Urban Skin Solutions, Oakland Acne Specialist, Ethnic Skin Expert, Black Skin Care » Sun

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.

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.

Raccoon Eyes, Puffy Lids and Bags

Kat — Sat, 30 Jan 2010 22:52:48 +0000

Facial structure can affect skin coloration in the orbital eye area. Prominent cheekbones and deep-set eyes, with light, translucent skin covering dark underlying tissue, can make the orbital eye area appear much darker than the rest of the face. Did a parent, grandparent or other family member also have dark circles? Facial structure and coloration can be hereditary. Were they smokers? Smoking causes severe dark circles, lips and gums and premature aging of the skin.

Genetic fat deposits under the eyes can appear in youth and gradually worsen with age. Under-eye fat can cause severe dark circles, especially just below the fat deposits, because they put pressure on those tissues. A safe, effective surgical procedure called transconjunctival blepharoplasty addresses excess fat through an incision placed inside the lower eyelid. It avoids the external incision, leaves no visible scar, and can be performed as early as the late teens or early twenties. Ask us for a referral to a board certified cosmetic surgeon.

Lack of sleep: Chronic lack of sleep, sleep disorders, frequent air travel, crossing time zones, graveyard-shift jobs and interrupted daytime sleep can lead to physical stress, causing dark circles, puffy eyes and other skin issues, including acne flare-ups. Manage your time before bed, create a consistent bedtime routine, sleep without your childen in your bed and get seven uninterrupted hours of sleep on a consistent basis. These changes will help improve skin problems dramatically.

Dehydration: Inadequate water intake causes dehydration and water retention, which can lead to dark circles, puffy eyes, bloating, low energy, dry skin and scalp, shedding hair and a darker, uneven skin tone. Coffee, tea, high sodium intake, sports and energy drinks, alcohol, medications, hard water, indoor heat, space heaters, smoking and secondhand smoke all significantly increase the body’s need to re-hydrate with water. Rule of thumb: Drink enough water to equal half your weight in ounces. For every dehydrating beverage and salty meal, drink extra water. Double your water intake if you must take antibiotics, diuretics, antidepressants, medication for sleep, allergies, sinus or colds, high blood pressure or diabetes, or any medication known to cause dry mouth.

Pressure-lowering eye drops and eyelash enhancing products can cause dark pigmentation on the eyelids and darken the color of the eye itself. Use exactly as directed and wear sunglasses.

Medication: Hormones, birth control pills and devices, antibiotics, antihistamines, diuretics, blood pressure and oral anti-diabetic drugs, antidepressants, painkillers, Accutane® and other drugs can cause severe sun sensitivity that leads to skin darkening. Skin lighteners, retinoids and other products can cause photo-sensitivity. Overuse of retinoids and anti-aging eye creams also cause irritation and temporary darkening. Longterm use of fluorinated steroid creams for itching in the eye area may lead to discoloration, thinning of the skin, swelling and broken capillaries.

Chemical irritation: Acne medications and cleansers that contain ingredients like benzoyl peroxide (BPO) can cause temporary darkening and swelling when applied too close to the eyes. Moisturizers applied simultaneously with BPO can cause them to migrate into to one another, darkening the skin in the eye area and diluting BPO’s action elsewhere. Cleansers that contain BPO, salicylic acid, alpha hydroxy acids, sulfur, fragrances and drying lathering agents shouldn’t be rinsed over the eyes. Perspiring during sleep can cause BPO to get into the orbital eye area. Bathing in hard water can dramatically dry out and darken the skin tone.

Contact dermatitis with symptoms that include itching, irritation, fine bumps and darkening can be caused by eye pressure drops, lash-enhancing products contaminated mascara and eye pencils, frosted eye shadows, D&C red dyes, scented skin, hair and laundry products, contact lens solutions, and by sensitivities to chemical sunscreens, skin lighteners, acne ingredients, alcohol or other cosmetic chemicals. Switch to matte eye shadows and fragrance-free products. Avoid make-up that contains red dyes. Keep acne medications and cleansers away from the eye area and if you perspire during sleep, wear BPO during the evening hours only and wash it off at bedtime. Replace mascara every three months and never share. Patch-test products that might be causing problems.

Metal eyeglass frames containing alloys like nickel can cause dermatitis around the eyes and on the brows, nose and temples. Those sensitive to nickel should choose Gucci-type plastic frames that are large enough to completely cover the eye area.

Out-of-control chronic allergies cause puffiness and dark circles. ‘Allergic shiners’ afflict both adults and children and run in families. Swelling, tearing, wiping, rubbing, blotting, scratching the eye area and failure to wear sunglasses and address the allergens that trigger allergy attacks are contributing factors. Old school antihistamines like Benedryl® cause dehydration, sun-sensitivity and drowsiness. Non-drowsy medications like loratadine (Claritin®) and fexofenadine (Allegra®) are better, but can still cause dehydration. Allergy symptoms and itchy puffy eyes improve dramatically when a saline sinus rinse like NeilMed® or a neti pot is used consistently two to three times a day. Eliminate cow’s milk, cheese and dairy products, which are known to trigger nasal congestion and increase mucus production. For more information, see: http://www.notmilk.com/kradjian.html

Explore and remove all irritants that trigger allergies, like dust, mold, pollen, dust mites, pet dander, fragrances, etc. Use a vacuum with a HEPA filter, stick to fragrance-free skin, hair, laundry and household products, sleep on fragrance-free bed linens (even when away from home), keep filters and air ducts clean, bathe pets often and use dander-remover. Wear a dust mask when you clean the house and work in the yard. Keep your car’s ventilation system on “circulate”, not “intake” from the outside to keep dust, pollen and particulate pollutants from getting into your eyes, nose and lungs.

Wiping and rubbing: Tearing, rubbing, wiping and scratching causes darkening because of friction and irritation caused by tearing. Remove eye make-up gently with a non-drying fragrance-free product. Pat dry after cleansing; never rub with a towel. Keep irritating cleansers, fragrances and chemical sunscreens away from the eyes. Avoid incense, smoke, wind and fans. Use caution with contact lenses, which make eyes more vulnerable to irritation and infection from debris, dust, pollutants, bacteria, protein build-up and rubbing. Replace lenses often and keep them clean. Wear UV-protective sunglasses, even on overcast days. At night, wear lightly-tinted sunglasses to protect your eyes from wind-borne debris, dust and pollutants.

Thyroid disease: Sun-sensitivity, darkening, puffiness, fluid retention and bulging in the orbital eye area, constant tearing, disturbed sleep cycles and delayed healing are symptoms that accompany Graves’ disease. Rubbing and wiping the eyes and not wearing sunglasses intensify the darkening.

Auto-immune diseases like lupus, rheumatoid arthritis, sarcoidosis, schleroderma, diabetes, thyroid disease, vitiligo and others increase sun-sensitivity, as can many medications often associated with treatment. Sun avoidance, protecting the skin from the sun with hats and physical sunscreen and wearing sunglasses are crucial to avoid skin darkening and severe reactions to the sun. Prolonged, unprotected sun exposure can also trigger an auto-immune response.

Obesity and sudden weight gain: Fat cells boost the body’s production of estrogens, which leads to sun-sensitivity and skin-darkening. The darkening can extend from the orbital eye area out onto the outer cheeks, face and neck. Drugs often associated with obesity including water pills, oral anti-diabetic drugs and blood pressure medications, dramatically increase sun-sensitivity. Sun avoidance, daily sunscreen and sunglasses will help slow down the darkening. Plan to get back to pre-medication weight. Cut back on salt, eliminate high sodium foods and dairy, increase water intake, reduce fat, simple carbs and sweets, and exercise regularly. These lifestyle changes will reduce weight and water retention, and improve blood pressure, general health, skin tone and self-esteem.

Sun exposure: Wear sunscreen and protective eyewear during even short episodes of sun exposure, including overcast days. The sun’s long UVA rays can penetrate clouds and windshields and cause dark circles, brown discoloration, skin cancer and premature aging, even on overcast days. 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.

Hormones: Pregnancy, hormonal imbalances and changes, hormone-containing medications and birth control devices, perimenopause and menopause can all cause sun-sensitivity, skin discoloration, dark circles, fluctuations in weight, mood swings and acne flare-ups.

Smoking: Cigarettes, cigars, clove cigarettes, blunts, weed and even limited exposure to secondhand smoke, fireplaces and incense can cause dark circles, especially on olive and deeper skin tones. Only a couple of cigarettes and small amounts of secondhand smoke can cause darkening on the eye area, lips and gums, along with the other well-known dangers of smoking. Now, we have one more valid reason to quit smoking and call an immediate halt to secondhand smoke exposure.

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.

Corrective products formulated to address darkening in the orbital eye area contain just enough fruit acid or retinoid to help active melanin-suppressing brighteners penetrate better. They also gently exfoliate and repair delicate under-eye skin, which helps reduce fine lines and improve elasticity and texture. Ceramides and moisture-building factors help hydrate delicate eye-area skin, which lacks sebaceous (oil-producing) activity and tends to dry out first. Wean onto active eye care products, starting every-other-night (if not using BPO). Apply very sparingly and massage gently until all traces have vanished into the skin. Overuse can cause dryness, temporary darkening of the epidermal cells, flaking, itching and redness. Avoid direct sun when possible, apply and reapply full-spectrum sunscreen and wear UV-protective sunglasses religiously.

Help with puffiness:

Sleep at least seven hours, with your upper body slightly elevated.
Decrease salt intake and eliminate processed foods, take-out foods, dairy products, salty snacks, sports drinks and soups.
Increase water intake dramatically and reduce intake of alcoholic beverages and caffeine. Eliminate soft drinks, sports and energy drinks, tomato juice, soup and all dairy.
Control allergies and stick to all needed lifestyle changes, including controlling exposure to dust, smoke, allergens, heaters, pollutants and fragrances.
Avoid scented skin care, hair care, household and laundry products.
Lose weight, quit smoking and wear sunglasses.
See an endocrinologist about diabetes, thyroid issues or if eyes are bulging and watery.
Consult a board-certified cosmetic surgeon about under-eye fat removal.

Help with loose, sagging skin around the eye:

Start with prevention, since sagging skin usually requires plastic surgery.
Avoid direct sun and wear sunscreen and sunglasses.
Keep weight stable. Frequent weight fluctuations contribute to sagging skin.
Don’t smoke or allow any secondhand smoke exposure.
Control allergies and their triggers so you don’t have to rub your eyes.
Use active skin care products consistently, including peptides, vitamin C serum, sunscreen and sunglasses during the day and gentle AHA and/or retinoid serums at night.
Consult a board-certified cosmetic surgeon about solutions for skin laxity.

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