Skin Care Tips

5.4% of Melanoma Cases Attributed to Tanning Bed Use!

HealthDay (7/25, Reinberg) reports, "Those who bronze themselves in tanning beds face a 20 percent increased risk of skin cancer, and that raised risk reaches 87 percent if they start before they are 35 years old," according to a meta-analysis published online July 24 in the BMJ. In addition, the study "estimates that one in every 20 cases (5.4 percent) of the most lethal form of skin cancer, melanoma, can be attributed to tanning bed use."

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Hair Removal (Skin Tip #3)

There are various conditions that create excessive hair growth. Sometimes it is genetically based or it could be due to excessive hormone production by the body. Excessive hair growth due to hormone imbalance needs to be investigated and may require oral medications to treat the condition. However for the majority of patients there is not a medical treatment for their excess hair. Health insurance companies with rare exception view hair removal as a cosmetic expense. Now let’s discuss various methods to deal with excessive hair.

1. Bleaching agents-If your hair is dark and you want to make it less noticeable you can bleach it with over the counter products that will lighten your hair. The problem with these creams is that they are often a bit smelly and can become irritating after persistent use.
2. Vaniqa- a prescription cream (though not usually covered by insurance companies) that is used twice a day. The medication works by preventing an enzyme that makes a vellus hair become a mature hair. You will NOT have less hair but it will be less thick. Results vary and may take at least 4-6 months to see results.
3. Shaving or Plucking-A common inexpensive way to remove the hair and depending on location and the amount may require daily care. Downside is one can get roughness of their skin and discoloration of the skin, and  ingrown hairs can develop if you are shaving against the grain.
4. Electrolysis- very helpful particularly if you have WHITE or GRAY hairs.  Multi-needle technique is best as you can treat 20-30 hairs at a time. Topical anesthetics can make this procedure very tolerable. Downside is discomfort, frequency of treatments and inability for most to address large surface areas in one visit.  This is a tried and true treatment and for many and an affordable option for hair removal that will lead to long lasting results.
5. Light based Hair Removal-Intense Pulse Light- These machines are NOT lasers. They emit a broad spectrum of light. They work best if you have light skin and dark hair. Multiple treatments are required and like regular lasers they work by targeting the pigment in the hair follicle. They DO not work well on most blonde, white or gray hair. Proper patient selection is key so a consultation should be obtained to discuss side effects and risks.
6. Laser Hair Removal- There are several wavelengths that are effective for hair removal. They work by targeting the pigment in the hair follicle.The most commonly used machines or either an Alexandrite laser(755nm) or an NdYag(1064nm). Type 1-3 skin types typically do best with the Alexandrite. Skin types 3-6 do best with the Yag. Facial hair removal requires many more sessions than hair removal from other areas and will require maintenance treatments. You can achieve excellent results from either system if you follow the protocols. It is important to have a full consultation prior to initiation of treatment to discuss side effects and risks.

Proper consultation with your dermatologist will lead to you to choose the appropriate treatment that is best for you.

Acne Management (Skin Care Tip #2)

Acne is one of the most common problems a dermatologist sees in the office. The majority of patients with acne are teenagers but at least 20-25% of patients are over the age of 18. The primary problem in acne is the clogging of the pilo-sebaceous unit. These changes occur primarily on the face, chest and back. However severe cases can involve the scalp, arms and legs. Early intervention is crucial to prevent permanent scars from developing. Now let’s talk about what to do:

1. Proper Cleansing of involved areas- Your cleanser should be tailored to whether you have sensitive skin or oily skin. In general any soap is sufficient to degrease the skin help prevent clogging of the pores. Salicylic acid preparations and benzoyl peroxide based cleansers can be used by those who have oilier skin. Use of facial electronic brushes can used to more properly clean and degrease treated areas and get rid of all that makeup you may be using to cover up the acne.
2. Depending on the type of acne lesion you have various prescription agents that can be used:
   1. Primarily blackheads(comedones)- retinoid crèmes and benzoyl peroxide containing creams.
   2. Pustules and blackheads- combination benzoyl peroxide/antibiotic preparations,  benzoyl peroxide/retinoid combinations, sulfacetamide containing products.
   3. Inflammatory papules- topical treatments for sure but may need oral antibiotics to decrease bacterial counts on the skin and inflammation. Some evidence for nicotinic acid improvement in the literature.
   4. Cystic lesions and nodules- most definitely require  antibiotics and topicals, maybe intralesional steroid injections to quickly reduce the lesions as it is these type of lesions that will most likely lead to potential scarring.
   5. Severe and persistent cystic acne lesions- systemic retinoids maybe on option(i.e.  generic accutane medications) or systemic steroids in the rare aggressive case- again the goal here is to prevent  permanent scars that can lead to disfigurement and the psychological implications that can develop as a result of scarring.
   6. In female patients oral contraceptives and hormonal modulating medications are often a very useful to control the development of severe acne cysts that can lead to scarring.
3. Diet - Good hydration is very important. Very few placebo double-blinded studies have ever shown true cause and effect, however anecdotal discussions with patients do seem to show that some patients worsen after ingesting chocolate, caffeine, dairy and fried food. Common sense dictates that if you break out after eating a particular food and it happens repeatedly then stop and see if it makes a difference.
4. Other options to help acne that are not prescription based and considered cosmetic:
   1. Blue light therapy- 417nm light when administered can excite natural occurring chemicals on the skin that kill bacteria naturally (not ultraviolet light. UV light helps too but can increase your risk of skin cancer if not properly protected against). Multiple and repeated treatments are required.
   2. Photodynamic therapy- the addition of aminoleuvulinic acid plus light activation to kill bacteria and control of oil production. Multiple and repeated treatment required.
   3. Laser therapies - both pulse dye lasers and low energy Nd-Yag laser can improve acne lesions and early scars caused by inflammation. Multiple and repeated treatment required.
   4. Aesthetic Treatment- the use of facials, peels, microdermabrasion and hydrafacials are a common adjuvant to any acne plan.
   5. Resurfacing lasers - erbium glass (Fraxel Restore), carbon dioxide lasers-fractional of ablative and Erbium lasers-fractional or ablative are important treatments to aid in the management of acne scars.

So as you see it can become quite complicated to manage and treat acne. Consultation and discussion with the dermatologist will help determine what products and approach is best for you.

Managing Dry Skin

Many of us experience a change in our skin when the weather changes from Summer to Fall. Dry skin or ichythoses is often an inherited trait that is exacerbated by the change of seasons. If not dealt with, you may experience flares of severe dryness which can lead to "winter itch", or worse, eczema. To help manage and prevent the flares, a few easy changes in your bathing routine is often all that is needed:

1. Take a shorter length shower or bath - 10 minutes tops.
2. Turn down the water temperature from hot to room temperature.
3. Use a mild soap or skin cleanser, preferably one without coloring agents or a fragrance.
4. Gently pat dry when finished and immediately use a body moisturizer that contains either ceramides or hyaluronic acids, or both, in its ingredients. The moisturizer will lock in the hydration that you just created from your shower or bath and help to create a more intact epidermal barrier.
5. If these simple changes to your routine are not helpful then you should consider making an appointment to discuss other causes and methods to manage your condition.