skin, Dr. Susan Taylor's Prescription for Flawless Skin, Hair, and Nails (Amistad).

NEW ON THE HORIZON "Although lasers have been used successfully in treating stretch marks, none have been safe enough for Black women until now," says Woolery-Lloyd. The Excimer Laser, originally used for vitiligo and psoriasis, is safe for our skin, she says. "A recent study showed that it offered a 68 percent improvement in older, light-colored stretch marks." You'll need about nine biweekly treatments, plus a maintenance program.

ZONE: UNSIGHTLY VEINS

TRIED AND TRUE Varicose veins have traditionally been treated by surgical stripping, which requires a hospital stay, anesthesia and lengthy healing time and often results in leftover scarring. Fortunately, current procedures offer real hope.

* Lasers: Great for spider veins. Strong pulses of light penetrate the skin, collapsing targeted veins. Lasers can, however, burn pigmented skin, so it's best for fair-skinned sisters. Look for a doctor experienced with skin of color and one who uses an Nd:YAG laser, which is safest for our complexion.

* Sclerotherapy: Veins are injected with a chemical solution, causing them to close. The blood reroutes to nearby normal veins, and the closed vein is absorbed by the body and disappears. The procedure is most effective when compressive wraps or tights are worn for up to three weeks to help seal veins shut. "Injections alone are less effective," Gray says. Sclerotherapy works best on spider veins, takes minutes, and leaves no scarring. It may cause "staining," a brown trace where the vein once was.

* Ambulatory phlebectomy: Varicose veins are pulled out by a miniature "crochet hook" through a series of tiny, nearly invisible skin incisions. Compression stockings are worn for up to one month afterward. Ideal for large varicose veins, and you can return to work the next day but should refrain from stressful physical activities for at least a week. A caveat: There is a possibility of nerve damage, persistent swelling and, in rare cases, blood clots.

* Closure (ablation): A catheter is inserted into the vein through an incision, usually at the knee. The tip of the catheter is heated, causing the vein to seal shut. It's effective for larger veins, with little scarring, but the veins may reopen, with a very small risk of clots, skin burns or nerve damage.

NEW ON THE HORIZON A two-step process known as harvesting permanently closes malfunctioning valves, causing most varicose and spider veins to disappear, says its inventor, vascular surgeon Hesmat Majlessi, director of the Park Avenue Vein Center in New York City. Several sclerotherapy sessions are performed to eliminate any remaining spider veins. After both procedures, patients must wear compressive tights for up to ten days. One drawback: The procedure is not yet readily available throughout the country. This method is not without controversy, however. Some doctors question its permanence. "Varicose veins are a lifelong issue," says Gray.

ZONE: DETOXIFICATION

Many believe beauty is truly an inside job. You be the judge

You Are What You Eat

Refresh your body from the inside out by nourishing yourself with foods that are naturally brightly colored--orange, green, purple, yellow--advises nutritionist Goulda Downer, R.D., in Washington, D.C. This will help you obtain the widest variety of nutrients--important for healthy skin and hair, which the body will sacrifice first if your nutrition is lacking. And healthy fats, including raw nuts and seeds, cold-pressed olive oil and fish, help keep skin looking lush, says holistic nutritionist and naturopath Sally Kravich of Los Angeles and New York City. "When we don't get good fats, we crave unhealthy ones, like those found in fried foods," she says. Cut back on white flour, sugar and processed animal foods, and minimize your intake of full-fat dairy products (replace with low-fat yogurt or sheep's or goat's milk, which is more like human milk).

Juice for Life

Want to jump-start your healthy eating plan? Try juicing fresh, preferably organic, fruits and vegetables. "You can get a much higher concentration of nutrients into your body by drinking your fruits and vegetables than by eating them," says Los Angeles naturopath Eve Virginia Allen, Ph.D. Start out by blending celery and apple or celery, apple and carrot. "The combination of celery and apple breaks down metabolic waste and the fats that form cellulite," Kravich says. Carrot, celery and beet juice cleanses the liver and intestines and helps clear the skin, she adds. For maximum cellulite-fighting, celery juice, which tastes somewhat salty, should take up at least half the glass, Kravich says.

Are you a first-time juicer? Three tomatoes (antioxidant), five celery stalks and two to three carrots will produce an appealing, flavorful blend. Once you become accustomed to these flavors, add more beets (liver cleanser), cucumber (diuretic), parsley (urinary-tract cleanser) and spinach (antioxidant) in small quantities as your tastes expand. You can always add an apple for sweetening.

Supplemental Insurance

Start with a quality multivitamin like those manufactured by Solgar or Twinlab, Kravich suggests. Add B-complex to stress (use formulations containing 400 milligrams of folic acid says); vitamin C to boost your immune system; calcium for strong bones; essential fatty acids (EFAs) to keep skin soft and supple and bowels moving smoothly; a "green drink" for chlorophyll, B vitamins minerals; and acidophilus to aid digestion. Check with your physician first before starting any new juicing or supplements regimen.

PHOTOGRAPHY BY MICHAEL BRANT

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