Possible causes include acne, razor bumps, sunburn, sun damage, chemical irritation, hard water, dehydration, eczema, allergic reactions, insect [more...]]]> How to Delete Dark Spots and Brighten Uneven Skin Tone

Of all the skin disorders that affect skin of color, hyperpigmentation is the chief complaint. Skin problems, medications and medical conditions and many other factors, including minor “skin insults”, can lead to skin discoloration.

Possible causes include acne, razor bumps, sunburn, sun damage, chemical irritation, hard water, dehydration, eczema, allergic reactions, insect bites, prescription medications, hormonal melasma, pregnancy,  hormone pills and devices, obesity, auto-immune disease, chicken pox, skin infections, cold sores, smoking, shaving irritation, depilatories, waxing, tweezing, electrolysis, product overuse, abrasive scrubs, friction, scrubbing your skin, wiping your eyes, rubbing, picking, tampering with your skin by any means, tight and/or ill-fitting headgear, underwear, clothing and footwear, trauma, burns, minor injuries, surgical procedures, lasers, IPL and microdermabrasion.

Hormonal and post-inflammatory hyperpigmentation on all races and skin types can be improved dramatically with light skin peels, topical alpha hydroxy acids and retinoids in formulations containing  melanin-suppressing skin brighteners, sun avoidance and diligent use of non-clogging, full-spectrum sunblock suited to skin type. The “must do” list includes (1) taking a complete health history, (2) addressing lifestyle issues that cause or worsen the problem, (3) starting a skin brightening regimen, (4) getting professional skin peels, (5) adhering to safe sun practices, and (6) monitoring product overuse, sunblock under-use and sun exposure.

Address the cause of the skin problem, and the factors that can worsen it. Only then can pigmentation problems can be improved or overcome. If you have acne, razor bumps, “rashy” skin, tamper with your skin, fail to follow instructions, have serious underlying medical problems, take sun-sensitizing medications or are overweight, these issues must be factored in to your plan of action.

Active skin brightening “cocktails” can contain mild glycolic or lactic acid (fruit acid exfoliators that act as “vehicles” to deeper tissues), dimethyl isosorbide (gentle, penetrating vehicle), retinoids (deep-penetrating active vitamin A derivatives), hydroquinone (FDA-approved skin lightening ingredient), l-ascorbate (stable, absorbable form of vitamin C), and the following melanin-suppressing brighteners: kojic acid dipalmitate, alpha arbutin, azelaic acid, vitamin K, mulberry extract, bearberry (beta arbutin), licorice extract, niacinamide (vitamin B3), emblica extract, Tego® Cosmo C250, Gigawhite™ , mandelic acid and citrus juice extracts. Patch-tested and used exactly as directed and in the right formulation, there is a low incidence of irritation or allergic reaction.

It is important to discuss past skin brightener and fade cream usage  (especially hydroquinone) and subsequent reactions, amount of daily sun exposure, sunblock usage (or lack of use) and the need for sun avoidance. Passive sun exposure, like riding in a car, waiting for the bus, working in the sun, gardening and outdoor sports poses the greatest risk. Many people mistakenly feel that they don’t need sun protection for brief intermittent sun exposure or because they have a darker skin tone.

Tips for Success

Lose weight. Dark pigmentation is easier to address if you lose weight. Fat cells alter the body’s hormone levels and can increase darkening and sun sensitivity.

Address the exact cause of your discoloration, including acne, razor bumps, shaving irritation, excessive, sun exposure, failure to apply and reapply sunscreen, insect bites, tweezing, picking, scratching, over-scrubbing, product over-use, depilatories, heaters, obesity, weight gain, friction, ill-fitting shoes or clothing, medications, harsh or inappropriate treatments, dehydration, health issues, hormones, etc.

Avoid the sun, use the right sunscreen and reapply often. Use a product that contains high levels of micronized zinc oxide and/or titanium dioxide. Apply a generous amount, massage gently until it disappears and reapply often. Don’t forget your neck, chest, arms, feet and hands.

Reapply sunblock often, especially when driving, walking, golfing, running, swimming, skiing, gardening, outdoor work, football practice, doing double days in training camp, etc.

Get your car windows tinted to the legal limit. Keep that sunroof closed too.

Protect the orbital eye area.  Wear large 100% UV protective sunglasses the cover the entire eye area. Prescription eyewear that “transitions” when you go outside may not darken enough in cars and buses and are usuallyway  too small to do the job.  Don’t be fooled by overcast skies because the skin-darkening UVA rays penetrate clouds and windshields. That’s when you need protection the most.

Don’t try to rush things! If your skin gets irritated, you may be overusing your active lighteners by applying them too thick or too often.

Get professional treatments every two to four weeks in the absence of irritation. Exfoliation and brightening procedures boost your  home care efforts.

Get follow-up evaluations often to review your overall treatment plan, product potency and usage, safe sun practices, health and lifestyle.

Get refills before you run out or you may have to start over.

Do not use scented products on any sun-exposed body parts, even with sunscreen.

Wear 100% UV protective sunglasses at all times.

Do not scrub your skin if you start to peel or flake. Don’t use washcloths, buffing pads or abrasive scrubs. Ask for help if constant flaking is an ongoing issue.

Follow directions. Apply your active brightening products (a) exactly as directed, (b) in small amounts, massaged all the way into the skin, and (c) in the total absence of irritation. Avoid the entire mouth area and smile lines every other day if you’re directed to do so. Avoid sensitive areas for a few days if they become darkened, too dry or irritated.

Never attempt to ‘dot’ lighteners onto the spots only.

Never apply a thicker coat of your skin lightener to dark areas. This will cause light “halos” around the dark spots and patches, and cause irritation and rebound darkening of those areas.

© 2010, 2011 Kathryn Khadija Leverette

The material on this website is provided for educational purposes only, and is not to be used for medical advice, diagnosis or treatment.

What to look for: Acne or dermatitis on one side of your face, neck and body where you sleep, on [more...]]]> Laundry Products Must Be Free of Perfumes and Dyes

Problem: Laundry detergents, additives and fabric softeners can leave harmful residues that can irritate sensitive skin, cause a severe case of contact dermatitis, and worsen your acne or eczema.

What to look for: Acne or dermatitis on one side of your face, neck and body where you sleep, on your back, areas where you perspire, along the seams of your clothes, including under bra straps, necklines, waistlines, panty lines, the seams of your jeans, under socks, and anywhere clothing is fitted, tight or your skin comes in contact with chemical residue from washing powders, liquid detergents, additives and fabric softeners.

Allergies? When your skin comes into contact with perfumes and toxic chemical residues, you’re inhaling them too, triggering nasal allergies, wheezing and headaches.

Gentle detergents: Cheer Free & Gentle, All Free & Clear, Tide Free & Gentle, Tide Coldwater Free, Tide 2xUltra Free, Arm & Hammer Free of Perfumes/Dyes, Purex Free & Clear, CVS Free, ShopRite Ultra Free & Clear, Rite Aid Free, Seventh Generation Free & Clear, Safeway Select Free and Costco Kirkland Free & Clear Ultra. Instead of chlorine bleach, try Clorox2 for Colors Free & Clear. These products are free of perfumes, dyes, chlorine bleach, phosphates and enzymes, and are especially gentle on sensitive, rashy, dehydrated and acne-prone skin.

Less detergent and smaller loads: Do you “crowd” soiled clothing in the washing machine by attempting to turn three loads into two? Do you pour detergent directly into the washer without measuring?  Wash 25% less laundry per load, and use 25% less “free” detergent in the process. Always measure and then use a bit less. Clothing and bedding get much cleaner by agitating and circulating better. Less laundry in the washer and less detergent means cleaner, softer fabric, less chemical residue, a fresher natural scent and fewer skin problems.

Extra rinse cycle: When possible, put clothes through an extra rinse cycle to remove traces of soap residue to reduce the potential for persistent irritation.

Avoid fabric softeners, including fragrance-free dryer sheets, which leave a waxy residue that can clog your pores and irritate your skin. People freely admit to tossing multiple softener sheets into the dryer for one overcrowded load of “still soapy” laundry. Also, dryer sheets leave a transparent film on the lint filter that can restrict air flow, burn out the heating unit or start a fire.

Try using dryer balls, which last forever, save money and are environment-friendly. Add four to six dryer balls to soften clothes and bedding without chemicals.

Rewash everything you own with “free” detergent, including bedding, towels, clothing, socks and lingerie.

Clean shared washers, dryers and lint filters before each load with white vinegar (in a spray bottle) to remove detergent and softener residue left by others.

Wash new clothes before you wear them. Imported designer jeans, clothes and scarves are sprayed with toxic fungicides, pesticides and formaldehyde, and must be washed multiple times before wearing to prevent body acne, bacterial infections, rashes and skin discoloration.

Static? Try Static Guard, but only if static cling is a problem.

Dark, dry or irritated hands are often caused by exposure to sun, scented soaps, harsh detergents and fabric softener residue. No matter how busy or financially comfortable, some people insist on doing their own laundry, which can involve folding heavily-scented softener-soaked clothes with unprotected hands. Switch to unscented detergent, avoid fabric softener and wear fleece-lined latex gloves for household chores. Carry fragrance-free liquid soap, hand sanitizer, baby wipes and hand cream with you. Apply sunscreen to hands and arms before sun exposure.

©2010 Kathryn Khadija Leverette, Urban Skin Solutions, Inc. and urbanskin.com

The material on this website is provided for educational purposes only, and is not to be used for medical advice, diagnosis or treatment.

Sleep [more...]]]> Lifestyle Issues That Can Affect Your Skin

Reduce your stress. Do whatever it takes. Stress, a major acne aggravator, is caused by the wear and tear of day-to-day living and changes that take place in your life, both good and bad. Moving is comparable to the death of a child in its ability to cause extreme stress.

Sleep seven uninterrupted hours per night on a consistent basis. Night shift jobs, broken sleep, late night time management, insomnia, hormonal changes in mid-life, long plane trips and crossing time zones causes severe physical stress, making it harder to clear acne and lighten dark circles.

Laundry products must be FREE of perfumes and dyes: Cheer Free & Gentle, All Free & Clear, Tide Free & Gentle, Tide Cold Water Free, Tide 2xUltra Free, Arm & Hammer Free of Perfumes/Dyes, Purex Free & Clear, CVS Free, ShopRite Ultra Free & Clear, Rite Aid Free, Seventh Generation Free & Clear, Safeway Select Free and Costco Kirkland Free & Clear Ultra. Safe bleach: Clorox2 for Colors Free & Clear.

Avoid laundry additives, enzymes and fabric softeners, including fragrance-free dryer sheets, which leave a waxy residue that can clog pores and irritate skin. Instead, try dryer balls, which are chemical-free, last forever and are good for the environment. Use 25% less detergent, and wash 25% less clothes at a time. If possible, run an extra rinse cycle. Imported designer jeans and scarves are sprayed with toxic fungicides, pesticides and formaldehyde, and must be washed multiple times before wearing to avoid body acne, skin infections, rashes and discoloration. Victoria Secret bras, shown to contain the carcinogen formaldehyde, have been linked to toxic skin reactions, even after they’ve been washed.

Avoid dietary iodine: Dairy products (milk in coffee beverages, cheese, ice cream, sour cream), processed foods, take-out food, frozen dinners, fast food, canned food, soft drinks, salty snacks, salted nuts, canned, packaged and restaurant soups, ramen noodles, tomato juice, V-8, seasoned salt, iodized salt, salty condiments, Gatorade, Propel, PowerAde and other high-sodium sports drinks (Vitamin Water is OK), energy drinks, seaweed, Chinese food (salty sauces, MSG, soups, soy sauce), Mexican food (cheese, sour cream, refried beans and salted tortilla chips), processed meats (lunch and deli meat, hot dogs, bacon, franks, hot links, sausage) and condiments containing kelp, MSG and/or iodized salt.

Peanuts, peanut butter and wheat germ contain hormones and can cause breakouts. You can enjoy other nuts, as long as they’re unsalted. Try almond and cashew butter. Cold and flu meds with sodium and bromide (Alka-Seltzer® and Bromo-Seltzer®) can aggravate acne. Avoid kelp, sodium, iodine, seaweed and spirulina in nutritional supplements and green detox programs. Take with meals: GNC iodine-free Women’s Formula Multi, zinc monomethionine (with meals), enteric-coated fish oil, flax seed oil, MSM, probiotics (Align®, Culturelle®, Jarrow®) vitamins C and B-complex. Can’t sleep? Estrovan PM®, Alteril®, valerian root and melatonin. Hormonal? Estrovan Maximum Strength®.

Skip the dairy: Cheese, milk, ice cream, sour cream and dairy-rich coffee drinks. Dairy is linked to acne, allergies, weight gain, digestive problems, water retention, high blood pressure, bloating and many other health problems. Concerned about calcium and vitamin D? Eat lots of dark green veggies and take supplements with calcium citrate, magnesium and vitamin D. On cereal, try ice-cold naturally good-tasting almond or rice milk. Soy milk is better than cow’s milk, but is processed to taste better, contains hormones, sugar and fat, and can be difficult to digest.

For more information, see: http://www.notmilk.com/kradjian.html

Caution: Fish and seafood from “questionable” sources, can cause persistent skin problems, including a rash-like acne. This doesn’t seem to happen in better restaurants. If your acne is treatment-resistant and rashy, try eliminating fish and seafood from your diet for a month or two.

Avoid seasoned salt, which contains iodine and MSG. Try a blend of iodine-free sea salt, Mrs. Dash Table Blend, garlic powder, onion powder, black pepper, paprika and cayenne pepper.

Get professional treatments including enzyme peels with steam, light chemical peels and tune-up peels formulated for acne, dark spots, scars, ingrowns and razor bumps. Professional treatments exfoliate the skin evenly and help home care products penetrate better. Power bleaching and other skin-smoothing “boosters” will enhance the results dramatically.

Irritated? Constantly flaking? If so, you may be dehydrated from low water intake, gotten too much sun, over-scrubbed your skin, or applied your products too thick or too often.

Do not scrub off dead skin cells. Washcloths, spa gloves, abrasive scrubs, brushes, buffing pads, alcohol-based astringents and rubbing with a towel can cause over-exfoliation, irritation, darkening, dead skin build-up and more flaking.

Follow directions carefully. Don’t overuse or underuse your home care. Ask for help if you need it.

Don’t slack up on prescribed home care. If we help you get clear, don’t think you’re so cute that you can quit using your products. You might stay clear for a while, but skipping home care products will allow the microscopic beginnings of pimples and ingrown hairs to form deep in your pores, causing more breakouts, which will lead to new dark spots.

Get refills (ask us about product upgrades) before you run out. Stock up before you go out of town. Don’t stop your regimen because you run out of one or two products.

Use sunscreen (with zinc oxide and/or titanium dioxide) and reapply often when exposed to direct sunlight, including overcast skies, and when driving. Avoid direct sun and wear sunglasses.  Sunscreen use helps keep dark spots, blotchy skin tone, and dark circles from darkening even more.

Drink more water to maintain healthy skin, fight fatigue, plump up fine lines, reduce dark circles, brighten your skin tone, and keep your skin from getting dry and irritated from active products. Drink at least half your body weight in ounces.

Stop picking, scratching and skin tampering! Women, get a set of acrylic nails, file them blunt, and maintain them every two weeks. Leave “stop picking” notes to yourself on mirrors, day planners, briefcases, desk drawers, rear view mirrors and in lockers. Picking pushes bumps deeper into the follicle, slows the healing process, invites secondary infection, introduces airborne bacteria, causes thickened, dark dead skin build-up and scarring, and turns tiny bumps into huge brown, black or red blemishes that take forever to heal and fade.

Tell us about changes in your skin, health, medical history, medications, lifestyle, home address, email address and phone number.

Use ice to reduce inflammation. Rub ice cubes in a circular motion on red, inflamed pimples and hair bumps twice a day for two minutes. This really helps!

Avoid fragrance, including skin care, hair and body products, scented aftershave, aromatherapy products, perfumed detergents, soaps, lotions and fabric softeners. Sunburn, rashes, acne, dark blemishes and dark “staining” of the skin can develop, especially on sun-exposed skin.

Severe “photo-sensitivity” can be caused by prescription medication, which leads to skin darkening, unsightly brown patches, blotchiness, hyperpigmented acne, darkening of existing scars, and uneven skin tone on the outer cheeks, neck, eye area, forehead, temples, knuckles, chest and other areas. These meds include all hormones: birth control pills, Depo-Provera® shots, NuvaRing®, OrthoEvra® patch, Mirena® IUDs with hormones and hormone replacement, oral anti-diabetic drugs, diuretics, blood pressure meds, antihistamines, antibiotics, Accutane®, retinoids (Retin A®, Differin Gel® and Tazorac®) and anti-depressants. Weight gain can also cause darkening of the skin tone.

Some medications cause acne including lithium, hormones (oral contraceptives, Provera®, DepoProvera®, PremPro®, progesterone, Lupron Depot®, Errin®, Ortho Mictronor®, Mirena® IUD, Nuvaring ®, OrthoEvra® patch), systemic steroids and anti-rejection meds (prednisone), testosterone precursors (androstendione, DHEA) and anti-convulsives (Dilantin, Tegreto®l).

Medical conditions: Thyroid, liver and kidney disease, diabetes, lupus, scleroderma, sarcoidosis, RA, MS and other auto-immune diseases, hemochromatosis (storing too much iron), obesity and rapid weight gain, menopause, peri-menopause, pregnancy, PCOS, hormonal imbalances and changes, anemia and smoking can cause delayed healing and sun-sensitivity resulting in darkening of the entire face or outer cheeks, forehead, upper lip, neck and orbital eye area, and slow-to-heal skin lesions, including acne and dark blemishes.

Acne mechanica is caused by (a) friction (rubbing), (b) pressure and (c) occlusion (restricted air flow), which results in deep acne and ingrowns, scalp bumps and severe darkening. Avoid friction, like leaning on your hand or phone, sleeping on your hand or arm, wearing tight doo-rags, wave caps, sleeping scarves, hats, caps, visors, headbands (and moving them up and down on the forehead). More trouble: Poor-fitting glasses, football helmets, tight bra straps and bands, leaning and putting more pressure on one side of your butt as you sit, heavy shoulder bags and backpacks, clothing with chemical additives, over-scrubbing and rubbing with a towel. Use a Bluetooth® device, headset, speakerphone or ear bud.

Pore-clogging chemicals: Avoid products with the fatty acid IPM (isopropyl myristate) and its chemical cousins, including isopropyl palmitate, isopropyl lanolate, myristal myristate, isopropyl isothermal, isostearyl neopentonate and more. Other cloggers are sodium chloride (salt), algae, potassium chloride, decyl oleate, oleic acid, oleyl alcohol, octyl stearate, octyl palmitate and isocetyl stearate and PPG myristyl propionate, sodium lauryl sulfate (SLS), sodium laureth sulfate, laureth-4, lanolin and acetylated lanolin, sodium chloride (salt), algae, most natural butters and oils, except fragrance-free safflower, sunflower and mineral oil.

Evaluate all hair products, wefted hair and loose hair if breakouts are concentrated on the hairline, forehead, temples, sides of the face, neck and jawline, sideburns, scalp, behind the ears or upper back. Whatever you put in your hair will migrate onto your skin. You perspire when you toss and turn in your sleep, get stressed, rush through your day, climb stairs and exercise. Human hair should be shampooed before your weave or braids. The chemicals in synthetic and human hair can cause itching, rashes and acne. Hairspray must be light and unscented; cover your face with a cheap paper plate before you spray. This trick won’t work with oil sheen, braid spray or scented hairspray.

Avoid: (1) pressing creams, butters and oils; (2) oil-sheen, hairspray and braid spray; (3) mousse; (4) locking wax (except hard bees wax); 5) curl activator; (6) scalp grease; (7) brown gel; (8) scented gel; (9) keratin treatments and protein conditioners; (10) aromatherapy oils; (11) oil (see below).

Problem oils:  Coconut oil, cocoa butter, sweet almond oil, carrot oil, olive oil, apricot kernel oil, palm kernel oil, argan oil, Moroccan oil, vitamin E oil, grapeseed oil, wheat germ oil, aromatherapy oil blends, fragranced oils and many other oils.

Safe oils: Fragrance-free sunflower oil, safflower oil, petrolatum and low concentrations of jojoba oil.

Avoid these product lines if you’re acne prone: Abba, Affirm, African Pride, Argan Oil, Aussie, Aveda, Avlon, Bed Head, Bee’s Wax hair products, Biosilk, Blue Magic, Bone Straight, Botanicals, Bumble & Bumble, Care Free (except Care Free Lite), Carol’s Daughter, Carrot Oil, Circle of Friends, CitreShine, Crème of Nature, Curl Junkie, D’arcy’s Botanicals, Dark & Lovely, Davines, Design Essentials, Deva, Doo Gro, Dr. Miracles,  Dove, Dudley, Duke, Enjoi, Enjoy, Garnier Fructis, Glover’s, Goldwell, His Mix (Mixed Chicks for Men), IC, Influance, Isoplus, Jessicurl, JLife, JML, Joico, Kemi Oyl, Kenra, Keracare, Kerapro, Kinky-Curly, Kiti Kiti, Let’s Jam, Luster, Mane and Tail, Marrakech Oil, Matrix, Miss Jessie’s Curly Pudding, Mixed Chicks, Mizani, Mop, Moroccanoil, Motions, Murray’s, Nairobi, Neutrogena T-Gel, Nexxus, Nioxin Protectives, Olive Oil products, One Better “Instant Shine” Finishing Gloss, Optimum, Organic Root Stimulator, Pantene Relaxed & Natural, Paul Mitchell and generics, Philosophy, Phyto, Pink Oil, Proclaim, Proline, ProStyle (except Clear Ice), Purology, Redken, S Curl, Sensitive by Nature, Soft Sheen “Optimum Oil Therapy”, Sportin’ Waves, Suave, Sulfur 8, TCB Hair Food, Talijah Wahid, Tresemme, Warm Spirit and Wen.

Safe hair products: Neutrogena T-Sal Shampoo, Pantene Pro V “Smooth”, “Color”, “Classic Care” and “Curls” conditioners, Care Free Lite Gel Activator, Clinical Formula Self-Emulsifying Oil, Gabriel Correctives shampoo, conditioner and laminate, Free & Clear shampoo, conditioner and gel, Original Formula Infusium 23 leave-in, L’Anza leave-in, ProStyl Clear Ice, American Crew Firm Hold Gel, Vanicream, Vaseline, sunflower oil and safflower oil.

Scalp issues: Scaling, inflammation and/or itching on the scalp, hairline, ears, brows, forehead or side of the nose? You may have seborrhea or seborrheic dermatitis, common genetic conditions that are easy to treat. Part of an oily, acne prone, sensitive skin profile, they worsen dramatically (a) in cold weather, (b) during stressful times, (c) when using harsh soaps and perfumes and (d) with infrequent shampooing. 

Ignoring these issues can lead to moderate-to-severe dandruff, unsightly scaling, reddening of the inner cheeks, forehead and hairline, hyper-sensitive skin, a pink or light-pigmented patchy rash, tiny red bumps on the face and scalp, an itchy scalp, thinning hair and hair loss (brows, scalp and eyelashes). We can help you with this.

Toothpaste can cause small breakouts and darkening around and below the corners of the mouth, especially if it contains sodium lauryl sulfate (SLS), tarter control, fluoride and aromatic flavors. Keep toothpaste in your mouth, where it belongs. If it gets on your skin, use cleanser to remove it. Look for SLS-free toothpaste.

Workout wear should be cotton and laundered in fragrance-free detergent with no fabric softener. Shower after perspiring with sulfur soap or BPO wash.

Warning: Don’t use a brush, scratch your scalp (or let a stylist do so), pat or rub your scalp. Thinning hair, itching, dead skin build-up, inflamed sores and bumps will only get worse. Low thread count pillowcases can thin fragile hair on the side you sleep, so switch to satin, silk or high count cotton. Pick white if you’re using benzoyl peroxide (BPO).

Avoid recreational drugs, especially marijuana, cocaine, X and speed, which can aggravate acne, especially if you’re a picker. Alcohol consumption doesn’t cause your acne to worsen unless you’re too drunk to apply your home care products.

Avoid oily cosmetics and skin care products: FD & C red dyes in foundations, blushes, lipstick and powders, MAC foundations and powders (especially Studio Fix), Shiseido, Lancôme, Estee Lauder, L’Oreal, Chanel, Flori Roberts, Fashion Fair, Posner, Iman and other cosmetics. Re-evaluate your cosmetics and moisturizers if breakouts continue. Oil-free products may be free of natural oils, but contain “synthetic oils” known as fatty acids. Avoid make-up that sticks to the sink when you wash it off. Safe FD&C red dye alternative: Iron oxides. Safe make-up examples: Dermacolor Cover Cream, Everyday Minerals, PRIIA and Jane Iredale. Mineral make-up should be free of fragrance, oil, fatty acids, red dyes and bismuth oxychloride.

Hormones are linked to breakouts and hyperpigmentation, including low estrogen birth control pills, Norplant®, OrthoEvra® IUD, Provera, Depo Provera®, Lupron Depot® (testosterone), progesterone-only pills (Errin®, Ortho Mictronor® and others), Premarin®, PremPro®, polycystic ovarian syndrome (PCOS), hormonal changes, fibroids, imbalances, irregular periods, PMS/PMDD and obesity (fat cells can boost the body’s estrogen production). OrthoTricyclan®, Yaz® and Yasmin®, advertised to help clear acne, don’t live up to the claims, and can cause breakouts, dry eye, sun sensitivity, melasma and other major health problems. HMOs routinely make contraceptive substitutions that are cheaper for them, but not true generics. Want an IUD? Choose the hormone-free T-shaped copper IUD over Mirena®.

Pregnancy, post-partum and menstrual cycles can cause hormonal flare-ups. Use a calendar to chart your cycle. Practice diligent skin care and suncare throughout the month. Pay close attention to your lifestyle to counteract problems during these times. Avoid direct sun. Protect your neck (which darkens) and face (watch for dark melasma patches). Pregnant and lactating women should discontinue retinoids, antibiotics and hydroquinone, and discuss nutritional supplements and recent Accutane® (isotretinoin) use with their physician.

©2010 Urban Skin Solutions, Inc, Kathryn Khadija Leverette and urbanskin.com

The material on this website is provided for educational purposes only, and is not to be used for medical advice, diagnosis or treatment.

A daily system of antibacterial and exfoliating products is needed to treat acne. True control means no physical sign of the disease shows in its active stage. Since acne is a treatable condition with no cure, most adult acne sufferers will be tied to a basic acne-fighting regimen for life, along with [more...]]]> Homecare and Lifestyle Changes

A daily system of antibacterial and exfoliating products is needed to treat acne. True control means no physical sign of the disease shows in its active stage. Since acne is a treatable condition with no cure, most adult acne sufferers will be tied to a basic acne-fighting regimen for life, along with several necessary lifestyle changes. It’s “skin care suicide” to abruptly abandon home treatment once acne completely clears. Retention hyperkeratosis (the process of dead skin cells building up and sticking together in the pore) is an ongoing, chronic condition that runs in families. If the acne-prone person doesn’t adhere to a daily system to interfere with retention hyperkeratosis, and make permanent lifestyle changes (less stress, enough sleep, reduced iodides in the diet, avoiding pore-clogging products, etc.), the visible signs of acne will begin to reappear almost immediately.

Clinical Acne Treatments

Professional skin peels and clinical facials provide these corrective and preventative benefits:

• They exfoliate dead skin cells.
• They gradually help fade dark spots left by residual acne and razor bumps.
• They help fade dark patches and even out the skin tone.
• They lighten “beard shadowing” caused by razor bumps, ingrown hair and shaving powders.
• They help exfoliate dead skin build-up that buries ingrown hairs.
• They help soften and reduce the thickness of scar tissue.
• They help dissolve and control excess oil.
• They reduce flakiness and tightness.
• They make extraction of pimples and blackheads easier.
• They help smooth rough-textured skin.
• They help evacuate clogged pores.
• They help deliver active ingredients deeper for enhanced results.
• They help reduce the depth of fine lines and wrinkles.

Antibiotics

To individuals reluctant to abandon their “old school” tetracycline, minocycline and erythromycin, consider this: “If tetracycline can arrest venereal disease within ten days, why are you still breaking out after all these years?” Or: “If erythromycin can cure an ear infection just a few days, why do you still have active acne?”

The medical definition of acne reads something like this: Acne is a genetic disease evolving from retention hyperkeratosis of the follicular epithelium. So, if we are dealing with a disorder of the follicle (pore), why flood the body with antibiotics in the hopes that some of it ends up in the pores? Then, consider the side effects, which include severe sun sensitivity (leading to severe skin discoloration), dehydration, thinning hair, birth defects, yeast infections and digestive disorders to name a few. Topical antibiotics like clindamycin, erythromycin and tetracycline can control bacteria in open surface lesions only, but they don’t penetrate deep enough into the pores to kill bacteria where acne starts, and they can’t interfere with the process that actually causes acne.

Benzoyl Peroxide

Benzoyl peroxide (BPO), used for decades, is possibly the most effective acne medication available. Available over-the-counter, by prescription and from clinical estheticians, BPO penetrates deep into the pore, releases oxygen and kills p. acnes, a bacteria that lives without oxygen below the skin’s surface. It also causes a desirable “peeling effect” deep in the follicle, similar to retinoids and alpha hydroxy acids, which loosen and soften acne impactions. With regular use, BPO kills bacteria and exfoliates dead cell build-up deep in the follicles. This action below the skin line halts p. acnes overgrowth and prevents new impactions from forming.

The good news is many BPO formulations are unsurpassed in their ability to control all grades of acne. Unlike Accutane®, oral antibiotics and retinoids, BPO is safe for pregnant women. The bad news is BPO products are not all “created equal”. First, we must examine the base with which the BPO is formulated. Is the BPO mixed with oil, fatty acids, glycerin, sulfur and/or water? Your BPO might be 10%, but its oily or fatty-acid base may seal off the skin, preventing adequate penetration of the BPO itself. Some BPO products are glutted with pore-clogging ingredients. The shelf life of over-the-counter BPO may not be monitored closely and older BPO products can lose their potency.

Any BPO product that can be tolerated overnight the first week or two is not going to be strong enough to control acne in the long run. The skin rapidly gets used BPO, and it stops working. That being said, any BPO product that’s strong enough to clear acne, and keep it that way, is definitely too strong to be tolerated overnight for the first 2-3 weeks of treatment.

Side effects from incorrect use or overuse can include redness and peeling, which is why some people abandon their treatment. BPO should be introduced gradually to allow the skin to become accommodated to it and to keep side effects to a minimum. BPO should not be worn in sunlight or if one expects to perspire for any reason. BPO also migrates through sunscreens, moisturizers, lips balms, eye creams and petroleum jelly and can end up in areas where it wasn’t applied. This may cause causing dryness, irritation, peeling and temporary darkening in those areas. For the same reason, BPO cleansers should not be rinsed over the eyes or onto the neck.

Retinoids

Retinoids are a class of chemical compounds related to vitamin A, used to treat acne and sun-damage. Topicals include tretinoin (Retin-A®, Avita® and Renova®), adapalene (Differin®), tazarotene (Tazorac®), retinol and retinyl propionate, most of which are available in gel, serum and cream formulations.

Retinoid gels and serums are helpful in the treatment of non-inflamed blackheads, closed comedones (whiteheads), clogged pores and rough texture, if one isn’t sun-sensitive or exposed to long periods of direct sun. The emollient cream versions are often loaded with pore-clogging ingredients and can be acne aggravators. They’re more suitable for photo-damaged skin that isn’t acne prone. The problem with retinoids is this: While they facilitate a desirable peeling effect deep in the follicle and help loosen and dislodge comedones, they don’t kill p. acnes bacteria. Side effects can include thinning of the skin, redness, prolonged peeling, irritation and sun sensitivity that can lead to severe darkening. Retinoid gels and serums, alternated with or layered under benzoyl peroxide at night, can be excellent “skin texturizers” that can help clear acne, refine the pores and rejuvenate and brighten the skin. When using retinoids, it’s very important to apply them only at night, to avoid direct sun and to protect the skin with a non-comedogenic physical sunblock during the day.

Alpha Hydroxy Acids

Alpha hydroxy acids (AHA) are often used to treat acne and include glycolic acid (from sugar cane), mandelic acid (from bitter almonds) and lactic acid (from sour dairy and other foods). They penetrate the follicle and, when introduced gradually and used as directed, can have fewer adverse side effects than retinoids, i.e. excessive flaking, redness, dark blotches, irritation and sun sensitivity. They help reduce dead cell build-up in the pore, fade dark spots and soften scar tissue, have a lower price tag, and are widely available without a prescription. Home care products are available in gels, serums, lotions and creams in strengths ranging from 5% to 20%. Oil-free glycolic, mandelic and lactic acid gels and serums can be formulated with salicylic acid, azelaic acid and skin brighteners, and are highly effective for treating acne and post-inflammatory blemishes and should be introduced gradually.

AHA Skin Peels

At higher concentration, glycolic, lactic and mandelic acid and AHA blends make highly effective skin peels. Peels are safe and beneficial for all skin tones and for a wide variety skin types, when performed correctly and chosen carefully according to skin sensitivity and condition, home care used, peel percentage and pH and other factors.

Mandelic Acid

Mandelic acid is one of the newer AHA ingredients used to treat mild to moderate acne. An aromatic alpha hydroxy acid derived from bitter almonds, it’s available in skin peels, acne topicals, skin brighteners, cleansers and toners. Because of its well-established antibacterial, pore-purging, anti-aging and skin brightening action, mandelic acid is ideal for adult acne, folliculitis and laser resurfacing patients. Mandelic acid is less irritating than glycolic acid when formulations contain little or no alcohol.

Salicylic Acid

Salicylic acid, also called beta hydroxy acid (BHA), is an oil-soluble anti-bacterial ingredient that is plant-derived and indirectly related to aspirin. It causes epidermal cells to shed more readily, opens clogged pores, helps dissolve sebum, neutralizes bacteria and is most often used in acne products and dandruff shampoos. When formulated with glycolic and lactic acid, it penetrates better to increase cell turnover and prevent pores from clogging up again. Gel formulations can be worn under benzoyl peroxide at night. Salicylic acid products rarely clear acne completely when used alone and can be irritating. Beta hydroxy skin peels, though quite uncomfortable when applied, help remove blackheads and whiteheads, diminish fine lines, improve active acne and brighten the skin tone.

Azelaic Acid

Azelaic acid, derived from wheat, rye and barley, is marketed as a stand-alone acne treatment (Azelex®) because it helps reduce inflammation and bacterial growth in the follicles. Finacea® is less potent than Azelex® and prescribed for mild to moderate rosacea to help kill bacteria, calm inflammation and diminish redness. However, azelaic acid works best as a skin lightener and acne-inhibitor when formulated with alpha hydroxy acids, salicylic acid, mandelic acid and/or kojic acid, producing a more potent synergistic effect on the skin.

Niacinamide

Niacinamide (vitamin B3) is a stable, versatile ingredient that possesses antibacterial, anti-inflammatory and pigment-reducing properties, and often found in skin brightening formulations. Used for mild acne, rosacea and hyperpigmentation, niacinamide has also been shown to help regulate sebum, improve barrier function, increase immunity, reduce sensitivity and improve the visible signs of aging without irritation. Niacinamide is safe and effective as part of a longterm maintenance program for hyperpigmentation and adult acne. It works best when used in combination with other acne and skin brightening products.

Skin Brighteners

Brightening ingredients help inhibit the over-activity of tyrosinase, the key enzyme involved in melanin synthesis and skin coloration. Tyrosinase activity is accelerated in melanin-producing cells by the stimulation of free radicals caused by sun exposure, DNA photo-damage and other skin stresses. This incites increased levels of melanogenesis, a complex chain reaction that leads to the formation of skin discoloration.

Melanin-suppressing ingredients include the controversial FDA-approved hydroquinone (HQ), kojic acid , kojic dipalmitate, alpha arbutin, azelaic acid, vitamin K, mulberry extract, bearberry (beta arbutin), licorice extract, niacinamide (vitamin B3), l-ascorbate (stable, absorbable vitamin C), emblica extract, Tego® Cosmo C250, Gigawhite™, mandelic acid and citrus juice extracts. Mandelic acid, niacinamide and azelaic acid possess both depigmenting and acne-fighting properties.

Gel and serum brightening “cocktails” formulated with retinoids or alpha hydroxy acids are able to penetrate better and carry ingredients deep to the target tissues. This makes them effective against acne while they interfere with the mechanism that leads to the over-production of melanin in the skin. Patch-tested and used exactly as directed and in the appropriate formulation, there is a low incidence of irritation and allergic reaction.

Prescription “bleach” creams compounded by pharmacists, including Kligman’s original formula and modified versions (including Tri-Luma®), are combinations of HQ, tretinoin and steroids. While effective for discoloration, they are indicated for short-term use only, and not appropriate to treat acne. Other prescribed combinations include HQ and glycolic acid (Lustra® and Glyquin®) and HQ and retinol (Alustra®), in addition to a variety of old school HQ-only formulations which perform poorly and can be comedogenic.

Sulfur

Sulfur has been used for centuries as an anti-inflammatory and drying agent. As an acne medication, sulfur is formulated with resorcinol, benzoyl peroxide or sodium sulfacetamide, and helps to dry out active acne, reduce oiliness and prevent new breakouts. Sulfur clay masks dramatically improve skin texture by exfoliating dead skin cells, and make the skin more bio-available to active acne products applied after the mask is removed. Sulfur is safe and effective to treat acne, oily skin and fungal infections, unless one is allergic to it or suffers from extremely dry skin or eczema. It works best when used in conjunction with other acne methods.

Rasul Clay

Also known as rhassoul clay and ghassoul clay, this mineral-rich clay is found in the mountains of Morocco. Lerosett® Mask by Gunilla of Sweden is a well-known brand. Free of chemicals and preservatives, rasul clay absorbs oil and follicular debris and helps dry out active acne, though it doesn’t penetrate the follicle or kill bacteria. Like sulfur, rasul clay works best when used in combination with other acne methods.

Resorcinol

Resorcinol, an antiseptic chemical exfoliator derived from resins, is usually formulated with sulfur, and dries out active acne and helps reduce oily build-up on the skin. Jessner’s solution, a chemical peel made with a combination of salicylic acid (BHA), lactic acid and resorcinol, has been used for decades to address acne, superficial scars, sun-damage and rough texture.

Combination Topicals

Several acne products are combinations of two or more active ingredients, including benzoyl peroxide-sulfur, sulfur-resorcinol, sodium sulfacetamide-sulfur (Sulfacet-R®), benzoyl peroxide-antibiotics (Benzamycin®, Duac® and BenzaClin®), clindamycin-tretinoin (Ziana®), and benzoyl peroxide-adapalene (Epiduo® Gel).

Dapsone

Dapsone gel (Aczone®) is approved for the topical treatment of acne. Dapsone is a sulfone drug used mainly as an oral medication for leprosy and less commonly as a treatment for acne. The FDA warned Allergan that their claims overstated the clinical efficacy and that they misleadingly suggested the drug was safer than has been demonstrated by substantial evidence and clinical experience. Until recently, they failed to disclose the fact that using dapsone gel followed by benzoyl peroxide can result in temporary yellow or orange skin discoloration and facial hair.

Sodium Sulfacetamide

Sodium sulfacetamide lotion belongs to a class of drugs called sulfa antibiotics, sold as Klaron® (sodium sulfacetamide) Sulfacet-R®, Novacet® (sodium sulfacetamide with sulfur) and other generic brands. For sensitive skin, seborrheic dermatitis and rosacea, it’s well-tolerated and less irritating than other topicals. It’s often prescribed in combination with other acne methods because the skin builds up a tolerance over time and it loses its effectiveness. Versions containing sulfur are mild exfoliants and some people are bothered by the strong smell. There is increased risk for systemic side effects if used on “open” acne, broken skin or on large areas of the body, and it should not be used if pregnant or nursing.

Isotretinoin

Accutane® (isotretinoin) is a powerful systemic retinoid, related to vitamin A, often used as a “last resort” to treat severe cystic acne. It works by shutting down the sebaceous activity in the entire body. Side effects can include severe birth defects, depression, suicidal thoughts and attempts, fatigue, problems regulating blood sugar, kidney malfunction, pancreatitis, liver abnormalities, fragile skin, dryness and peeling, redness of the face, skin infection, delayed wound healing, blurred vision, decreased tolerance to contact lenses, cataracts, conjunctivitis (“pink eye”), decreased night vision, chapped lips, gum inflammation and bleeding, severe sun-sensitivity, rashes, hair loss, aching joints, bone changes, osteoporosis, chest pain, headaches, nausea, vomiting, and chronic inflammatory bowel disease with rectal bleeding. Monthly blood tests for liver and kidney function and glucose levels are required

Because isotretinoin can cause severe birth defects, including mental retardation and physical malformations, a woman must not become pregnant while taking it. Women of child-bearing age must undergo monthly pregnancy testing and use two forms of foolproof birth control. All patients (male and female) are required to sign a detailed consent form outlining the many severe side effects. Since 2005, all patients who use this drug, all doctors who prescribe it, and all pharmacies who fill prescriptions must join the national FDA-mandated “iPLEDGE” Accutane Registry.

Unfortunately, many patients with lesser grades of acne are being prescribed isotretinoin very casually. Not only is it potentially dangerous, it simply doesn’t work for all types of acne. Tens of thousands of disillusioned post-Accutane® failure cases were promised permanent results and put at risk when it was clearly not even indicated for their grade of acne. Often, the acne would clear up after one or more cycles, only to have the condition return within months of stopping the drug.

Also, isotretinoin interferes with the skin enzyme collagenase, so there is increased risk of severe scarring if procedures like dermabrasion, deep chemical peels, laser resurfacing and other facial surgery are performed. Roche and other manufacturers have withdrawn this drug from the market because of lawsuits and huge financial losses. At this time, only a couple of generic versions are still available.

Spironolactone

Spironolactone is a synthetic hormone and anti-androgen diuretic drug is used to treat high blood pressure and fluid retention. Because it decreases testosterone production, it is also utilized to treat hirsutism, PCOS and hormonal acne in women. The birth control pill Yaz® also contains this drug.

This is not a popular treatment for those who are NOT diagnosed with an androgenic hormonal imbalance. Side effects include dehydration, nausea, fatigue, irregular periods, sun-sensitivity, headache and a link to cancer. Since it interrupts the masculinization of male fetuses, foolproof birth control is mandatory. When severe acne is accompanied by insulin resistance, obesity and hirsutism, and polycystic ovarian syndrome (PCOS) has been diagnosed, spironolactone is sometimes prescribed in combination with oral contraceptives and metformin, a drug used to treat adult-onset diabetes. Hormones and spironolactone are also prescribed for male-to-female gender reassignment patients as part of their transition therapy. However, acne and hirsutism can be genetic and cultural, i.e. run in certain families, and most cases are not always linked to PCOS.

Some tests have shown that topical spironolactone may be effective at 5% under an occlusive covering to address androgens (DHT) deep in the follicle (on the back). Some acne formulations are using trace amounts in their formulas (along with active OTC acne ingredients), but since it’s only effective at much higher percentages, the label would have to identify spironolactone as an active ingredient. The birth control pill Yaz®, which contains spironolactone, and the more potent oral spironolactone never received rave reviews for acne. While they may have worked for some, their side effects often outweigh the benefits.

Oral Contraceptives

Birth control pills are sometimes prescribed in an attempt to control hormonal acne, often with disappointing results. OrthoTricyclen®, Yazmin® and Yaz® are advertised as to help clear acne, though this claim has been disputed. Oral contraceptives can cause severe sun sensitivity, weight gain, mood swings, acne flare-ups, elevated blood pressure, cardiovascular risks and melasma, an unsightly hormonal and sun-induced hyperpigmentation characterized by large dark patches on the face that are challenging to treat and control.

©2011, 2012 by Kathryn Khadija Leverette

The material on this website is provided for educational purposes only, and is not to be used for medical advice, diagnosis or treatment.