Accutane was a brand name for an oral, anti-acne medication that is no longer being prescribed, but the active ingredient in it (isotretinoin) is now available as a generic. Accutane/isotretinoin has the potential to cure acne or at the very least make it go away for awhile. Once a round of isotretinoin is done, the acne may still return; however, if it does, it is rarely as bad as before.

Regrettably, isotretinoin is a difficult drug. There are lots of serious side effects such as elevated cholesterol, liver problems, loss of hair, unbelievably dry skin, birth defects if you get pregnant while taking it, depression (though that side effect is controversial), headaches, bloody nose, and on and on. But for me, my acne was even more difficult than all of those health risks, which is why, once I was fully informed about the risks, I still opted to take this medicine to help my acne.

Prior to Accutane, every morning for me was a living nightmare of having to look in the mirror to see what had happened to it overnight. It was agonizing and it was rarely good news. And then during the day I could feel eruptions developing as I touched my face or felt the small throbs where swollen bumps were growing. I even hated the word “pimple.” I found it embarrassing and insulting. I am sure anyone struggling with acne knows just how I felt, and how strong the desire for clear skin becomes.

When I finally decided to try Accutane it was with utter abandon. I would do anything to not have this struggle of seeing red, inflamed, white dotted lesions on my face.

When I started my prescription I noticed a difference within the first week. I’ll never forget the moment when I touched my face and felt nothing that I was so used to feeling. All I could feel was smooth skin! Much to my continued surprise, it remained that way for weeks. I had some of the side effects I was told about, including bloody nose, dry lips, and headaches. No one tested for liver function and cholesterol levels in those days and I was beyond getting pregnant so there is much I don’t know for what did or didn’t go wrong for me internally. What I do know is that it was the first time in my life since the age of 11 that I liked looking at myself in the mirror.

At the three month point I started experiencing hair loss and that freaked me out. As a result, I stopped taking the drug and, as expected, the hair loss stopped. The trade-off for stopping too soon to save my hair was my acne came back about two months later. I did a great deal of research and found that the dosage and timing was a big deal. A lower dose taken over a longer period of time seemed to be far better. I discussed this with a new physician and started another cycle of Accutane. Thankfully, it went much better the second time around.

Today, almost 17 years later, I still struggle with breakouts but nothing like I did before Accutane. I sometimes think I should have taken another treatment cycle but never did, not because of the risks, it was just that I never got around to it and I was happy enough with the results two rounds of Accutane provided.

Given everything known about isotretinoin/Accutane my only personal regret is that I waited so long to take it. I can only guess what my mornings would have been like in my 20s and early 30s had I taken the drug back then, and not wasted so much time and money on irritant-laden products that made matters worse not better. Like many of you, I just didn’t know any better and just kept buying product after product hoping something would work.

Everyone has to weigh the pros and cons of many things they do in life; for me, Accutane was a no-brainer. Whether you feel the same way is a decision only you can make, but if you decide to take isotretinoin, be certain you’re fully informed of the risks, particularly if you’re a woman of childbearing age.

If you are anything like me, when you envision the CEO of a cosmetics company you may picture an authoritative figure wearing a designer outfit with an executive assistant sitting right outside their door, waiting to answer every beckoning call. Ok, The Devil Wears Prada may have influenced this vision a bit, but the fact remains that we often perceive these high power individuals to be intimidating, untouchable, and far removed from everyday people or everyday life just in general.

While that may be true for some corporations, let me set the record straight here at Paula’s Choice. I would know; I’m Paula’s assistant! First of all, I have to start out by mentioning that in the 30 years Paula has been flying around the world educating women about skin care, and running Paula’s Choice, this is the first time she has had an assistant. I’m flabbergasted at how she managed to juggle it all on her own (though to the credit of the office, she has had great support). Nonetheless, let’s get down to the details you really want to know…

Is Paula a diva? Well, she does like her Perrier mineral water and flying first class (but she flies me first class, too, so that part of her being a diva is fine with me), yet in reality Paula is about as down-to-earth as they come. Some days she comes into the office dressed to the nines, but other days she’s completely comfortable sporting a casual ensemble. She’ll be the first one to greet everybody as she enters the building, compliment you on a new hair cut, or stop to play with the dogs in the office. It’s easy to tell when Paula is here because you can usually hear a roar of laughter before she has even made it up to her office on the second floor. (Speaking of laughter, she has been known to interrupt a meeting to play a funny video she just saw on YouTube, but you didn’t hear that from me.)

Another surprising fact is how hands-on Paula is. You might typically think of a CEO as someone who has “people” for everything, but as busy as Paula may be, she will actually read letters from customers and take the time to respond. She holds weekly meetings with our Customer Service department to keep them up-to-date with the latest information, as well as get feedback on what our customers have to say. Even when she is traveling across the globe to different time zones, Paula will wake up at 3am to do her online radio show. Every product development idea, Beautypedia.com review, or Paula’s Choice promotion goes through Paula.

Last, but certainly not least, what sets Paula apart as a CEO and as The Cosmetics Cop is her capacity to relate to people. Fans catch a glimpse of this on her weekly radio show where Paula tells all from her struggles with puberty and acne as a teen, to her experiences with menopause and plastic surgery. Paula has sincere empathy for the skin-care issues that her customers, fans, friends, and employees face and she is always there to lend advice and sometimes even some free products. Moreover, what other CEO would recommend products outside of their own? Only someone who is dedicated to helping you find the best products for your skin. Now that’s a far cry from what most of us would picture of any CEO from any other company in the world.

Call in & ask Paula your skin-care questions during her live Internet talk radio show,
Be Beautifully Informed with Paula Begoun,
The Cosmetics Cop.

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Call (347) 426-3783 to listen live & ask questions at show time, or listen to live & archived segments online .

I want to thank all of you who responded to my request to help me figure out exactly how to describe my skin care and makeup company, Paula’s Choice, to other people who don’t know my products, books, or bulletins.

All of your comments were thoughtful, insightful, flattering, humbling, and truthful. Most of all they stimulated a meaningful contemplation of what my business is all about.

My marketing team and I have spent quite a bit of time discussing what you have contributed. It has brought a keen understanding of how those of you who shop Paula’s Choice, read my books, or use Beautypedia.com experience what we have created.

After reading all of your absorbing and fascinating comments, I think I can sum up my company and life’s work like this:

Paula’s Choice is a specialized range of skin care and makeup products I formulated after 32 years of research and writing 18 books analyzing the facts about skin care and makeup products.

Because my only mission is to help you find the best products to take care of your skin I am the only cosmetics company in the world that recommends products other than my own.

Come visit us at PaulasChoice.com and find out what you are missing!

Did you ever wish you could meet Paula up close and personal, get her take on skincare myths in the cosmetics industry, purchase a signed copy of her best-selling book, “Don’t Go to the Cosmetics Counter Without Me,” and get free samples of her newest products? Exciting News! Paula will be giving a free presentation on Skincare Mythbusting.

Date: Monday, February 16, 2009
Time: 7:30-9:00pm
Location: Warwick’s Bookstore
Street: 7812 Girard Avenue
City/Town: La Jolla, CA

About Paula: Paula Begoun is a nationally-recognized consumer expert on the cosmetics industry and the best-selling author of “Don’t Go to the Cosmetics Counter Without Me, 7th Edition.” Paula covers research-based reviews of thousands of skin care products and state-of-the-art ingredients.  Her goal is to cut through the hype and identify the best (and worst) products available in every price category to give everyone the chance to achieve beautiful, healthy skin. Paula’s work has resulted in thousands of interviews including repeat appearances on CNN, as well as programs such as Oprah, The Today Show, 20/20, Dateline NBC, The View, and Primetime.

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All in all I’ve been happy (actually, really happy) with the results I’ve experienced from the medical corrective procedures I’ve chosen. I do look younger, my tummy is flat (even though I’ve gained some weight since the operation), my face is doing great (no surgery, just Botox, dermal injections, and laser resurfacing), and my breasts have held up pretty well (no pun intended).

The problems I’ve experienced along the way was due to my tummy tuck (pretty major complications) and with the form of dermal injection I chose, Artecoll (also called ArteFill).

Why did I choose Artecoll? Well, I’m pretty high maintenance as it is, given how often I have to get my hair and nails done for media appearances and photo shoots. I already get Botox once every 6 to 7 months. So, anything I can do to spread out appointments, especially those requiring downtime, I’ll do.

I chose Artecoll because it lasts for years. Some would say it lasts “permanently” (but permanent needs qualifying because while Artecoll doesn’t break down the face will still “age” and the younger appearance will diminish).

The first time I had Artecoll injected was in 2000, and though I probably could’ve waited another two or three years at least. At the time, I wanted to get my lower lip done anyway and adding a little more along my upper lip and the fold that runs between the nose and lip made sense. I wanted a fresher, but still natural, appearance.

I know all the risks with dermal fillers. Artecoll shares the same risks with every other filler but Artecoll has an additional twist. Because Artecoll is a “permanent” filler the problem is that when something goes wrong the complication often remains. That was what happened for me. I got small, relatively imperceptible granulomas (little hard bumps) that I could slightly feel around my lips. Those little lumps did eventually go away (at least as far as I could feel). However, even now, if I press too hard on my lips to remove lipstick or once in a while in the middle of an intense kiss, it does ache. Not the best, but damn it does look good!

I’m not one to keep my beauty secrets a secret. Why bother. It just creates a distance between women and clouds reality. If your boobs are fake so what? From any perspective plastic surgery or cosmetic corrective procedures such as Botox, dermal injections, or laser resurfacing, should not be shocking or embarrassing. They are just choices like having sex, going on vacations, or dieting, and how much you do or don’t do is up to you.

For me, because I’m in the public eye more then most, I also don’t want people guessing at what I’ve had done. Sort of like we all do to celebrities, wondering what happened to Meg Ryan’s lips or Melanie Griffin’s face, or Penelope Cruz’s nose, or the fact that no celebrity or model over the age of 40 can raise their eyebrows (that’s Botox). And I surely don’t want to mislead people thinking that my face looks like it does simply because I use my products.

So for the record, I had breast implants in 1984 (I have not had them redone, they are the same ones and still look pretty good), a tummy tuck in 2006 (that looks great but I had serious complications after the surgery was over), dermal injections (twice now since 2000), Botox (every 6 or 7 months for the past several years), Thermage (that was not worth the trouble), IPL (about 4 times, which worked pretty well for brown skin discolorations and red surfaced capillaries), and FRAXEL (which has been very good for smoothing and firming).

As I do more, which I’m sure I will, I’ll let you know how it goes and why I made the choices and decisions I’ve made. Mostly I’m trying to avoid plastic surgery for as long as possible, that step seems truly scary as there are just too many examples of where people just don’t look the same and if anything they look really weird or other-worldly.

“We only use natural ingredients; synthetic ingredients are bad for your skin because they are fake and made from gasoline, such as mineral oil and petrolatum.”

I have yet to see any cosmetic that is “all” natural. Some synthetic ingredients are awesome for your skin, and regardless of the protestations of cosmetics companies to the contrary, every cosmetics product in the world contains its share of synthetic ingredients.

Synthetic ingredients are derived from many sources, but they all start as natural because everything comes from our environment; nothing is created via alchemy. Petrolatum and mineral oil are indeed by-products of the gasoline industry, but what is unnatural about that? Ironically, gasoline, which is derived from crude oil, is decidedly natural in and of itself as it comes from organic material, such as tiny aquatic plants and animals, that has been buried in the earth for millions of years. Petrolatum and mineral oil are remarkably good skin-care ingredients; they are also recognized by cosmetics chemists the world over for being superior emollients and completely harmless (Source: Dermatologic Surgery, June 1998, pages 661–664). Even the claim that these ingredients are occlusive (blocking) and, therefore, bad for skin is also without proof (Source: Contact Dermatitis, September 1996, pages 163–168).

“You have nighttime free radicals and daytime free radicals. Daytime free radicals are the sun and pollution, the nighttime free radicals are, um, I’m really not sure what those little boogers, the little nighttime pesticides, are that damage your skin at night, but they are there!”

Free radicals are destructive molecules that cannot tell time! Yes, it is true that sunlight is a major source of free radicals generated in the daytime, yet pollution, whether coming from auto exhaust or industrial pollutants, is ever-present. The level of pollutants may be higher during daylight hours, but it certainly doesn’t disappear when the sun goes down! And what about the fact that the oxygen we need to live is a potent source of free-radical damage, and that’s around all the time, too?

I don’t know what to make of the “nighttime pesticides” comment, but unless you are sleeping in a field or on farmland that has recently been crop-dusted, I wouldn’t be too concerned about pesticides on your skin at night.

Regardless of whether it’s day or night, antioxidants are state-of-the-art ingredients to look for when shopping for skin-care products, and there are dozens available (with no clear-cut “best” choice among them), but none of them can distinguish between daytime and nighttime free radicals. In theory, antioxidants in well-formulated skin-care products should perform regardless of the time of day.