Most every bride-to-be asks about them: the tiny, fleshy to red colored bumps on the outer, upper arms. How can they get rid of them before the wedding? The official name for these bumps is: Keratosis pilaris or KP. Up to 40% of women and men have KP.
Keratosis pilaris are plugs in hair follicles caused by keratin, a hard skin protein. These plugs create patches of bumpy skin typically on the outer arm or upper thigh. Dry skin can make the bumps worse, and KP is more noticeable on darker skin. Treatment regimes include topicals and in-office peels. Effective topical treatments are:
1) Ammonium lactate. (available as Lac-hydrin.) Lactic acid reduces roughness. In fact, it is rumored that Cleopatra bathed in spoiled milk (lactic acid) to give her skin softness.
2) Urea (available as Carmol) to help soften skin.
3) Retinoids (available as Retin-A) which promote surface cell turnover.
Now you can look forward to having bump-free arms on your special day!
Dandruff is annoying: both the itchiness and flaking. When my dandruff flares, it is hard to wear a black shirt for fear of conspicuous white flakes on my shoulders. Dandruff is caused by the overproduction of scalp cells, which in turn leads to excess shedding of dead cells. Stress, weather, and even yeast called malassezia have been linked to dandruff. Treatment regimens usually begin with a good dandruff shampoo. Neutrogena T/Gel or T/Sal are classic starter therapies. T/Gel contains an exclusive ingredient called Neutar that combats all major scalp issues and T/Sal contains salicylic acid, which aids the breakdown of scalp build-up. Another option is Nizoral A-D shampoo, which contains ketoconazole to eliminate yeast.
Whenever using a dandruff shampoo, leave it on for several minutes before rinsing. To avoid drying out the hair shaft, apply the shampoo only to scalp and use it only twice a week. Once your dandruff is under control, it is a good idea to use the dandruff shampoo once or twice a month as maintenance to help prevent recurrence.
As a dermatologist, I am not a huge fan of facials: steaming can break blood vessels and extractions can leave the pores larger. But, I do believe in and promote in-office peels followed by at home-kits and masks. All masks are best used at night after the skin has been cleansed. Masks can be used as an acne treatment, hydrator, or soother. Here are a few great buys to fit all of your needs:
* Queen Helene Mint Julep Masque: One of the cheapest masks on the market, at $3.99 this mask dries out pimples and pulls out blackheads. It does tend to leave the skin feeling quite tight, so I only recommend using it on areas prone to breakouts.
* Biore Purify Self-Heating Mask: Is a fun, spa-like treatment for home. This product heats, cleanses, and exfoliates while absorbing excess oil.
* Neutrogena Clear Pore Cleanser/Mask: This treatment can double as a daily cleanser and a mask. It helps fight acne by deep cleaning and eliminating oil.
* Eau Thermale Avene Soothing Moisture Mask: contains 70% spring water. Patients with sensitive skin often complain of tight, raw skin and seek a mask, which calms and soothes. This mask hydrates and nourishes sensitive skin while also providing relief for skin irritation.
Many patients and friends ask me what the difference is between tinted moisturizer and foundation. While both provide a bit of color to even out complexion, tinted moisturizers also hydrate the skin and often contain anti-oxidants and sunscreen to help protect skin. Tinted moisturizers are popular year round but especially during the hot summer months because they offer a lighter coverage while providing a sheer, natural glow. Foundations, on the other hand, provide heavier coverage for more noticeable skin problems but often do not provide the extra benefits of a moisturizer.
The tinted moisturizers which have a huge fan base are:
1) Neutrogena Healthy Skin Enhancer with SPF 20. While technically this is a lightweight foundation, it's so sheer and natural with spf protection, I personally categorize it as a tinted moisturizer. It enhances your natural color while nourishing and protecting skin and contains stabilized retinol.
2) Laura Mercier Tinted Moisturizer with SPF 20. Also provides sheer, lightweight coverage.
3) Vincent Longo Light Canvas Tinted Moisturizer with SPF 20. It contains mineral pigments which help reduce redness and provide a sun-kissed glow.
As a side note: the SPF 20 in these products is sufficient coverage for routine day-to-day travel to the office or for strolling to Starbucks, but they are NOT enough coverage for when you are in a tropical setting, on the beach, or in direct sunlight for longer than twenty minutes.
What is a serum, besides being my favorite skin care product? A serum is a layering product, which is applied to your face just after cleansing. Serums can provide many different benefits from delivering an agent like an antioxidant to help smooth skin to facilitating absorption of vitamins from your moisturizer.
In my opinion, the best serums on the market are:
1) Neutrogena Healthy Skin Anti-Wrinkle Intensive Serum which contains retinol and antioxidants.
2) Olay Regenerist Daily Regenerating Serum which contains amino-peptides to help hydrate skin.
3) SmashBox Photo Finish Foundation Primer with SPF 15. While this is not a serum, I often use this foundation primer in its place because it contains vitamins A & E, plus grape see extract and green tea to help protect and smooth skin.
I use a serum in the morning before I apply my makeup, and I use one again at night before my night cream. I find that my skin stays smoother and better hydrated and now I can't live without it!
Dusky, gray, coffee-stained teeth can make you look older, the same way wrinkles can. Coffee, tea, colas, and smoking are the biggest culprits in teeth discoloration, but age and regular wear and tear will also cause teeth to lose their original luster.
Last week, I went and had my teeth "Zoom!" whitened which is a technique where hydrogen peroxide is painted on your teeth and then exposed to a special light source. The combination breaks down and eliminates stains on your teeth. The side effects can be some slight tooth sensitivity, but the results are so worth it! My red wine, coffee, and blueberry stained teeth are now pearly, sparkly white.
Alternatively, if you are looking for an at home treatment, Listerine Whitening Quick Dissolving Strips or Crest Whitestrips are both easy, inexpensive options to lighten your teeth. Also, GoSmile B1 Tooth Whitening ampoules, mini tubes of teeth bleach which can be used at home or on the go, are another great option. Most drug stores sell Listerine Whitening and Crest Whitestrips and you can find GoSmile at Sephora.
No matter what method you choose, definitely invest in a good toothbrush and always KEEP SMIILING!
Melasma, also known as chloasma, are brown patches of hyper-pigmentation that typically occur on the face. Although melasma can affect anyone, it is most commonly seen in women. It is believed that estrogen, stimulated by pregnancy, birth control pills and hormone replacement therapy, causes skin to produce greater amounts of melanin in the skin. Sun exposure can make melasma worse, so the first line of defense is a broad-spectrum sunscreen like Neutrogena's Ultra Sheer line of sun protection products. I love this formulation because it comes in both a cream and a spray.
If you already notice developing melasma there are several treatments that can be used in order to fade darkening spots. Topical therapies include the use of hydroquinone, which inhibits an enzyme involved in the production of melanin, tretinoic acid, which increases skin cell turnover, and azelaic acid, which decreases the activity of melanocytes. Other treatments include: microdermabrasion, chemical peels, or laser treatment which all facilitate the fading of melasma. You should consult your dermatologist to explore all of your options.
One thing to note: melasma is stubborn, so you may need to battle it with several treatments. So, buy a good sunscreen and a hat or else you may find yourself fighting a losing battle!
Recently, my mother and I went to see the newly released movie "Sex and the City." There is a hilarious scene where the "gals" are discussing unwanted hair, which brings up the perennial summer subject of hair removal. As our winter clothing layers are being shed, many of us remember it is time to de-fuzz. Surprisingly the most common areas where women have unwanted hair are the chin and upper lip, next is the bikini area, followed by the under-arms. Even men have jumped on the hair-free bandwagon, typically seeking hair removal on their back and chest.
Shaving, waxing, and depilatories are all temporary options, but laser hair removal is the best way to eliminate unwanted hair and permanently stall hair growth. The laser targets the pigment in the hair follicle, which prevents the hair from growing back properly. However, because the laser targets melanin, only black or brown hairs can be successfully removed. The best candidate for laser hair removal is a person with dark hair and light skin because the greater the contrast between the skin and hair, the easier it is to remove, but laser removal will work for any skin tone if treated by a properly trained technician. Laser hair removal takes between three and six treatments spaced a month apart and each treatment lasts about 15 minutes per area. The procedure is permanent and is relatively painless, similar to a quick rubber band snap. The crucial take-home message is this: make sure the technician is properly trained and licensed and then get ready for smooth, hair-free glory.
The summer months are filled with bridal talk but lest we forget the groom who wants to look good too! Here are some tips for the man in your life! A frequent concern for male skin care is shaving. Men often ask whether it is better to use a razor or an electric shaver. I advise them (and you) to consider different factors in making your decision, such as: quantity of facial hair, skin type, frequency of shaving, the presence of skin problems or irritations, cost, and convenience. An electric shaver leaves hair edges ragged and split but is preferable for acne prone skin, whereas a razor produces a closer shave but can aggravate inflamed skin. A good idea is to experiment with both methods to see which one you prefer. Pre-shave preparation is essential to ensure a clean, close, less irritating, and quick shave.
1) Shave in the shower, towards the end, so the steam can soften your beard hairs (of course, not if you use an electric shaver! Too dangerous!)
2) Use a shaving gel rather than a foam or cream
3) Always use a sharp razor with three or more parallel blades
4) Shave with the grain first, this helps avoid ingrown hairs if you are prone to them. You can also apply a salicylic acid formulation like Tend Skin or a topical antibiotic like Clindamycin gel to shaved skin to prevent/treat ingrown hairs. Then for a closer shave, shave against the grain
5) Don't shave too closely, it can be too irritating to the skin
6) Do use a moisturizer with sunscreen after you shave. Use an oil-free preparation if you are prone to breakouts
7) Consult a dermatologist if ingrown hairs persist or become swollen or irritated.
Summer brings in all sorts of new and fun lip products. While I defer to Matin to advise you on summer shades and glosses, I would love to give some tips to keep your lip texture smooth and supple. Lips get a lot of action, kissing, eating, and smiling, and as a result, make our lips a very active and central focus of our face. Because chapped and peeling lips don't make a good canvas for lipstick, lips need sunscreen as well as weekly exfoliation to remove dead skin cells. A dry, soft toothbrush can manually remove the peeling skin. A good emollient, like Eucerin's Aquaphor Healing Ointment or Burt's Bees Lip Balm, are good sealants to use at night. Neutrogena also has a lip-rejuvenating product, Lip Boost Intense Moisture Therapy, which softens and enhances lips' fullness. Also, as we age, we tend to lose volume in our lips, and some may choose to supplement their lips with fillers. A dermatologist can plump your lips with products such as Restylane, Juvederm, and Cosmoplast. These fillers are temporary but create luscious, kissable lips while also camouflaging the effects of aging.
As a Mother's Day present to myself, I purchased a set of semi-permanent eyelash extensions. It took ninety minutes to have each of my individual eyelashes isolated and then glued to a dark black, gloriously long, synthetic eyelash. Seventy eyelashes in total were applied to my normally blond, stubby eyelashes. Cheri Woblenski, the eyelash pro of Manhattan, applied them while giving me the 411 on lashes. First of all, the lashes last up to three months, but they need to be filled in regular intervals, about every three weeks. The lashes are applied with a medical adhesive, which does not damage the eye or lash. No mascara is needed because the lashes themselves have a dark sheen. Now that summer is here and I am routinely dipping into the pool with the kids, I no longer have to worry about running mascara. Cheri has a cool website which you can peruse at www.lashboutique.com. Cheri uses Xtreme lashes, and also trains technicians around the globe. I cannot tell you how many compliments I have received. They look so real that most people just demand to know what kind of new mascara I am using!
Countless studies prove that ninety percent of all skin cancers are caused by sun exposure. With summer in full swing, it is an excellent time to chat about what you can do to keep your skin healthy and cancer-free. First, make sure to schedule an annual skin cancer screening. Each year, doctors diagnose 50,000 new cases of melanoma through routine screenings. Melanoma is the scariest type of skin cancer because it claims lives, whereas squamous cell and basal cell cancer, the other types of skin cancer, have a much lower instance of metastasis (spreading to other parts of the body). Melanomas do have a genetic component, but also are linked to sunburns in childhood. Unfortunately my grandmother had melanoma, and I have had two in situ melanomas. I grew up in Georgia where I used to bake myself. I cannot remember a summer in my childhood when the skin on my nose didn't peel off from sunburn. Despite my fair skin, I craved a tan and would make a towel out of aluminum foil and apply a concoction of baby oil and iodine to ensure a crisp tan. Now that I am older and am more aware of the risks, I have become very knowledgeable of the of art of self-screening, and I have not been tanning since I turned 21. Regardless of whether or not you lay out to tan, everyone should be aware of the dangers, utilize preventative products and know the most common signs of skin cancer for early detection. Always wear sunscreen and be on the look-out for changing moles. Here are the classic "ABCDs" of self-screening for melanoma:
Asymmetry: one half does not match the other
Border: edges are jagged like a leaf, or blurred
Color: un-uniform pigmentation with shades of black, brown, pink, or variegated
Diameter: typically moles should be smaller than a pencil eraser, and be wary of any moles that have changed size, bleed or itch.
The most common location of melanoma for a male is the back and for a woman the calf. Any new or changing mole is considered a dermatologic emergency. So be skin savvy and know your moles!
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Edited by Gervaise at 07/08/2008 8:52 AM PDT
Now that summer is here, many of us will find ourselves enjoying the great outdoors: cookouts, campfires, hikes, etc. A common, distressing call I receive is, "Help, I found a tick on my body! What do I do?" First, remove the tick promptly. The sooner it is removed, the less chance of infection. Grasp the tick where its mouth enters the skin and tug gently rather than squeezing the tick's body (which can literally become a bloody mess). Place the tick in a jar and take it to your dermatologist or internist who can have the tick identified. Certain species are known to harbor and transmit Lyme disease. In the Eastern United States, it is the Ixodes scapularis tick. Many physicians are recommending a single prophylactic dose of doxycylcine (200mg) for the prevention of Lyme disease if bitten. Sometimes, even though a tick is not found, a rash will develop, and patients wonder if their weekend in the woods has left them with an undiscovered infection. A typical early symptom is a slowly expanding red rash around the site of a tick bite. Secondary rashes on the body may develop as well. Other symptoms may include fatigue, headache, neck stiffness, and joint pain. Untreated, tick diseases can progress into rheumotologic, cardiac, and neurological diseases, so it is important to diagnose and treat them early.
So, if your summer plans take you into destinations where ticks are known to dwell, be savvy about unusual rashes. My own advice: Camp only at Four Seasons hotels. Less chance of ticks and bed bugs!
After a hard day's work we all look forward to enjoying a glass of wine or cocktail over dinner with friends, but drinking in moderation is key. Alcohol can be very damaging to the skin when consumed in large amounts.
Aside from the discomfort of a hangover, chronic alcohol use has damaging effects on every organ, in particular, facial skin. Alcohol dehydrates the skin, not to mention the rest of the body and leaves the face bloated and sallow. Alcohol causes the small blood vessels to dilate and widen which exacerbates conditions like rosacea and acne. The broken capillaries also create red, blotchy skin. Alcohol (especially when coupled with cigarettes) prematurely ages the skin by robbing it of vital moisture. Also, research indicates that women who average as much as two drinks a day, four days a week, are more than twice as likely to develop melanoma, as women who don't drink. Scary!
Experts recommend that women limit themselves to one drink a day. If a patient is prone to rosacea, I recommend that they avoid red wine because the tannins are particularly irritating to blood vessels. If you must drink, try to stay well-hydrated when imbibing. Drink eight ounces of water before your first drink and then eight ounces for every drink throughout the celebration. This will help your skin and prevent the dreaded morning-after hangover.
I LOVE Spas. Massages are a form a physical and mental therapy. However, I try to stay away from SPA facials. Following a routine skincare regime, in my opinion, is way more effective than going for periodic, "quick-fix" spa facials.
Blackheads and enlarged pores are accumulations of dead skin cells, debris, and excess oil. To reduce the appearance of these pores and treat the blackheads, it is more efficient to have an in-office procedure like a glycolic peel or microdermabrasion followed by an easy home maintenance routine. It's also best to alternate between glycolic treatments and mincrodermabrasion as skin can become inured to a single regimen. If you can't get to a dermatologist, there are some excellent microdermabrasion kits you can purchase which are quite effective. I recommend Neutrogena Healthy Skin Rejuvenator and Olay Regenerist Microdermabrasion & Peel System. Two additional options are Estee Lauder Idealist Micro-D and Prescriptives Dermapolish Treatment Cream. Both incorporate dermatological-type techniques and are gentle enough to use at home.
Simultaneously, I recommend instituting a retinol (over-the-counter) or retin-A cream (prescription strength) at night to topically soften skin and dissolve the debris while also utilizing a home glycolic peel kit or pore minimizing grain to exfoliate and give the skin a healthy glow. Take care of your skin - you'll thank yourself later.
