Winter skin care tips

Posted on October 17, 2012 by

With the chill in the air today I’m reminded that it is time to reevaluate our skin care routines for fall and winter. When the temperatures fall and the humidity drops, the skin becomes more dry and sensitive. It’s important to make a few adjustments so that we don’t get itchy and irritated.

Sunscreen is still important in the winter. If it is daylight there are ultraviolet rays and you need SPF every day. Switch from a sheer sunscreen to a lotion or cream.  And swap your lighter summer moisturizer to a thicker version.

When it’s cold out it’s tempting to linger in a hot bath or shower. But that can actually make your skin more dry. As soon as your skin starts to “prune” that’s a sign that you have absorbed as much water as possible, and at that point you will lose moisture. The heat and steam can dry out the top layers of your skin. When that happens– when you have a dry top layer– there is increased loss of moisture through your skin. It’s also harder for your skin to absorb the lotion that you are applying. So make your shower or bath a little shorter and warm, not hot, and apply lotion all over your skin right after bathing.

Beware of over-stripping the skin with soaps, chemical peels, and retinols. Products you might normally tolerate well in the summer could be too irritating in the winter when you don’t have as much natural oil. You may need to use your retinol every other night instead of every night, and have a lighter version of your usual your chemical peel monthly instead of every 2 weeks.

When in doubt, ask your dermatologist about your products and devise a winter regimen with her. It’s always a good idea to bring in what you’re using or what you want to use so we can look at the ingredients. Otherwise we really don’t know what’s in your “brand x” cleanser and it’s a challenge to give you a complete recommendation.

Posted in Uncategorized

My new favorite sunscreen

Posted on June 4, 2012 by

When anyone asks me what is the best sunscreen, I answer that the best is one that you will use, use regularly, and use generously. Then I get into more specific details: it should have an SPF of 30 or higher and should say clearly on the label that it offers broad-spectrum protection against both UVA and UVB rays.

This weekend I wandered into a surf shop on Long Island and I saw a brand I’d never seen before, Sun Bum.  First, I checked the ingredient list to make sure that it protects against both UVA and UVB protection.  It does, although this is a chemical suncreen as opposed to the physical sunscreens zinc oxide or titanium dioxide. This may be a more important factor to you if you have sensitive skin and are choosing a sunscreen for your face than when you are choosing one for your body.

After checking the ingredient list, I sampled the SPF 50.  It smells amazing, like coconut oil. It smells like the beach should smell. It is also lightweight and rubs in without being greasy or sticky.  I was sold.  I also bought the SPF 30 lip balm and the SPF 30 face stick.  I always carry sunscreen sticks and lip balms in my handbag so I can reapply without using my hands or fingers.  After all, I live in New York City so unless I’ve just washed my hands I will not touch my face.

Between the great smell and the fact that it goes on smoothly and isn’t greasy it’s easy to apply the right amount and reapply often. The reality is that almost no one puts on as much sunscreen as they should and are therefore not getting the amount of protection that it says on the label.  You really do need to use 1 ounce, which is a shot-glass full, to adequately protect your body.  Something else I liked about this sunscreen was that the bottle is 8 ounces. Many other sunscreens that I have and have seen on the market are 3 or 4 ounces, which is only enough for 3 or 4 applications.

According to Sun Bum’s website they also make SPF 70 lotion and both SPF 50 and 70 spray, but this store didn’t have it.  There may not be a significant increase in the protection you get from SPF 70 as opposed to SPF 50, but every little bit helps.  I’ll use the SPF 50 but I am definitely on the lookout for the SPF 70.

 

Posted in skincare, sunscreen

Painkillers and Skin Cancer

Posted on June 1, 2012 by

Recently a study was released in the journal “Cancer” http://onlinelibrary.wiley.com/doi/10.1002/cncr.27406/abstract reporting a decrease in the number of some skin cancers in people who took certain types of pain relievers, called non-steroidal anti-inflammatory drugs or NSAIDs, for many years.

Before you rush out and start taking a lot of aspirin, keep a few things in mind.  The people in the study were taking prescription NSAIDs. They were taking these medications for other reasons, not as part of a study looking at skin cancers. And all medications have risks.  Talk to your doctor before taking any new medication.

This study suggests, but does not prove, that taking NSAIDs in higher doses over many years may inhibit the development of some skin cancers. However, this does not mean that you can rely on NSAIDs to protect you against skin cancer. Your best defense against skin cancer is to apply a broad-spectrum sunscreen, avoid excess sun exposure, and avoid getting a sunburn.  See your Dermatologist once a year for a full skin examination and if you notice any changing moles, a spot that is bleeding or isn’t healing after a week or two, or a new growth that is getting larger.

 

Posted in Uncategorized

What’s your most common procedure?

Posted on May 21, 2012 by

This is a very common question, and the answer is: Botox!

Botox has been around for a long time. It has been studied by scientists for 100 years, has been used medically since the 1980s, and was first approved by the FDA in 1989.  It is currently FDA approved for a variety of treatments including spastic eye muscles, migraines, excess sweating, and my personal favorite, facial wrinkles.

Botox works by blocking the messages from the nerves to the muscles.  If the muscles can’t contract or can’t contract as strongly, the wrinkle smooths out.  Botox is not a poison.  It is not and does not cause the disease Botulism. Botox is a purified protein that selectively relaxes the muscles that create facial wrinkles.

Sometimes new patients come in and say “I want to get rid of this line but I don’t want that frozen look.”  They’re thinking of Botox the way it was used when it was newly approved for cosmetic use, and  doctors mostly gave it the same way in a “one size fits all” fashion.  Well, fashion changes.  It’s a rare day when I give someone enough Botox to completely paralyze the movement in an area.  Instead, I usually give small amounts, enough to decrease the movement and improve the line or wrinkle but still maintain a very natural appearance.

You’ll never know how many people get Botox, or a variety of other treatments for that matter, because when it’s done correctly it isn’t obvious.  You notice over-done, excess, “bad” work but not “good” work.

I also use a smaller needle than many others do, which I didn’t realize until patients told me that it didn’t hurt when I treated them.  I’m certainly not a fan of needles myself, so I do everything I can do to make it a more pleasant experience.

Botox is really quite helpful to help maintain how we look, to slow down the appearance of wrinkles, and make aging gracefully a little more graceful.

 

Posted in aesthetic

This is one trend you don’t want to follow.

Posted on May 18, 2012 by

Every new patient that I see is offered a complete skin examination. Even if the patient is coming in for a cosmetic consultation about Botox or lasers, he or she is encouraged to have a full skin check to look for skin cancer. I have found many suspicious growths this way, but what is really scary is that I’m finding more and more melanomas, and in younger and younger people.

What I’m seeing in my office isn’t just me.  A recent study released by the Mayo Clinic (http://www.mayoclinicproceedings.org/article/S0025-6196%2812%2900209-1/abstract) reported an increase in the number of melanomas in young people (ages 18-39), especially women. These researchers found that in the past 30 years the number of melanoma cases increased 4 times in men and 8 times in women.

So why is this?  The number one reason is tanning.  Young women are not only baking themselves on the beach but they are going to the tanning bed.  A CDC study (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6118a2.htm?s_cid=mm6118a2_w) reported that one-third of women ages 18-21 used a tanning bed in the past year, and women in their 20s used tanning beds more than 10 times in the past year.  That is really shocking to me.  I’m going to say it: it’s really, really irresponsible.  You might as well be begging for skin cancer.

The amount of ultraviolet radiation released by a tanning bed can be 7 times as much as the sun.  Many tanning beds emit mostly UVA and less UVB.  UVB are the burning rays, so people think “I didn’t get burned so I must be OK.” Wrong!  UVA rays are the really damaging rays, the ones that penetrate into your skin’s DNA leading to skin cancer and premature aging.  Think wrinkles, brown spots, and leathery skin. How attractive!  You wouldn’t want to go get a full body X-ray every day, would you?  Going to a tanning bed is also exposing yourself to radiation, why would you voluntarily do that to your body?

I’m not saying avoid the sun, stay home, don’t play tennis or golf or go swimming.  Do what you enjoy but be smart about it.  Apply a sunscreen with an SPF of at least 30 and apply A LOT of it. Reapply it every 1 to 2 hours, or immediately after you have been swimming or sweating. Even if it is water-resistant or sweat-resistant if you wipe your wet skin you wipe off your sunscreen.  Wear a hat with a wide brim.  There are so many cute, fashionable hats out there!

When it comes to sunscreen most people don’t apply enough. The SPF number on the label is tested in a lab where a thick layer is applied. Almost no one in real life applies that much.  In a typical application, most people are getting about half the protection that is on the label, which is why the higher the SPF you use the better.  And SPF tells you about your protection from UVB not UVA.  There is no good reference that tells you about your protection against UVA, no keyword like “SPF.” The only way to know if your sunscreen protects you against UVA is to make sure the label says “broad spectrum protection” or “UVA/UVB protection.”

The labeling rules for sunscreen are changing. Over the next few months sunscreen  manufacturers will have to comply with a new rule from the FDA.  In order to say “broad spectrum” on the label, the sunscreen will have been tested and proven to offer equivalent protection against both UVA and UVB.  So if a product says “Broad spectrum SPF 30” you can be confident that there is a protective factor of 30 against both UVA and UVB.  If it doesn’t offer adequate protection against UVA, even if it has a high SPF against UVB, there will be a warning on the label that says that the product has not been proven to protect against skin cancer.

The FDA passed this rule last year, but the date by which manufacturers need to comply isn’t until December 2012.  So this summer you will still need to read the label.  Look for SPF 30 or higher.  Look for the words “protects against UVA and UVB.”  Look at the ingredients.  I advise my patients to choose sunscreens with zinc oxide, or with zinc oxide, avobenzone, and oxybenzone.  These ingredients together will give you the best protection against both UVA and UVB.

Posted in medical, news, skincare

Pardon me…

Posted on May 16, 2012 by

But you might want to put on some flip-flops if you are walking around the gym  in your bare feet.  I see people every day walking around the locker room to and from the showers barefoot.  Fungus and viruses love a warm wet environment and you can catch athletes foot, toenail fungus, and plantars warts by walking around where someone with these conditions is also walking barefoot.

In the weight room and on the cardio equipment take advantage of the wipes that most gyms provide and wipe down the equipment before you touch it or lie down on it.  I always put a towel on the benches and mats so that my bare skin doesn’t come into contact with it.  I have a trainer (I need the motivation) and he laughs at me and my towel.  But I don’t care, because not only can you get athletes foot and warts, but you can potentially get a serious staph infection.

To be clear, it is not common to catch a staph infection this way but it is possible.  Do you really want to take any chances when it comes to your health?  I am seeing more and more antibiotic resistant staph infections, the so-called flesh-eating bacteria, and it’s not just in sick or hospitalized patients.  So take a little extra care, and if you have a cut or scratch or even a pimple on your body, wash it twice daily and put antibiotic ointment on it. If it isn’t getting better in 2 to 3 days or if it is getting worse seek medical attention promptly.

Posted in Uncategorized

I’m sensing a theme here…

Posted on May 16, 2012 by

Today I saw one acne patient after another. No, I don’t plan to see certain patients in the same day, but acne is one of the most common problems for people of all ages. Breaking out doesn’t mean you aren’t taking care of your skin (unless you are falling asleep with your makeup on, in which case you should know better).  There are actually several different factors involved in the development of acne and not all acne is created equal. This means that not all people with acne will treat it the same way.

Acne is not just a cosmetic concern, it affects how we feel about ourselves. One of my friends told me that she used to cancel social plans and just sit home alone when she had a bad acne breakout. Many people are left with discolorations and even permanent scars. There are many options for treating acne, so don’t wait to see a dermatologist until it gets so bad that you are sitting home alone.

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