Archives for July 2016

Aging in Ethnic Skin

Take a look at the images below – Halle Berry and Nicole Kidman – similar in age yet you can see more lines and sagginess in Nicole’s face – especially around her eyes. While these women both look amazing for being in their late 40’s, Halle maintains a much younger looking appearance.

There is an age-old adage, “black don’t crack” that I hear a lot as an African American woman and dermatologist. The adage refers to the tendency for people with darker skin to retain their youthful appearances, despite advancing in age. There is some interesting science behind this idea that people with darker skin do not age as early as their light-skinned counterparts. It turns out that genetics do play a helpful hand in helping those with darker skin tones to age later.

When we talk about aging, there are two elements to consider: Chronological aging and photo-aging. The first part of this – chronological – is the actual passing of years. We cannot stop the passing of years that will leave their mark. Photo-aging is aging that happens as a result of damage from Ultraviolet (UV) light. Darker skin contains more melanin which protects the body from UV rays. When there is less melanin, there is more chance of damage to the elasticity beneath the skin’s surface. This damage causes wrinkled, dry skin. Additionally, the body will attempt to produce additional melanin as a defense mechanism, but this can result in age or liver spots on the surface of the skin which also contribute to an older appearance.

Despite the genetics that help African American woman retain their youthfulness, a good skincare routine will go a long way to ensure that skin remains healthy and glowing. Living a healthy lifestyle is also important – if your diet is lacking and you aren’t getting enough sleep it’s going to show! Genetics alone are not going to protect anybody from the signs of aging!

Aging gracefully

I believe that everybody should be allowed to age with grace – in their own personal way. Proper skincare routines started from an early age will help to ensure healthy skin and will go a long way to help prevent the signs of aging coming too early. Once the aging process begins, there are plenty of non-surgical options that will help to mask the signs of aging.

My personal anti-aging routine is as follows (affiliate links):

1. I wash my face a with a gentle cleanser twice a day. Some brands I love are Vanicream Facial Cleanser, Hydropeptide Cleansing Gel, and Cetaphil Facial Cleanser.

2. I have acne, so I then apply my morning acne medication, followed by a moisturizer with sunscreen. I love Aveeno Positively Radiant and CeraVe AM Lotion. They both have SPF 30, which is a great sunscreen for the cooler months. In summer time, I use Spf 50 for added protection.

3. Once a week, I use a home peel. My current favorite is the Hydropetide Plump and Polish Peel, which has microdermabraision crystals that help minimize the appearance of my prominent pores.

4. As I am in my mid-thirties, I have now started to pay a little bit more attention to preventing aging around my eyes, so I use an eye cream called Eye Authority as well as a lash product that has resulted in fabulous thick eyelashes.

5. Twice a year, I get Botox in my forehead which helps me maintain a soft, wrinkle free look.

6. Lastly, I get chemical peels every 3 months, for added deep exfoliation and prevention of dark spots, and fine lines and wrinkles.

Feeling The Burn – Helpful Tips For Managing Sunburn

This time of year always brings an influx of patients that are suffering from sun-related damage. This week brought two serious conditions that I thought would be worthy of sharing here – each of them had a lasting impact on me because in both cases they were entirely preventable. Ultraviolet rays (UV) from the sun are very powerful and can do a lot of damage. This damage is preventable with sunscreen.

One of my patients this week was a teenage girl presenting with a rash on her face. She had recently suffered from a bad sunburn which then turned into a pretty nasty looking rash that spread throughout her cheeks.

Sunburn and Shingles

The rash, it turns out, was shingles. Anybody that has had chicken pox will have the varicella zoster virus in their central nervous system. This virus remains dormant until there is trauma or other factors that weaken the immune system. In this case, the sunburn was enough trauma to trigger the virus and reactivate a shingles outbreak.

Can Sunburn Trigger Shingles?

A very unfortunate reaction, shingles are not fun. If caught early there are some options to treat with antiviral medication. People often try to wait out this rash and only seek treatment when it is too late to medicate. The rash that appears with shingles is blistery and often very painful with burning and itching that can last a month. A tough price to pay for too much fun in the sun!

If you experience a sunburn, the best thing you can do is treat your skin to help reduce the pain and also heal the skin. From the AAD:

Take frequent cool baths or showers to help relieve the pain. Gently pat yourself dry and immediately apply a moisturizer to help trap water in your skin.
Use a moisturizer that contains aloe vera or soy to help soothe sun burned skin. An over-the-counter hydrocortisone cream can be used on areas that are especially uncomfortable.
Consider taking aspirin or ibuprofen to help reduce any swelling, redness and discomfort.
Drink extra water.
If your skin blisters, allow the blisters to heal. Blistering skin means you have a second-degree sunburn. You should not pop the blisters, as blisters form to help your skin heal and protect you from infection.
Take extra care to protect sunburned skin while it heals.

Sunscreen application should be a top priority when spending time outdoors. I find that many people do not actually apply sunscreen correctly and therefore risk burns. The infographic below is a nice demonstration of how much sunscreen you should be using for an adult. One shot glass full should be adequate for the average adult body.

The second patient that left me with a lasting impression this week was a 28 year-old male diagnosed with Stage 2 Melanoma. This young male is an athlete and spends a lot of time outdoors – without ever using sunscreen! This man has damaged his skin and will now have to endure treatment for this melanoma (including a large scar where the melanoma will be removed) and be diligent about sun protection and skin checks the rest of his life.

The weather is going to be beautiful in Boston this weekend. Grab some sunscreen and get outside to enjoy it!

Skin Cancer Does Not Discriminate

A few months ago, around the time of Bob Marley’s birthday, I shared an image on Facebook that was well circulated. The message I was spreading is that ‘Skin Cancer Does Not Discriminate’. Many people aren’t aware of the fact that Bob Marley died of skin cancer. He was only 36 years old and passed off a sore on his toe as a soccer injury. There is a common misconception that individuals with dark skin are not at risk for skin cancer. In fact, when skin cancer is diagnosed in dark skin, it has often already reached later stages and therefore the individual is more likely to die from the disease!

In the last few weeks we’ve seen Consumer Reports issue their Sunscreen Report and the EWG issued their 2016 Guide To Sunscreen. The news has been full about skin cancer related facts. This is all for good reason. Skin cancer is the most common form of cancer in the United States. Also, when detected early, skin cancer is almost entirely curable.

Diagnosing Skin Cancer in Minorities

Skin cancer presents the same regardless of what color your skin is. Learning the ABCDE’s of Melanoma is a key factor in knowing what to look for on your own body. Moles may be more difficult to examine in dark skin but there are some additional things you should pay attention to:

Know your body.If you have a spot (such as a scratch or pimple) and it isn’t healing as quick as usual, get it checked by a dermatologist. Generally, most small spots will heal in about a week, maybe two. Mr. T, a famous wrestler in the 1980’s, saw his doctor for a small spot on his ear that wasn’t healing. It turned out to be a form of cutaneous T-Cell lymphoma, which is lymphoma that is usually localized to the skin, but can also be systemic. This goes to show that noticeable changes that are not healing should be checked.
In dark skinned people, skin cancer is more likely to occur in places that we generally wouldn’t think of. Check the soles of your feet, the groin area and nail beds. This is referred to as Acral Lentiginous Melanoma and is the type of skin cancer that resulted in the death of Bob Marley

image source: http://healthh.com/wp-content/uploads/2014/07/acral-lentiginous-melanoma-pictures-3.jpg

Areas that have experienced chronic skin trauma (lesions on the skin from lupus, scars from burn injuries or diabetic ulcers) have an increased risk for developing types of skin cancer. Be sure to keep these protected from the sun and consult your doctor if you notice any changes to the color or size of the area.
Certain ethnicities are predisposed to skin cancer so regardless of the color of your skin there may be a genetic consideration. For example, if you have a really dark complexion but have some Irish genetics then you will have an increased risk for skin cancer.

Protecting Your Skin

A person of color will have a natural protection of about 13 SPF, but SPF of 15-30 is essential for everyone. I recommend SPF 30 for everyone. Regardless of your skin color, you should be using sunblock on a daily basis – choose a product that is broad spectrum (to block UVA and UVB rays) – and reapply every two hours when outdoors (more frequently if you are swimming or sweating). Check out the two posts below for some tips on how to select & apply sunscreen and how to keep your kids safe in the sun. Lip Pump Plumper

The Best Sunblock For Dark Skin

In my opinion, the best product to use for sun protection is a mineral-based sunblock. As a black woman, I know that it is frustrating to find a product that works well but also applies easily. Mineral-based sunblock is notorious for being thick and difficult to apply, leaving a white discoloration on the skin. Even my Caucasian patients often express their concerns about this. My personal recommendations include EltaMD Pure and La Roche-Posay Anthelios Mineral.

Soothe Your Skin – A Review Of Hydropeptide’s Soothing Serum

As a doctor, nothing makes me happier than hearing success stories when I have helped to improve somebody’s health or appearance. Today I’m sharing an update from one of my patients who was going through redness and inflammation in her face. She is a mom to three little kids and noticed that a lot of her skin changes happened when pregnant and breastfeeding – but after weaning her youngest child her skin didn’t clear up as expected. Another dermatologist had previously diagnosed her with Rosacea and prescribed a prescription that was going to be very expensive and possibly not provide any results. I suspected that inflammatory acne was to blame for the irritation and prescribed an over the counter acne medication called Obagi Clenziderm solubilized benzoyl peroxide and a light moisturizer.

Human Eye, Human Face, Women.

The patient started using the over the counter acne medication. This cleared up the acne but she was left with redness throughout her cheeks, nose and forehead. I suggested that she try Hydropeptide’s Soothing Serum.

Hydropeptide is a brand that I 100% stand behind. I use many of their products for myself and have been happy with the results. The products are ‘clean’ and use powerful peptides that work on a cellular level. The Soothing Serum that I recommended to this patient is formulated with calming peptides and a botanical stem cell that reduces the appearance of redness while comforting sensitive and irritated skin. The serum also strengthens the skins natural defense system, restores hydration and promotes rapid recovery from skin resurfacing procedures.

When using this product, remember that a little bit will go a very long way. A pea-sized amount will be enough to cover your face and once a day application should be enough (unless you have extreme irritation in which case you would apply twice a day). You can order direct from Hydropeptide.

Direct from my patient:

‘Hydropeptide Soothing Serum has been a game changer for me. The texture of this serum is really nice and it has a light, subtle scent. I use it immediately after washing my face, and let it soak in for a few minutes before applying a light moisturizer. Within two weeks, my skin was no longer irritated and felt so much smoother. Thank You Dr. Ip for helping clear my skin!‘

I recently saw this patient again and her skin is looking so much better. She has been able to scale down use of the acne medication to once every two to three days and is finding that the soothing serum keeps the redness to a minimum. If you suffer from skin redness related to rosacea or post-inflammatory redness from acne, try Microneedling Serum.

Bugged Out!

The mosquito’s are officially out. These things drive me crazy!! Bites from mosquito’s (and other insects) cause irritation but can also have longer lasting health issues. Insect repellent can help to protect you from bites but selecting the best product can be so difficult. The decision of what type of insect repellent to use will vary based on where you are spending your time, but there are some important considerations.

DEET

DEET is probably the most commonly known chemical insect repellent which you will likely recognize by its overwhelming odor. DEET has gotten some bad press over the years – concerns have been expressed about the effects of DEET on the central nervous system. The EPA has completed multiple reviews of DEET and has determined that the product does not pose a health concern. Personally, I am not a fan of products that contain DEET. However, if we are traveling to an area of the world that has a known issue with certain diseases (Zika, West Nile Virus) then I would consider using a product with a low amount of DEET for a short period of time. If you are planning to use a DEET product, 10% – 30% DEET is adequate protection for most areas, and the lower the DEET the better (just remember that lower levels don’t last as long so you may need to reapply). Only apply to exposed areas of skin and don’t use it under clothing. Never spray the product in the area of your face – spray into hands and then apply it. Finally, wash areas sprayed with soap and water as soon as possible.

Picardidin

Also known as Piperidine, this is another synthetic product that helps to repel insects. Also considered safe by the EPA, this one doesn’t share the same strong scent that DEET carries. Studies show that this repellent carries no significant toxicities but care should be taken to avoid eyes, mouth and nose. It is worth noting that Picardidin does not repel ticks (which are a big concern in the area I’m located). Products containing Picardidin should not be used in children under the age of 2.

Permethrin

This is another synthetic repellent, which should be applied to fabric. Do not apply directly to skin. A single application lasts 2 wks and it is superior to DEET for tick prevention.

Oil of Lemon Eucalyptus (PMD)

This is a synthesized version of oil of lemon eucalyptus which has been shown to offer protection that is similar to low levels of DEET. There is a risk of considerable eye irritation (take care when applying to the face) and this product is not recommended for children under the age of 3.

Natural Products

My family has had great results with a natural insect repellent called Buzz Away that I purchase at Whole Foods, and can be found on Amazon. It contains a combination of Castor oil, Geranium Oil, Soybean oil, Citronella, Lemongrass Oil, and Peppermint Oil. Three of the oils in this formulation have been found to have similar efficacy to low levels of DEET. However, this product smells amazing, works great and I have no concerns with the ingredients. If you search on Pinterest you can find all sorts of recipes that use essential oils to ward off the insects. My only caution with these is to test each ingredient as a potential allergen and to stop using if you notice any irritation.

How Should I Layer Products For Outdoor Use?

This is a question that I get asked often. In general, I recommend that sunscreen be applied first, followed by bug repellent. Remember, sunscreen needs to be applied every 2 hours for maximal protection against harmful UV rays. Bug sprays tend to last longer on the skin (3-4 hours or longer). In general, I go by a two to one rule… two applications of sunscreen for every one application of my bug spray.

Combination Products

I want to take a minute to specifically address products that combine sunscreen and insect repellent. Many parents think this is brilliant. I know that it isn’t the easiest task to apply these products to young children so only applying one product that offers two solutions is ideal. I do not recommend these combination products. Sunscreen needs to be applied frequently whereas insect repellent is longer lasting. These combination products almost always contain a low level of DEET. In addition, they are usually formulated as an aerosol spray, which increases the risk of little ones inhaling harmful chemicals. If you reapply as often as necessary you will be over-exposing to the chemicals in insect repellent.

Beyond The Bug Spray

No insect repellent is 100% effective so I always recommend some extra precautions to help prevent insect bites.

Keep legs and arms covered with clothing and tuck pants into socks if hiking in thick grass/brush
Use a net to cover a baby in a stroller or a car seat, and a hat with a net works well for bigger kids too. If the bugs can’t get in, they can’t bite you!
Remove the threat – we have a water table and kids pool in our backyard that gets emptied and rinsed every evening. Mosquito’s love these environments (warm, stagnant water).
If you live in an area where lyme disease is prevalent, always make sure to check over your skin and your children’s skin for ticks. I have found two ticks on my daughter over the last 3 years. The most recent bite she had was in the late fall (go figure).

Ouch! He Bit Me

While we are on the topic of insects (just writing about these things makes my skin crawl!) I wanted to give some tips on what to do if you do get a mosquito bite.

Wash the area with warm water and soap
An ice pack might help relieve some of the itch
Apply calamine lotion or an anti-itch cream with a cortisone
If you notice severe swelling at the site of a bug bite, this could be a more severe bite reaction. Children are more prone to such reactions. In this case, you may need to visit your dermatologist to get prescription strength steroids.

How do you protect your family from insect bites? Any great tips to share? Comment below or send them to me at info@vibrantdermatology.com.