You don&#39;t need eye cream, injections or plastic surgery to look younger and more attractive. There&#39;s a free way to get there. Just spend more time between the sheets.

When people in a study got at least 8 hours of sleep, they were deemed by outward appearances to be healthier folks compared with when their looks were evaluated after a bout of little sleep.

Face-refreshing sleep 
No doubt about it, a lack of sleep will show up on your face, giving you the appearance of aging skin. So it&#39;s no surprise that when people were kept up for 30 hours in the study, they were perceived as &quot;tired looking.&quot; The way sleep affected looks went even deeper, though. After a good night&#39;s sleep, the same people not only were deemed healthier looking but also were considered to be more attractive in general&mdash;just based on other people&#39;s perceptions of a morning-after photograph. Yep, turns out that the need for &quot;beauty sleep&quot; isn&#39;t just a lame excuse for leaving a dinner party early.&nbsp;

Best face forward 
A lack of sleep doesn&rsquo;t just contribute to aging skin. It affects the way your brain, endocrine system, and immune system work, too. And sleep deprivation can contribute to serious health problems, including high blood pressure and weight gain. Are droopy eyelids, dark circles, and saggy facial expressions broadcasting your sleep battles in the bedroom? Time to do something about it&mdash;you&rsquo;ll not only look younger, but you&rsquo;ll feel better also.

Medically reviewed in April 2020.

How to Look Younger Fast

If you don&#39;t know a pentapeptide from an antioxidant and, frankly, you don&#39;t care -- you just want your gator-dry legs to be soft and silky-smooth -- look no farther than your kitchen. The answer lies in that bottle of <a href="https://www.sharecare.com/health/herbal-supplements/can-safflower-oil-lose-weight?myAttribute=yay">safflower oil</a> sitting on the shelf. This polyunsaturated oil, beloved by cardiologists for being good for your heart, is just as good for your skin, but from the outside in.

The oil, which is pressed from the seeds of spiky yellow safflowers, is a super moisturizer. &quot;That&#39;s because it&#39;s very high in linoleic acid, a fatty acid that skin normally makes to keep its moisture level up and barrier function intact,&quot; says New York City dermatologist Amy Wechsler, MD, RealAge&#39;s skin expert. Because the body&#39;s linoleic acid production gets sluggish with age, it helps to replace it from the outside.

&quot;In theory, you could use <a href="https://www.sharecare.com/video/sharecare-experts/william-li/olive-oil">olive oil</a>, too, which is also high in linoleic acid. But you&#39;d smell like a salad!&quot; Wechsler says. Along with being odorless, safflower oil has the advantages of being colorless and cheap. And that&#39;s not all. Safe enough for sensitive skin, it&#39;s so gentle that it&#39;s massaged into the skin of newborn babies at some hospitals.

Although this natural oil is one of Wechsler&#39;s favorite treatments for dry lower legs (where flakiness can be especially persistent), you can use it body-wide -- though not when you&#39;re in a mad rush, as it takes time to soak in. &quot;Smooth it on immediately after a bath or shower to seal in the moisture your skin has just absorbed. You can even apply it on your face, as long you don&#39;t get it into your eyes; stop a bit below the lower lid.&quot;

If you&#39;re not sure about moisturizing with pure cooking oil, you can find safflower oil in moisturizers, lip balms, and scrubs. &quot;Look for a product that lists it among the first three ingredients, which means it contains a high concentration of the oil,&quot; says Dr. Wechsler.

Otherwise, just pour some safflower oil into a pretty little squeeze bottle and add it to your toiletries. No one will ever guess you cook with it, too. And your legs will look amazing!

Be good to your skin, from top to toe, with your own personalized skin care routine.

Medically reviewed in April 2020.

The Secret to Perfect Summer Legs

Congratulations on losing weight! Unfortunately, your battle of the bulge may not be over just yet. That&rsquo;s because substantial weight loss can leave behind loose, saggy skin that can make you feel self-conscious.

Enter <a href="https://www.sharecare.com/health/body-contouring/what-is-body-contouring" target="_blank">body contouring surgery</a>. Also known as skin removal surgery, body contouring surgery may be the last hurdle to overcome before you&rsquo;re content with your looks.

Why get it done? 
Body contouring surgery is elective; if you&rsquo;re happy with your appearance, you don&rsquo;t need it. But if you&rsquo;ve lost a lot of weight in a short period of time&mdash;as can occur after weight loss surgery&mdash;the excess skin may be bothering you. Body contouring surgery is a way to remove excess skin so that you can feel better about your looks.

What areas of my body can be treated? 
After substantial weight loss you can have excess skin in almost any area. Surgeons offer a <a href="https://www.sharecare.com/health/surgical-procedures/what-plastic-surgeons-bariatric-surgery" target="_blank">variety of procedures</a>, including:

<ul>
	<li>Tummy tuck</li>
	<li><a href="https://www.sharecare.com/health/cosmetic-surgery/what-belt-lipectomy" target="_blank">Belt lipectomy</a> (lower abdomen and back lift)</li>
	<li>Brachioplasty (arm lift)</li>
	<li>Face and neck lift</li>
	<li>Inner thigh lift</li>
	<li>Mastoplexy (breast lift)</li>
</ul>

How does it work? 
It depends on which area of the body you&rsquo;re working on, but all body contouring surgeries require an incision to remove excess skin and sutures to close the wounds. The procedures are performed under general anesthesia, so you are asleep during surgery. If you need more than one procedure, they will likely be done in stages, over a period of years to reduce complications and allow you time to heal properly.&nbsp;

What are the risks? 
Body contouring surgery, like all surgeries, has <a href="https://www.sharecare.com/health/body-contouring/risk-body-contouring" target="_blank">risks</a>. They can include infection, blood clots, scars, and anesthesia complications. There is also a chance you may not be happy with the results &ndash; your skin may still be loose or asymmetrical, or the results might not meet your expectations.

How much does it cost? 
Body contouring surgery can be expensive, and it&rsquo;s usually not covered by insurance. Costs vary widely, depending on the type of procedure, the surgeon&rsquo;s experience and your location. Make sure you understand the total cost of the procedure before you go under the knife.

Skin Removal Surgery After Weight Loss

In May 2019, a random tweet from a guy named Conor Arpwel had Twitter users in an uproar when he asked them one simple question: &quot;Do you wash your legs when you take a shower?&quot;

While it may seem random, it&rsquo;s an interesting question to ponder.

The Twitter poll, which generated over 852,000 votes, was split 80-20, with the majority of voters stating yes, they wash their legs while showering. Days later, comedian and talk show host Ellen DeGeneres put up the same poll on her own Twitter account, which garnered similar results.

This entire debate left us wondering if we should be washing our legs when showering. And what about the rest of the body? Is there a proper way to bathe from head to toe?

To settle the debate once and for all&mdash;and to learn the best way to take care of your skin while showering&mdash; we turned to Vinod Nambudiri, MD, a dermatologist at <a href="https://www.sharecare.com/group/grand-strand-medical-center">Grand Strand Regional Medical Center</a> in Myrtle Beach, South Carolina.

Why bathing is important&nbsp;&nbsp; 
First things first: bathing should be a regular part of most everyone&rsquo;s normal routine and it&rsquo;s likely you know why. But as a reminder, regular bathing helps to remove <a href="https://www.sharecare.com/health/embarrassing-health-questions/slideshow/5-down-and-dirty-facts-about-sweat">sweat</a>, dirt and dead skin cells while preventing body odor. If you don&rsquo;t bathe, sweat can mix together with germs that in some cases make their way inside the body through cuts and scrapes, causing more serious problems like infections.

So should you wash your legs? 
The Twitter users who defended not washing their legs argued that soap and water tend to drip when cleaning other parts of the body, so focusing on those lower limbs is not necessary.

While it is true that soap and water trickle down, &ldquo;I do recommend deliberately rinsing the legs with water,&rdquo; says Dr. Nambudiri. Plus, if you&rsquo;re in the shower or bath already, it&rsquo;s the logical thing to do. But unless they are visibly dirty, you probably don&#39;t need to wash your legs as thoroughly as other areas like your underarms or groin.

If you plan on&nbsp;<a href="https://www.sharecare.com/health/skin-and-beauty/slideshow/foolproof-tips-smooth-shaving">shaving your legs</a>, meanwhile, it may be a good idea to prime them before, and giving them a rinse is a great way to do it.

&ldquo;Make sure your legs are wet before you begin shaving,&rdquo; says Nambudiri, &quot;so your hair and skin will be softer, which will help wash away dead skin and oils that accumulate on the skin surface.&rdquo; A good rule of thumb is to shave your legs at the end of the shower.

Bottom line? While you may not need to spend a lot of time cleansing your legs, it&rsquo;s a good idea to rinse them off each time you take a shower or bathe.

6 bathing tips everyone should know 
Now that you understand leg-washing best practice, you may be curious about the rest of your body. Bathing is a very individualized process, since everyone&rsquo;s skin is different, and some may have conditions that require special treatment or products.

How often you need to shower also varies from person to person. If you&rsquo;re sweating more or your body is dirty, it&rsquo;s likely you&rsquo;ll need to shower more often. However, there are some general tips that most of us can follow:

<ol>
	<li>Start at the top: When bathing and showering, you should consider starting at the top of your body, then working your way down. &ldquo;Shampoo and condition your hair first since some of those products can linger on your skin if you save them until the end,&rdquo; says Nambudiri. &ldquo;Lingering products can promote things like acne or skin irritation, especially on the face.&rdquo; 
	 
	Then, move on to cleansing your face, followed by the upper body, lower body and then feet. This will ensure the products you&rsquo;re using are properly washed away. 
	&nbsp;</li>
	<li>Pay special attention to the dirtiest spots: When you&rsquo;re bathing, it&rsquo;s especially important to focus on the areas of your body that tend to be the dirtiest. &ldquo;The areas that have a greater number of sweat glands should certainly be cleaned every day,&rdquo; says Nambudiri. 
	 
	The most common culprits are the groin regions, under the breasts, armpits, the underbelly area, or any other place where skin folds overlap upon each other. The crevices of the elbows and backs of the knees and feet also tend to have sweat buildup. 
	&nbsp;</li>
	<li>Cool it down: Although it can be tempting to make the water temperature hot, doing so can dry out your skin. &ldquo;Hot water actually washes away more of the natural oils, which our bodies produce to hydrate our skin,&rdquo; says Nambudiri. Stick to warm water when you&rsquo;re bathing, and don&rsquo;t stay in any longer than needed. 
	&nbsp;</li>
	<li>Choose a mild cleanser: &ldquo;If you&rsquo;re choosing between a soap and a cleanser, cleansers are usually mild and less harsh, and probably won&rsquo;t strip away the oils of the skin,&rdquo; says Nambudiri. This is because they&rsquo;re less likely to contain the ingredient sodium lauryl sulfate, which is a common skin irritant. Cleansers typically work whether you have oily or dry skin. It can also be helpful to pick a cleanser with a moisturizing component to it, he adds. &ldquo;A moisturizer can counteract any of the drying that comes with cleansing the skin.&rdquo; 
	&nbsp;</li>
	<li>Don&rsquo;t over-exfoliate: Exfoliation, the process of removing dead skin cells from the surface of your skin, can be tricky. If done correctly, exfoliation can lead to brighter, more <a href="https://www.sharecare.com/health/skin-and-beauty/slideshow/how-pamper-neglected-body-parts">youthful looking skin</a>. But overdoing it can have the opposite effect, causing the skin to become red and irritated. 
	 
	&ldquo;If you use anything that&rsquo;s like a scrub, you want to be somewhat gentle,&rdquo; says Nambudiri. &ldquo;There&rsquo;s a fine line between exfoliation, which is turning over dead skin cells, and excoriation, which is actually stripping off the healthy skin cells that are on the top layer of the skin.&rdquo; 
	 
	Instead of exfoliating every day, opt for just a few times a week on areas like your face. Men should focus on hair-bearing areas like the chest or back, since they tend to have more dead skin cells. It&rsquo;s best to apply the product in a small, circular motion until the beads or grittiness dissolves, but don&rsquo;t rub the area for longer than 30 seconds. Rinse with lukewarm water when you&rsquo;re done. Never exfoliate if you have any sort of open cut or wound. 
	 
	The type of exfoliation and how often you need to do it will all depend on your skin type, so talk with your healthcare provider to learn what&rsquo;s best for you. 
	&nbsp;</li>
	<li>Pat-dry and moisturize post-shower: Nambudiri suggests gently patting skin dry post-shower, since rubbing can cause irritation. Then, make a habit of moisturizing the skin 2-3 minutes after showering when your skin is still moist.</li>
</ol>

So, the next time you hop in the shower, practice these healthy skin habits that are sure to keep your body clean, head to toe, legs included.

Medically reviewed&nbsp;in July 2019.

Should You Wash Your Legs? Plus 6 Other Must-Know Showering Tips

&quot;I want to look older.&quot;

Said no one ever (no one over 20, that is).

Six weeks after my daughter was born, I saw them. Lines! Crow&rsquo;s feet! When did that happen? Of course, I&#39;m proud of the life experiences that brought these lines. But that doesn&rsquo;t mean I won&#39;t put up a leeeetle bit of a fight to prevent them. Fortunately, we have many options now&mdash;from minimal to more involved treatments. Unfortunately, there is also a lot of hype and false claims around skin care products and anti-aging treatments. So, to tell us what really works, I asked two of my favorite dermatologists&mdash;Amy Kim, MD, dermatologist at MetroDerm in Atlanta and founder of Baby Pibu Products, and Brian Raphael, MD, dermatologist and fellow at Skincare Physicians in Chestnut Hill, Massachusetts.

Consider this your a&#39;la carte menu for getting skin that&rsquo;s smoother than a baby&#39;s you-know-what.

What to do at home 
1. Sunscreen:&nbsp;This one&rsquo;s a no-brainer. Daily use prevents wrinkles and <a href="https://www.sharecare.com/health/anti-aging-skin-care/what-treatments-for-age-spot">age spots</a> in the first place. News flash: most of us aren&rsquo;t using it correctly. You need to use a nickel-sized amount for your face and reapply every one to two hours to get nonstop protection. Make sure to use SPF 30 and above, broad spectrum. Don&rsquo;t want to mess up your makeup? Use a mineral powder with SPF for touchups (I keep this in my purse, and writing this just reminded me to reapply&mdash;so thank you!).

2. Retinoids: Every dermatologist I know swears by retinoids&mdash;a vitamin A derivative that comes in cream or gel form. Retinoids work their magic by preventing collagen breakdown and stimulating skin cell turnover, giving you what Dr. Kim calls the &quot;Retinoid Glow.&quot; They also prevent and treat acne (No one warned me that you could get both acne and wrinkles in adulthood. Whose idea was that?). Opt for the prescription form (often called tretinoin or Retin-A), as they are much more effective than over-the-counter forms. Most insurance companies won&rsquo;t cover retinoids and&mdash;warning&mdash;they can be expensive. But one tube will last you at least two to three months and is a better investment than most expensive over-the-counter creams. Expect your skin to peel at first, and only use a small amount as directed. Those with sensitive skin may find that they can only tolerate it every other night.

3. Basic Moisturizers: Moisturizers are great for hydration, and are important as our skin ages. However, most of the claims for expensive/&quot;high tech&quot; moisturizers don&rsquo;t provide significant benefit over those from reputable drugstore brands and probably don&rsquo;t merit the additional splurge.

Treatments to Consider at the Dermatologist 
If you want to go a step further to brighten dull skin, reduce wrinkles and fade brown spots, here are the most effective options. Note: You do not have to do all of these to get positive results (in fact, please don&rsquo;t&mdash;look no further than certain celebrities to know that more is often less when it comes to cosmetic procedures).

4. Chemical Peels: To really reduce lines and improve the tone and texture of your skin, derms recommend getting a &quot;medium depth peel&quot; two to three times a year. The downside: You&rsquo;ll look (and feel) like you have a really bad sunburn for three to five days, so be sure not to schedule this before any important events. It&rsquo;s smart to get a <a href="https://www.sharecare.com/health/skin-disorders/what-are-chemical-peels">chemical peel</a> in the winter, since you have to avoid all sun exposure for a few days after treatment.

5. Laser Treatments: These treatments are newer and can be pretty expensive, but they do smooth the surface of the skin and reduce the appearance of wrinkles and lines. There are a variety of <a href="https://www.sharecare.com/video/sharecare-experts/shirley-madhere/how-can-laser-treatments-help-my-skin">laser treatments</a>, some which have a similar effect to peels, and others with greater intensity for older skin. Your dermatologist will be able to recommend which is better for your skin.

6. Botox: Dr. Raphael noted that Botox injections are helpful for not simply treating wrinkles, but preventing them in the first place. Botox is best for between the eyebrows, around the eyes and forehead and will need repeat injections every three to six months to maintain its effect. Botox placement can truly change your appearance (ever seen the permanently &quot;shocked&quot; people?) so if you do go this route, please avoid the &quot;Discount Botox&quot; places, and instead go to a board-certified dermatologist or plastic surgeon&rsquo;s clinic.

7. Fillers: These are effective for rejuvenating the lower portion of the face, says Dr. Raphael, especially around the nose and mouth and under eye area. Depending on the type of fillers, they can last anywhere from six months to two to three years.

While these cosmetic fixes can improve your look from the outside, don&rsquo;t forget the impact that a healthy body has on your skin. Even in the ER, I can often tell someone&#39;s health status from their skin&mdash;it reveals their nutrition and exercise habits, whether they smoke, have heart disease, get enough sleep and have good social support. Especially the last one&mdash;because having beauty doesn&rsquo;t guarantee you&rsquo;ll be happy and loved, but being happy and loving certainly ensures that you&rsquo;ll be beautiful.

Medically reviewed in April 2018.

Busy Woman's Guide: 7 Best Anti-Aging Beauty Secrets

With a few healthy habits, you can steer clear of cuts and razor burn.

5 Foolproof Tips for Smooth Shaving

Get the facts about vampire facials, cryotherapy, fish pedicures and other strange spa trends.

10 Bizarre Beauty Treatments You Won’t Believe Actually Exist

Wrinkles may be an inevitable part of aging, but that doesn&#39;t mean fighting them is useless. Protecting your skin from exposure to ultraviolet radiation is the most significant thing you can do to prevent wrinkles, sagging and discoloration. And some people try invasive techniques, such as chemical peels, Botox, dermal fillers or surgery. But those efforts are all done from the outside. What about protecting your skin from the inside?

Can something as simple as modifying what you eat and drink help to smooth the lines on your face or prevent future wrinkles?

Erase wrinkles: No . . . look younger: Yes 
Studies show that what you eat or don&#39;t eat has a definite effect on the health of your skin. As your body&#39;s outermost barrier and largest organ, your skin is continuously exposed to various sources of stress, including many environmental factors. So, although a new diet won&#39;t clear away all your wrinkles or halt skin aging, nutrition can make a huge difference not only in how you look but also in how you feel.

Foods to fight aging 
Experts suspect that vitamins A, C and E and the minerals zinc and selenium may keep wrinkles at bay by reducing the amount of potentially damaging free radicals produced by skin cells. And carotenoid-rich fruit and veggies such as cantaloupe, apricots, carrots, sweet potatoes and spinach may also boost your skin&#39;s health. Tip: Choose fruits and vegetables that have deep green, yellow, orange and red hues. The intense color is the calling card of carotenoids.

Minimize your intake of simple or high-glycemic-index carbohydrates, such as enriched bread or flour products, processed and refined foods, candy and soft drinks. These are often low in nutrients and high in sugar. Instead, choose complex or low-glycemic-index carbs, such as legumes and whole-grain breads and cereals.

Healthy food choices for your skin 
Vitamin A

<ul>
	<li>Spinach, leaf lettuce, carrots, squash, sweet potatoes</li>
	<li>Papayas, mangoes, cantaloupe</li>
	<li>Low-fat milk, eggs</li>
</ul>

Vitamin C

<ul>
	<li>Red bell peppers, broccoli</li>
	<li>Peaches, oranges, papayas, kiwifruit</li>
</ul>

Vitamin E

<ul>
	<li>Nuts and seeds</li>
</ul>

Zinc and Selenium

<ul>
	<li>Fortified whole-grain cereals</li>
	<li>Eggs, low-fat milk</li>
</ul>

<a href="https://www.sharecare.com/health/healthy-skin/good-skin-food">Find more skin-healthy foods</a>.

Visit the water fountain of youth 
Imagine what happens to a plant when it goes without water for too long. It begins to droop, and then it becomes dry and brittle. Watering the plant may bring it back, but it will likely have damaged leaves. Water works similarly within people. By drinking water, you moisturize your skin from the inside out, helping to maintain its elasticity and suppleness, which means less droop, less dryness and less damage.

<a href="https://www.sharecare.com/health/water-liquid-nutrient/article/how-much-water-do-you-really-need">How do you know if you&#39;re drinking enough water? Here&#39;s how to tell.</a>

You&#39;ll get out what you put in 
It may not be a sure cure for crow&#39;s-feet, brow furrows, or laugh lines, but improving a few food and behavior choices could help your skin. Although studies specific to wrinkle prevention are currently limited, a host of other studies reveal that the same vitamins and nutrients that may protect your skin also are beneficial to the health of your eyes, teeth, nails, bones and circulatory system. So if a more youthful appearance overall is what you&#39;re after, then skin is only one part of the equation. Eating a <a href="https://www.sharecare.com/health/healthy-eating-guidelines/why-eat-variety-healthy-foods">diverse diet</a>, with plenty of fruit and vegetables can make your RealAge younger and can bring out a healthier and younger-looking you.

Medically reviewed in April 2020.

Is Your Diet Giving You Wrinkles?

Immunotherapy is a category of cancer treatment that helps the body&rsquo;s natural immune system fight cancer. It has been called &ldquo;the fourth pillar&rdquo; of cancer treatment (the other three pillars being chemotherapy, surgery, and radiation therapy).

Although they are a recent development in cancer treatment, numerous immunotherapy drugs are being used to treat a variety of cancers, including skin cancers like advanced basal cell carcinoma, advanced squamous cell carcinoma, and melanomas.

Cancer and the immune system 
One of the main functions of the immune system is to rid the body of anything that doesn&rsquo;t belong&mdash;including harmful bacteria, viruses, and parasites, as well as damaged cells and cells that have mutated (like cancer cells). To do this, the immune system creates antibodies that attack and destroy anything abnormal.

To protect normal, healthy cells from antibodies, the body uses something called immune checkpoints. These are proteins that signal the immune system not to attack certain cells.

Some cancerous cells&mdash;including some skin cancer cells&mdash;use immune checkpoints to remain undetected. This allows the cancer to continue to grow and divide without being attacked by the immune system.

Immune checkpoint inhibitors 
The immunotherapy drugs used in the treatment of skin cancer are called immune checkpoint inhibitors. These drugs work by disabling immune checkpoints, which allows the immune system to identify and attack cancerous cells.

Immune checkpoint inhibitors are typically used for advanced skin cancers, skin cancers that have spread to other sites in the body, and/or skin cancers that cannot be treated with surgery.

Different immune checkpoint inhibitors are indicated for different types of skin cancer:

<ul>
	<li>Basal cell carcinoma (BCC). Basal cell carcinoma is the most common form of skin cancer. The first immune checkpoint inhibitor indicated for the treatment of basal cell carcinoma was approved by the FDA in February 2021. It is used to treat advanced BCC that has not responded to other medications.</li>
	<li>Squamous cell carcinoma (SCC). Squamous cell carcinoma is the second-most common form of skin cancer. There are two immune checkpoint inhibitors that can be used in the treatment of advanced squamous cell carcinoma when surgery and/or radiation therapy are not appropriate treatment options.</li>
	<li>Melanoma. Melanoma is less common than the other two skin cancers on this list, but it is more likely to spread. There are four immune checkpoint inhibitors approved for the treatment of melanoma, which target different checkpoints. These are used in cases where the melanoma cannot be treated by surgery or have metastasized (spread to other sites in the body). Some are also used as adjuvant treatments&mdash;therapies that help prevent a recurrence or relapse of cancer.</li>
	<li>Merkel cell carcinoma. Immune checkpoint inhibitors may also be used in the treatment of this rare-but-aggressive form of skin cancer, usually when the cancer has spread.</li>
</ul>

It is important to remember that not every treatment is right for every person, and that every case of skin cancer is different. Like other cancer treatments, immunotherapy drugs cause side effects, and a person should work with their healthcare team to understand the potential risks and potential benefits before starting any treatment.

Sources:

Philip Hunter. &ldquo;The fourth pillar: Despite some setbacks in the clinic, immunotherapy has made notable progress toward becoming an additional therapeutic option against cancer.&rdquo; EMBO reports, 2017. Vol. 18, No. 11. 
American Cancer Society. &quot;Immunotherapy for Advanced Basal or Squamous Cell Skin Cancers.&quot; 
American Cancer Society. &quot;Immunotherapy for Melanoma Skin Cancer.&quot; 
Cancer Research UK. &quot;The immune system and cancer.&quot; 
National Cancer Institute. &quot;Immune Checkpoint Inhibitors.&quot; 
NCI Dictionary. &quot;Immune checkpoint inhibitor.&quot; 
American Academy of Dermatology Association. &quot;Types of Skin Cancer.&quot; 
U.S. Food &amp; Drug Administration. &quot;FDA approves cemiplimab-rwlc for locally advanced and metastatic basal cell carcinoma.&quot; 
Skin Cancer Foundation. &quot;Melanoma Overview.&quot; 
American Cancer Society. &quot;Targeted Therapy Drugs for Melanoma Skin Cancer.&quot; 
American Academy of Dermatology Association. &quot;Skin Cancer Types: Merkel Cell Carcinoma Diagnosis &amp; Treatment.&quot; 
Elsevier Point of Care. &quot;Clinical Overview: Merkel cell cancer.&quot;

Can Immunotherapy Treat Skin Cancer?

Keep your skin hydrated with these simple tips from a dermatologist.

6 Ways to Prevent Dry Skin

The winter weather outside might be frightful, but your skin can stay delightful. That&rsquo;s right! Say goodbye to chapped lips and dry, cracked skin. We&rsquo;ve got five tricks to take your skin from drab to fab all season long.

1. Lock in moisture 
Between the cold air outside and the dry air inside (the unfortunate drawback of running your heater), your skin loses a lot of moisture. Couple that with the fact that 80% of the sun&rsquo;s UV rays can reflect off the snow, and it&rsquo;s a perfect storm for wrinkles. To help keep your skin looking youthful, use a double-duty moisturizer that contains a broad spectrum&nbsp;SPF&nbsp;of at least 30 that contains&nbsp;<a href="https://www.sharecare.com/health/skin-moisturizing-care/what-ingredients-choosing-moisturizer" target="_blank">these key ingredients</a>. Your fingers, especially around the nails, are also vulnerable to winter weather. To protect your hands, try using a heavy moisturizing cream that&rsquo;s free of perfumes and other additives that may irritate your skin. <a href="https://www.sharecare.com/video/sharecare-experts/rosemarie-ingleton/how-can-i-keep-my-dry-skin-moisturized-during-the-winter" target="_blank">Find out the best time to slather on the moisturizer.</a>

2. Feed your skin wrinkle-fighters 
You&rsquo;ve probably heard that getting&nbsp;vitamin C&nbsp;can help you fight a cold, but it&rsquo;s also a secret weapon against wrinkles. Vitamin C helps plump up&nbsp;collagen&nbsp;and stops skin from sagging&mdash;so make sure to put oranges, grapefruits or other citrus fruits on your grocery list. Not a fan of citrus? Using a topical cream that has vitamin C can also fight wrinkles and prevent dryness.

3. Wash with the right stuff 
You want to keep your skin clean, but you don&rsquo;t want to overdo it. In the winter switch to a&nbsp;gentle pH-balanced cleanser&nbsp;that won&rsquo;t irritate your skin and that keeps moisture in. If your skin is super dry, try washing your face only once a day instead of twice. And remember to pat your face dry with a towel so that you don&rsquo;t dry out your skin even more.

4. Don&rsquo;t forget to exfoliate 
Sloughing off dry, dead skin cells&nbsp;is essential in the winter because it helps reveal new, more moisture-rich cells. Plus, it reduces the appearance of fine lines, and who doesn&rsquo;t want that? Make sure you choose a&nbsp;gentle exfoliant&nbsp;that won&rsquo;t irritate and dry out your skin even more. Also, look for products that are enzyme-based. These products have ingredients like papain, bromelain or protease. And don&rsquo;t forget to moisturize afterwards. Want to make a homemade exfoliant?&nbsp;<a href="https://www.sharecare.com/health/skin-hair-nail-beauty/article/why-your-skin-craves-oatmeal" target="_blank">Try this dermatologist-recommended recipe.</a>

5. Love your lips 
Cold weather can leave your&nbsp;lips chapped and cracking at the corners. But if you reach for lip balm, not just any product will help. Some lip balms actually contain ingredients that can dry out your lips even more. Avoid lip balm with mineral oil. It creates a film on your lips that fools your skin into thinking it can stop producing its own oils.

5 Winter Skin Savers

Five things your hair is trying to tell you.

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Your smile may reveal some important clues about your overall health. Research suggests that gum disease may be a risk factor for a variety of health issues, including some cancers, heart attack, stroke and even dementia.

The good news is that taking better care of your gums can help you protect your long-term health.

Are you at risk for gum disease? 
Gingivitis, the mildest and most common form of gum disease, occurs when bacteria-laden plaque takes up residence between your gums and teeth, causing inflammation. If you&rsquo;re not brushing and flossing properly, plaque can harden along your gumline and form tartar. Unlike plaque, which is colorless, tartar is yellow or brown and can&rsquo;t be removed with just a toothbrush. The longer plaque and tartar stay on your teeth, the more irritated your gums will become, making them red, swollen and prone to bleeding.

&quot;In an ideal world, your gums should be healthy enough not to bleed when you brush your teeth,&quot; says Jonathan Miodownik, DMD, an associate program director of the Mercy Dental Clinic, located within <a href="https://www.sharecare.com/group/saint-joseph-mercy-health-system">St. Joseph Mercy</a> Oakland hospital in Pontiac, Michigan. Besides bleeding and swelling, gum disease may be marked by receding gums that can make your teeth look too long, as well as bad breath, which is caused by the accumulation of bacteria on your teeth and gums, he explains.

Advancing age is a risk factor for gum disease. In the United States alone, as many as two in three older people have gum disease, according to the Centers for Disease Control and Prevention (CDC). Other risks may include smoking, a history of diabetes, tooth grinding and poor oral hygiene, Dr. Miodownik adds.

Hormonal changes, certain medications (such as high blood pressure or immune system-suppressing drugs), or a vitamin C deficiency can also lead to gingivitis.

Left untreated, the condition can progress into periodontitis&mdash;more advanced gum disease that can erode the tissue and bones supporting your teeth. Healthy gums hug each tooth, but diseased gums begin to form pockets where bacteria can seek shelter and do even more damage. When plaque then gets trapped in these pockets, it can no longer be removed with brushing and flossing alone.

&quot;The plaque accumulates, and this triggers an inflammatory response, first in your mouth and then elsewhere in your body,&quot; Miodownik explains.

Research has linked periodontal disease (gum disease) to a range of health issues, including:

Heart attack: People with gum disease may have a higher risk for heart attack. In a February 2016 study of 1,610 people published in Circulation, those with a history of gum disease were 28 percent more likely to have a heart attack. Precisely how gum disease affects the heart isn&rsquo;t known yet, but several theories exist.

The main bacteria found in diseased gums&mdash;Porphyromonas gingivalis&mdash;may enter your bloodstream through your gums. This bacterium has actually been found in the kind of plaque that clogs heart arteries, further adding credence to this theory, Miodownik says. In addition, inflammation of the endothelial cells&mdash;the lining of the blood vessels&mdash;is also believed to play a role in causing heart disease. &ldquo;The bacteria may induce the body&rsquo;s inflammatory response,&rdquo; he adds.

Dementia: Gum disease may also affect your brain health and increase your risk for mental decline. An analysis of health data compiled on 262,349 people aged 50 and older found that people with chronic periodontitis have a 6 percent higher risk for developing dementia than their peers without gum disease. The findings, published in March 2019 in the Journal of the American Geriatrics Society, held true even after researchers controlled for other behaviors known to increase risk for dementia, such as smoking. Another January 2019 study published in Science Advances found P. gingivalis in the brain tissue of people with Alzheimer&#39;s disease, the most common type of dementia, according to the Alzheimer&rsquo;s Association. The link between periodontitis and brain disease may be tied to bacterial infection, inflammation or the buildup of plaque in the arteries.

Diabetes: This relationship is more of a two-way street, says Miodownik. Essentially, people with diabetes are more likely to develop gum disease, especially if their condition isn&rsquo;t under control. People with diabetes are at higher risk for infections. When the condition is left unchecked, blood sugar levels in saliva help bacteria grow, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Meanwhile, severe gum disease can cause blood sugar levels to rise, increasing the risk for complications associated with diabetes.

Cancer: No one can say with 100 percent certainty if poor oral health ups cancer risk. But when researchers culled data from dental exams of 7,466 people who were followed for a median of 14.7 years, they found a 24 percent increase in the risk of developing cancer for those who had severe gum disease, compared to individuals who had mild or no gum disease when the study began. The 2018 study, published in the Journal of the National Cancer Institute, found the highest risk was for lung cancer, followed by colon cancer.

Another June 2019 study published in the United European Gastroenterology Journal suggests that gum disease may increase the risk for liver cancer. The study, which involved more than 469,000 adults between 40 and 69 years old who were followed for an average of six years, found those with poor oral health were 75 percent more likely to develop the disease. Experts at the American Academy of Periodontology also note that gum disease has also been linked to an increased risk for kidney cancer, pancreatic cancer and blood cancers.

It&rsquo;s unclear how gum disease could affect cancer risk. Some theories suggest that diet may play a role. People with poor oral health and tooth loss are less likely to eat diets rich in crunchy fruits and vegetables&mdash;which are known to help protect against cancers. It&rsquo;s possible that systemic inflammation is also involved, Miodownik points out.

Stroke: If you have gum disease, you may be more likely to have a stroke, and the more severe your gum disease, the higher this risk is, according to a January 2018 study published in Stroke. The study&rsquo;s authors suggest that seeing your dentist regularly for cleanings and taking ownership of your oral health may help reduce the likelihood that you have a stroke.

Preterm delivery: Hormonal changes during pregnancy can increase the risk for gum disease. Meanwhile, pregnant women who develop gum disease may be more likely to deliver prematurely or have a baby that&rsquo;s too small. Researchers are still investigating how poor oral health affects pregnancy, but all infections pose health risks to a fetus. Miodownik points out that pregnant women and women who are trying to conceive should be mindful about proper oral hygiene and visit their dentist regularly for routine checkups and cleanings.

Healthy gums, healthy body 
The good news is that gum disease is largely preventable.

When there is plaque on your gum lines, it can be cleaned out with regular dental visits and better oral hygiene. Once plaque hardens into tartar, however, you&rsquo;ll need the help of a dentist to remove it.

&quot;Brush your teeth twice a day and floss once a day,&quot; Miodownik says. &ldquo;Seeing your dentist for a cleaning twice a year is a great place to start, but some people including pregnant women may need to visit their dentist more often.&rdquo; Talk to your dentist about how often you need cleanings.

Using mouthwash with antibacterial properties can help fight plaque, but the real aim is to physically break down the plaque and that is what brushing and flossing do best, Miodownik explains. &quot;Brushing gets plaque off of the front chewing surface and back of your teeth while flossing breaks up the plaque in between your teeth,&quot; he adds.

Some people may benefit from using an electric toothbrush or water flosser that sprays water in between teeth to remove plaque, but brushing with a regular toothbrush and flossing is typically enough to keep gums healthy.

&ldquo;Gingivitis is reversible because the bone hasn&#39;t shrunk and your gums haven&#39;t yet receded so you can still prevent tooth loss and other consequences,&quot; Miodownik says. &quot;Periodontal disease is more of an uphill battle.&quot;

Your dentist can do a deep scaling and root planing procedure to get rid of plaque above and underneath your gums and to smooth your roots so your gums re-attach to your teeth. If this doesn&#39;t make enough of a difference, a gum specialist or periodontist may be needed. &quot;Periodontists can surgically reduce the pockets around your gums,&rdquo; Miodownik says, &ldquo;and they can also add gum tissue back to some areas.&rdquo;

Medically reviewed in July 2019.

6 Surprising Reasons to Take Care of Your Gums

If Cleopatra indulged in all the beauty treatments attributed to her, she wouldn&#39;t have had time to rule her empire, seduce Mark Antony, or learn to speak Egyptian. But a girl&#39;s gotta bathe, so the one skin-smoother she probably did rely on -- milk baths -- no doubt helped her bring Caesar and Mark to heel. Did Cleo know something we&#39;ve forgotten? Actually, yes.

&quot;<a href="https://www.sharecare.com/health/milk-nutrition/is-milk-good-for-you">Milk</a> is a super soother for chapping, windburn, sunburn, eczema, and other skin irritations,&quot; says New York dermatologist Amy Wechsler, MD. &quot;It contains proteins (whey and casein), fat, amino acids, lactic acid, and vitamins A and D, all of which calm dry, upset skin.&quot;

For irritations like sunburn and eczema, Dr. Wechsler suggests applying compresses dipped in cool milk. But use whole milk; skim won&#39;t do because it doesn&#39;t contain fat, one of milk&#39;s most soothing components.

If compresses aren&#39;t practical&mdash;say you&#39;ve managed to broil the backs of your legs on a beach getaway&mdash;a <a href="https://www.sharecare.com/health/daily-skin-care/can-milk-bath-soothe-skin?myAttribute=yay">milk bath</a> will give you some relief. Add 2 to 4 cups to a warm (not hot) tub and soak for 20 minutes. You can use powdered whole milk, too: As the water flows from the faucet, sprinkle the amount of powder needed to make a quart of milk.

Milky baths also soften skin, according to Wechsler. Milk&#39;s lactic acid weakens the &quot;glue&quot; that sticks the dead, ready-to-be-shed cells to the skin&#39;s surface and makes it look dull and dry. Soak for 15 minutes, and then give your body a gentle neck-to-toe scrubdown with a bath brush, loofah, or washcloth. This will slough off those dead cells, leaving skin smoother and softer.

Medically reviewed in April 2020.

Milk This Tip for All It's Worth

At the end of a long day, it&rsquo;s all too easy to skip a step in your nighttime routine and go to sleep without washing your face. But you may be doing more harm to your skin than you think by sleeping with makeup on. &ldquo;Makeup and oil buildup can cause breakouts, infections, rashes, enlarged pores, wrinkles and a dull complexion,&rdquo; says James Ralston, MD, dermatologist and founding president of the <a href="https://www.dermatologymckinney.com" target="_blank">Dermatology Center of McKinney</a> and dermatologist at&nbsp;Medical City McKinney. Here&rsquo;s why that 30 seconds of cleansing is worth it.

Worst-case scenario #1: You could breakout, big-time. 
Not washing off makeup, like foundation and concealer, can bring on the pimples. &ldquo;When makeup clogs the pores, the bacteria involved with acne formation can get trapped in those pores and cause breakouts,&rdquo; says Dr. Ralston.

Lip-gloss and lipstick, which often contain pore-clogging waxes, are zit culprits, too. &ldquo;If you sleep with lipstick on, you can get blackheads or acne right around your lip area,&rdquo; says Ralston.

Worst-case scenario #2: You could get an eye infection. 
Leaving your mascara or eyeliner on overnight can lead to clogged eyelid pores and a nasty <a href="https://www.sharecare.com/health/bacterial-eye-infections/what-is-stye">stye</a>. Plus, &ldquo;rubbing your eyes on the pillowcase while you&rsquo;re sleeping can get makeup in your eye, and can cause inflammation or an infection,&rdquo; explains Ralston.

Worst-case scenario #3: You could add years to your skin. 
A clean face gives your skin room to breathe and repair itself overnight. While you&rsquo;re sleeping, melatonin in your skin fights the development of fine lines and hormones help collagen-producing cells improve elasticity and tightness. &ldquo;Pollution and free radicals collect on your skin throughout the day and&mdash;if skin isn&rsquo;t cleansed properly at night&mdash;stay on your skin, breaking down collagen. This causes wrinkling and gives you a dull complexion,&rdquo; says Ralston.

Oops, you did it again. What now? 
Reverse repeat-offender damage by getting back on a regular cleansing routine. Keep your face-washing regime simple so you&rsquo;ll stick to it. &ldquo;In general, wash your face for 30 seconds at night with warm water and a gentle cleanser,&rdquo; advises Ralston. He recommends mild cleansers that are fragrance-free and have a neutral <a href="https://www.sharecare.com/health/lab-tests/what-is-ph">pH</a> to avoid irritation and dryness. Keeping makeup-removing wipes on your bedside table can also help you remember to cleanse your face before bed. See your dermatologist to discuss a skin care routine that&rsquo;s right for you.

Medically reviewed in November 2018.

Worst Case Scenario: Sleeping With Makeup On

It&rsquo;s likely you&rsquo;ve had the same skin and makeup routine for years, but you may want to think about updating your regimen. Why? Some of those habits may be irritating your skin, and might even encourage wrinkles&mdash;and nobody wants those. &nbsp;

Here are seven makeup and skin mistakes you may be making, plus how to reverse the damage and keep your skin glowing going forward. &nbsp;

Mistake #1: You never wash your makeup brushes &nbsp; 
Do you toss your makeup brushes back into your makeup bag day after day? It might be time to stop. Dirt, oil and yeast can build up between the bristles on your brushes, and may cause your skin to break out.

Fix it: Wash your makeup brushes once a week with soap and water or with brush cleaner you can get from the drugstore. Dermatologists also recommend that you avoid sharing makeup brushes, since the spread of germs can cause acne. &nbsp;

Mistake #2: You forget to wash your face at night &nbsp;&nbsp; 
After a stressful day, it&rsquo;s very easy to crawl into bed without cleansing your face, <a href="https://www.sharecare.com/health/skin-makeup-cosmetics-use/article/worst-case-scenario-sleeping-with-makeup-on">but leaving makeup on all night</a> may lead to oil buildup, breakouts, infections, rashes, enlarged pores, wrinkles and a dull complexion.&nbsp;

Foundation and concealer can clog your pores and cause you to breakout. While eye makeup like mascara and eyeliner left on overnight can clog your eyelid pores and cause an uncomfortable stye, or infected eyelash follicles. Sleeping on your pillow with makeup on can also cause an eye infection or inflammation.

A clean face at night gives your skin room to breathe and helps prevent fine lines. When your skin is able to breathe at night, you&rsquo;ll improve your complexion and the tightness and elasticity of your skin.

Fix it: In general, it&rsquo;s best to wash your face once in the morning and one at night, and after heavy sweat sessions. Wash your face for 30 seconds each night&mdash;you&rsquo;ll want to use warm water and mild, fragrance-free cleaners. Cleansers with a neutral pH can prevent irritation and dryness. It&rsquo;s best to talk with your dermatologist about the products right for you and your skin type.

Mistake #3: You don&rsquo;t replace your mascara often enough 
It&rsquo;s important that you&rsquo;re careful when it comes to makeup products that go on or around your eyes and eye lids. Every time you swipe your mascara brush onto your lashes, microorganisms latch on to the brush and then head back into the tube. An old mascara tube can be a breeding ground for certain germs to grow.&nbsp;

Fix it: If you use mascara every day, replace your tube every two to three months. If you use it only occasionally, it should last for six months.

Mistake #4: You constantly touch your face or pop pimples &nbsp; 
Both popping a facial pimple and resting your hand on your chin while reading may seem tempting and unavoidable, but both can wreak havoc on your skin.

Popping or squeezing a pimple may actually make it worse, and may even cause scarring. Touching your face with your hands unnecessarily throughout the day brings dirt and oil to your face, which can cause breakouts, too.

Fix it: Make a conscious effort to keep your hands away from your face during the day, and if you do get a pimple, treat it with medication or cover it up with oil-free makeup. If you&rsquo;re having frequent breakouts, talk to your dermatologist about medications that might help.

Mistake #5: You&rsquo;re an exfoliating pro 
Exfoliation, or the removal of the topmost layer of dead skin cells, can improve your skin&rsquo;s appearance. But scrubbing your skin with too much pressure or using the wrong type of cleanser can cause irritation and premature aging.

Exfoliation can help topical skin treatments work more effectively, and can also leave your skin looking and feeler brighter. But exfoliating&mdash;especially heavy exfoliation&mdash;is not for everyone. If you have inflammatory acne or rosacea, exfoliation may make your condition worse.

Fix it: As a general rule, if you have dry or sensitive skin, it may be better to get salicylic acid peels at your dermatologist&rsquo;s office rather than exfoliating at home. If you have thick, oily skin, it&rsquo;s probably okay to use over-the-counter salicylic acid washes or mechanical exfoliation products like motorized brushes.

So how often should exfoliate? It&rsquo;s different for everyone. If you have oily skin, you may need to do it once a day, but if you have sensitive skin, maybe just one or twice a week. Any peels or procedures done at the dermatologist&rsquo;s office are typically administered over a couple of weeks. No matter what your skin type, talk to your dermatologist before trying exfoliators.

Mistake #6: You forgo a daily facial moisturizer 
You&rsquo;ve heard it time and time again, and for good reason: a facial moisturizer (or any moisturizer for that matter), can trap water in the skin, leaving the skin looking youthful and hydrated. &nbsp;

Fix it: Apply a facial moisturizer under your makeup each morning, and be sure to use it before you hit the hay, too. If you have rosacea, your skin is going to be more sensitive to certain ingredients, so look for moisturizers with lipids like ceramides. If you have acne, choose moisturizers that are oil-free and non-comedogenic so they won&rsquo;t clog your pores.

Mistake #7: You skimp on sunscreen 
About one in five Americans will develop some form of skin cancer in their lifetime. Sunscreen can help protect you from skin cancer, but can also protect you from premature skin aging (aka wrinkles).

Fix it: Even on cloudy days, experts recommend you use a daily sunscreen on any part of the body that&rsquo;s not covered by clothing, whether it be a sunscreen itself or sunscreen that&rsquo;s part of your foundation or primer

Choose broad-spectrum sunscreens that are SPF 30 or higher and water resistant. If you do head outdoors, stay in the shade as much as possible and cover your body with protective clothing like hats, sunglasses and long-sleeved shirts. And whatever you do, avoid tanning beds; use self-tanning lotions or sprays instead.

7 Makeup Mistakes You Are Probably Making and How To Fix Them

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Who wouldn&rsquo;t want smoother, wrinkle-free skin? According to a report from the American Society of Plastic Surgeons (ASPS) Botox (Botulinum Toxin Type A) was the top minimally-invasive cosmetic procedure in 2015, with over 6.5 million Americans opting for Botox injections to reduce and, in some cases, completely smooth out facial wrinkles and frown lines. That&rsquo;s a 759 percent leap from 2000, suggesting that the quest for the fountain of youth hasn&rsquo;t dried up.

While some people would never consider the idea of injecting small amounts of a toxin into their faces, others are more than happy to find younger-looking skin in a syringe. Why is it so popular? &ldquo;We know it works,&rdquo; says <a href="https://www.sharecare.com/doctor/melissa-levin-md">Melissa Kanchanapoomi Levin, MD,</a> a clinical instructor at Mount Sinai Icahn School of Medicine and dermatologist at Marmur Medical in New York City. &ldquo;Botox is pretty painless and works well to eliminate wrinkles such as crow&rsquo;s feet, frown lines, and forehead wrinkles.&rdquo; Not only that, there&rsquo;s minimal to no down time: Unlike <a href="https://www.sharecare.com/health/dermal-fillers/how-do-injectable-fillers-work">injectable wrinkle fillers,</a> which are more likely to cause bruising, you can get Botox at lunchtime with no one the wiser when you return to the office. There may be small pinpricks here and there at the site of injections, but these resolve within an hour and can be covered easily with makeup.

How does it work? 
Botox injections provide a temporary softening of wrinkles that come from repeatedly contracting facial muscles in the same way. For example, someone who squints a lot may develop crow&rsquo;s feet, while a frowner may end up with two vertical lines between the eyebrows&mdash;commonly called &ldquo;angry 11&rsquo;s.&rdquo; While there are different brand names for these injectable neuromodulators&mdash;Botox, Dysport and Xeomin&mdash;they all work in the same way. &ldquo;They block the nerve impulses of the injected muscles to temporarily reduce muscle movements that cause wrinkles,&rdquo; says Dr. Levin. In essence, you&rsquo;re freezing muscles so that you can&rsquo;t make the frown lines that make you batty every time you look in the mirror.

Depending on the brand used, it can take from three to seven days after the injections to begin to see results. And how long will Botox work its magic before it starts to wear off? &ldquo;It varies by patient,&rdquo; says Levin. &ldquo;It could be anywhere from two to six months.&rdquo;

When should you start Botox? 
If you think you can prevent wrinkles if you start injections early enough, think again. &ldquo;It&rsquo;s completely off to think you won&rsquo;t get wrinkles if you start young,&rdquo; Levin says. She notes that a woman in her twenties might want Botox to improve facial symmetry&mdash;for example, if one eyebrow sits lower than the other or lacks an arch. &ldquo;Some people make exaggerated expressions without realizing it,&rdquo; she says. &ldquo;Frowners, squinters, eyebrow raisers. We may use Botox to retrain those muscles so they&rsquo;re not moving in an exaggerated way that can lead to etched-in wrinkles.&rdquo; According to the ASPS report, those mostly likely to get the injections are middle age or close to it: 57 percent were ages 40 to 54; 23 percent were 55 and over; 18 percent were between the ages of 30 to 39 and just one percent were ages 20 to 29.

What are the risks? 
&ldquo;First, you can&rsquo;t catch botulism from the use of Botox, but there is a small chance that you&rsquo;ll have an allergic reaction to the preservatives and ingredients used,&rdquo; Levin says. The biggest risk, she says, comes from healthcare providers who aren&rsquo;t adequately trained in giving the injections. &ldquo;Don&rsquo;t believe any doctor who says you&rsquo;re not at risk to get brow or eyelid ptosis, which is when your brow or eyelid droops because too much drifted down or up in the eye area,&rdquo; she says. &ldquo;This has happened in every doctor&rsquo;s office, but the more qualified your doctor is, the lower the risk.&rdquo; Over-application is another hazard&mdash;the muscles can become so weakened that it can cause the eyelid to droop. &ldquo;No one&rsquo;s face is perfectly symmetric. Therefore, the injection with Botox can result in an asymmetric appearance, so follow-up with your physician is important,&rdquo; says Levin. &ldquo;There is an understanding of facial anatomy as well as artistry involved in the technique, so be sure your injector is highly experienced in administering it.&rdquo;

<a href="https://www.sharecare.com/health/muscoloskeletal-drugs/risks-side-effects-botox">Discover other possible Botox side effects.</a>

What does it cost? 
&ldquo;Some doctor&rsquo;s offices price by the unit,&rdquo; Levin says. &ldquo;It can range from $10 to $30 per unit. Others charge by the area. Every syringe may contain 10 or 15 units, so it could range from $350 to $700 or more.&rdquo; She notes that men usually need more injections since their muscles are bigger and thicker. What about going to places like day spas or using coupons for injections? Levin says you run the risk of injections that are administered improperly, or the practitioner may use Botox that&rsquo;s been watered down or expired.

What are some other options? 
According to Levin, there&rsquo;s hope for those who would like to address wrinkles without the injections. <a href="https://www.sharecare.com/health/retinoid-treatment-for-skin/can-retinoids-skin-look-younger">Retinoids</a> found in creams like Retin-A (tretinoin) and Differin (adapalene) are vitamin A derivatives that have been effective in smoothing fine lines, lightening brown spots and boosting your skin&rsquo;s production of collagen. While some skin care creams contain these derivatives (called <a href="https://www.sharecare.com/health/retinoid-treatment-for-skin/topical-retinol-treat-signs-aging">retinol</a> when bought OTC), prescription strength is stronger and can be more effective if your skin can tolerate the medication.

Levin says new developments have occurred for over-the-counter retinol/retinoid products, which can minimize wrinkles without the needles. One that she recommends is AlphaRet (by Skin Better Science). &ldquo;This is exciting because it&rsquo;s the first retinol with the efficacy of a retinoid to be dispensed without a prescription,&rdquo; she says. Also, Differin (by Galderma) is now available to consumers over the counter, after years of being a prescription.

Beauty and Personal Care