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Monthly Archives: March 2017

How to Use a Skin Exfoliant

Our skin is constantly renewing itself, growing new skin cells to replace the surface skin cells that grow old, die, and fall, or slough, off. Every minute of every day, between 30,000 and 40,000 dead skin cells flake away.

Factors like age and dry skin can mean that dead skin cells don’t fall away as easily as they should. When these cells build up, they can make the complexion look rough and pasty and can also contribute to the clogged pores that lead to adult acne. The regular yet careful use of a skin exfoliant can help slough off dead skin cells and uncover fresh, more youthful skin.

There are two main types of skin exfoliants: mechanical exfoliants and chemical exfoliants. Both are commonly available, and both have pros and cons regarding their use and the types of skin conditions for which they are most appropriate.

Mechanical Skin Exfoliants

Mechanical exfoliants work by sanding off dead skin cells using mildly abrasive substances. These skin exfoliants typically are facial scrubs, creamy cleansers with tiny, rough particles. As you gently massage the exfoliant over the surface of your face and skin, the friction works to loosen the old skin cells.

Mechanical skin exfoliants are readily available in drugstores and easy to use. They are particularly good for people with oily skin or acne, as they remove skin cells and debris that clog pores, but only if you don’t scrub too hard as this can cause further irritation.

However, mechanical exfoliants can be harsh. When you use them, you’re literally sanding away the outer layer of your skin. Some contain particles so jagged and rough that they could actually cut the skin. Because of this, dermatologists recommend using a gentle motion when using a skin exfoliant, and skipping them altogether if you have sensitive skin.

Chemical Skin Exfoliants

A chemical skin exfoliant uses gentle acids to dissolve whatever bonds are preventing the outer layer of dead skin cells from falling off your face and body. There are two main types of chemical skin exfoliants, those that include an alpha hydroxy acid (AHA) and those that include a beta hydroxy acid (BHA):

  • Alpha hydroxy acids are derived from different foods, from fruits, such as apples and grapes, to milk. Some of the most common AHAs to look for on product labels are glycolic acid, lactic acid, malic acid, alpha-hydroxyoctanoic acid, and triple fruit acid. An alpha hydroxy acid is best for people with dry or thickened skin.
  • Beta hydroxy acids are the chemical cousins of alpha hydroxy acids, but are more oil-soluble and therefore better at exfoliating oily skin or acne-prone skin. The best known beta hydroxy acid is salicylic acid. On product labels, look for salicylate, sodium salicylate, beta hydroxybutanoic acid, or tropic acid.

Alpha hydroxy acid and beta hydroxy acid skin care products tend to be less harsh on the skin than mechanical exfoliants. They also help refresh the skin in ways a facial scrub can’t: They lower the skin’s pH level and help smooth small, shallow wrinkles, improving the look of skin that is dry or sun damaged.

Finding the right formulation for your skin involves some trial and error. According to the U.S. Food and Drug Administration, you should choose alpha hydroxy acid-based chemical exfoliants with an alpha hydroxy acid concentration of 10 percent or less and a pH of 3.5 or more. Beta hydroxy acid-based exfoliants containing salicylic acid are effective at levels of 1.5 to 2 percent. Using stronger solutions can cause skin irritation.

Another caveat: These types of exfoliants increase your skin’s sensitivity to the sun for as long as a week after each use. Before going out, always apply sunscreen — a skin-saving recommendation for everyone.

How and When to Use Exfoliants

You should not use an exfoliant every day. Your skin needs time to regenerate its topmost layer, which exfoliation strips away. People with dry skin should only exfoliate once or twice a week, while those with oily skin can exfoliate two to four times a week. Stop using an exfoliant if you find your skin becoming irritated or developing a rash. Remember to moisturize your skin after exfoliating, to soothe it and keep it from drying out.

From Acne to Wrinkle Treatment

The body needs vitamin A to develop strong teeth and tissues, healthy vision, and healthy skin. Retinol is a type of vitamin A that can be found in food sources like whole-milk dairy products, liver, meats, and eggs.

Vitamin A is also available in topical forms, known as a retinoids, that are used as medications to treat skin conditions. Retinoids were initially marketed and approved to combat very severe acne. But researchers soon discovered another valuable property of retinoids: They could reduce the signs of photoaging (aging of the skin from sun exposure) and were soon used as a wrinkle treatment.

Retinoids for Skin Solutions

There are two major types of natural retinoids used medically.

Isotretinoin (formerly marketed under the brand name Accutane) is an oral medication that may be prescribed for people who cannot control severe acne through topical treatments or with antibiotic medications. Though it’s been found to be extremely effective in managing acne, it has serious side effects, including birth defects if taken by pregnant women. Generic isotretinoin may cause depression and, rarely, thoughts of suicide. And while new information is emerging that it could contribute to or worsen irritable bowel disease, a study found that isotretinoin use did not affect the incidence of IBD.

Tretinoin (Retin-A, Avita, Renova) is a topical vitamin A prescription acne treatment. It’s also used to help reverse damage to the skin from sun exposure. Tretinoin works as an irritant, which results in more rapid turnover of skin cells, causing old cells to die more quickly. Tretinoin helps acne disappear as it sheds old skin cells. While it also minimizes the appearance of wrinkles and dark spots on the skin, exactly how it works against wrinkles and sun damage isn’t completely understood.

There are also synthetic forms of topical retinoids available by prescription for acne treatment: adapalene (Differin) and tazorotene (Tazorac).

Prescription Versus Over-the-Counter Retinoids

Studies have examined the effectiveness of various types of prescription retinoids on both acne and as a wrinkle treatment. Researchers have concluded that topical retinoids are an effective acne treatment and are also effective in preventing acne breakouts. Research has also found impressive results when it comes to reducing — and in some cases reversing — sun damage.

Cosmeceuticals (cosmetics that also claim to treat a skin condition, such as wrinkle creams) that contain weaker forms of retinoids are widely available, but relatively little research has been done to determine their effectiveness. Of the studies that have been conducted, cosmeceticals with the form of vitamin A called retinaldehyde are the most successful in reducing the signs of aging.

The Cost of Care

Isotretinoin and tretinoin are only available through a prescription and should be used under a doctor’s supervision. Costs vary according to your pharmacy and health insurance. In some cases, the medication may be covered partially or fully by your health insurance plan, particularly if the treatment is for acne. The use of a retinoid topical cream for cosmetic reasons is less likely to be covered by insurance. A year’s supply of treatment with Retin-A can cost somewhere in the neighborhood of $200.

The less potent, non-prescription retinoids, such as retinol and retinaldehyde, can be purchased over-the-counter as ingredients in skin care products marketed to erase wrinkles, sun damage, and other signs of aging. There are many brands available, including RoC and Olay, among others. Retinol- and retinaldehyde-based products are available at drugstores and beauty counters. Products range in price from about $10 to $20 or more.

The uses of vitamin A have evolved over the years, from the body’s natural needs to man-made treatments that get rid of pimples and minimize wrinkles and dark spots on the skin. Whether you seek acne or wrinkle treatment, buy it over-the-counter or with a doctor’s prescription, be aware of possible side effects, and make sure to follow all instructions carefully.

Choosing the Right Skin Care for You

Selecting skin-care products can be a daunting task, what with all the choices filling pharmacy aisles. You’ll find dozens of over-the-counter products with such labels as “maximum strength,” “clinical strength,” and “original prescription strength” — plus seemingly identical products that are available only by prescription. What do all these labels mean, and how do you know which product is the best one for you? Here are some answers.

How Much Active Ingredient?

The active ingredient in an over-the-counter product is often the same as the one found in its prescription counterpart, but at a lower dosage. Over-the-counter dandruff shampoo contains a lower dosage of the active ingredient ketoconazole (1 percent), while the prescription-strength versions contain 2 percent. Inhydrocortisone anti-itch cream, the maximum over-the-counter dosage is 1 percent, while prescription-strength creams contain 2.5 percent. According to U.S. Food and Drug Administration (FDA) regulations, once a product’s active ingredient reaches a certain percentage — such as 1.5 percent for hydrocortisone, or 2 percent for salicylic acid in acne treatments — it requires a prescription from a doctor.

Sometimes It’s Just a Marketing Strategy

Because the FDA does not closely regulate over-the-counter skin-care products, a company can label a product “maximum strength” or “clinical strength” for any reason it sees fit — and the label is no guarantee that the product will actually be any stronger than others on the market. The best way to find out whether you are really getting the “maximum” strength of an ingredient is to check the ingredients label, says Robyn Gmyrek, MD, assistant clinical professor of dermatology at Columbia University College of Physicians and Surgeons. “Compare the label with other products on the shelf,” says Dr. Gmyrek, and check the percentage of the active ingredient in each product.

Although an increase in the active ingredient in a product of 1 percent may not seem as though it would significantly affect the strength, it can, says dermatologist Doris Day, MD, director of Day Cosmetic, Laser and Comprehensive Dermatology in New York City and a professor at NYU Medical School. For this reason, it’s best to test a new skin-care product by applying a dime-sized amount on your forearm, to see if it causes a reaction.

Prescription Products Must Be Approved by the FDA

For the FDA to approve a product’s switch from over-the-counter to prescription-strength status, regulations require a company to show that even a slight increase in the amount of active ingredient (for example, 1 percent) “changes the structure or function of the skin.” All prescription products are reviewed by the FDA and have gone through numerous clinical trials, says Debra Jaliman, MD, a New York City dermatologist. The FDA also decides what dosage level constitutes a prescription. Some OTC products may be labeled “original prescription strength,” which means a prescription from a doctor was once required, but the product is now available without one.

Finding the Right Product for You

How do you know which product to try? Stronger dosages can have harsher effects on your skin, so it’s generally safer to start with a lower dosage. Try the basic OTC product for a minimum of two weeks to gauge the results, then move on to a maximum- or clinical-strength product, if necessary, or request a prescription, says Dr. Day. For acne, you should expect to wait a little longer — from four to six weeks — to see results. And if any product irritates your skin or makes symptoms worse, see your doctor immediately.

Simple Acne Treatment Tips

If you have acne, you’re among more than 70 million people in the United States who have suffered from this skin condition at some time in their lives. It is so common that acne affects about 80 percent of Americans 20 to 30 years old. During the teenage years, acne is more common in boys than in girls, but in adults it’s more common in women.

Despite the fact that it’s so commonplace, there are many misconceptions about acne, says Guy Webster, MD, PhD, a clinical professor of dermatology at Jefferson Medical College in Philadelphia and founder of the American Acne and Rosacea Society.

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Getting to the Root of Acne

Whether you call it acne, pimples, or zits, in order to treat the condition, it’s important to understand the causes:

  • Clogged pores and bacteria: In your teens, the glands in the skin begin secreting sebum, an oily substance. This normally comes out through the pores, but in some people, sebum clogs up in the pores, allowing a bacterium, called P. acnes, to begin to grow.
  • Hormones: In your teen years, hormones start changing and affecting your body, including causing acne. This also happens during pregnancy, which explains why pregnant women or women having their periods often have acne breakouts. Hormones released during stressful times can also cause acne.
  • Genetics: You may be more likely to develop acne if your parents had acne when they were younger.

The Right Acne Treatment

There are many ways to take care of acne, depending on what causes it and how bad it is. Moderate and severe acne usually needs acne treatment recommended by a doctor, but mild acne, blackheads, whiteheads, and a few pimples can usually be treated at home.

Dr. Webster says one big misconception is that acne is caused by dirty skin. “The goal is not to scrub acne away,” he says. “If you scrub, you’re taking off skin, and there’s a reason for the skin being there.” Skin is a protective barrier.

Here are some tips that Webster shares with people who have acne:

  • Wash gently; don’t scrub.
  • Use a gentle soap to wash your face.
  • Wash with your hands, not a washcloth or “scrubby.”
  • Use a 5 percent benzoyl peroxide product.
  • Treat your whole face — don’t “spot treat.” This way, you’re treating pimples still under the skin but not yet visible.

And what should you stay away from?

  • Facial scrubs of any kind.
  • “Face puffs” or abrasive pads.
  • Expensive cosmetic regimens that people try to sell you.

Acne Treatment: Other Tips

Other tips to keep acne from getting worse:

  • If you’re a male, be careful shaving.
  • Don’t pick or scratch at pimples.
  • Avoid the sun. While many people feel that sun exposure makes their acne better, this is not always so. The rays can also cause other unwanted issues, such as premature aging and skin cancer.

When Should I See a Doctor for Acne Treatment?

According to Webster, if the pimples are leaving scars or if your treatment isn’t working, then it’s time to see a family doctor or dermatologist.

And while acne is a bummer, it doesn’t have to take over your life; take action and take control of your skin.