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Buying Personal Care Products On Amazon

Amazon Prime has become a saving grace in my household – two day delivery makes it so easy to maintain supply of things without having to fit in extra stops and errands after a busy day at work.  For a long time, I was hesitant to purchase personal care products on Amazon.  I’ve read horror stories of purchases that ended up being expired or fake. When it comes to putting anything on my skin I am super cautious.  Fake ingredients could wreak havoc on your skin and cause irreversible damage.  Women tend to invest a large amount of money in quality ingredients and if you receive something that is expired it is not going to work very well. 

Patients, friends and family are constantly asking me for product recommendations and I built Vibrant Dermatology as a way to share those recommendations with everyone.  I’ve embedded an Amazon Store in this website for convenience after doing my homework about safely purchasing personal care products online.  It is safe to order skin care products from Amazon but requires a little attention to some details.  Check out the list below for five things to check when purchasing personal care products from Amazon.

1. Check the seller details and manufacturer

When you click onto a product page on Amazon you can learn more about where the product is coming from.  Amazon fulfills orders direct from their warehouse or can facilitate a sale with a 3rd party.  When there is a 3rd party seller on Amazon it means that Amazon is merely facilitating the transaction between you (as the buyer) and the store (as the seller) but don’t actually ship you the product. Non-Surgical Nose Job

When it comes to personal care products, I steer clear of items that are not fulfilled by Amazon.  Introducing a 3rd party makes it more difficult to determine where the product is originating and can make going through a returns process a bit more of a hassle.

Skin care companies designate authorized retailers for their product and this helps to validate that you are purchasing from a valid source.  When purchasing something on Amazon, you can see who you are buying the product from right on the product details page.  By purchasing something Shipped and Sold By Amazon.com you have validation that they are an authorized retailer for the product.  If the Sold By company name is shown, you will have to do a little investigating to determine if this is a valid authorized retailer.

The images below show three different sale options for the same product.  The first image is sold and shipped by Amazon.  In the middle, the item is sold by Wiki Deals and shipped by Amazon.  The third is a 3rd party option.

2. Check the price

If it is too good to be true, it probably is.  If you are replacing a product that you have purchased in the past then you should have a pretty good idea of the cost of that item.  If not you can compare pricing using other reputable websites that fulfill the same product (I often compare pricing using skincare.com or Nordstrom.com).  Luxury skincare products rarely go on sale so if you see an item with a significantly reduced price then it is likely fake, expired, or possibly damaged.

Check out this example where I found Obagi Clenziderm Therapeutic Lotion on Amazon for $36.30.  I’ve prescribed this Benzoyl Peroxide based product to many of my patients and I know that it is generally more expensive than this (a quick check at skincarerx.com shows that this product is sold for $81.  I trust products from skincarerx.com but don’t tend to order from there because I like my Amazon Prime quick shipping!).  Further review on the Obagi website reports that Amazon is not an authorized retailer for their products so I would not purchase this product through Amazon. 

Side note:  You will always get the best price on HydroPeptide products by purchasing from www.hydropeptide.com and using code ‘Doctor-Ip’ at checkout for a 15% discount. 

3. Check the reviews

Amazon is full of product reviews and these reviews can help you determine the validity of a product.   To access Amazon reviews simply click on the stars next to the product name and then start reading.  If somebody rates a product with only a few starts I want to know why.

Back up to the example of the Obagi Clenziderm Therapeutic Lotion being sold for $36.30.  Check out this review:  “This is not the real thing!  It looks, feels, and smells different”.  Utilize Amazon reviews to see what kind of experience other people have had with the product.

4. Check the return policy

Amazon makes it easy to return items within 30 days of purchase so if you receive an item in the mail and aren’t happy with the quality you can get your money back.  However, if the item you ordered came from a 3rd party supplier (as I referred to in ‘check the seller’ above) then you will need to check the return policy for that seller.  If there is no return policy I would steer clear of making a purchase.  Amazon does offer an A-to-Z guarantee on items ordered through a 3rd party but personally I question the authenticity of a personal care product being offered through a 3rd party on Amazon and would source the product elsewhere to save some headaches.

5. Check the product

Once your order arrives there are a few things to check before opening and using the product.  First, check the packaging.  Is there any damage?  Are product seals in place?  Next, check the expiration date.  The shelf life of personal care products can have a big range of dates depending on the stability of the ingredients in the product, but you should make sure that the product will last long enough for your benefit.  Finally, once you open the product is the smell and consistency normal?

Did you end up with a fake, damaged, or expired product?  Be sure to return through the Amazon process and then leave a review to make sure others know your experience!

I only add recommended products to my Products page when I am confident that they are coming from a reliable, authentic source.   You can shop my top picks for every skin concern on Amazon here.

Try Amazon Prime with a Free 30 Day Trial (affiliate)

Skin Care For A New Momma

Fresh home from the hospital with your new bundle of joy and you’re focus is likely almost entirely on your new baby.  Babies show up with their own list of skin-related concerns but there are a number of skin questions for mothers that can arise post-delivery and I’m here with all of the answers for you!  In general, after delivery your body is healing.  It is important to nourish yourself with nutritional food and plenty of water in the days and weeks after having a baby.  Our bodies heal from the inside out and if you aren’t providing your body with the resources it needs, healing will be a much longer process.

Delivery

C-section scars:  If you have delivered your baby via C-section you will have to focus on making sure that your surgical incision heals completely.  Your doctor will leave you with care instructions upon discharge from the hospital and it is very important to follow those instructions.  Take care when in the shower to not scrub your wound but let soapy water rinse over the area.  Most C-section incisions are mostly healed in about a week.  If you develop a fever or find that the skin around the incision is red, hard, or painful or that it starts to ooze pus, it’s time to call the doctor as these are signs of an infection. 

The scar – this is something that you can’t worry much about early on.  There will be a scar but your genetics are what determines just how dark, wide, or big that scar is going to be.  Once your incision has completely healed (about six weeks) you can begin to use scar-reducing ointments like bioCorneum plus SPF Advanced Scar Supervision (affiliate) which will help with the appearance of your scar.  If you find that these ointments are not helping there are laser options that will help. These options should be discussed with your dermatologist.  Sometimes, you can develop a hypertrophic (when the scar thickens and appears ropey) scar. If this happens, your dermatologist can help to smooth the scar out by injecting it with intralesional steroids.

Vaginal Tearing:  If you delivered your baby vaginally and required an episiotomy or had any tearing, you have a few days of tenderness ahead of you.  Minor tearing (1st degree) will heal without stitches in just a few days.  Major tearing that requires stitches will take a bit longer.  To help ease the pain, keep a squirt bottle (peri-bottle) and use warm water to pour warm water on your perineum while going to the bathroom. Cleanse the area with more warm water after and then pat yourself dry from front to back.  Twenty-four hours after delivery you can soak in a warm tub or sitz bath for 20 minutes, three times a day. 

Scarring can occur after your initial tear or cut has healed and can be painful, especially during intercourse.  You should consult with your OB-GYN for options that can help to resolve this.

Post-Delivery

Cracked Nipples: If you have cracked nipples, you will want immediate relief so that you can continue with nursing your baby with as little pain as possible. Make sure that you check your babies latch and positioning to help prevent future cracks.  There are many causes of sore, cracked nipples, including: 

  • Poor latch
  • Thrush, which is a yeast infection on the skin of the nipple which can also be inside the baby’s mouth
  • Bacterial infection on the nipple or in the milk ducts
  • A nipple bleb (a tiny white blister on the end of the nipple)
  • Raynaud’s syndrome occurs when the nipple turns white after feeding and hurts as blood flows back in

If your cracked nipples are due to a poor latch, a product with lanolin will be your best friend.  Apply after you feed your baby and leave your breasts exposed as much as possible to let them dry out.  Some ladies also find hydrocolloid dressings  very helpful.  I, for one, found these to be extremely helpful and often alternated between lanolin and these dressings.  A moist nursing pad or bra presents warm air and moisture, which will not help with the healing process.  If you have corrected your latch and are still experiencing pain and cracks in your nipples, consult with a doctor who can assess your breasts and provide treatment accordingly. 

Stretch Marks:

Mid section of pregnant woman touching abdomen over white background

You probably noticed these forming as your belly grew larger and larger during pregnancy.  Stretch marks are caused by changes in the tissues that lie just beneath the skin and can range in color from pale pink to dark brown depending on your skin color.  Once the pounds start to drop these marks may begin to fade but they never go away completely.  Sadly, there is no cure for stretch marks but topical medications like Retin-A and glycolic acid may help to minimize the appearance of stretch marks.  Laser treatments can also help to restore the skin’s elasticity and change that pigmentation of the marks (so they will match the rest of your skin).

Melasma:

The “mask of pregnancy”, melasma occurs when pigment collects in excess quantities and creates a patch of skin that is irregular from your regular skin tone.  You should see this hyperpigmentation slowly fade post-delivery. However, for some women these patches of discoloration do not go away and help from a dermatologist is required.

If you have some discoloration on your skin during or after pregnancy, SPF is your best friend (honestly, this statement applies regardless of being pregnant, SPF should be applied every single day).  UV exposure is one of the key contributors to melasma so protecting your skin from the sun is very important.  There are a variety of products available over the counter that promise to lighten and brighten your skin.  In truth, many of these are moisturizers and won’t have much benefit to you.  You need the right ingredients to treat melasma:

  • Hydroquinone is a powerful skin bleaching cream that produces quick results and will help to reduce the appearance of any hyperpigmentation related to pregnancy.  Many people have luck with NeoStrata Targeted Treatment HQ Skin Lightening Gel 
  • Many people do not tolerate Hydroquinone well which can result in the spots darkening or becoming irritated.If you find this to be the case, stop using your Hydroquinone product immediately.  An alternative cream that does not contain Hydroquinone is Lumixyl Brightening Cream.
  • A dermatologist can also treat your skin with a chemical peel which will help to reduce the appearance of any spots.

Note:  please consult with your doctor if you are breastfeeding before treating melasma

Hormonal Acne:

After delivery of your baby, progesterone and estrogen levels will rise resulting to an increase in sebum production and clogged pores.  This type of acne will typically appear on the neck, chin and lower areas of your face, ranging from mild to severe.  The bumps are generally red and painful to touch. Non-Surgical Nose Job

A product containing Benzoyl Peroxide (such as Obagi Clenziderm Therapeutic Lotion or  La Roche-Posay Effaclar Duo Dual Action Acne Treatment) is a safe option to treat acne when breastfeeding and will help to penetrate clogged pores.  However, if you are suffering from painful, cystic acne, this likely will not clear your skin.  A visit with the dermatologist would be recommended. 

Hormonal changes can also result in dry skin immediately following pregnancy. Be sure to stick to a mild cleanser, lots of moisturizer, and drink plenty of water.

Enjoy that new baby, and make sure to show yourself some TLC to keep your skin looking and feeling great!

An Alternative to Hydroquinone – Introducing LumaProC

Over the last few months I’ve been testing out a product from HydroPeptide and I’m so excited that this product is going to be released to the market very soon.  LumaProC is a skin brightening serum, and I’m hooked!  It reduces the appearance of hyperpigmentation due to aging, sun damage, post-acne spots and “pregnancy mask”. 

12/1/2016 Update:  You can now order LumaPro-C direct from Hydropeptide.

If you have any kind of brown spots or hyperpigmentation on your skin then you have likely explored the world of skin lighteners and brighteners.  There are a number of products on the market that claim to target brown spots but the truth is that many of these products are just moisturizer.  If you truly want to minimize the appearance of brown spots you will need active ingredients that have skin lightening benefits. Harmful UV rays from the sun are the primary cause of spots so if you suffer from brown spots then SPF should be your best friend.

A large number of the skin brighteners that target brown spots contain an active ingredient called Hydroquinone.  Brown spots develop when there is an excess amount of melanin.  Hydroquinone prevents melanin from accumulating which results in brown spots gradually fading.  However, many people do not tolerate hydroquinone well.  In some cases, people who use hydroquinone excessively will develop exogenous ochronosis which will result in the skin darkening where the product was applied.  Skin lightening products that do not contain hydroquinone are often not very effective at reducing brown spots.  If you are looking for an alternative to hydroquinone, LumaProC is for you!

Every summer, regardless of how much SPF I apply I always develop mild melasma.  Certain areas of my face will darken, especially on my upper lip area.  I put LumaProC to the test this summer and applied it every morning after washing my face.  I was thrilled with the results – minimal brown spots where I tend to have very noticeable melasma.

What’s in it?  How does it work?

LumaProC combines a resurfacing peptide with the most advanced and stable forms of vitamin C and resveratrol to combat signs of aging, defend against environmental stress and revitalize the skin.  Add in eight key brightening ingredients that work to encourage skin resurfacing, prevent excess pigmentation from accumulating along with key brighteners to enhance skin luminosity and even skin tone and you have a safe, effective product that will help to minimize current brown spots and prevent new ones from forming.

This product is suitable for all skin types – even those with sensitive skin that haven’t fared well with skin brighteners and lighteners in the past should tolerate this product well.  If you are looking for a hydroquinone alternative, this is definitely worth a try.

How should I use it?

With LumaProC, I learned that a little bit goes a very long way.  One pump from the bottle will produce a pea sized amount which is enough to smooth over your face.  After washing, dry face with a soft towel and then apply LumaProC.  As it is a serum, it has a very smooth finish and applies easily.  Follow up with a moisturizer and SPF.  You could also use this product to treat brown spots on your hands, neck or other areas of your body.  I suggest applying in the morning and evening to treat stubborn brown spots and once daily for preventative treatment. Non-Surgical Nose Job

You will soon be able to purchase LumaProC direct from Hydropeptide. 

Hair Loss In Women

Today we’re talking about something that seems to be an increasing trend:  hair loss in women.  After the birth of my son almost two years ago, I noticed that my hair was shedding in abnormal amounts.  With my medical background and knowledge, I knew that this shedding was likely caused by hormones and I shouldn’t worry.  Honestly though, it was terrifying to see so much hair in the shower drain.  Read on to determine if your hair loss is simply shedding, or if it’s something that requires medical attention.

Everybody loses hair on an ongoing basis.  Hair sheds as part of the natural turnover process and is constantly regenerating.  The average human will shed between 50 to 100 hairs during the course of a day.  When the shedding hair becomes more than average and you begin to notice areas of baldness, many people begin to worry and this is when people begin to seek help.  A dermatologist can examine your scalp and hair loss patterns to help identify the underlying cause of the hair loss.  In some cases hair loss can be indicative of an underlying medical condition so it is important to seek out a medical opinion.

How much is ‘normal’

I think it is important to understand what a normal amount of hair loss looks like.  This can be really hard to measure because at times – after washing, brushing, etc – it seems like A LOT of hair is falling out.  However, it’s the cumulative effect over a day that we will monitor.

When it’s too much, you will notice

  • Clumps of hair on pillowcase in the morning
  • Areas of baldness and excessive thinning – check for a change in your part size, hair loss is usually more obvious here
  • An accumulation of more hair in your brush or shower drain than usual

When the amount of hair you are shedding goes beyond the average, it is termed excessive shedding.  If the hair does not re-grow, it’s termed hair loss.  Once you begin to notice a pattern of excessive shedding or loss, it is time to seek out the advice of a dermatologist.

Understanding the Cause

There are a number of reasons for excessive hair shedding and hair loss in women, and understanding the reason for excessive shedding will ultimately help determine the treatment options.

Genetic Causes

Our genes play a role in the most common type of hair loss.  If your father or mother experienced hair loss – sorry but you probably will too.  The good news is that there are options available to help prevent and treat this type of hair loss.  If hair loss is a common pattern in your family, treatment can begin when hair loss is at its earliest stages and is often more effective.

Stress & Hormonal Factors

When we talk specifically about hair loss in women, the term Telogen effluvium comes to mind.  This term is used to describe the thinning or shedding of hair resulting from the early entry of hair in the telogen phase (which is the resting phase of the hair follicle).  Stress is one of the main causes of this – both emotional and physiological stress – and some medications can also cause it.  Most common causes include:

  • Loss of 20 or more pounds
  • Childbirth
  • High fever
  • Operation or medical procedure
  • Nutritional changes – eating disorders
  • Stress (job change, caring for loved one who is sick, divorce, etc)

This type of shedding will typically begin a few months after the stressful event and will peak around 4 months.  Within 6 to 9 months your hair should regain its original fullness and strength – although it’s worth noting that if the stressful condition causing excessive hair shedding remains, it could result in long-term excessive shedding.

Medical Conditions

There are a number of medical conditions that can result in the body shedding hair at an excessive speed.  These conditions require attention from a medical doctor and often with management the hair shedding or loss can be reversed.

– Hypothyroidism occurs when the body produces too little thyroid hormone which will cause a variety of symptoms – including hair breakage. A blood test will confirm thyroid levels and there are medications that can help control the hormones.

– Alopecia Areata is an autoimmune disease which causes bald spots on the scalp (in some case the entire scalp).

– Anemia – iron deficiency anemia can cause hair loss. When you are anemic, your body will send oxygen to support vital functions which means your hair will be getting less oxygen.

Lifestyle

I think it is worth talking about lifestyle because many people don’t realize the damage they are causing their hair with certain products and hair styles.  I’ve seen many cases where a person has damaged their hair through styling which resulted in bald patches and very thin hair. The AAD has some great tips on styling hair without damage.  Personally, when I want my hair pulled back, I opt for a simple braid with a loose band to hold it in. 

Treating Hair Loss

If you think that your hair shedding is becoming excessive or if you have noticed hair loss, it is time to consult with a dermatologist.  There are a few basic tests that can be performed to help identify the cause of the problem.

  • Blood tests – helps to identify underlying medical conditions
  • Pull test – we will actually pull a small amount of hair and examine both how easily the hair sheds as well as the root that was pulled out.
  • Scalp biopsy – if we suspect an infection or certain condition we will scrape a small amount of skin from the scalp to examine.
  • Examination – a light microscopy is used to examine the base of the hair to help identify any issues with the hair shaft.

Some types of hair loss will require treatment by your primary care physician (for example, if you have hypothyroidism, you doctor will need to monitor your hormone levels and provide medication).  However, if hair loss is hereditary or the result of a skin condition, a dermatologist can offer treatment plans.  Treatments for hair loss in women will differ from treatments for men with hair loss. Treatments will help to produce some amount of hair growth but they are often most helpful in slowing down hair loss (which is why early action of any symptoms is important).

Minoxidil (Rogaine) is the only topical medication approved by the FDA for treating hair loss in women.  When applied topically, this solution can help to stimulate hair growth.  Available over the counter in strengths of 2% and 5%, this solution does take some time to work.  In general, I recommend women use 5% rogaine one time a day. Results are usually noticeable in three to four month and treatment will need to continue once hair growth begins. 
 

Hair transplantation is expensive but is growing quickly in popularity.  This involves taking hair follicles from one area of the scalp and transplanting to the affected area.  For women, this surgery is not always beneficial and should only be considered if hair loss falls into certain categories.  For example, transplanting hair to an area with scarring will not be effective.

Just shedding?

If you determine that you are experiencing hair shedding and not true loss, I have some tips for managing the shed:

  • Gentle styling – use a detangle spray to help with knots and a wide tooth comb to separate hair. Don’t pull and tug with a brush.
  • Avoid heat – the irons, driers, etc. Occasional use is ok but if used daily you will damage your hair over time. Non-Surgical Nose Job
  • Loose hairstyles – avoid tight ponytails and braids unless absolutely necessary.
  • Products – Volumizing shampoos can be helpful to improve the thickness of remaining hairs.  I personally use Art Naturals Organic Moroccan Argan Oil and other patients swear by the Viviscal line which includes a hair growth serum.
  • Cover it up – Try moving your part around to help cover any thin areas.  A hat or scarf can be a fun accessory too!  Hair microfibers can also help when hair loss is more severe (try TOPPIK Hair Building Fibers. 

Hair loss can be a very stressful experience for women. I cannot emphasize enough the importance of seeing your dermatologist, if you feel that you have unusual/excessive hair loss. Early intervention is key!!

Do you have any hair loss tips or stories?  Share in the comments or email them to me at info@vibrantdermatology.com

Don’t miss this post where I share a DIY recipe for a hair oil that I used when I began to notice my hair shedding after the birth of my son:  Can You Find Beauty In The Kitchen

Join the Vibrant Dermatology Beauty Club for skin tips via email, giveaways, and more!

Curing Your Acne With Over The Counter Products

adapalene and benzoyl peroxide over the counter

If you walk through any drug store you will find a wide variety of topical acne medications available without a prescription.  They all declare a similar message about clear skin.  If you examine the ingredients closely you will find that they all contain varying degrees of different medications and this can be very confusing.  In today’s post I’m going to cover the common acne medications that are available like Adapalene and Benzoyl Peroxide over the counter and provide some specific recommendations about what products work best for which types of acne.

Before we jump into this, I want to take a minute to refresh the topics that I have already covered in this blog series.  We started with the most important step – making the diagnosis.  There are four types of acne and knowing the type of acne that you have will be key in determining the best treatment options.  Next up was the best face wash for acne prone skin.  Keeping your skin clean is important and in this post we covered the types of cleansers available as well as how to properly clean your face.  The third post was all about oily skin – the cause of oil and what you can do to help control it.  If you are new here, enter your email address below and I’ll send the prior posts to you. 

Knowing the type of acne you have will help determine what products will best treat that acne.  A quick review of the four types of acne:  1) comedonal acne (non-inflammatory); 2) inflammatory acne (pustular and cystic); 3) combination acne (both comedonal and inflammatory); and 4) hormonal acne.

The two main ingredients in OTC acne medications are Salicylic Acid and Benzoyl Peroxide.  This summer, the Federal Drug Administration approved adapalene (aka differin), which is a topical retinoid, for over the counter sales. This is huge in the acne world, because prior to this you usually needed a prescription to procure a retinoid.    Update: In January, 2017 Adapalene became available over the counter. Read on below for how to purchase.  If you remember back to the 2nd post in this series, we discussed these same ingredients in face washes.  It’s important to find a balance of products that will treat your acne without causing irritation.  Too much of any ingredient could leave you with dry, irritated skin. 

The ingredients

First up, Salicylic Acid.  This is probably the most common solution when it comes to treating acne.  Salicylic acid is comedolytic meaning that it helps declog blackheads and whiteheads so it’s great when treating comedonal acne.  Salicylic acid also works as a powerful exfoliator and will slough off dead skin.  Products that contain 0.5 to 2 percent salicylic acid would be recommended – anything stronger will likely cause irritation.   Salicylic acid is best used as a face wash. There are many OTC salicylic acid spot treatments, but I do not believe that spot treating acne works very well. Salicylic acid can also be used in much higher strengths in chemical peels. I use these often in my acne patients. However, these peels should be performed in a doctor’s office. Non-Surgical Nose Job

cSalicylic is an aspirin based product so if you are allergic to aspirin, products that contain salicylic acid should be avoided.  If you are looking for a face wash that contains salicylic acid to help clear up comedonal acne, I recommend Neutrogena Acne Wash or Hydropeptide Purifying Cleanser (order from Hydropeptide with code Doctor-Ip for 15% discount!). 

Next is Benzoyl Peroxide.  If you have inflammatory acne, this is the product for you. Benzoyl Peroxide unclogs pores and stops bacteria (which is the cause of inflammatory acne).  Typically available in strengths that range from 2.5% to 10%, starting with a low strength is recommended until you know how your skin will react to the product.  People often report dry skin and some slight burning or tingling when starting to use this product.  After applying the medication, I recommend using a thick cream to help retain moisture and prevent dryness.  My personal favorite is OTC benzoyl peroxide is Obagi Clenziderm Therapeutic Lotion.

Finally, a new introduction to the OTC acne treatment options is Differin. In July, 2016 the FDA approved Differin for OTC use.  Differin is a retinoid that treats mild to moderate acne. Topical retinoids are powerful comedolytics, which means that it can help knock blackheads out of the water.  They help to encourage cell turnover and reduce inflammation.  Differin is usually very effective on blackheads and whiteheads (comedonal acne) and tends to be less irritating than other prescription based retinoid treatments.  Only a small amount is needed nightly, a pea-sized amount for the entire face.   

In January, 2016 Differin was released for sale over the counter.  I’ve seen it on shelves at Target, Walgreen’s, CVS and on Amazon.com. 

Woman touching her face

If you remember back to Step 2 of the Cure Your Acne blog (The Best Face Wash For Acne Prone Skin), there are many facial cleansers that contain Salicylic Acid and Benzoyl Peroxide (two of the ingredients that I’ve covered above).  The key to clearing your skin is finding the correct balance of ingredients for your skin type.  Below I’ve summarized my suggested routine for each type of acne.  Often, I find that the best combination is a gentle cleanser with treatments applied after washing.  Too much of any one ingredient could cause excessive dryness and further irritate the skin. 

  • Comedonal acne – Wash with a gentle cleanser twice a day, followed by a moisturizer.  In the evening, use a pea-sized amount of a topical retinoid (Differin) before applying moisturizer.
  • Inflammatory acne – Wash with a gentle cleaner and use a mild OTC benzoyl peroxide cream twice a day, followed by a moisturizer
  • Combination acne – Wash with a gentle cleanser twice a day.  A mild OTC benzoyl peroxide cream can be used during the day and a topical retinoid like Differin can be used at night. After medication is applied a moisturizer should always be applied.
  • Hormonal acne – A combination of products may be effective but you will likely need a hormonal remedy.

Product Recommendations

Gentle Cleanser:  Hydropeptide Cleansing Gel or Vanicream Facial Cleanser

OTC Retinoid:  Differin

OTC Benzoyl Peroxide:  Obagi Clenziderm Therapeutic Lotion or La Roche-Posay Effaclar Duo Dual Action Acne Treatment

Moisturizer:  CerAve AM and Cerave PM add Vanicream if you experience excessive dryness

As with most products that are applied topically, a small amount of the drug can enter your bloodstream.  If you are pregnant or breastfeeding these products are not safe to use and should be avoided.  When starting a new treatment for acne it is important to ease into the new routine.  Start off by applying any new medications every other evening as part of your skincare routine and only increase to daily if you find that you need it.  Also, these treatments tend to be very drying so you will want to make sure you are moisturizing well when using.  My preferred facial moisturizers are Cerave AM, Cerave PM and Vanicream. 

Looking for more skin tips & advice like Adapalene and Benzoyl Peroxide over the counter?  Take the Clear Skin Challenge.  A free e-book filled with tips to set you on a path to clear skin.  Click here to sign up with Vibrant Dermatolog!

Back To School

It’s that time of year!  In some areas kids are already returning to school and where I live, they will be heading back soon.  There are a handful of skin conditions that are quite common among school-aged children.  None of these conditions are really life threatening, but they are very contagious and can be quite time consuming and frustrating.

Educate your children on proper hygiene measures (hand washing is so important) and be sure to remind them not to share personal objects such as hats, headbands and hooded jackets.

Head Lice

This topic always makes my skin crawl.  Head lice are teeny little insects that take up residence in human hair and feed on blood from the scalp.  They are about the size of a sesame seed and spread quickly, especially when hair is worn down or hats are shared.

  • Prevention is totally possible! Wear hair pulled back and rely on natural oils (ie, don’t wash hair every day) to help prevent lice. Educate your children to not share hats or other items that are worn on the head. Shampoos like So Cozy Boo! Lice Scaring Shampoo may also be effective. My daughter has long, thick hair and I encourage her to wear it pulled back as much as possible but I also pay close attention when I’m washing and brushing her hair.
  • If your child does come home with head lice, take immediate action. Purchase a special lice comb and comb out each nit and lice. You also need to treat any bedding, stuffed animals, and clothing and may have been exposed to the lice. Sometimes, a prescription lice shampoo is required. Your doctor will be able to prescribe this for you.

Ring Worm

 This name often confuses people as this doesn’t actually mean that your kid has worms.  Ring worm is used to classify skin fungal infections that present as red, scaly bumps which over time may form a ring with raised, scaly borders.  Ring worm usually shows up on the body but can also present on the toes, scalp or nails.  This condition isn’t really dangerous or painful but can be incredibly itchy and will require a topical antifungal medication (oral medications are used to treat ring worm of the scalp or nails). 

Molluscum Contagiosum

A viral infection that causes a mild skin rash, Molluscum Contagiosum appears as one or more small

 bumps with a central depression that are usually pink or flesh colored and is most common in children between 1 and 12 years old.  This infection is highly contagious and can be passed through skin-to-skin contact but also by touching objects that have the virus on them.  While the infection can clear on its own (which usually take about a year, but can take up to 4 years) most doctors will recommend treatment options that can help you clear the infection faster.   

Impetigo

 One of the most common skin infections among children, impetigo produces blisters or sores in infected areas (most common on the face, neck, hands and diaper area). Impetigo spreads easily through direct contact and through contact with other items that have touched infected skin.  The infection can also be spread to other parts of the body by scratching and is more likely to develop when there is a sore or rash already present.  Impetigo is treated with antibiotic ointments, although in some cases an oral antibiotic may be required.  It is important to keep infected areas clean and covered to aid in healing and prevent spreading.  Impetigo is more common in kids who play sports, particularly contact sports like wrestling. Sometimes students may be temporarily asked to stop playing a sport if they are found to have impetigo, because it is so contagious.

Keep an eye out for any rough patches of skin that are particularly itchy or irritated.  Child eczema is a very common cause of irritated skin but it is always possible that there is something being passed around the classroom.  When irritated skin persists, a visit to the doctor is important to help prevent any disease from spreading and to help limit the amount of pain your child might be experiencing.  If your child is diagnosed with a contagious condition, notify the school so that items in the classroom can be sanitized and other parents can be notified.

As always, feel free to share your comments or questions below, or email me at info@vibrantdermatology.com.

Image Sources:

Head Lice – http://www.mayoclinic.org/diseases-conditions/head-lice/multimedia/head-lice/img-20007669

Ring Worm – http://www.healthline.com/health/ringworm

Molluscum Contagiosum – http://www.healthline.com/health/molluscum-contagiosum

Impetigo – http://www.mayoclinic.org/diseases-conditions/impetigo/home/ovc-20202557

Taking Care Of The Skin Down There

skin care for down there

We often shy away from talking about caring for the skin in our nether regions, yet it’s a very important part of our regular routines.  Many women think any little itch or irritation is a yeast infection and turn to over the counter treatments quickly.  However, many times it is not a yeast infection and these treatments could actually make the condition worse. It’s best to always have skin care for down there. 

Do you suffer from winter itch? Get some help and enter to win one of my favorite products. Check out: Surviving Winter Itch

There is a lot to cover on this topic, so I’ve broken it down into three parts.

Part 1 – Common Complaints – the top 7

Part 2 – Gentle care down there

Part 3 – The male Version

In Part 1 of this series I’m covering the top 7 complaints ‘down there’.  Before we get into the specific list I think it is important to point out that many of these conditions have similar symptoms so if the condition persists after at-home treatment or is severe from the start, only a trained doctor can make a correct diagnosis and prescribe treatment.  Symptoms will usually fade quickly once treatment begins, bringing much relief.

1.  Yeast Infection – Medically termed candidiasis, this is an infection caused by yeast on the skin and/or mucous membranes.Yeast is completely normal in the digestive system and vaginal area but can lead to an infection in certain conditions (especially when skin is damaged, in warm and humid conditions, and when the immune system is compromised). Antibiotics lead to a growth of yeast because they kill normal bacteria so that yeast can grow.  The symptoms of a yeast infection vary based on the person and the area of the infection.In women suffering from a yeast infection in the vaginal area, there will be white or yellow discharge from the vagina along with itching, redness and burning on the vaginal skin.

There are a number of over the counter treatments that can effectively treat a yeast infection.  However, the symptoms of a yeast infection can resemble many other skin conditions so consulting a doctor for a diagnosis is important.  A doctor will complete a medical history and physical exam and may scrape off a skin sample to confirm the diagnosis.  Most yeast infections will be treated effectively with a medicated ointment like Monistat but in severe cases an oral anti-yeast medication may be prescribed.   

Candida Intertrigo is a yeast infection of skin folds that is caused by a specific type of yeast.  Areas of the body that have skin touching create a skin fold (groin area, under heavy breasts, fat folds) and provide a warm and moist area (breeding ground for yeast).  Hot and humid weather can contribute to this condition.  Wearing loose, comfortable underclothing and proper hygiene is usually enough to help prevent this condition.  If you find yourself with redness and irritation in fold of your skin, a dermatologist can help to diagnose, treat and offer tips to manage the area to prevent the condition in the future.

2.  Folliculitis – This is a very common skin condition which occurs when hair follicles become inflamed.Typically caused by bacteria or by significant irritation of the follicles (i.e after waxing), it usually appears as small red bumps or white-headed pimples around hair follicles (which are the pockets from which hairs grow). A mild case of folliculitis will usually clear on its own if you follow basic self-care measures.Sometimes the infection will spread and result in crusty sores that don’t heal on their own.

If you have a mild case of folliculitis, gentle care of the area should result in quick improvements.  Self-care of the area includes gently washing the infected skin twice a day with an antibacterial soap, and soothing lotion or hydrocortisone cream to help relive itchy skin. If you have folliculitis it is best to avoid shaving if possible but if you must shave try an electric razor and moisturize well afterwards.

More severe cases of folliculitis will require an antibiotic. I usually start by giving my patients a topical antibiotic, but sometimes oral antibiotics are needed.   There are many different types of folliculitis, which range from superficial (limited to the skin) to deep infections that involve the entire hair follicle.  A doctor can examine the infected area and prescribe treatment based on the symptoms.

3.  Allergies – Allergic contact dermatitis that affects the genital area is commonly caused by fragrances, preservatives or rubber.These allergies aren’t always easy to diagnose but the patient will usually notice a pattern of irritation after exposure to the allergen.

Although rare, it is possible for women to be allergic to male semen.  If you notice redness, swelling, itching and burning when semen contact skin then an allergy is likely the cause.  Minimizing contact with semen is suggested to minimize reactions but doctors can also help to desensitize you to the allergen.  It is also possible to have a latex allergy and because most condoms are made of latex you may notice irritation following condom use.

A lot of people also have allergies to certain fragrances that are used in laundry detergent, body wash and lotions.  These are more difficult to identify but sticking to fragrance free products will help to limit any reactions.

4.  Vaginal Eczema – Often mis-diagnosed as a yeast infection, vaginal eczema can cause intense itching and burning in the vaginal area.Your history of eczema, allergies, and cleaning habits will help to diagnose vaginal eczema.Typically vaginal eczema will present with redness, scaling, cracking and thickening of the skin.There are two important elements when treating vaginal eczema.First, you need to avoid scratching the area so that irritation can heal.A mild topical steroid can be used to can help to relieve itching. In severe cases a stronger corticosteroid ointment can be very effective. The second element of treatment addresses caring for the skin. Gentle skin care is a must. Baby wipes should absolutely be avoided, as they can worsen eczema and cause contact allergies, as should harsh soaps. Great care should be made to avoid excessive cleansing of the area (which people are more inclined to do when they feel like they have a problem down there). Given the sensitive nature of the area and the intensity of vaginal eczema, it is important to consult with a doctor for the proper diagnosis and treatment.

5.  STDs – Sexually Transmitted Diseases. There are a number of STDs that could be causing vaginal irritation, and a doctor is the only one that can make the official diagnosis. The STD’s that most often cause vaginal irritation (itching, redness, bumps) are Chlamydia, Gonorrhea, Herpes Simplex, HPV (genital warts), Syphillis, and Trichomoniasis. If you suspect that you have an STD, stop all sexual activity and see your doctor immediately for treatment. Be sure to check out Part 2 of this series where I delve into STDs in more detail. 

6.  Molluscum Contagiosum is a skin infection caused by a virus. The virus is spread through skin-to-skin contact as well as through contact with infected surfaces so can be spread during sexual activity, towels, washcloths etc. The bumps associated with Molluscum will usually appear within 2 to 6 weeks of coming into contact with the virus and will appear as small, smooth, round pearly bumps (with a noticeable dimple in the middle). When these bumps appear in the genital area, treatment is often necessary to prevent spreading the virus through sexual contact. Treatment options include freezing, scraping, or a prescription cream. If you suspect that you have molluscum, avoid sexual contact until you have had a chance to discuss with your doctor.

7.  Lichen Simplex Chronicus – Caused by persistent itching and scratching of the vulvar skin, lichen simplex chronicus results in thick, leathery, brownish skin. This condition can be the result of minor irritations, or sometimes may be a result of psychological stress or environmental factors. Breaking the itch-scratch cycle is key to the treatment of this condition. Vulvar lesions can be treated with a mild topical corticosteroid, which will help to manage the condition.

If you struggle with dry, itchy skin in the winter, be sure to check out this blog post. I’ve got tips to ease the itch and a GREAT Giveaway.

Stay tuned for the next part of this blog that will take you through a gentle care routine for ‘down there’.

Part 2 – A deep dive into Sexually Transmitted Diseases

Baby Bath Time – Newborn Skincare

As a new parent, I found giving my baby a bath one of the most nerve-wracking aspects of newborn care.  I remember feeling like their tiny bodies were so slippery!! Their tiny bodies and delicate skin require gentle touch and care.  The market makes us think we need fancy tubs and toys for a successful bath but it is really much simpler than that.  Read on for my bath time tips and common baby skin concerns.

Washing Your Baby

In the really early months, babies don’t really need a full-on bath.  Their skin is extremely delicate and very prone to dryness so a gentle washing will do.  The best method for cleaning tiny babies is to use a soft cloth and warm water and simply wipe areas that are dirty.  Keep the hands clean (since they so often end up in the mouth) and pay special attention to skin folds under the neck, which can accumulate milk products and dirt.

When it is time to give baby a bath, safety first!  Invest in a baby tub that will help contain your baby to a smaller area.  Limit bath time and use warm (not hot) water to help ward off dry skin.  Use a gentle baby wash (I like Aveeno Baby) and moisturize immediately after the bath (I like Vanicream).  While we all want our babies to smell nice, it is important to avoid overly fragrant baby washes and moisturizing lotions. Babies who are more prone to eczema may develop allergies to the fragrances found in such products.  As much fun as bubble’s in the bath can be, these products tend to be harsh on the skin so I prefer to avoid them (or limit to once a month or so). 

Eczema

If you baby have persistently dry skin or skin that appears to be very itchy, it is possible that he or she has mild eczema. Babies who have eczema have a harder time retaining moisture in their skin. I first noticed mild eczema in my daughter when she was four months old. I was a resident physician at the time.  One of the things I learned from my daughter’s skin is that babies with eczema need to bathe less often. I know that goes against everything you may be thinking in terms of keeping a baby clean. Furthermore, many use bath time as part of their sleep routine.  However, bathing every other day and moisturizing skin daily can solve most mild baby eczema.  To find out why, check out my eczema blog. In my home, we bath out children every other day. They are allowed to enjoy bath time for as long as they would like. When they get out of the bath, we pat them dry and immediately apply a thick moisturizing cream to their skin.  On non-bath days, I fill a sink with soap and water and clean the stinky parts, but I do not submerse their skin in water.  Again, I follow this up with a thick moisturizing cream.

Cradle cap

Infantile seborrheic dermatitis is the official name for cradle cap, and it’s VERY common and completely harmless.  I hear from a lot of worried parents when they see flaky patches of skin on their babies head.  Cradle cap often presents as dry skin that looks like dandruff and can also bring yellow or brown crusting patches.  This condition doesn’t warrant a trip to the doctor but you may want to bring it up during a routine visit.  Most likely it will clear up all on its own in six to twelve months. Often babies who have eczema may also have more severe cradle cap. If cradle cap is severe, it can cause irritation of the scalp and itching.   A few things you can try (gently!):

  • Using your fingers or a soft brush you can gently massage to loosen the scales. Do not pick! Let the dry patches fall off on their own.
  • After shampooing, be sure to rinse all product out of your baby’s hair. Use a soft brush or towel to brush the hair. This will help to loosen some of the patches.
  • Some parents have had good luck with massaging a natural oil into the scalp to help with tough cases of cradle cap. I suggest olive oil – rub a small amount onto the scalp and leave for about 15 minutes. Gently comb out flakes with a fine-tooth comb or brush with a soft brush. Wash the scalp with a gentle shampoo afterwards. Leaving oil on the scalp could result in clogged pores and cause the flakes to stick.
  • If seborrhea appears on the face, similar steps can be taken to remove it. However, if it persists a mild topical medication may need to be prescribed from your PCP.

As your baby turns into a toddler and then grows up to be a big kid the dirt will start to accumulate and bath time will become an entirely different scenario.  I’ll cover bath time for toddlers and big kids in another post soon!

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

sunburn and shingles

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!

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Problems We Treat

In the Clear

Acne: Adults & Teens

lllumination

Hyperpigmentation, Sun Spots, Melasma

Red, Red Go Away

Rosacea, Facial Redness, Sensitive Skin

Tall Drink of Water

Excessively Dry Skin, Eczema

Fountain of Youth

Anti-Aging, Skin Rejuvenation

Mommy & Me Skin Care

For Pregnant & Nursing Mothers

Just for Kids

Skin Care For Those 12 & Under
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Dedham MA 02026
Phone: (617) 250-0257

Vibrant Dermatology
1 Central Ave.
Milton MA 02186
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Phone: (617) 250-0257

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