Kathryn Khadija Leverette, Oakland Acne Specialist, Ethnic Skin Expert, Black Skin Care » Body

Scrub Sense or Nonsense: Less is More

Kat — Sat, 30 Jan 2010 23:27:59 +0000

Avoiding the Pitfalls of Mechanical Exfoliation

The debate has always been heated among skin care specialists and dermatologists as to the risks and benefits of scrubbing one’s face and body parts. There is a danger of creating microscopic tears and abrading the skin if a scrub contains granules with irregular edges (crushed walnut shells or apricot pits) or if too much pressure is used with any method of exfoliation, friction or scrubbing action.

Washcloths vs. Scrubs vs. Astringent/Cotton vs. Buffing Pads: There are pitfalls to every exfoliation method, friction, pressure and skin tampering technique, especially on darker, thin, post-operative or sensitive skin.

Who’s at Risk: Sensitive and thin-skinned individuals, people of color, post-operative skin (laser, deep dermabrasion and peels) and those using or over-using shaving powder or other hair removal chemicals, retinoids, Accutane, benzoyl peroxide, BHA (salicylic acid), glycolic acid and other AHAs and sun-sensitive skin. Because many active ingredients and professional treatments can cause temporary superficial flaking and/or peeling, the temptation to “speed up” the process by scouring off their dead skin cells can be irresistible.

Abrading and tampering with the skin manually, including scrubs, buffing pads, loofahs, rubbing with a washcloths or towels, picking, scratching, patting, using alcohol and cotton, scraping the skin while shaving, being shaved or removing shaving powders, wearing tight, binding or ill-fitting hats, clothing, boots and shoes, microdermabrasion and/or using excessive pressure for any reason, can temporarily “over-process” the skin. Applying “active” products and exposure to UV rays on irritated skin can turn mild flaking into excessive scaling and prolonged irritation. This can “activate” the melanocytes in the basal layer of the skin (the cells that provide your natural coloration) and incite an unnecessary increase in pigmentation problems, especially if skin is exposed to continued sunlight, scrubbing, rubbing, friction, pressure, picking, or product overuse. Repeated manipulation, friction and skin tampering can slow down the healing process, introduce bacteria, and cause epidermal cells on and around blemishes to thicken, darken, and get larger as the body struggles to defend itself from constant “self-assault”.

Unwelcome Results: Side effects include temporary redness, burning, prolonged scaling, increased sun-sensitivity, a thick build-up dead skin cells, pigmentation problems and an uneven skin tone. Symptoms can last anywhere from a few days to a few months.

Warning to People of Color: Abrasion caused by overzealous manual exfoliation, scrubbing too often, scraping the skin, using too much pressure, picking, scratching, rubbing with a towel, wearing tight headwear, clothing or footwear, exposure to sun and lack of adequate water intake can leave temporary hyperpigmentation in its wake. You can’t scrub the “black” off your skin, or someone else’s skin! And, you can’t scrub, scrape or pick off thickened dead skin cells. This situation will only worsen, and will improve dramatically when you stop.

Better Yet: Use home care products exactly as directed. To combat flaking, try sulfur mask, a mild, non-mechanical exfoliant that will “passively” dissolve dead skin cells. Apply a generous coat and allow it to remain on the skin for as long as it remains wet, without letting it dry out. Shower or rinse it off with warm water and gentle pressure from fingertips only. Stop scrubbing. Back off using or over-using active home exfoliants and moisturize more often. Ask us about other methods to help exfoliate dead skin cells without traumatizing your skin.

Safer Scrubs: Scrubs containing finely-ground meal (like cornmeal), papaya enzyme creams, man-made jojoba beads, fine polyethylene granules, soaps containing powdered exfoliants, and tiny marble spheres have a smooth, uniform surface, won’t tear delicate skin. Keep in mind that scrubbing, product overuse, frictions of any kind, and/or applying too much pressure on even slightly irritated skin can still cause problems!

Experienced skin care professionals can perform light skin peels or gentle enzymes formulated for sensitive skin if you need to exfoliate. Exfoliants designed for home use are safe bets and can safely boost skin-smoothing results, if and only if they are used exactly as directed.

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

Keratosis Pilaris

Kat — Sat, 30 Jan 2010 23:26:13 +0000

KP: Rough and Bumpy Skin

Guide to the Management of Keratosis Pilaris

What does KP look like? This annoying skin disorder, called keratosis pilaris (KP), is characterized by thousands of hard, non-inflammatory keratin plugs that cover the hair follicles, making the skin rough and pebbled, in appearance and to the touch. And, it worsens dramatically if picked and scratched. Skin tampering invites secondary infection, enlargement of the bumps, delayed healing and unsightly discoloration. These dark, discolored sores can mimic burned-out acne and cause large blemishes and permanent scarring.

Does KP look different on People of Color? Yes. On many black, Hispanic, Asian and dark or olive-skinned people, KP resembles thousands of tiny blackheads and dark blemishes blanketing the skin. Yet, KP can also be tan, flesh-toned or even red in color.

What parts of the body are affected? Affected areas can include the backs of the arms, forearms below the elbow, shoulders, hips, buttocks, back and sides of the upper legs, calves, and cheeks (especially younger people), though its not limited to those areas.

What causes KP? Though KP has been blamed on everything from shaving to tight jeans to dry skin, keratosis pilaris is a chronic, genetic condition caused by hyperkeratosis, the build-up of hardened dead skin cells that cover the follicle opening. Hormones can also be a factor.

Is there a cure for KP? No. Though KP can be controlled, the can bumps often return shortly after one abandons daily treatment. While there is no lasting “cure”, consistent home management can keep those bumpy symptoms in check, lessening the risk of hyperpigmentation.

What can I do to treat KP on the body? Gentle, twice daily use of a nylon net sponge with an alpha hydroxy acid, sulfur or benzoyl peroxide soap or cleanser can sometimes solve mild KP problems. Keratolytic topicals like sulfur/resorcinol , benzoyl peroxide (BPO), glycolic or lactic acid, urea and potent retinoids can all be highly effective with regular use. Most health insurance carriers won’t cover retinoid prescriptions for adults over 26 years of age and the large amount needed to keep KP in check make retinoids financially prohibitive.

My KP seems to improve when I get a lot of sun. Why? Sun exposure causes mild burning and subsequent peeling (similar to BPO, Retin-A®, AHA, BHA, etc.) that temporarily exfoliates and camouflages KP bumps. But, the sun also darkens bumps on People of Color and causes premature aging, the destruction of skin texture, unsightly sun spots (keratoses), sagging of the skin and skin cancer. When the tan fades, thousands of dark spots remain in its wake.

How do I use exfoliating products? Since keratosis pilaris most frequently affects the non-sensitive areas of the upper arms, thighs and buttocks, topical exfoliating products may be used once or twice a day in the absence of skin irritation. Product potency and the daily application schedule should be evaluated and varied according to individual skin sensitivity of those areas and other affected body parts.

What if my KP is red in appearance? Some light-skinned KP sufferers get a non-inflamed form of “red” KP characterized by thousands of tiny rough red bumps. Some have an inflamed KP condition that resembles active acne and the larger lesions are often caused by picking. Cleansers and topicals containing benzoyl peroxide (BPO) and/or sulfur, which are both anti-bacterial exfoliants, work well on all red and/or inflamed KP, especially on the body. They work best when worn on the affected area at bedtime. Other exfoliating lotions can be worn duriung the day. Keep in mind that BPO bleaches fabric and must not be worn if one expects to perspire or be exposed to the sun and can migrate through other lotions into sensitive areas.

What if my KP is bumpy, but not inflamed? Alpha hydroxy acid (glycolic, mandelic or lactic), salicylic acid, acetyl salicylate and/or potent urea lotions or gels can be applied sparingly once or twice daily in the absence of irritation, and massaged thoroughly into the skin until all traces have been absorbed. Unlike benzoyl peroxide, these active ingredients won’t discolor fabric or migrate into sensitive areas.

What if my KP bumps are much darker than my skin tone? Sometimes, KP looks like a sprinkling of blackheads, especially on People of Color. Exfoliating “bleach” soaps and products formulated with alpha hydroxy acid (glycolic, mandelic or lactic) and skin brighteners can work wonders on KP that is darker than the surrounding skin. Body exfoliants containing AHA and skin brighteners (alpha-arbutin, kojic acid dipalmitate, mandelic acid, azelaic acid and others) are designed specifically for use on hyperpigmented skin in the absence of irritation, if direct sun is avoided and full-spectrum sunscreen is used religiously.

How do skin lighteners fade the spots caused by KP? These products work three ways. First, alpha hydroxy acids exfoliate the buildup of keratin (dead skin cells) that buries the hair follicle. Next, they can also act as a “vehicle” to carry skin brighteners deeper into the follicles. Last, the brightening ingredients help inhibit the over-production of dark melanin coloration in the basal layer of the epidermis. Brighteners include alpha-arbutin, kojic acid dipalmitate, mandelic acid, bearberry extract (beta-arbutin), mulberry extract, azelaic acid, licorice root extract, l-ascorbic acid, vitamin K, lemon and lime extract and others. Brightening melanin-suppreesors perform best when formulated with a “penetrant” (like an AHA or retinoid) that acts as a “vehicle” to carry them deeper into the follicle.

Can I go into the sun after the KP clears up and my spots fade? If your skin is exposed to any direct sun at all, it is important to apply full-spectrum sunscreen hourly. Try to make every effort to avoid the sun whenever possible. This is especially important if any discoloration is present, or if your skin blemishes have a tendency to over-darken. Previously hyperpigmented skin can darken faster than the surrounding skin, even after the spots have faded and the KP is under control. Keep in mind that a variety of health problems and medications can make your skin extremely sun sensitive and total sun avoidance is advisable.

What are the side effects of these treatment products? The side effects of the treatment for keratosis pilaris can include temporary dryness, mild peeling and itching and the presence of superficial darker patches of dead skin cells. These symptoms subside as the skin gets used to exfoliating lotions and gels, and if they are used exactly as directed. Overuse will worsen or prolong these symptoms.

Can scrubbing help my KP? Performed regularly and in the absence of irritation, gentle exfoliation can help keep KP-affected skin smooth. To reduce the the risk of uncomfortable side effects like irritation, temporary discoloration and sun sensitivity, don’t overuse homecare products, apply excessive pressure, scrub too hard, rub with a towel, pick at the bumps, or wear clothing or footwear, especially boots and tight jeans, that bind or rub the skin.

Are any treatments available to boost my efforts? Professional light skin peels, used only in the absence of irritation, can help address stubborn KP.

Can I stop treatment after I clear up? No. Keratosis pilaris is a chronic genetic condition with no permanent cure. Home maintenance must be ongoing and diligent to prevent bumpy symptoms from recurring.

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

Fungus Among Us

Kat — Sat, 30 Jan 2010 23:24:43 +0000

Tinea Versicolor Fungal Infection

The non-contagious fungal rash of tinea versicolor is a chronic, asymptomatic superficial infection characterized by light scaly, macular patches. These patches range in color from light pink to deep tan to a darker brown. Although the name suggests a variety of colors, the hue of all patches is about the same in any one individual.

The areas involved are usually restricted to between the chin and the waist, on the trunk and arms, sometimes to the wrist. Facial involvement is rare except in blacks. The rash may be mildly itchy, especially when perspiring, but most people are bothered most by its unsightliness. Involved untreated areas are usually hypopigmented patches that appear significantly lighter than the surrounding skin, especially where perspiration occurs first and most often, i.e. the upper back and chest. A simple wood’s light exam performed in a dark room on uncleansed skin will show intensified pigmentary changes and allow the extent and margins to be easily observed. Infected areas usually appear yellowish gold to greenish yellow-gold in fluorescence.

Tinea versicolor is caused by the organism Pityrosporum orbicular. It is seen mostly in young adults living in temperate climates and accounts for about five percent of all fungal infections. The fine scales of tinea versicolor are teeming with “hype” and “spores”.

Factors predisposing a clinical infection:

Pregnancy
Genetic predisposition
Underlying disease
Patients taking systemic steroids
Hot and humid climate
An active lifestyle that includes exercise, perspiration and occlusive workout wear

Tinea versicolor can infect people for years because of inconsistent treatment and re-infection. Tinea versicolor is unique because it produces hypopigmented lesions that lack skin color. The fungus produces an enzymatic reaction that interferes with melanin production in the affected areas.

Tinea versicolor may be treated in a variety of ways, some of which may prove successful if used diligently for a prolonged period of time. The problem is that most topical methods are messy, tedious, frustrating and time-consuming. People often give up, and choose to “live with it” rather than undergo the often-unsuccessful standard treatment protocols.

In the past, application of of anti-fungal preparations or dandruff shampoos were prescribed follow an exfoliating bath. Though infection sometimes cleared up, re-infection was common, and pigmentary changes took months to resolve.

Common medically-prescribed treatment methods:

Dandruff preparations: Zinc pyrithione, selenium sulfide suspension, sodium hyposulfite 25%, or Tinver Lotion (25% sodium thiosulfate, 1% salicylic acid, 10% alcohol) applied to lesions twice a day for fourteen days.
Anti-fungal creams: Lamisil® (terbinafine), Lotrimin® (clotrimazole), Monistat-Derm® (miconazole), Halotex® (holoprogin), Tinactin® (tolnaftate) and topical prescription Nizoral® (ketoconazole) preparations applied to lesions 2 to 3 a day for fourteen days.
Topical retinoids: Applied twice a day for two weeks, retinoids can exfoliate tinea versicolor spores and help to resolve the pigmentary changes, but is prohibitively expensive since many insurance companies will not cover the use of Retin-A® and generic topicals for this purpose.
Oral anti-fungals: Systemic anti-fungal drugs (Lamisil® and Nizoral®) promise up to a 90 percent “temporary” cure rate. These potent broad-spectrum anti-fungal agents are useful in the treatment of most stubborn fungal infections. However, intermittent use of oral anti-fungals to control a chronic fungal infection is dangerous because it can lead to liver toxicity. Because of this risk, they should be utilized as a one-time last resort in the most serious, treatment-resistant cases only. And even then, re-infection often occurs.

Urban Skin Solutions’ alternative approach:

Cleansing twice daily and immediately after perspiring with a sulfur or benzoyl peroxide soap and a net sponge to exfoliate the uppermost fungus-infected epidermal cells
Using a natural anti-fungal body spray after cleansing and sweating
Applying an over-the-counter anti-fungal topical (Lamisil Gel®, terbinafine, etc.)
Applying an alpha hydroxy acid (mandelic, lactic and/or glycolic) body product to the entire affected area (and massage all the way in) 10 minutes after the topical anti-fungal is applied. This will help (a) the anti-fungal product penetrate into the deeper cell layers and (b) soften and exfoliate fungus-infected skin cells.

This routine must be performed consistently to achieve results and prevent recurrence. Avoid wearing occlusive clothing like spandex, nylon jogging suits, and clothing made from silk, polyester and synthetic materials. If you can’t shower immediately after prespiring, change into a clean cotton T-shirt laundered in fragrance-free detergent without fabric softener. Results take time and diligence, but are safe and effective.

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

Beating the Bump

Kat — Sat, 30 Jan 2010 23:01:21 +0000

Pseudofolliculitis barbae, known as razor bumps, is the number one complaint among black men and women who shave or perform other hair removal methods. Caused by stiff facial hair and a genetically-caused curved follicle, the hair tips reverse their course and literally penetrate and grow back into the skin, like a horseshoe, before they would normally exit. Similar to hundreds of splinters, these trapped hairs incite an inflammatory response, causing soreness, redness and swelling. This reaction, called “bumping up” creates perifollicular papules best described as swollen, pus-filled lesions blanketing the beard, or other shaving area.

Similar problems can affect women on the chin, sideburns, neck, chest, abdomen, legs and in the bikini area from tweezing, waxing, shaving and sometimes even depilatories. The sensations experienced by the razor bump (ingrown hair) sufferer are constant itching, tingling, burning, soreness, swelling and sometimes real pain. Symptoms can be mildly annoying and localized for some, and severe and extensive for others.

Pseudofolliculitis barbae is a chronic condition that can persist as long as the individual shaves, waxes, threads, and/or tweezes. Obviously, the problem can be dealt with by just allowing the hair to grow out. As the hair grows longer, it simply pops out the follicular opening and new “bumping up” ceases because the individual has stopped shaving, waxing or tweezing. This option, however, is not always practical due to the pressure of one’s employer, lifestyle, beauty and grooming customs.

Strict grooming regulations have been historically imposed by law enforcement agencies, fire departments, parcel delivery services and the military. These and other industries have traditionally insisted on the clean shaven look, and this has caused suffering and disfigurement to thousands of black and bump-prone men. In recent years, consciousness has gradually increased and some rules are slowly changing. Some branches of the military, most notably the Navy, are allowing extremely bump-prone men to sport a short, neatly groomed beard.

For decades, viable solutions to this universal problem eluded the medical, esthetic and drug store markets, and continue to do so on a wide-scale basis. Most physicians have relied unsuccessfully on topical steroids, retinoid creams and systematic antibiotics.

Over-the-counter and mailorder systems have utilized single edge blades, weak cortisone creams, bromelain enzymes, abrasive scrubs and alcohol-based salicylic acid solutions. While these methods can help improve the condition, they rarely offer total clearing or longterm relief. As a result, this all-too-common skin disorder presents a wide open arena for knowledgeable esthetic practitioners. Clinical skin care pros can dispense exfoliating, calming and antibacterial professional products (exfoliating masks and scrubs, AHA exfoliants, BPO, skin brighteners, acetyl salicylate solutions and hydrocortisone) and have the skill to release ingrown hairs correctly in a safe setting.

Shaving Habits: We instruct our clients to shave in the direction of hair growth with a single-edge disposable blade like the PFB Bump Fighter or Bic for Sensitive Skin, which is used once or twice and discarded after use. Examine the shaving area and determine which areas are less “bumped up” than others. Carefully imitate the shaving method and direction you use on the clearest areas, and repeat the same process on the entire shaving area.

Do not repeatedly go over the same area in a back-and-forth motion in an effort to get a closer shave. Use fragrance-free shaving creams, mild shaving soaps and gels containing benzoyl peroxide or alpha or beta hydroxy acid, which work well with single-edge disposable blades. The blade should be used no more than once or twice.

If the preferred shaving method involves an electric razor, we prefer the traditional barber’s trimmer, called a T-edger or liner, which gives a close, more precise shave that larger clippers. An example of this compact trimmer is the Wahl, designed for black men who shave, but Oster, Andes and other trimmers work equally well. Professional disinfectant spray (Clippercide or Oster) must be used before and after shaving to disinfect and lubricate the blades.

We include wives, mothers and girlfriends in the consultation. They are often the ones who wield the sewing needles and tweezers, or observe the picking, digging, unhooking, tweezing and other types of skin tampering habits at home. Tampering with the skin of introduces secondary bacteria and leads to inflammation, delayed healing, scarring and larger, thickened dark spots. Tweezing, threading and waxing trap recently removed hairs deep below the skin line, and set them up to become trapped again and again as they re-grow.

Avoid rotary shavers that cut beard hair at too many different angles, seriously compounding the problem. The skin should never be stretched to obtain a closer shave. When the skin bounces back, newly-shaved hair will be situated (and later trapped) below the skin line. The same principal applies to twin, triple, four and five-blade razors; the first blade stretches the skin, while the second (third, fourth and fifth) blade(s)s shave(s) way too close.

Depilatory creams and shaving powders should be discouraged once one of our anti-bacterial, keratolytic topicals is applied nightly in the bump prone area without irritation. Use of depilatories leads to dark hyperpigmentation of the lower face and neck, sometimes called “shadowing”, caused by chemical irritation and subsequent sun exposure. Melanin-suppressing skin lighteners should be introduced gradually in the absence of irritation and allergy. During the day, gentle skin brigheners, greaseless anti-inflammatory creams and oil-free full-spectrum sunscreens are vital to correcting and discouraging beard discoloration.

Electrolysis: Those with chronic “trouble spots” (often on the neck or cheeks where tweezing was performed repeatedly) might want to explore the “blend method” of electrolysis for problem areas. The electrologist should be skilled and experienced in the treatment of black, bump-prone clients with curved, often scarred, hair follicles. The curved follicle, healing process, risk of scarring and hyperpigmentation, as well as inflammatory reaction to the temporary “trauma” of electrolysis can differ radically from other races.

Laser hair removal has become increasingly popular in recent years to gradually and permanently reduce hair on the face and body. It is important that candidates do their homework to steer clear of the risks related to lasers, especially scarring and hyperpigmentation on darker skin tones.

Laser practitioners must:

(a) Use the safest, most appropriate laser for darker skin tones, like the YAG Q-switched neodymium yttrium aluminum garnet laser that produces a 1064nm wavelength of laser light.

(b) Be well-trained and experienced in the use of that laser.

(c) Disclose exactly what that laser can and cannot do for you, i.e. delete light, gray or white hair, and tell you how often you must go for treatment, usually every 4 to 5 weeks.

(d) Be experienced working with your ethnic skin type.

(e) Be able to address pre-laser pain management, disclosure of permanent cosmetic tattoos, reduction of post-laser inflammation, the need for melanin suppression (to control pigmentation) and sun protection/sun avoidance, removal of mineral make-up and physical sunblock before laser treatment, and be able to treat post-laser skin issues if they arise.

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

Dry Skin Tips

Kat — Sat, 30 Jan 2010 22:56:15 +0000

Cold, dry air, wind, low humidity, heaters, air conditioners and hard water can spell disaster for your skin, sinuses and scalp. Interior HVAC, airplane cabin pressure, space heaters, fireplaces, car heaters, hot ovens, long hot showers, hard water, decreased water intake, dehydrating beverages, cold, allergy and flu meds, antibiotics, water pills and other medications all aggravate the problem.

Dull skin? This common complaint is easy to correct by adding a few specialty products, tweaking your home care and making simple lifestyle changes. We can modify your cleansing and skin care routine during the colder months or if you live in a dry climate or hard water area. Urban Skin Solutions’ gentler cleansers, milder exfoliants and moisturizing products can help you get that glow back.

Lower the heat at night, crack the windows, wear cotton flannel sleepwear and warm socks, and use an electric blanket, mattress warmer, extra blankets or a comforter to keep warm.

Cool mist humidifiers hydrate the skin, scalp and sinuses. This is an inexpensive way to moisturize and improve your breathing as you sleep.

Don’t use space heaters! They “fry” and darken your skin tone and dehydrate your entire body. The same is true for fireplaces, so use them only occasionally. Stay far away! Dress warmly, and only use a space heater to warm up a room before you go in, and then turn it off! Better yet, bag it up and put it in the garage.

Increase water intake dramatically, especially if you drink coffee, tea and alcoholic beverages or take any medication. Water intake hydrates the body and helps brighten skin tone and under-eye circles, soften fine lines and wrinkles, reduce puffiness and bloat, calm irritation, relieve dryness, prevent chapped lips, improve digestion, curb appetite, increase mobility and boost energy.

Puffy eyes can be reduced by getting more sleep, elevating your upper body while you sleep, drinking more water, cutting back on alcohol, salt, take-out and processed foods, eliminating dairy from your diet, using a sinus wash twice a day, and keeping the heat low or off while you sleep.

Avoid long hot showers and baths, and don’t stand or sit close to heaters, fireplaces and hot ovens.

Hard water can be devastating to your skin, especially during the colder months. Chlorine, minerals, sulfates and other chemicals can dry you out, darken your skin tone, cause rashes and ashy skin, trash your hair, and trigger acne and eczema flare-ups. Filtered showerheads and handheld sprayers can make hard water feel like rainwater, soften your skin and hair, and eliminate those hard-to-remove limescale spots.

MrWaterFilter.com carries a huge selection of water filters and systems at reasonable prices. They’ll help you select appropriate filtering equipment for your skin concerns, dwelling type and geographical area.

Sunscreen and sunglasses are crucial to help preserve your skin tone, prevent dark circles, brighten dark spots and beard shadowing, stop premature aging of the skin, and to prevent age spots, spider veins and skin cancer. UVA penetrates clouds and car windows, so don’t be fooled.

Sinus rinses deliver dramatic benefits by (a) hydrating sinus passages and mucus membranes, (b) relieving congestion, pressure and nasal dryness, and (c) washing out mucus, crust, bacteria, viruses, dust, pollen, pet dander, mold, debris and particulate pollutants. For maximum benefits, be consistent. Do this when you brush your teeth. Other benefits when used daily include clearer vision from clean tear ducts, brighter skin tone around the eyes, less puffiness, reduced allergy, sinus and cold symptoms, fewer headaches, decreased need for medication, deeper, more relaxed breathing, better sleep, improved sense of taste and smell and sweeter breath.

Sinus rinses and net pots are available at pharmacies and health food stores and online at NeilMed.com. Google terms like sinus rinse, nasal irrigation, neti pot, NeilMed and SinuPulse for more information. See a demo at NeilMed.com or search sinus rinse or neti pot on YouTube.

Seborrhea and seborrheic dermatitis flare up in colder weather and during stressful times. Symptoms affect the skin and scalp and include extreme sensitivity, redness, inflammation and small bumps, flaking, itching, crust on the scalp and ears, peeling on the forehead, hairline, brows, inner cheeks and sides of nose, and a light or red rash, especially on the inner cheeks and hairline. Avoid strong soaps, fragrances and toners with alcohol. Wash your hair and ears at least once a week with a deflaking shampoo. Don’t scratch your scalp or allow your stylist or barber to do so. This condition is easy to treat and symptoms will begin to improve almost immediately. Ask us about our specialized product line formulated for seborrhea and sensitivity.

Stop smoking and avoid secondhand smoke, including pipes, cigars, blunts, weed, incense and fireplace smoke, which dehydrate your skin from the inside out and cause dark circles, respiratory problems, dehydration, dry skin and sinuses, dull skin tone, sagging skin, fine lines, deep wrinkles, premature aging, dry mouth and bad breath, as well as severe health consequences like heart disease, high blood pressure, lung cancer, mouth and throat cancers, emphysema and stroke.

Don’t scrub your skin. Take a gentler approach to cleansing your skin. Over-scrubbing, using spa gloves, rubbing with a towel and other types of friction will lead to irritation, dryness, flaking and darkening.

Omega 3 essential fatty acids and vitamin E improve your health and help reduce the inflammation, dryness and flaking of seborrhea, eczema, psoriasis, itchy rashes, ichtyosis and dry skin. Salmon, flax seeds, walnuts are excellent omega 3 food sources. Other sources include cauliflower, cabbage, halibut, shrimp, cod, tuna, soybeans, tofu, kale, Brussels sprouts and collard greens. Supplement your dietary intake with flax seed oil, enteric-coated fish oil capsules and vitamin E supplements. Check with your physician if you take other medications.

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

Are You Practicing Safe Sun?

Kat — Sat, 30 Jan 2010 22:54:37 +0000

Who Needs Sunscreen and Why?

Darker and olive skins are just as vulnerable as lighter skin tones to the “ravages” of sun. Sun damage produces many “looks” including chronic sunburn, redness and spider veins, deep wrinkles and fine lines, sagging skin, a rough, leathery skin, hyperpigmentation (uneven skin tone, dark spots and hormonal patches called melasma), pre-cancerous lesions known as keratoses and skin cancers, including the often fatal melanoma.

Denial leads to damage: Often, people of color will tell me: “I’m not trying to get darker”; “I’m dark, so I don’t need sunscreen”; “The melanin in black skin is enough protection”; “I’m never out in the sun” or “I never burn”. The sad truth: All intermittent day-to-day sun exposure has a cumulative effect and discolors the skin tone, roughens the texture and damages the underlying structure of the skin itself. Casual sun exposure, like riding on a bus, driving a car, running, walking or gardening, is the most damaging sun because it occurs on a daily basis over a long period of time.

Depleted ozone: The realities of diminished ozone and global warming have been well-publicized. Most people in developed countries are well aware of the need to protect their skin and their children’s skin from the sun, though most still don’t make it a priority. Before going into the sun, even for a short time, full-spectrum sunscreen needs to be applied generously to all exposed skin. Then, it must be reapplied often, even when exposed to indirect sun, and also after swimming, exercising, perspiring and rubbing with a towel.

False sense of security: Products claim to be waterproof, but under most conditions most don’t last, so it’s important to reapply as often as every hour when exposed to continuous sun. Sun protection factors (SPFs) are numbers that indicate how long the skin can be exposed to UVB rays before “burning and reddening” occurs, so don’t rely on a waterproof SPF 70 sunscreen to protect you during six hours of continuous sun or even against the subtle, deeper-penetrating UVA rays on overcast days. Windows and cloudy skies won’t protect your skin from sun damage.

Don’t be fooled by clouds and overcast skies. That glare that causes us to squint on overcast days just confirms the presence of the longer UVA rays. It’s these skin darkening, cancer-causing rays that penetrate the cloud layer and car windows, causing the skin and eye area to darken, become uneven and blotchy, flesh moles to surface, freckles to multiply and skin cancers to form. Even brief sun exposure can cause a rough, swollen itchy rash called photo-dermatitis if one is naturally sensitive to sun, suffers from an auto-immune disease or is taking one or more sun-sensitizing medications.

Don’t neglect your body: Don’t neglect the backs of your hands, forearms, shoulders, chest, ears or neck, as these areas darken quickly, especially on the “driver side.” Wear gloves to protect your hands when washing dishes, gardening and doing household chores and apply sunscreen religiously. Chemically-irritated hands exposed to sun can result in unattractive pigmentary changes, rough texture and aging.

Physical Sunblocks

Physical sunblocks contain micronized titanium dioxide and/or zinc oxide and provide immediate protection from both UVA and UVB rays by reflecting and bouncing harmful rays away from the skin.

Advantages: Physical blocks are effective the minute they’re applied, and don’t require the 20 minute wait that chemical sunscreens need to penetrate the skin. Many are fragrance-free, so they’re ideal for sensitive skin and soothing on inflamed skin. Drawback: Some products don’t appear sheer (at first) and must be massaged gently into the skin with the heel of the hand to prevent that “whitish” or “purplish” haze. This process takes an extra minute at most, and the effort is well worth it. Many professional skin care offices and spas carry sheer physical sunscreens that give the skin a matte finish without a cloudy haze or oily residue. If a product seems heavy and too chalky, take the time to massage it all the way in.

Chemical Sunscreens

Chemical sunscreens, on the other hand, prevent UV rays from penetrating a chemical barrier in the skin. They must absorb completely to be effective, and a generous amount must be applied to all exposed skin no less than 20 minutes before sun exposure. Chemical sunscreens include avobenzone, octyl methoxycinnamate, benzophenones, oxybenzone, dioxybenzone, homosalate, octinoxate, PABA and padimate O.

Advantages: Chemical sunscreens are inexpensive, readily available in both dry and moisturizing formulas and look sheer the minute they’re applied, an advantage when one has very dark skin. Drawbacks: They can be greasy and contain pore-clogging tropical oils and sun-reactive fragrances and can cause the eyes to sting. Many high-SPF products lack the key ingredients to fully protect the skin against the longer UVA rays, since the SPF levels only measure protection against UVB rays. And, since they must be applied 20 minutes before sun exposure, the necessary “wait time” can be problematic for those facing time constraints. There will be gaps in true sun protection while exposed to continuous sun. Sunscreen must be re-applied after swimming, perspiring and/or rubbing with a towel, and it takes at least 20 minutes for chemical sunscreens to begin working again. Experts are now recommending that these sunscreens be reapplied every 20 minutes when in direct sun.

How to choose? Your sunblock should be “user-friendly” and be appropriate for your skin sensitivity, sensitivity to sun, skin type, lifestyle (always in a rush?) and the product’s potential to aggravate acne and irritate the eyes. Some products discourage daily compliance because of greasiness, chalky texture or eye irritation. Oily skin, acne prone skin requires a water-based, tropical oil-free formulation. People with sensitive skin should stick to the new generation of sheer, chemical-free, unscented zinc oxide and/or titanium dioxide products. Those with very dark skin who aren’t sun sensitive or prone to hyperpigmentation, and don’t take medication, can use chemical sunscreens over SPF 30 that contain avobenzone if they reapply regularly

Words of caution: Most sunscreens contain ingredients that can cause stinging, clogging, sensitivity and allergic reactions on sensitive skin. High levels of chemical sunscreen ingredients and fragrances have more potential to cause rashes and irritate the skin, especially in the eye area on allergy sufferers due to tearing and rubbing, and when using topical or systemic retinoids, including tretinoin, adapalene, tazaroten, retinyl propionate, retinol and isotretinoin.

If you’re an athlete, have extremely sensitive skin, are sun-sensitive for any reason, are pregnant, taking medication or hormones, work outdoors and/or perspire a lot, avoid the chemical sunscreens altogether. Instead, use fragrance-free products that contain micronized zinc oxide and/or titanium dioxide.

Protect your eyes and lips: UV-protective eyewear should be worn when outdoors for any length of time. These days, most sunglasses provide UV protection. Sunglasses must be large enough to cover the entire orbital eye area. While prescription “transition” lenses darken in direct sunlight, they may not darken sufficiently while riding in a car or bus, and are often too small to adequately cover the eye area. Athletes who can’t wear sunglasses while participating in their sport do best with the micronized, chemical-free physical sun products, which won’t sting when perspiration runs into the eyes. There are many lip products available that contain full-spectrum protection, so shoot for one that is fragrance-free with an SPF of 30. Use daily and reapply often. In addition to preventing sunburn, they help fade lip discoloration and prevent cold sores, which often flare after direct sun exposure.

Make-Up with SPF

Make-up products that contain sunscreens usually provide too little UV protection, block only the UVB “burning” rays, not the UVA “browning” rays and don’t address areas where make-isn’t applied, like the neck, ears, check, arms and hands. Get a full-spectrum stand-alone sunscreen with UVA blockers (zinc oxide, titanium dioxide or avobenzone) to protect your skin before you apply make-up.

Mineral foundation and some cover creams (used to hide dark circles and skin abnormalities) contain chemical-free sunscreen and pigment. They provide some physical sun protection and are sometimes moisture-proof, but again, they don’t protect all exposed skin.

Choose and ‘fine tune’ all make-up color choices in natural filtered daylight, not in artificial light or direct sunlight. Re-evaluate colors often if you’ve been getting skin peels and/or using skin brighteners. For a natural look, take the time find the right shade and use a light touch. Practice until you get it right, blending carefully into the neck, temples, smile lines and hairline.

Sun-Sensitivity

Many factors cause sun-sensitivity: Pregnancy, oral contraceptives, fertility drugs, hormone-containing devices, hormonal imbalances, oral antibiotics, blood pressure meds, diuretics, oral anti-diabetic drugs, Accutane® (even if it was discontinued years ago), Retin A®, Differin Gel®, tretinoin, TriLuma®, retinol, antihistamines, chemical peeling, dermabrasion, microdermabrasion, laser resurfacing, dehydration, medical conditions, including auto-immune diseases (lupus, scleroderma, vitiligo, RA, sarcoidosis, MS, thyroid disease, etc.), and kidney disease, obesity, weight gain, allergies, product overuse, friction and over-scrubbing can cause sun-sensitivity on virtually anyone.

Warning: Sun-sensitivity leads to a worsening of pigmentation problems, especially on people of color and women who are pregnant, taking hormones or using hormone-containing devices. Many people are naturally sun-sensitive and already recognize the fact that they can’t tolerate the sun. Only five minutes in the sun for a photo-sensitive person can be as hard-hitting and damaging as three hours in that very same sun for someone else.

Protect Your Skin for Life

Sunscreen use can be dangerous for some people because they prolong their sun exposure, believing they are safe from the damaging effects of the sun. Avoid unnecessary sun exposure and avoid exposure between 10 am and after 4 pm whenever possible. Apply and reapply a potent full-spectrum sunblock religiously, even on overcast days. Make it a daily habit and be sure to apply enough sun protection to do the job. If you protect your face, neck, chest, forearms arms and hands correctly, a four-ounce bottle of sunscreen shouldn’t last longer than about two months. Remember, it’s better to be safe than “uneven-toned” or worse.

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

Dealing with Dark Spots

Kat — Sat, 30 Jan 2010 22:53:38 +0000

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.

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

Allergy & Acne-free Clothes

Kat — Sat, 30 Jan 2010 22:51:22 +0000

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.

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

Staying Clear

Kat — Sat, 30 Jan 2010 22:47:06 +0000

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.

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

Acne: Treatment Techniques

Kat — Sat, 30 Jan 2010 22:33:34 +0000

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.

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