From Embarrassment To Action: Expert Advice On Coping With Overactive Bladder (OAB)

Astellas compensated FOF with an advertising sponsorship to write this post. Regardless, we only recommend products or services that we believe will benefit the women in our community. Geri Brin, Founder,

The concert should have been a fun outing for Elaine and her young daughter, but it became a nightmare even before they left the car. “I had the urge to urinate and couldn’t hold it in another second,” Elaine recalls. Not wanting her “accident” to spoil the evening,  she wore a sweater around her waist for hours while her clothes were drying. That’s when Elaine knew she had to see a doctor. In her late 40s at the time, she’d been living with overactive bladder (OAB) for about six years and it was affecting her quality of life more and more.  

Characterized by frequency (needing to urinate eight or more times in 24 hours) and urgency, OAB can result in leakage if you don’t get to the bathroom in time.1 It occurs when your bladder contracts too often, even when it’s not full.2 “Instead of getting a first, second or final warning that you need to urinate, you get just the final warning, when the bladder is at maximum capacity.  If it begins to contract before you make it to the bathroom, you may experience a leak,” according to Dr. Ekene Enemchukwu, a urologist at Stanford University Medical Center.  

“The prevalence of OAB increases with age in both men and women.3 Almost 30 million people in the United States live with OAB symptoms,” Dr. Enemchukwu said.  

Years before her accident at the concert, when Elaine started working at a call center, she had to ask her boss if her desk could be located closer to a bathroom.  “Bathroom breaks were timed, and bonuses were based on the number of calls made each day and how long each one lasted,” Elaine remembered. But since she needed to use the bathroom two or three times an hour, she was afraid the job wasn’t going to work out.  Elaine bit the bullet and told her supervisor about her issue. While it was embarrassing to discuss bathroom problems, Elaine luckily had an accommodating boss and kept her job.


Elaine (left) shares her experience coping with symptoms of overactive bladder

As time went on, however, Elaine began to limit the activities she loved. She wanted to sign up for classes, for example, but she was concerned her frequent bathroom trips would distract the class. So she didn’t sign up. Her accident at the concert was the proverbial straw that broke the camel’s back. “I had been coping, but I wasn’t being proactive with my lifestyle,” she said.

Elaine may have thought she was coping effectively, but Stacy Kaiser, psychotherapist and relationship expert, calls it unhealthy coping. “Coping in general is how we go about dealing with any difficult change in our life, such as a family challenge, a financial issue, stress at work, or a medical condition,” Stacy said. “And coping with a medical condition such as OAB, which can be very embarrassing for some women, is especially challenging.”2

        Stacy Kaiser

Elaine wasn’t coping successfully when she started avoiding activities she really wanted to do. Although she thought she was managing the situation by avoiding embarrassing moments, it wasn’t productive for her to withdraw from activities she enjoyed, Stacy said. People with OAB may isolate themselves from their support systems or social network,1 also a prime example of unhealthy coping. Healthy coping is finding ways to continue participating and engaging in your life, Stacy emphasized.

Once Elaine decided to reach out to a doctor, she was ready to shed her unhealthy coping habits and start taking charge of her life, rather than letting her condition take over. “Learning about a medical condition from a physician or medical expert helps give us the skills to get through challenging experiences in our lives,” Stacy stressed


             Dr. Ekene Enemchukwu

“Many people don’t go to the physician’s office because they think OAB is a normal part of aging.2 Instead, they ignore the problem,” Dr. Enemchukwu said. They also find it difficult to discuss and don’t know how to bring up the subject up with their doctor. OAB patients can feel anxious, isolated and hopeless because they think there’s no way to address or fix a problem that has dramatically altered their lives.5

“Self-consciousness also stems from feeling like you’re the only person dealing with the situation and no one else will understand,” Stacy said. In fact, 39 percent of women with symptoms reported that OAB interfered with daily activities; 12 percent said their symptoms caused them to stay at home; 38 percent reported decreased physical activities and 34 percent attributed their weight gain to an inability to exercise.4 Sharing what you’re going through with others is key to helping you learn about OAB and can also provide emotional relief. Talking to friends and family and having a good support network are important, too.

It turns out that seeing a doctor was one of the best things Elaine could do for her emotional well-being, and for her OAB. She not only learned how common it is, but she also discovered it’s a medical condition that can be managed by behavioral, lifestyle and dietary changes and, in certain cases, prescription medications. Dr. Enemchukwu has a few recommendations:

  • Pre-empt the urge: If you experience urinary leakage or frequency, try to get ahead of your symptoms when possible by remembering to use the restroom before you feel the sudden urge to go, or before heading to an outing or road trip.
  • Be mindful of your fluid intake: Many patients believe that limiting fluids will help manage their OAB symptoms, but this can be problematic as it creates concentrated urine, which may be irritating to your bladder.5 It can also lead to dehydration.5 Your body needs water to function, so if you don’t drink enough, it will affect you in other ways.5
  • Avoid foods or drinks that can irritate your bladder: These include caffeine, spicy foods, carbonated fluids, citrus, tomato-based products, alcohol and tobacco.6 Keep in mind it’s important to talk to your doctor before making changes in your diet or exercise routine.


Now retired and living with her fiancé in Florida, 64-year-old Elaine said she lives a proactive lifestyle, refusing to let her OAB symptoms control her daily activities.

Planning ahead is important to her. Elaine keeps an extra outfit on hand when she’ll be out for hours and doesn’t drink too much if she’s going on a long trip. Often having a loved one at her side— namely her daughter— is a big support, she said. “We recently made the long drive north from Florida to New Jersey, and my daughter started looking for bathrooms on the road before I did since she knows I’ll have to make a lot of stops.”  Elaine also relieves stress by listening to music and meditating and performs Kegel exercises to help strengthen her pelvic floor muscles.1 She advises anyone living with OAB symptoms to seek support from loved ones and health care professionals.

Passionate about helping other women with OAB to “enjoy their lives and have fun, not to let it overrule their lives,” Elaine has joined a new OAB awareness campaign called Coping Confessions, sponsored by Astellas. The campaign is brimming with online resources, including an online self-assessment tool that helps you become more aware of the way in which you cope, and “on-the-go” videos of women coping with OAB. To learn more about how you can assess your own coping behaviors and about overactive bladder, visit

In a Coping Confessions video clip, Elaine joins experts on-the-go to share how she copes with overactive bladder

“We want to empower people to talk about their symptoms and to understand that healthy, productive coping is an important part of managing a medical problem, in addition to seeking expert guidance,” said Dr.  Enemchukwu. “I’ve seen so many patients who have been dealing with OAB for decades, too embarrassed to talk to anyone about it, even their own family members or friends. Talking about OAB can reduce the stigma associated with this condition.”


Although the precise causes of OAB are unknown, it impacts both men and women, but occurs more frequently in women.4,7 

If you believe you may have OAB, visit your healthcare provider so he or she can conduct a thorough evaluation of your symptoms and perform a physical exam. If you do have it,  your doctor can help you take the right steps to manage your symptoms. Go to the appointment with a short list of your symptoms,  which can help make the discussion productive. Make sure to give specifics, including:

 How many times you went to the bathroom in a given day.

➧  How many times you get up during the night to use the bathroom.

  How many times you had to change clothing because you leaked or had an accident.

  How many times you had to drop everything you were doing and run to the bathroom.

  Any activities you’ve avoided because you feared you may have an accident. 

This article is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always talk with your doctor before starting any diet or exercise program. This article is sponsored by Astellas.


1Mayo Clinic. Overactive bladder: symptoms and causes (03-10-2018). bladder/symptoms-causes/syc-20355715. Accessed 05-02-2019.
2Gormley EA, Lightner DJ, Burgio KL, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. American Urological Association Education and Research, Inc. 2014.
3Coyne KS, Sexton CC, Vats V, Thompson C, Kopp ZS, Milsom I. National community prevalence of overactive bladder in the United States stratified by sex and age. Urology 2011;77(5):1081-7.
4Reynolds WS, Fowke J, Dmochowski R. The burden of overactive bladder on US public health. Curr Bladder Dysfunc Rep 2016; 11(1):8-13.
 5MacDiarmid S. Maximizing the Treatment of Overactive Bladder in the Elderly. Rev Urol 2008;10(1):6-13.
 6Interstitial Cystitis Network. 2012 ICN Food List for Interstitial Cystitis, Bladder Pain Syndrome, Overactive Bladder (2019).
 7The North American Menopause Society. What You Should Know About Overactive Bladder in Midlife Women (2017).

Honest-to-Goodness Skincare For Life-Changing Results

Sally, a 55 year-old from Phoenix, disliked her fine lines, large pores and loose, delicate skin. “I looked like a much older woman,” she lamented. After investing a small fortune in anti-aging creams that promised to “turn back the clock” – but did nothing – Sally was so dismayed, she started thinking about plastic surgery.

Across the country, in Atlanta, Marie had been suffering with consistent acne for about eight years. She tried treating it with one product after another, including oral medication the dermatologist prescribed. Nothing worked. When it came to her skin, she couldn’t focus on anything else, and desperately wanted a way to get rid of her blemishes.


Sally’s appearance was changing right before her eyes, thanks to the beauty brand’s Clinical 1% Retinol Treatment. “If I had to pick one skincare item, this would be it. My skin is tight, firm looking and no longer looks fragile. I have fewer lines and smaller pores,” said Sally, thrilled to look like the young woman she is!

Meanwhile, Marie thought her Paula’s Choice exfoliant was magic in the bottle.  “I’m not one to share my opinions with the entire internet, but I think this product has made the single biggest difference in my skin,” Marie wrote in her 5-star review of Paula’s Choice Skin Perfecting 2% BHA Liquid Exfoliant. “My skin was smoother and softer within the first week, and my existing acne cleared up in another few weeks,” she said. Marie’s been using the exfoliant twice a day for two months, and her acne is completely gone. “I can finally concentrate on supporting and nourishing my skin. This product is legitimately amazing,” she raved.


Like millions of women in their 40s and beyond, Marie and Sally yearned to find honest-to-goodness solutions for their bothersome skin problems.  Paula’s Choice delivered because it’s refreshingly – and dramatically – different in a beauty market overflowing with exaggerations, misleading information, and downright lies! 

Paula’s Choice follows the truth – not what’s popular. It doesn’t promise miracles, but delivers results. Relying completely on science and research to create potent and effective formulas, Paula’s Choice uses everything skin needs and nothing it doesn’t. 

“We don’t follow trends or opinions. We follow the facts,” said Paula Begoun, whose best-selling books of candid beauty advice led to the creation of her eponymous skincare brand of honest products. A consistent cult favorite among the internet’s beauty cognoscenti, Paula’s Choice becomes the “can’t-live-without-it” brand when a woman discovers its remarkable results on her skin.  Just take a look at the thousands of exceptional reviews on its website.

Paula’s Choice chemists understand skin physiology, and precisely how the ingredients in their products react with our skin.

Consider the following:

◉     Although most of us adore fragrance in our skincare products, the truth is that it irritates the skin. While you might not see the damage on the skin’s surface, it can be silently lurking below. Just because an ingredient is “natural” doesn’t mean it’s always best. Paula’s Choice formulas never have a bit of fragrance or essential oils. What’s more, they’re never tested on animals, have dyes or drying alcohol.

◉     Glass jars or transparent packaging may be appealing on the outside, but honestly, they’re only helping the skincare ingredients inside to oxidize faster and lose their potency. Every time you open a jar you’re exposing the formula to large amounts of air. Light also can pass through transparent containers, another problem. Paula’s Choice products are always packaged to ensure that their power-packed formulas stay stable and effective.

◉     While other beauty products claim they’re created for mature skin, Paula’s Choice appropriately develops its unique collection based on women’s skin types –  from dry to super oily and super sensitive. The truth is “age is not a skin type,” said Deborah Kilgore, director of skincare education for the company.   Women can have oily skin with enlarged pores and bumps well into their 50s, 60s, and beyond, for example. No matter her age, a woman with oily skin needs lightweight and fluid products, and one with dry skin requires creamier formulas with lush textures.

While age isn’t a skin type, Paula’s Choice understands that a woman’s skin can experience changes in mid-life, from becoming thinner and laxer to redder and unevenly textured. That’s why it offers specific products to match every woman’s needs, with textures to match her skin type. A universal set of products can’t work on everyone. Paula’s Choice range of products lets each woman create her own curated routine.


If we all began taking care of our skin when we were young –  most importantly, protecting it from sun damage – we’d have younger looking skin as we aged.  Sun, pollution and poor diet – not chronological age – are the three biggest skin-aging culprits. The sun begins to affect our skin from the moment we’re born. Even women in their 30s can have substantial sun damage if they haven’t been protecting it.

Outstanding News: It’s never too late to start a skin protection regimen. These four Paula’s Choice products should be part of every woman’s daily skincare routine, and used in the order they’re listed here:

◉     WATER-SOLUBLE CLEANSER: You want a gentle but effective cleanser that can be rinsed away easily with your hands or a soft washcloth. “You don’t want a cleanser that must be wiped off, and involves you tugging at your face, which further breaks down the elastin fibers,” Paula noted.  

“I am loving how my skin looks after using Paula’s Choice toner and exfoliant for six weeks.” – Geri

◉     GENTLE TONER: This lays down a layer of antioxidants, anti-inflammatories and hydrating ingredients that aging skin needs to preserve and reinforce its barrier, help reduce the appearance of wrinkles, increase firmness and improve uneven skin tone. “It’s like a liquid moisturizer, especially during the hot months, when you’d prefer something light,” Paula said.  It also removes the last traces of makeup. 

◉     LEAVE-ON EXFOLIANT:  A gentle, leave-on exfoliant is essential for removing built-up, dead skin cells that make skin look and feel dull, uneven and rough. It helps stimulate the process of skin cell regeneration that has been slowed down by sun damage and age.

            Exfoliant formulated with water-soluble alpha hydroxy acid (AHA) works only on the skin’s surface to slough away dry, dead skin so that new, more evenly pigmented cells can form and make the skin smoother. AHA is preferred by those with normal/dry skin with sun damage.  It’s a great option for diminishing the look of lines and wrinkles, improving the look of dull uneven skin, and enhancing natural moisturizing factors in skin.

            Exfoliant with oil-soluble beta hydroxy acid (BHA) works on the skin’s surface and deep inside the pores to slough away dead skin cells and relieve pore congestion. BHA is preferred by those with oily/combo skin that’s prone to bumps, clogged pores, rosacea-related redness and sun damage. 

     DAYTIME MOISTURIZER WITH SUN PROTECTION AND ANTIOXIDANTS: This may be the last product to apply, but it’s absolutely not least in terms of protecting our skin. We must be “religiously obsessive” about using moisturizer with sunscreen “every single day, inside and out,” Paula emphasized. “It should be like brushing your teeth.  I can’t say it enough!” Insert video of me using this product with this caption: 

“Broad spectrum sunscreen and gentle exfoliation are the steps missing from most women’s routines, and unless you use both, you won’t get maximum results,” Deborah explained.  An exfoliant will help make your skin brighter and clearer, but if you don’t also apply sunscreen every day, you’ll help diminish all the good you’re doing for it.

It would be nice if one skincare product really, truly did it all, but different concerns demand different formulas. Paula’s Choice has created the absolute best treatment products for every woman’s skin. Start treating your skin to them. Pronto!

and get 15 percent off your entire order by entering code FAB15


The brilliant author and screenwriter Nora Ephron wrote publicly about IT. The exquisite and talented actress Katharine Hepburn covered IT up. My statuesque and Southern former boss had IT “fixed.”

IT is their necks.

                                          Kate & Nora

Hepburn hid her aging neck beneath turtlenecks. Ephron publicly discussed hers in the book I Feel Bad About My Neck: And Other Thoughts on Being a Woman,  a blunt and entertaining look at aging women who are dealing with everything from menopause to maintenance.  My ex-employer promptly hired a plastic surgeon to banish the telltale signs of aging from her neck—and face–soon after they appeared. She had her first facelift at 50!

I don’t feel bad about my neck. I hate it!  And although I like turtlenecks, I’m not about to wear them in 90 degree heat. That leaves me with three choices: Stop peeking at my neck in the mirror, accept it, or have a neck lift.  It’s unlikely I’m going to stop looking and start accepting. So I decided to find out what’s involved with a neck lift from Dr. David Sieber, a cosmetic and reconstructive surgeon in San Francisco. While I was at it, I  asked him about my (droopy) jowls and the rest of my (decades-old) face.

First, I’d love to share what I learned about the changes in most of our necks and faces as we age, and what we can do about them. It’s strictly a personal choice, of course, but the more you know, the more you can decide what’s best for you.


Neck Lift. This 66 year old woman underwent a neck lift and limited brow lift for facial rejuvenation.

SIEBER  “Most people will lose 30 percent of the fat in their faces, starting in their late 30s and early 40s. We also lose collagen, a large component of our skin, which diminishes the elastic properties it had when we were in our 20s. Our skin simply can’t recoil as it once did, and since it has nowhere to go—and less fat to fill it in—it  re-drapes over other things on our faces.

“Loss of fat and collagen, plus gravity, can create drooping skin around the eyes, sunken cheeks, pooching jowls, sagging neck, pronounced folds between our nostrils and the sides of our mouth (nasolabial folds), not to mention wrinkles and creases.

“Jowling is caused when your facial skin starts to fall and gets stuck on the ligaments that attach jawbone to skin on each side of your face. Known as mandibular retaining ligaments, they prevent our faces from totally falling down. The drooping skin also creates the two vertical lines that extend from the outer corners of the mouth down to the jawline on either side of the chin. We call these marionette lines.”


“Injectable fillers can make a face look really good. But when injectables are overdone on a face that has lost a great deal of fat and collagen, it will look worse and worse, like a balloon.  No one needs that much volume. The only option in that case is to surgically remove and reposition the fat where it should be on the face.”

Keep Reading…

Get Younger-Looking Eyes, Instantly!

This is a “sponsored post.” Westmore Beauty compensated FabOverFifty with an advertising sponsorship to write it. Regardless, we only recommend products or services that we believe will be helpful for our readers. All insights and expressed opinions are our own.

Many fab women I know over 50 are exasperated by bags and puffiness under their eyes. Don’t even get them started on those annoying crow’s feet that landed at the outer corners. Regrettably, these unwelcome signs of aging are facts of life, especially after our skin has been exposed to decades of sun. 

I’ve used concealers, serums – even cucumber slices – to reduce the trio of irksome eye problems. Not a single one has lived up to its promises! 

When Westmore Beauty invited me to try its 60-Second Eye Effects Tinted Firming Eye Gel as the editor of a trusted website I thought “sure, what do I have to lose?” I remembered seeing – but not believing – the results when the gel was demonstrated on TV on a 70-year-old woman. “Impossible,” I thought. Now I’d get to see for myself if it really works.

I asked my sister Shelley if she’d apply 60-Second Eye Effects, too, so we could compare the results. Since a photo is worth a thousand words, take a look at how it worked on us!

This stuff is magical! Just like the tube says, it took about 60 seconds to diminish the look of our under-eye discoloration, fine lines and puffiness. Our crow’s feet looked less noticeable too. What’s more, the skin felt and looked firmer and the texture was smoother.  

Actually, it’s Hollywood Magic.

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The Westmore family has been involved in the Hollywood makeup business for over 100 years. They opened the first movie studio hair and makeup department in 1917, glamorized stars including Marilyn Monroe and Shirley McLaine, and did the special effects for movies such as Dr. Jekyll and Mr. Hyde.  

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The secret is Flex-Tensor Technology, which creates an invisible and flexible film that instantly smooths and tightens under-eye skin, especially the “bags” you want to send packing. Color correctors in the formula help diminish the look of dark circles. Hyaluronic acid provides hydration to help plump the skin. And, special light-reflecting, micro-filler ingredients fill in lines and pores so under-eye skin appears smoother and more radiant. What’s more, the formula includes retinol and vitamin E, two remarkable anti-aging ingredients. 

The results of 60-Second Eye Effects Firming Gel are so unmistakably astonishing that 

all 30 women who participated in a company-sponsored user perception study agreed:

The appearance of crow’s feet and under-eye circles was visibly diminished.

Lines and wrinkles appeared significantly diminished.

Skin felt and appeared firmer.

Skin texture was visibly improved. 

You’ve got to see it for yourself. And, if you’re not as excited as my sister and I, as well as the countless women who’ve written glowing reviews, send back your tube within 60 days for a full refund less S&H! 

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A Cut Above All Others

As I sit here watching TV news about the coronavirus, I am debating with myself whether to post anything at all that’s not related to the crisis we’re experiencing. 

Taking the appropriate precautionary measures is critical at this point, which I hope you will do.  Many of you thought this was being overblown by the media. That’s not the case.  

To entertain you for a couple of minutes, enjoy my love video to Rami, who has been cutting and coloring my hair for the past three years.


Don’t Let Sun Damage Age You Prematurely

Ask baby boomers today about nutty things they did in the 1960s and 1970s and they’ll likely say they rubbed baby oil all over their teenage bodies before hitting the beach to soak up the sun. Those  who were really determined to get the most from the rays even spiked the oil with iodine and used sun reflectors to speed up the process. If only we knew then…

    Dr. Mary Lupo

“Sun damage is insidious. You get it from the day you’re born and throughout life, so the more you can protect yourself when you’re young, the better off you’ll be when you reach your 40s and 50s,” said Dr. Mary Lupo, Lupo Center for Aesthetic and General Dermatology in New Orleans. But even if young people in 2019 are more enlightened about protecting their skin than boomers were half a century ago, they often ignore their parents warnings. “Parents can control toddlers and pre-teens. My grandchildren wear sun-protective clothing, sunscreen and hats. But when adolescents and young adults defy their parents and go out in the blazing sun without safeguarding their skin, they’re inviting the sun damage process to begin,” Dr. Lupo explained.  


When you’re soaking up the summer sun, its short Ultraviolet B (UVB) rays hit the top layer of your skin (epidermis) and can cause burns, brown speckling, mottling, and broken capillaries. Unprotected skin can burn in as few as 15 minutes! The longer Ultraviolet A (UVA) rays reach into the skin’s second layer (dermis) and stimulate the melanin (natural pigment), which creates a suntan that makes you glow and look ultra healthy. Ultraviolet C (UVC) rays are the shortest of all and the most dangerous, but fortunately they’re filtered out by the earth’s ozone layer and don’t reach the earth’s surface, or our skin. 

Unfortunately, repeated exposure to UVA energy over years accelerates signs of premature aging–think fine lines and wrinkles–by destroying the skin’s collagen and elastin foundation, which decreases its strength, flexibility and suppleness.  Called “photoaging,” the consequences also include age spots, freckles, ruddiness from dilated blood vessels, scaly red patches, and tough, leathery skin that feels and looks dry and coarse.

The sun’s UVA rays are just as intense during the winter, and can penetrate the windshield when you’re driving and the living room windows when you’re relaxing on the sofa. 

Sun damage can have medical manifestations, too, such as basal and squamous cell carcinoma, and melanoma, a fatal cancer if not caught and treated early. “And, the sun can damage the immune system cells that live in the dermis and survey for viruses, bacteria and funguses,” Dr. Lupo said. “When your immune system is weakened by the sun, you can develop uncomfortable and unsightly fever blisters.”

The best line of defense against sun damage is to faithfully shield your skin in the first place, from properly using effective sunscreen year round to driving with the sun visor down, from wearing sun-protective clothing to avoiding sun during the peak hours of 10 am to 4 pm. It’s never too late to start saving your skin, but a number of treatments can mitigate the damage for the millions who already have it. It’s wisest to consult with a dermatologist who will assess your situation and recommend the most effective treatment for you, depending on your type of skin and the severity of the condition.

Dr. Gilly Munavalli

The following treatments are among those favored by Dr. Lupo and Dr. Gilly Munavalli, Dermatology, Laser & Vein Specialists of the Carolinas. As esteemed dermatologists practicing in warm climates, both have invaluable experience and expertise dealing with sun damage. But even if you live in Minneapolis, the sun’s powerful UV rays can penetrate your car and home windows in frigid temperatures. Most everyone’s skin is a candidate for sun damage. It’s a fact of life. 


The most abundant antioxidant in human skin, vitamin C (aka ascorbic acid) helps protect skin cells from sun damage. Since our bodies can’t produce it, and derive only a small amount from oral supplements, we can get vitamin C from citrus fruits and dark green leafy vegetables. And thanks to scientific advances in the beauty industry, it’s available in topical formulas called cosmeceuticals, which are cosmetic products with bioactive ingredients that can help repair damaged skin and prevent further damage. 

Vitamin C cosmeceuticals also promote collagen production to reduce fine lines, and have the potential to thicken the dermis; prompt an anti-inflammatory response in the skin to prevent redness and inflammation even after sun exposure; reduce hyperpigmentation at levels of 5 percent and above, and improve the appearance of sun-damaged skin by strengthening our skin’s ability to repair. 

Dr. Lupo likes C+ Correcting Complex 30% from Revision Skincare, which helps brighten and even out the skin tone while protecting the skin from free radicals that can cause skin damage and signs of premature aging. The product is also shown to improve skin firmness. Almost 90 percent of users reported brighter skin and 94 percent saw an improvement in the evenness of their skin tone, according to the company’s website. 

Dr. Munavalli likes cosmeceuticals that also include phloretin, a flavonoid (plant pigment) substance that’s derived from apples and apple tree bark. Research has shown that it has antioxidant ability and can improve the appearance of discoloration and overall skin tone. SkinCeuticals Phloretin CF includes 2 percent phloretin, 10 percent pure vitamin C, and .5 percent ferulic acid for protection against premature signs of aging from sun damage and ozone pollution. 


Chemical peels can improve the appearance of sun-damaged skin by using a chemical solution to remove the outer layer of old skin. The new skin that replaces is typically smoother and appears less wrinkled. Solutions used include glycolic, trichloroacetic, salicylic, lactic or carbolic acid. During the procedure, patients may experience a burning sensation that lasts five to 10 minutes. The best candidates for chemical peels have fair skin and light hair. 


     Before & After photos of a Lumenis IPL treatment

Exciting light and laser technologies are changing the face of the beauty business for their ability to safely, gently and effectively treat a wide range of skin conditions. Devices that deliver a broad spectrum of intense pulsed light (IPL), for instance, can reduce sun-induced damage, including sunspots, broken capillaries, fine lines and thickened, dry and wrinkled skin from prolonged and excessive exposure to the sun. 

Many dermatologists across the country favor the Lumenis IPL, which lets them adjust pulse duration and wavelength depending on your skin type and what they want to treat. “I’m on my 4th IPL device from Lumenis in the past 20 years. It’s extremely versatile and can target red and brown pigmentation issues, from broken capillaries and ruddiness to sunspots,” said Dr. Lupo. “When the water in the skin absorbs the light energy, collagen renewal is stimulated and patients also see improved skin texture and overall appearance.” Besides their effectiveness, treatments with the Lumenis IPL don’t impose downtime on patients.

IPL treatments for sun damage are more effective in the short and long term than topical formulas, but using topicals after your IPL sessions will help you maintain your skin health and appearance. Each IPL treatment generally takes about 30 minutes, and patients see improvement following the first one. Minor redness and swelling tend to disappear quickly. “Patients usually need three sessions. We’ll go after the pigment during the first treatment and the redness and texture during the second. Then we’ll see what we need to revisit for the final visit,” Dr. Lupo explained.

Your Skin’s in the Sun and You’re in the Dark

If you’re a woman over 45 years old, it’s likely you haven’t the foggiest idea how to take complete care of your skin to keep it healthy and radiant looking. You probably know that drinking water is crucial for skin hydration. Smoking ages the skin prematurely. And, adequate sleep will help reduce under-eye puffiness. But you’re clueless when it comes to the skin care products you use. Sure, you’ve been buying serums, creams and lotions for decades. You’ve also undoubtedly tried countless brands that made innumerable claims. So, of course you think you know what’s best.

But you don’t!

How do we know? We know because 209 OF YOU TOLD US in your answers to an exclusive eight-question FabOverFifty skincare survey. 

Two-thirds of the respondents aren’t satisfied with their skincare products because they fail to treat their concerns. Yet, only 11 percent say sun damage is something they want to improve. And, 13 percent use sunscreen! These answers reveal their profound lack of skincare knowledge.

Sun damage, not age, is the single biggest contributor to aging your skin. So, if 87 percent of you don’t use products with sunscreen, and 89 percent of  you don’t even think about improving the sun damage to your skin, you are seriously misinformed! Fact is, while aging itself certainly contributes to wrinkles, fine lines and discoloration, the sun’s ultraviolet (UV) rays are responsible for the vast majority of the visible suns of aging. Vast majority, as in 90 percent! 

Rubbing cream on your crow’s feet and having Botox injected into the wrinkles on your forehead aren’t doing much good if you continue to let the sun play havoc on your skin. 

See how your answers correspond to those of the women who responded to the FabOverFifty survey.  In the upcoming weeks, we’re going to introduce you to hard-and-fast facts about skincare products that will probably astound you. And, we’ll tell you the four types of products you absolutely must use every single day. I, for one, wasn’t using three of them.  Now I am.

FOF Survey: Choosing and Using Skincare Products

If you think buying a house is easier than choosing skincare products, you’re probably going about it the wrong way. Please answer these eight simple questions about an extremely complicated subject, even if it isn’t rocket science.

Geri’s Excellent Aesthetics Adventure

    The young me with Grandma Rosie

When I was younger, I often wondered why handsome men were attracted to me because I never considered myself attractive. I’d look in the mirror to do my hair and makeup in the morning, but rarely after that. I never actually thought about my overall face. Now, when I flip through old photo albums, I realize I was appealing, even if not in a traditional Reese Witherspoon kind of way. Problem is, by the time it registered that I was attractive as a young woman, I had turned into a less fetching older woman. I’m far more emotionally secure today than I was decades ago, and my personality is as stellar as ever, but my face had definitely become less alluring. 

A tight neck and jawline had given way to hanging skin and jowls. Once rosy cheeks became dull. Bright eyes now looked sunken. Previously uninterrupted smoothness was punctuated with fine lines, folds, and wrinkles. Many women accept these inevitable changes, but I wanted to do something about them, especially after I learned about aesthetic medicine from dermatologists and plastic surgeons who I interviewed for

THIS is not a good look

Aesthetic medicine involves non-invasive to minimally invasive procedures that are designed to help improve a woman or a man’s physical appearance.  Even if you’ve never elected to have your frown lines temporarily erased with botulinum toxin injections that paralyze your forehead muscles, you probably know someone who has. But today doctors can go to work with sophisticated machines using different kinds of energy to firm, tighten, smooth, brighten, contour and revitalize the skin all over your body without a single incision. They’re freezing fat cells. Exfoliating dead cells. Heating collagen. Zapping unwanted tattoos, unsightly hair, undesirable discoloration, and much more.

These new game-changing techniques are safer and less expensive than plastic surgery. They often involve little to no downtime. There’s minimal pain and discomfort. And they can help keep you looking rejuvenated for years. Before the invention of these minimally invasive methods to help reverse the signs of aging, plastic surgery was a woman’s only option. No longer. As a matter of fact, many plastic surgeons across the country have reinvented their practices to focus on aesthetic medicine.

It looks painful. It wasn’t.


After seeing the outstanding results of the procedure Dr. Gilly Munavalli performed on 69-year-old Gray O’Neill, I wanted to know what he thought he could do for my face. I was especially interested in reducing the laxity and discoloration around my eyes, and the sagging neck skin, jowls and droopiness around my mouth. Dr. Gilly confidently told me he could improve my concerns with a group of non-to-minimally invasive treatments that would work synergistically, over time, to help achieve natural and noticeable results. I liked what I heard and booked an appointment.  

I had the following four procedures: 

♦ Jeauveau injections to reduce the dynamic lines between my brows and on my forehead. Recently introduced, these injections don’t create an “artificial, stiff appearance,” Dr. Gilly told me. “You want some movement, rather than a completely frozen look.” I will need to repeat these injections every four months if I want to keep my lines at bay. 

 A full-face fractional CO2 laser treatment with the Lumenis UltraPulse to stimulate collagen, tighten the skin, minimize the appearance of wrinkles and fine lines, and even out skin texture and tone. “This device has two handpieces: Its Deep FX provides deeper collagen stimulation for maximum contraction, and its Active FX provides textural improvement,” Dr. Gilly said. He did two passes around my eyes with the Deep FX at a lower density to contract the skin as much as possible.  

Neck following liposuction

♦ Liposuction of my neck and jowls, followed by subdermal heating with a laser, to tighten my neck and improve my jawline. Dr. Gilly calls this a “non-surgical neck lift.” Tumescent fluid (eg lidocaine) is injected locally to produce anesthesia, swelling and firmness of the area (“a well established and safe technique,”), and then three small incisions are made under the chin and along the jawline. After using cannulas to remove submental fat and reduce fullness, Dr. Gilly worked with the laser to produce further contraction. “Rather than cutting and pulling the skin to tighten it, we’re relying on heat,” he said. 

Protecting my skin from the sun

♦ A microneedling treatment from mid cheek to the bottom of my neck using radio frequency (RF) energy to induce the body’s natural healing response to regenerate collagen, elastin and hyaluronic acid. “While this RF device safely heats the mid dermis for maximum contraction of the skin, it doesn’t affect the skin’s surface or the pigment,” Dr. Gilly explained.  It also further tightens the cheeks, jawline and neck following liposuction. .  

It took about three hours for Dr. Gilly and his team to perform the menu of treatments, although it felt like far less time. Semi-conscious throughout the session, I experienced discomfort at one point, but soldiered on. It was bearable. Aesthetic medicine may be minimally invasive, but CO2 laser and RF energy actually injure the skin in order to stimulate cell turnover, which slows down as we age. These treatments also revive the production of proteins that give the skin elasticity and firmness. Declining proteins such as collagen often causes increased laxity, folds, wrinkles and fine lines. 


Swelling going down

A picture says a thousand words, but I looked a lot grimmer than I felt.  I had no pain, despite the swelling, redness, modest bleeding, and bruising. I filled a prescription for a mild painkiller, but never used a single pill. I took Tylenol for minor discomfort. It was a bigger pain in the neck – figuratively speaking – to wear the stylish garment on my head that’s designed to help tighten the skin after liposuction, but it came off after a few days. 

Like a dutiful student, I faithfully did my homework assignments, which included gently washing my face with a mild cleanser and applying a thick clear ointment to protect my healing skin. Going outside without a hat to shield my face was a no-no. When it comes to the signs of aging, sun is one of the biggest offenders, even if you haven’t been a sun worshipper for decades. Believe it or not, harmful rays can penetrate the windshield of your car. “A patient in her late 40s did well for the first two weeks, but then she went to the beach and now we’re battling hyperpigmentation, where patches of skin become darker than the surrounding skin,” Dr. Gilly related.  

Neck is looking good and face has color without makeup

I had the treatments on September 19, 2019, and started to look noticeably better by the sixth day. Despite my black and blue neck, lumps and bumps under my chin, peeling skin on my cheeks, and overall splotchiness, I could see the effects of Dr. Gilly’s artistry. My eyes opened wider and looked brighter. My neck was tighter and firmer. A healthy glow had returned to my complexion. My face continued to improve every single day for the next few weeks. “The initial Inflammatory stage lasts about four weeks, but that all goes away,” Dr. Gilly explained. 

It’s been four months since my aesthetic adventure began, and I’m pleased with the results. I think I now look considerably better without makeup than I used to look with makeup. “It can take up to six months to see the full effects of the treatments, because new collagen forms more slowly in the deeper tissue.” Dr. Gilly explained. “You’ll see the surface results first, but your skin will contract even more when when collagen is created in the tissue below.” 


Swelling and bruising are gone

I’m 72, but if you have aesthetic treatments when signs of aging start accelerating  – say in your fifties – the long-term benefits will be greater. That’s because your skin won’t have lost as much of the elasticity, moisture and radiance that make younger faces look, well, younger! While I wouldn’t mind looking like I did when I was in my fifties, that ship has sailed, so I’m delighted to look like a more refreshed 72 year old. 

The advantages will be greater yet for women in their twenties and thirties who opt for aesthetic procedures. And every year more and more are doing just that. We look younger than our mothers did at our age, and when our daughters become FabOverFifty, they’ll look younger than we did. Many women emphatically say they want to “age gracefully,” but  I’m not sure what that means. I see nothing graceful about wrinkles, jowls, crows feet and turkey necks, not to mention gray hair that resembles straw, underarms that jiggle like Jell-O, and breasts that look downhearted.  

I’m certainly not a fan of faces and bodies that have been excessively pulled, snipped,  lifted, tucked, and injected, a la Joan Rivers. But I’m all for looking refreshed. If we reupholster sofas that look dingy, discolored, and worn, and repaint walls that have cracked and peeled, why not laser and microneedle our faces if they have the same issues? I’m delighted when friends compliment my home. When they think I look great, I’m over the moon.

                                              Refreshed but still the old me



Dr. Gilly Munavalli, medical director and founder of Dermatology, Laser & Vein Specialists of the Carolinas in Charlotte, NC, brings to his practice an impressive academic background and breadth and depth of clinical experience.  He earned a Master of Health Science from the Johns Hopkins University School of Public Health followed by a Doctorate of Medicine from Morehouse Medical School. After an internship and residency at the Mayo Clinic and Emory University, he received dermatologic surgery fellowships in Mohs Micrographic Surgery, cutaneous oncology, facial reconstruction, cosmetic and laser surgery at  UC San Francisco.

         Dr. Gilly Munavalli

Board Certified since 2002 from the American Board of Dermatology, Dr. Munavall currently serves as an Assistant Professor at the Wake Forest University School of Medicine – Department of Dermatology, and as a Cosmetic Dermatologic Surgery Fellowship Director for the ASDS. His diverse expertise includes tumescent liposuction, blepharoplasty, laser skin resurfacing, facial volume enhancement, fat transfer, as well as laser removal of small blood vessels, birthmarks, acne, tattoos, fine lines and wrinkles. 

Dr. Munavalli enjoys reading, keeping tropical fish, international travel, exercising and sports. He and his wife have a son.

Treating the Skin of Modern American Women with Ancient Indian Beauty Rituals

Aavrani compensated FabOverFifty to create this sponsored post, but we only recommend superior products or services that we believe will benefit women in our community. Insights and opinions are our own. All facts are fully substantiated.

   “The absolute best mask I’ve ever used.” -Geri

Visiting her grandmothers in Calcutta during Christmas, or at home in Detroit with her mother, young Rooshy Roy would often catch a whiff of turmeric wafting out from the kitchen. But the aroma didn’t necessarily mean she’d be enjoying a luscious dinner that evening. Indian girls like Rooshy grew up watching their moms concoct the creams and solutions for their faces with the same ingredients they’d gather to cook their families’ favorite meals. Now brilliant and glowing, grown up Rooshy is bringing centuries of tried-and-true Indian beauty secrets to American women through aavrani, her carefully conceived and curated collection of skincare products.

While working in finance, Rooshy rediscovered the beauty rituals she learned during her childhood. “I started to fully appreciate them in my 20s,” said the young woman whose composed manner belies her 29 years. Taught from their youth that beauty emanates from the inside out, Indian women fully embrace healthy lifestyles, from what they eat and how they sleep to the ways they center their minds and bodies. Think yoga and meditation. “We understand that how we live our lives, not only what we put on our skin, is vital to looking and feeling our most beautiful,”Rooshy told me in her downtown Manhattan office. 

Clean Recipes for Beautiful Skin Passed Down From Generation to Generation 

Determined to keep aavrani beauty formulas “as authentic to ancient Indian rituals as possible,” Rooshy uses the same clean natural ingredients, in identical combinations, favored by her mother and grandmother. “The recipes are so rooted in our culture, passed down from generation to generation, that It’s hard to pinpoint when I learned which elements work together best,” she explained. Rooshy choose the name aavrani (rani means queen in Hindi) to signify female empowerment and the celebration of natural beauty. 

                       Rooshy Roy

The aavrani collection is handcrafted in the United States from high-quality ingredients that are sourced from around the world. Organic manuka honey comes from New Zealand, for instance, because it’s the best variety for preserving hydration of the skin, Rooshy noted.  And neem comes from India. Extracted from the neem tree, this natural herb acts like a strong anti-inflammatory agent and is amazing for blemishes, redness and calming the skin, she added.  

Remaining true to ancient rituals also means sourcing naturally derived preservatives that will prolong the life of each unique aavrani formula, but won’t alter its potency and integrity. “Natural preservatives aren’t easy to find and don’t all work well with the ingredients we want to highlight, which adds time and expense to our research and development processes,” Rooshy said. “The inexpensive preservatives used in many mass market products, such as parabens and mineral oil, wind up being harmful or associated with harmful effects.” 

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A Modern Four-Step Skin Care Ritual Rooted in Ancient Traditions

Women are becoming more and more educated at younger and younger ages about what they’re putting on their bodies as well as into their bodies, Rooshy related. “We’re want to appeal to them when they’re exploring new beauty products at transitional stages in their lives, whether they’re 20-something professionals or 50-something women with new skin concerns. These women are willing to spend a little more on better quality, more efficacious products,” Rooshy maintained. 

Aavrani provides solutions for every woman’s essential skin care needs, including anti-aging, brightening, resurfacing, hydration and moisture retention, Rooshy said.  Seeing her brand as the pioneer of iBeauty, her mission is to introduce Indian beauty rituals to American women in a way that has never been done. Unlike K-Beauty (Korean beauty), which can have up to 20 steps and intimidate women who are looking at their skin in new ways, the complete aavrani ritual takes only four steps. 


             The wonderful four-step aavrani ritual

Aavrani’s hero product, formulated with organic turmeric, neem, jojoba and honey, this acts as a cleanser and mask to gently exfoliate, brighten and even skin tone. Neem is an “amazing and superior alternative to alcohol because it doesn’t irritate the skin and can be used on sensitive skin types,” Rooshy said. 


Formulated with tea tree oil, cucumber extract, chamomile flowers, and witch hazel, this toning polish removes toxins, reinstates the natural moisture barrier of our skin, and enables aavrani Hydra-Whip to work more effectively. 


Formulated with coconut, meadowfoam and rosehip seed oils, plus shea nut and lavender extract, this ultra-hydrating yet lightweight solution locks in moisture, nourishes, and soothes skin. “We wanted to create a moisturizer that maintained the hydrating benefits of coconut oil but didn’t feel heavy and greasy or clog pores. You only need to apply a pearl-sized amount for the entire face, and it will last for hours and hours,” Rooshy explained.


Formulated with sweet almond oil, rosewater, avocado oil and vitamin E, this revitalizing eye treatment minimizes dark circles and puffiness, stimulates collagen production, and decreases the appearance of fine lines. A metal rollerball at the top is cooling and depuffing. 

“This set is amazing for women of all ages. Dryness and wrinkles all come down to lack of hydration. The aavrani ritual can maximize your skin’s ability to retain water and make it look its best,” Rooshy said. 

The aavrani Complete Ritual Set of skin beautifiers comes in TSA-friendly amounts so you can experience the ritual before purchasing the larger sizes. And, it would make a distinctive Christmas gift for the important and beautiful women in your life. Check out the hundreds of outstanding reviews online.

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