Body Acne June 15, 2010

 

For many people acne is not just a problem on their face – they experience breakouts on their chest and back as well.   Of course, this can be as distressing as facial acne particularly as summer approaches and you want to wear a bathing suit or more revealing clothing.

The above illustration does a great job at representing the most common areas of on the body that breakout .  Why do the red areas above break-out the most?  Because that is where the sebaceous glands, or oil glands, are most concentrated on the body.  The above illustration also highlights the groin and buttocks area which can experience breakouts as well or what appears to be breakouts.  If you breakout in your groin or buttocks area it is important to see a dermatologist in order to investigate what exactly the breakouts in those areas are. 

The reasons for breaking out on your chest and back are the same reasons why you breakout on your face – clogged pores and bacteria.  To understand more why one breaks out see my earlier posts:  How Acne Forms and What Causes Acne.

  

Treatment Options for Body Acne

 

Treat your body acne like you would your facial acne.  The main frustration with treating back acne is not being able to properly reach the area that you want to treat.  There are a few ways to get around that issue.  You can use a loofah or sponge on a stick to reach your back when cleansing in the shower.  Acne.org sells a buddy body that helps you apply lotions and creams to your back.   Or if your anti-acne product is in a liquid form (like a toner) transfer it to a spray bottle so you can reach your back with ease.  If all else fails enlist someone in your household to help you apply your anti-acne products on your back.

Some body acne can be brought under control just by gently cleansing the skin and then applying a benzoyl peroxide cream or lotion in the evening.  I suggest using benzoyl peroxide in the evening since it can bleach fabric, and you don’t want to ruin your clothes.  Remember to exfoliate those areas like you would your face a few times a week.  Using an exfoliating product with salicylic acid would be perfect for body acne.

If your chest and back acne is more severe I suggest cleansing with a salicylic acid cleanser and then applying a benzoyl peroxide lotion or cream nightly.  In the morning you could tone those areas with a salicylic acid toner. 

Make sure that your body wash or soap doesn’t contain ingredients that can clog your pores like coconut oil.  And never use any form of alcohol to treat your body acne!  Alcohol is far too drying for anyone’s skin. 

When you use sunscreen on those areas be sure to use an oil-free one.  For instance, just use your facial sunscreen on those area. 

Shower immediately after exercising so that sweat and grime doesn’t have a chance to settle in your pores and clog them.  Make sure that you wear breathable fabric clothes so that sweat doesn’t get trapped on your back and chest.  Avoid irritating those areas or rubbing those areas too much.  There could be a small chance that your fabric softener is leaving a waxy residue on your clothes and aggravating your acne.  Experiment – forgo using fabric softener in your next two or three washes and see if that helps your body acne.

For those of you with long hair make sure that when your hair is covered in conditioner it isn’t sitting on your back while you shower.  After applying conditioner to your hair clip your hair up on top of your head until you are ready to rinse it out.  Conditioners contain a large number of heavy, fatty ingredients that can clog pores.

If none of the above suggestions help your body acne be sure to see a dermatologist for prescription products.

 

  

Recommended Products

 

• Clearasil Ultra Acne Clearing Gel Wash
• Acne.org 2.5% benzoyl peroxide gel
• Paula’s Choice Clear Extra Strength Targeted Acne Relief Exfoliating Toner

 

 

Sources and Further Reading

 

• Treating Body Acne – Skin Guru Yahoo! Health – by Dr. Leslie Baumann November 1, 2007
• Body Acne – acne.org

June is National Acne Awareness Month June 3, 2010

It turns out that June is National Acne Awareness Month. 

Did you know?

Nearly 80% of people will experience some form of acne during their lifetimes. Acne is the most common skin disorder in the United States, affecting 60 million Americans at any one time, according to the American Academy of Dermatology (AAD).

Here are some resources to find out more information about acne, its causes, and treatment options:

• Acne.org – my hands down favorite online resource for all information about acne
• Acne Month is a website set-up by the makers of  Differin and Epiduo.  This site is pretty good with lots good, basic information about acne and its causes.  Of course since it is sponsored by the manufacturers of prescription acne medications the site continually recommends that you go see a doctor for acne treatment.

 

Since I’ve suffered from acne ever since puberty I have a great personal interest in the topic.  No surprise – I’ve written about it a lot on this blog.  Here are some of my previous posts about acne:

• Hidden Acne Causes
• Can Over Washing Your Face Cause Acne?
• How Acne Forms
• What Causes Acne?
• Recommended Reading for Information about Acne
• Is Your Diet Causing Your Acne?
• Why was Accutane Taken Off the Market?
• Ingredient Spotlight: Benzoyl Peroxide
• Ingredient Spotlight: Salicylic Acid

 

If you have acne – don’t despair.  There are so many different treatment options available for acne.  There is a solution out there for your acne woes.

Ingredient Spotlight: Salicylic Acid May 31, 2010

 

I recently wrote about the anti-acne ingredient benzoyl peroxide so I thought it would be good to write about  another great OTC anti-acne ingredient – salicylic acid. 

Salicylic acid is a beta hydroxy acid that is a derivative of aspirin and functions as an exfoliant helping to loosen and expel comedones (aka blackheads and whiteheads – clogged pores) from the skin.  Salicylic acid also has anti-inflammatory properties which can help reduce the redness of inflamed breakout lesions.  So this combination of exfoliation and anti-inflammatory properties helps the skin heal, prevents scarring, and helps to decrease the chance of future breakouts.  Salicylic acid, which is oil soluble, is able to penetrate deeply into the pore helping to keep sebaceous follicles clear of cellular buildup and can help minimize the formation of new comedones.

In order for the salicylic acid product to be effective it should have at least a 1% concentration of the ingredient but preferably a 2% concentration.  But just as important is the pH level of the product.  The pH must be between 3 and 4 in order for the product to be effective.  Otherwise the salicylic acid is not effective as an exfoliant.  Of course, it is quite hard to determine the pH level of products on one’s own.  Though pH strip tests are available for home use I instead refer to the charts at the back of Lydia Preston’s excellent book Breaking Out (pages 207-208 and 210-212).  Preston tested the pH levels of different salicylic acid cleansers and lotions in order to determine which products would actually do what they claim to do. 

You might also find willow bark listed in the ingredients of products that claim to have salicylic acid in them.  When ingested orally willow bark is converted by the body into salicylic acid.  It is questionable if the same process takes place when willow bark is applied topically. 

 

Lastly, a lot of ob/gyns recommend that women who are pregnant or nursing not use salicylic acid because of its connection to aspirin.  Most likely a OTC product with 1 to 2% salicylic acid will not harm your child, but be sure to check with your doctor before using such a product during pregnancy or while you are nursing.

 

Recommended Salicylic Acid Products (taken from Breaking Out)

 

Cleansers:

• Clearasil 3 in 1 Acne Defense Cleanser
• Clearasil Total Control Deep Pore Cream Cleanser
• Clearasil Icewash Acne Gel Cleanser
• Neutrogena Oil Free Cream Cleanser
• Zapzyt Acne Wash Treatment

Lotions

• Aveeno Clear Complexion Daily Moisturizer
• Clean & Clear Blackhead Clearing Astringent
• Clean & Clear Clarifying Toner
• Neutrogena Blackhead Eliminating Astrigent
• Neutrogena Multi-Vitamin Acne Treatment Lotion
• Paula’s Choice 1% Beta Hydroxy Liquid Solution normal to oily

 

My Recommendation

 

Any Paula’s Choice BHA lotion, gel, or toner.  These products work and are easy to order online.  Buy samples if you aren’t sure that you want to invest in a whole regular size product.  I like the fact that you can use these as frequently or infrequently as you need to. 

 

Sources and Further Reading

 

• Breaking Out by Lydia Preston  – pages 55-57, 207-208, 210-212
• The Beauty Bible, 2nd edition by Paula Begoun – pages 239-240
• Willow Bark – Paula Begoun’s online ingredient dictionary
• Treat Your Oily Skin to Salicylic Acid – Skin Type Solutions Blog

 

 

Ingredient Spotlight: Benzoyl Peroxide May 26, 2010

One of the most common and easy to find anti-acne ingredients is benzoyl peroxide.  There is a simple reason for benzoyl peroxide’s availability – it works well as an anti-acne treatment particularly in conjunction with alpha hydroxy acids (like glycolic) or even better with salicylic acid products.  In the case of benzoyl peroxide there is both exhaustive and conclusive research that proves its effectiveness in fighting blemishes which definitely makes it a worthwhile ingredient to seek out if you suffer from blemishes.  

  

How Benzoyl Peroxide Works

 

Benzoyl peroxide works by destroying the acne causing bacteria in the hair follicles; benzoyl peroxide can penetrate into the hair follicle without causing too much irritation at the same time.  Benzoyl peroxide works by allowing the benzoyl to draw peroxide into the follicle.  Once the peroxide is in the follicle it releases oxygen that destroys the acne causing bacteria.  Additionally, benzoyl peroxide is anti-inflammatory and can help reduce inflammation around the hair follicles. 

  

The Upside and Downside to Benzoyl Peroxide

 

Benzoyl peroxide works quickly which is a definite upside about this product.  Another good thing about benzoyl peroxide is that it does not lose its effectiveness over time like antibiotics do.  Having said that many people have the perception that benzoyl peroxide does lose its effectiveness over time.    What really happens when someone perceives this problem is that benzoyl peroxide has done all that it can to heal the acne lesions, and in order to see further improvement the acne sufferer needs to add another anti-acne ingredient to their daily skincare regime like salicylic acid or a retinol. 

The downside to benzoyl peroxide is that it can cause irritation, dryness, stinging, and even bleach the clothes and hair of the user.  For that reason not every acne sufferer finds that they can use or want to use benzoyl peroxide.

 

 

Which Benzoyl Peroxide Product is Right for You?

  

Benzoyl peroxide can be found in face washes, creams, gels, and serums in both OTC versions and prescription ones.  Some of the prescription benzoyl peroxide products are combined with antibiotics which makes them super anti-acne fighting products and are good for those suffering from more severe acne.   You can find benzoyl peroxide in concentrations of 2.5%, 5%, and 10% in anti-acne products.  In higher concentrations benzoyl peroxide can be irritating, as already mentioned above, and as such it is a good idea to start out using the 2.5% concentration (my favorite 2.5% benzoyl peroxide product is pictured above) especially if your skin is more sensitive or on the dry side.  If you find cream or gel benzoyl peroxides to be irritating you can try a face wash that contains benzoyl peroxide since the active ingredient won’t stay on the skin for too long.  Begin by using the benzoyl peroxide product once a day, working up to twice a day, if necessary, once your skin has adjusted to the product.  Apply the product after cleansing but before your moisturizer, sunscreen, and make-up.

Another interesting point when it comes to benzoyl peroxide products is that a 2.5% concentration product can be just as effective as a 10% concentration product depending on the formulation of the product.  I always recommend that clients start out using a 2.5% benzoyl peroxide concentration product before trying a 5% or 10% product.  Depending on your acne and skin the lower concentration of benzoyl peroxide might be all that you need to help get your acne under control.

 

 

Sources and Further Reading

 

• Examining Over-the-Counter Acne Treatments by Zoe Diana Draelos, MD – Cosmetic Dermatology, July 2009, Vol. 22, No. 7
• Breaking Out by Lydia Preston – pages 51-55 and pages 82-84
• Healing Adult Acne by Richard G. Fried, MD, PhD – page 53
• The Beauty Bible, 2nd edition by Paula Begoun – pages 240-241

Hidden Acne Causes May 9, 2010

 

So perhaps for some people the topic of this post might seem like a bit of a stretch but bear with me.  Do you hold your cellphone up to the right side of your face?  Do you have breakouts on the right side of your face?  Do you forget to wash your pillowcase on a regular basis?  Can you never figure out the real source of your breakouts?

Both your cellphone (and your home phone) and your pillowcase are magnets for bacteria and dirt.  First think about your cellphone – you touch it without cleaning your hands, it falls and you pick it up, and then it usually stored in a dark, warm place (like a purse or a pocket).  All that adds up to a bacteria breeding ground.  When you press your cellphone into your face as you talk on the phone that bacteria is then transferred from your phone to your face.  According to a study your cellphone is the dirtiest object in your household!  So get those antibacterial wipes out and clean your cellphone (and all your phones) VERY often.

Your pillowcase holds onto dirt, debris, bacteria, and microscopic bugs and dust mites which can make it an acne causing stew.  And if you have sensitive skin make sure you use a laundry detergent that is free of fragrance, unnecessary chemicals, and colors since all these ingredients can irritate sensitive skin.  I make sure to wash my pillowcase once a week since I also usually sleep with wet hair covered in five million heavy and creamy hair care products. 

And speaking of hair care products make sure you use separate towels for your hair, face, and body.  Yes, I have three different towels in my bathroom for daily use.  You wouldn’t want your pore clogging hair care product to accidently be transferred to your face and cause breakouts.  Keep your towels separate and wash them on a weekly basis.

Sources: 

• Complexion Perfection! By Kate Somerville – pages 25 and 26
• Mind-Beauty Connection by Amy Wechsler, MD – page 45, third paragraph paperback book

13 Reasons You Should Get A Chemical Peel From An Esthetician April 11, 2010

I think chemical peels are great and not just because they are part of my repertoire as an esthetician.  I like to think of chemical peels as a “reboot” for your skin allowing healthy skin appear.  A series of chemical peels can help treat a myriad of skin issues.  There really is no reason not to try one.

This post addresses the issue of chemical peels performed by estheticians.  There are plenty of “peels” that are available for home use.  Peels that you use at home provide very superficial peeling, simply exfoliation, and can help you maintain even toned, healthy skin.  Chemical peels performed by estheticians have a lower pH than home use products so that they can penetrate much deeper into the skin, will normally cause you to turn red, a lot of time your skin will peel following a peel, and these peels, when performed in a series, can treatment skin conditions such as hyperpigmentation and acne.  Simply put – a chemical peel performed by an esthetician will do a lot more for your skin than a home use product called a peel.

What Are Chemical Peels?

There are many different types of chemical peels, and each company that sells peels has its own series of formulations.  Having said that the chemical peels used by estheticians are generally a solution that has a combination or sometimes just one alpha hydroxy acid (AHA) or beta hydroxy acid (BHA).   The solution is applied to the skin, normally in layers though some peels are simply one layer, like a treatment mask.  The peel is either removed at the end of the treatment or left on to self-neutralize.  The acids in the peel work to dissolve the top layers of the skin creating a controlled wound and thus allowing the skin to regenerate itself.

Reasons to get a Chemical Peel

A chemical peel will:

1. Improve the texture of your skin
2. Increase the cell turnover rate of your skin
3. Improve your skin’s ability to hold moisture
4. Help your skin produce more collagen
5. Reduce fine lines
6. Decrease hyperpigmentation
7. Unclog pores and help clear up acne
8. Leave your skin smooth
9. Make your skin softer
10. Make your skin look more even-toned
11. Give you a “glow”
12. Make your skin look dewy
13. Improve minor scarring

A chemical peel cannot make dramatic improvements to deep wrinkles or very sagging skin.  Conditions like that need to be treated with lasers or cosmetic surgery.

Who Can Get a Chemical Peel?

Truthfully pretty much anyone can get a peel as long as they don’t have any of the contraindictions listed below for peels.  Generally people with darker skin need to take more precautions before getting a peel and must make sure that the peel they are receiving is formulated for their skin type.  The reason for this is that very strong chemical peels can actually cause more hyperpigmentation on darker skin.

Contraindications:  It is generally recommended that pregnant and nursing women not receive peels since there are no studies, as of yet, about the effects of peels on fetuses or nursing babies.  You cannot get a peel if you have been off Accutane for less than 6 months.  If you are prone to cold sores a peel can actually bring on an outbreak so you need to take anti-viral medication before, the day of, and the day after your treatment.  Also if you have a tendency to scar, are taking antibiotics, have cancer or an autoimmune disease, or have an open sore you cannot get a chemical peel.

Everyone’s skin will be more sensitive to sunlight following a peel so make sure that you have plenty of sunscreen on hand after your peel, and be sure to vigilantly apply and reapply your sunscreen after a peel.  Hopefully the esthetician who performed the peel will either include post-peel products in the price of the peel or have them available for purchase at a reasonable price.

Make sure that the esthetician who is performing the peel has asked you an extensive list of questions before going ahead with your peel.  An esthetician must keep many factors in mind before performing a peel so that the client gets the best possible result with the fewest possible side effects.  You will be asked questions about medical conditions, allergies, the products you are currently using, and the results you want to achieve.  You may also want to go with a lighter peel the first time you get a chemical peel and build up the strength of your peels from there.  All of these issues should be discussed with your esthetician before you receive your first peel.

How Are Peels Performed?

Before you get a peel you should exfoliate at home or have a professional microdermabrasion treatment so that your skin in properly prepped for the peel.  Your skin will be cleansed and “degreased” before the peel is actually applied.  This means that all surface oils and debris are removed so that the peel can penetrate properly.

How Does It Feel?

Generally you will feel a warmth over the area being peeled during the procedure.  The esthetician performing the peel will either fan the area being peeled or provide you with a small electric fan to hold over the area.  You may feel stinging, burning, and even itching while the peel in performed.  Those sensations will stop once the peel is over.  Your esthetician will check in with you throughout the peel so if you ever feel any great discomfort she or he will know to stop the peel immediately.

What to Expect After a Peel

As I already mentioned first and foremost your skin will be quite sensitive to the sun following a peel so be extra vigilant about sunscreen use following your peel.   Because of this it usually isn’t a good idea to get peels in the summer or right before going on a vacation to a warm climate.

Following a peel your skin will feel tight and then a little dry.  You may remain red for an hour or so following the peel.  If you peel after the chemical peel treatment peeling will begin approximately 3 to 5 days following your peel.  The extent of peeling varies according to the person and the depth of the peel.  Not everyone peels following a chemical peel actually.  Some people have some mild itching following their peels.

Keep In Mind

Because chemical peels are stimulating you actually need to modify your lifestyle behavior slightly following a peel so that you don’t cause any unneeded irritation or hyperpigmentation to your skin.  So following a peel avoid excessive exercise with sweating for a few days.  Don’t scrub or pick at your face.  You cannot use retinol products or AHA products for at least 10 days following your peel.  And avoid any sort of excessive heat source like a sauna or hot tub.

How Often Can You Get a Chemical Peel?

Generally it is best to get a peel every four to six weeks.  But if you suffer from acne there are some peels that you can do every two weeks until you get the results you want.  Generally it is a great idea to buy a series of four or five peels up front so that you can achieve the treatment results that you want.  Also when you buy a series of peels upfront you will probably receive a discount.  Consider buying a deal that allows you to get chemical peels interspersed with microdermabrasion treatments or facials.  The microdermabrasions and the facials will enhance the results of the peel by helping to exfoliate the flaky skin you have on your face.  These treatments will also help prep your skin for your next peel.

When Will You See Results?

Truthfully chemical peels can be a bit unpredictable.  Some people see results as little as 10 days after their peels.  Other people won’t see results until about three weeks following their peel.  And for people who receive many facial treatments a chemical peel may just enhance the normal way their skin always looks.

Sources and Further Reading

• Cosmetic Procedures: Chemical Peel Treatments  – WebMD
• Chemical Peels – Paula Begoun
• After Glow – Allure
• The Art and Science of Chemical Peels –   LNE and Spa – February 2011

Acne Marks and Scars: Treatment Options April 7, 2010

Once your acne has cleared you may be left with unsightly marks and scars on your skin which can remain for months, years, or even permanently.  For this reason acne marks and scars can be just as upsetting to the acne sufferer as the acne itself.  But before you despair there are lots of treatment options available to get rid of both acne marks and scars.

Post-Inflammatory Hyperpigmentation

The mark left on the skin from an inflamed acne lesion is a macule or a “pseudo scar” which is a flat, reddish spot on white skin, and brown, black, gray, blue, or even blue-black on skin of color.  This form of hyperpigmentation it is not raised or sunken.  This mark indicates that the inflamed acne lesion is in its final stage.  A mark like this can remain on the skin anywhere from a few weeks to six months or longer depending on how deep the damage extends into the layers of the skin.  For more information about post-inflammatory hyperpigmentation and how to treat it please see my previous post Help for Hyperpigmentation.

Acne Scars

Though post-inflammatory hyperpigmentation is unsightly and may take many months to heal, acne scars are a more troubling reminder of past acne lesions since they simply do not fade or heal with the passing of time.  Scars are reminders of injury to tissue and the body’s attempt to repair that injury. There are two main types of acne scars:  hypertrophic and atrophic.  Both are formed in the same way – inflamed lesions destroy a portion of the dermis and along with the collagen in that area.  There is no way to predict who will scar, how deep the scars will be, and if they will improve over time.  Most frequently scars result from severe inflammatory cystic, nodular acne.  Though by no means a perfect solution, one way to prevent scars or to ensure that they aren’t very severe is to treat acne as early as possible and for as long as necessary.  The faster you respond to the inflammation in the skin the more likely you are to prevent scars.  Though this, of course, is no guarantee that scars will not develop it is a way to perhaps help ensure they will not be deep scars.

Hypertrophic scars are created when the skin responds to injury by overproducing new collagen.  This type of scar is also called a keloid scar.  The excess amount of collagen that forms gets piled up in fibrous masses thus resulting in protruding, firm, and smooth scars.  Typically these scars are 1 to 2 millimeters in diameter, but some may be much larger – 1 centimeter or more.  Keloids can be red or purplish in color and most significantly, keloids extend above the skin’s surface.  This type of scar can hurt, be itchy, and even become infected.  There is a genetic connection when it comes to the formation of keloids with such a condition running in families, and the cause of this type of scar is not completely understood.  Unfortunately, once keloids develop they can grow both uncontrollably and unpredictably and even recur after treatment.  Keloids can be treated with localized injections of corticosteroid or interferon.  Laser treatments can be combined with steroid treatment in order to avoid a recurrence of scars.  Cryotherapy, the freezing of keloidal scars, can also be combined with steroid injections as a removal option.  There are also a few unproven therapies that might help keloids like using silicone sheets applied directly to the scar or applying creams such as Mederma and Aldara.  Sadly keloids remain difficult to treat and, as already mentioned, may even return after treatment.

Atrophic scars are caused when the damaged collagen only partially, or not at all, grows back.  This leaves a depressed area in the skin.  The website skincarephysicians.com/acnenet lists five different types of atrophic scars that can occur because of acne:

• Ice pick scars that usually occur on the cheeks.  They are usually small and can be either shallow or deep, dark or soft to the touch.
• Depressed fibrotic scars that are usually quite large and have sharp edges and steep sides.
• Soft scars which are usually small and circular in shape.  They can be either superficial or deep  and are soft to the touch.
• Atrophic macules are soft and often have a slightly wrinkled base.  They are small when they are on the face but can be a centimeter or larger on the body.
• Follicular macular atrophy usually occurs on the chest or back.  These scars are small, soft, and white.

Atrophic acne scars cannot really be completely eliminated but with both resurfacing treatment and fillers they can be improved about 80%.  By seeing how a scar reacts to gentle stretching you can get a rough idea of what type of treatment would be best for you.  Shallow or soft-sided scars will almost or totally disappear when the skin is pulled taut; these types of scars can be corrected with resurfacing and fillers.  Scars that cannot be stretched out when you pull the skin generally require surgical excision to correct.

Numerous treatments exist for atrophic scars.  They include: excision, dermabrasion, chemical peels, laser treatments, skin fillers, and implants.  Very briefly I will describe each of these procedures:

• Excision is used for ice pick scars and is done with a small surgical instrument whose size matches that of the scar being treated.  The entire scar area is punched out with the instrument.  There are variations on this technique, and it is combined with dermabrasion and laser treatment for the best result.
• Dermabrasion is performed by doctor who uses a motorized tool with a metal head or a wire brush to remove the epidermis and the papillary layer of the skin.  Though tissue damage occurs it initiates a healing process by which new collagen is formed.  Though this is a very effective treatment for scars problems though pigmentation problems can develop even when the procedure is done properly.
• Light chemical peels work by removing dead skin cells and promoting the production of collagen.  You need between four to eight light peels in order to see results.  Doctors can perform deep chemical peels that usually remove part of the epidermis.  This leads to collagen remodeling and renewal of the epidermis.  Trichloroacetic acid (TCA) is usually used for the deep peels, in concentrations of 20 to 70%.
• Two types of laser treatments exist: ablative and nonablative.  Ablative lasers destroy tissue while nonablative target only a specific area and not do destroy tissue.  In both cases the regeneration of the epidermis occurs.
• Skin fillers plump or elevate the area of the skin that is sunken.  Fillers fall into two main categories: biodegradable or permanent.  Biodegradable fillers are made from either human or animal tissues.  The body metabolizes these substances eventually and then most, if not all, of the benefits are lost.  The rate at which this metabolism occurs depends on the substance used and the individual’s unique characteristics.  There are both cow and human collagen fillers as well as hyaluronic acid fillers available.    Also fat from another area in the patient’s body can be injected into the face.  Permanent fillers are usually made from silicone and are supposed to stay in place pretty much permanently (as their name indicates), but silicone fillers are surrounded by controversy because of their link to autoimmune diseases and allergic reactions that can occur from their use.
• Implants are the least commonly used technique to correct acne scars.  These are skin grafts that use skin from another area of the patient’s body.  This graft is implanted in the dermis beneath the acne scar.  Additionally, Synthetic implants made from polymers can be implanted beneath acne scars.

There are numerous treatments available that can significantly improve the look of acne marks and scars so there is no need to be unhappy with your appearance if you have post-inflammatory hyperpigmentation or acne scars (or both).  In order to find out what your best treatment option is it is important to talk to a qualified medical specialist.

 

 

Sources and Further Reading

• AcneNet – Acne Scars American Academy of Dermatology
• Breaking Out: A Women’s Guide to Coping with Acne at Any Age by Lydia Preston – chapter 13
• Dr. Susan Taylor’s Rx for Brown Skin: Your Prescription for Flawless Skin, Hair, and Nails by Dr. Susan Taylor – chapter 11
• Healing Adult Acne: Your Guide to Clear Skin And Self-confidence by Dr. Richard Fried – chapter four
• Acne Scars Can Be Solved – Daily Beauty

Can Over Washing Your Face Cause Acne? April 4, 2010

For some reason the idea exists that if you over wash your face – that is wash your face too many times during the day or use a cleanser that leaves your face feeling “squeaky clean” – your body will begin to  produce more oil and you will get more acne.  Now if this was true – how would there be anyone with dry skin?  And since there are many people who have dry skin obviously there must be another explanation here for this theory.

The issue here isn’t over washing your face.  The issue is really balance.  It is actually quite easy to over wash your face so it is important to find the right cleanser for your skin type.  You never want to use a cleanser that consistently makes your face feel dry and tight.  And that “squeaky clean” feeling?  You never want that feeling when it comes to washing your face.

Over washing your face can lead to irritation and redness.  Over washing your face breaks down the very top layer of the skin, the stratum corneum, and that leads to bacteria entering your skin since your skin can no longer protect itself.  More bacteria can mean more acne.  Over washing your skin can lead to excessive dryness which in turn can cause inflammation.  Since acne is an inflammatory disease more inflammation can lead to more acne.

(Please see my earlier posts What Causes Acne? and How Acne Forms for more in-depth information about acne.)

I do think that cleansers that contain additional, active ingredients like salicylic acid, benzoyl peroxide, or glycolic acid can be beneficial for the skin – in moderation.  At the first sign of flaking, irritation, dryness, or redness take a break from using such a cleanser.  In my opinion only teenagers or young adults with moderate to severe acne should and can use a cleanser with salicylic acid or benzoyl peroxide twice a day.  Remember – the cell turnover rate for a teenager and young adult is very high so their body is constantly shedding and producing new skin cells. As such cleansers with added active ingredients are less likely to cause them irritation and more likely to help their skin. 

Once you are in your mid-20s and certainly once you are in your 30s I recommend using a mild cleanser on a daily basis.  (For more information about how to wash your face see my previous post – Is There A Correct Way To Wash Your Face?)  If you suffer from breakouts I do think it is a good idea to have a cleanser with salicylic acid or benzoyl peroxide on hand to use once or twice during the week or a few times a month.  You can definitely have a cleanser with glycolic acid on hand to use twice a week or so to exfoliate, as long as you aren’t using other products with AHA or a retinol. 

 

It’s all about balance

 

You want to clean your face without drying it out or irritating it.  You can still remove all your make-up, extra oil, and dirt from your face without stripping your face of its needed protective barrier.  Keep in mind that healthy skin is soft, moist, and slight acidic.  Over washing your face will upset that “ideal” balance.  So when it comes to washing your face – less is definitely more.

 

Recommended Mild Cleansers

 

• Dermalogica Special Cleansing Gel
• Skinceuticals Gentle Cleanser
• Replenix Fortified Cleanser
• PCA Facial Wash
• PCA Creamy Cleanser

 

 

Stress and Your Skin April 3, 2010

Last Saturday I spent the day at McCormick Place in Chicago attending the Face and Body Conference Midwest.  While there I had the opportunity to attend a few lectures on a variety of topics from skincare ingredients to treatment options to marketing strategies.

The first class I attended last Saturday was called “Cutting-Edge Ingredients” and the speaker was Rebecca James Gadberry from YG Laboratories.  The class covered numerous topics, and the first topic covered was stress and the skin.  At the end of the section of the lecture on stress Rebecca Gadberry recommended that everyone read the book The Mind-Beauty Connection by Dr. Amy Wechsler for further information about how stress affects the skin.  This is a book I’ve already read and recommended here on my blog (see my previous post with my review).  The information in this post is taken from both the lecture I heard and from Dr. Wechsler’s book.

As you probably already know stress is bad for you, very bad for you.  Stress is also terrible for your skin.  As a matter of fact too much stress triggers your skin to start the aging process prematurely leading to wrinkles and fine lines before you want to have them.  Stress can actually age you three to six years, at least.  And not only that – stress can create a vicious cycle that just continues to affect the way you look – stress affects your looks, you become unhappy with your appearance, this leads to you becoming unhappy in general and you can’t cope with stress well, and then your looks suffer yet again.  This holds true for both women and men.

Stress causes the hormones in our body to begin to operate ineffectively and to become unbalanced.  When hormones do not work properly our bodies suffer in many ways – for example stress can lead to health problems and diseases.  In addition, skin conditions such as acne, psoriasis, eczema, and rosacea can all be affected and worsened by stress.  Stress can make us feel tired and weak and unable to cope with life.   Furthermore, when we are under stress our body release a number of hormones including adrenaline and cortisol that begin to wreak havoc on our skin when these hormones stay in our bodies for a long time (for instance when we are under chronic stress).  For a much more in-depth discussion of this topic see chapter 5 of Dr. Wechsler’s book “How Stress Gets Under Your Skin”.

There are a few different ways stress can affect your skin.  They include the following:

• Cortisol degrades collagen and directly leads to the formation of wrinkles in the skin.  When you live in a chronic state of stress your body finds it harder and harder to repair itself naturally and so you develop more wrinkles and fine lines.
• The stress hormone CRH can fuel inflammation in the skin and that in turn can cause acne.  Since acne is an inflammatory disease all it takes is in increase in inflammation in the body to cause more acne.  And if you are stressed you are more likely to pick at your breakouts which could lead to even more breakouts.
• Stress hormones can cause your body to release histamines which can cause a range of skin conditions like dermatitis, irritation, hives, or inflammation or aggravate existing skin conditions like psoriasis.
• Stress can make your hair fall out and make your nails brittle
• Stress makes your eyes look tired.  This could be because you are not getting enough sleep since you are stressed out.  A chronic lack of sleep could lead to fluid stagnation under the eyes and then dark, puffy under-eye circles in the morning.
• Stress could cause your skin to enter mini-menopause.  A chronic flow of cortisol causes a drop in estrogen which means your skin produces less collagen and less moisture.  Your skin could end up looking dull and dry as a result.

 

So what can you do to prevent this seemingly endless flow of bad hormones and skin problems?  Learn ways to cope with stress better, try meditation, exercise, and find ways to get enough sleep.  Any of these behavior changes will cause your stress level to drop.  Nourishing your body and soul in a healthy way will go a long way to helping you cope better with stress and to attaining the healthy skin you desire.

 

Further Reading

As I already mentioned most of the information in this post was taken from The Mind-Beauty Connection by Dr. Amy Wechsler.

• Chapter 4: Nine Days to a Younger-Looking (and feeling) You – will help you figure out which stress profile you are and will give you great tips on how to cope with and even overcome the stress in your life.  The chapter includes skincare advice, food tips, and lifestyle suggestions.
• Chapter 5: How Stress Gets Under Your Skin – goes into great detail about what happens to your body when you are under stress.
• Chapter 6: Skinology – explains how the skin works and behaves and how stress affects the skin.

  Also read this article:  Managing Stress Can Help Clients Improve Their Skin Conditions – Skin Inc.

Ridiculous iPhone Apps? Part 2 March 30, 2010

I had written earlier in this blog about iPhone apps that claim to help treat acne.  See my post Ridiculous iPhone App?  for more details.  In my previous post I pointed out that claiming an iPhone app can help clear acne with the use of light therapy was silly and down right misleading.

Much to my great surprise I came across the following blog post from Dr. Leslie Baumann (The Skin Guru on Yahoo! Health, whose blog I have mentioned already numerous times in my blog) actually telling her readers that such apps are worth a try???!!!  I found this advice quite amazing in light of all the advice from other physicians that such apps do not work, provide acne sufferers with false hope, and can even be harmful. 

Here is Dr. Baumann’s post:

Wouldn’t it be great if you could erase acne and wrinkles while chatting on the phone? Well, two new iPhone apps promise to do just that!AcneApp and Atomic Red both harness the iPhone’s light emitting diode (LED) screen to emit wavelengths that can benefit skin. The principle is the same as that behind the red and blue light therapy offered in your dermatologist’s office–albeit on a much less powerful scale–which has been shown to kill acne-causing bacteria, reduce inflammation, and treat wrinkles by boosting collagen production.

AcneApp uses alternating pulses of blue and red light and is purported to have anti-aging in addition to pimple-fighting properties, while Atomic Red promises to ease muscle and joint pain as well as firm sagging skin (a third app, Atomic Blue, is intended to treat seasonal affective disorder).

While I think this is a genius idea, I doubt the iPhone is powerful enough to have much efficacy. But for $1.99 per app, it sure is worth a try!

These could be fun and perhaps slightly effective self-treatments for periods between in-office light treatments from a board certified dermatologist. Such treatments cost around $75 per visit, are painless, and require no downtime; in my experience, they are more effective as an acne treatment than for anti-aging (there are other lasers, such as the Pearl and Fraxel, that work far better on wrinkles and sagging skin). The number of treatments required will vary depending on severity of your acne.

 

Once again, I am extremely surprised that a dermatologist would actually semi endorse such an iPhone app and even encourage her readers to give it a try.  Please read my earlier post to understand why most doctors disagree with the use of such iPhone apps.