I’ve been writing a lot about summer time skin care lately, and today’s post is something that I know bothers a lot of people this time of year. Sweaty pits. It’s hot and humid and personally, for me that means a lot of sweat.

Sweat is a normal bodily function that affects everyone differently. As your body heats up, it will naturally attempt to cool itself by sweating. When sweat combines with bacteria on your skin it produces an odor that is usually unpleasant. There are two products on the market that will help to reduce sweat and the odors associated with it:  antiperspirant and deodorant.

Antiperspirant Versus Deodorant

The fundamental difference between antiperspirants and deodorants lie in the way that these products work.

• Antiperspirants contain fragrances to help mask odor but also contain chemical compounds that block pores to stop perspiration, blocking sweat from reaching the area applied.
• Deodorant allow the release of sweat but prevent odor with antiseptic agents which kill the odor-causing bacteria. They also tend to include fragrance which helps to mask odors.

The Nasty Chemicals

For a long time now, various advocacy groups have voiced concerns over ingredients found in many antiperspirants and deodorant. When you put a product on your skin, tiny amounts could be absorbed into your skin. There are five ingredients that can be found in deodorant/ antiperspirants that could cause cancer:  Aluminum, Triclosan, Phthalates, Fragrance, and Parabens. Research on the long-term effects of these ingredients is ongoing.

I know that it is hard to read concerns about ingredients that we use in every day products and not react to them. If you have hyperhidrosis, like I do, it’s hard to avoid Aluminum all together because that is the active ingredient that helps to prevent sweating. There are statements from both the American Cancer Society and the National Cancer Institute about the lack of research and the connection or lack thereof between aluminum and cancer.

A ‘Clean’ Solution

Vanicream

earlier posts (Vanicream Skin Cream and Seb Derm) and this product is no different. In the past I’ve rotated through various products to help reduce or mask the sweat but never had one antiperspirant or deodorant that was long lasting. After using this product for a few months now, I have to say that I’m ready to add it to my regular list of products. 

• Ingredients are clean – if you suffer from allergies, eczema or any other kind of skin irritation, this product will be great for you. The ingredients are clean and there is nothing included that is going to trigger irritation.
• Unscented – I find a lot of deodorant and antiperspirant contain fragrance that isn’t always pleasant. Even unscented products sometimes have a smell.This product is truly unscented and doesn’t leave any scent on your skin.
• Smooth application – This product applies smoothly and doesn’t leave a sticky feel at all.I found it best to let it dry a few minutes before getting dressed so that it wouldn’t leave any markings behind on my clothes.

Permanent Solutions

There are some more permanent solutions to sweating, although these come with a decent sized price tag. I’ve talked about Botox for sweaty pits on the blog before.  Botox works great, and I routinely do this procedure in my office. The downside is that it requires about 20 tiny injections per an armpit, so it is not for the needle phobic. The results last 6-9 months. Another new option is Miradry which is a treatment that uses laser energy to target and destroy sweat and odor glands in your underarm. This is a long lasting option that your dermatologist can offer information about Non-Surgical Eye Lift. 

Free Product!

If you want to try Vanicream™ Anti-perspirant/Deodorant, click here to enter your contact information and be entered to win one of six sticks of anti-perspirant/deoderant that we are giving away.

*Giveaway closes August 15.

Summer is officially here!  Between camps, trips to the beach, and just spending a lot more time outdoors in general, there is a lot to keep track of!   I’ve put together my summer skin care guide to help you treat common ailments at home, and so that you know when to see the doctor.  Enjoy your summer, and as always, don’t forget the sunscreen!

Young Women Sunbathing

1. Sunburn – Probably one of the most common summertime skin ailments, the sunburn.  As a dermatologist, I will first preach the benefits of adequate skin protection from the sun.  UV rays not only leave your skin tingling and pink, the effects of a sunburn are lasting.  Overtime sunburned skin will start showing signs of aging sooner and even one sunburn leaves you more likely to get skin cancer.  However, if you forgot the sunscreen or missed a spot and find yourself with a sunburn, check out my tips for managing sunburn.  
2. Bug bites and stings – Another very common summertime skin ailment, bug bites and stings can be frustrating!  Most bug bites are harmless but some can spread dangerous diseases 9like Lyme, Zika, and malaria).  Prevention is helpful – insect repellent, appropriate clothing, and bed nets for infested areas.  Most bug bites and stings can be treated at home. Non Surgical Eye Lift For painful bites an over-the-counter painkiller (acetaminophen or ibuprofen) will help.  Itching bites can be helped with an ice pack or over-the-counter hydrocortisone.  If there is swelling, apply an ice pack.  More severe symptoms that occur after a bug bite (rash, fever, or body aches) should be referred to your doctor or board-certified dermatologist immediately for treatment.  
3. Bed bugs – Also in the bug category but deserving its very own spot on my list is bed bugs.  If you find yourself in the unlucky category of being exposed to bed bugs, wash the bites with soap and water to help prevent an infection and help reduce itch.  A corticosteroid cream can help to reduce any itchiness.  If you have a large number of bites or develop blisters or inflammation you should visit a board certified dermatologist for treatment.  Some people will have an allergic reaction to bed bug bites or may develop an infection and require antibiotics.  Knowing how to identify bed bugs is really helpful – whenever I travel I now check out the mattress as soon as I walk into a hotel room for any evidence of bed bugs! It’s also possible to bring bed bugs home with you, in which case you will need to treat your skin and your home. Check out these remedies to help rid yourself of bedbugs. 
4. Eczematous dermatitis – Heat, humidity and chlorine can cause contact dermatitis to flare in the warmer summer months.  To avoid flare ups in the summertime be sure to:
   • Rinse skin after swimming – chlorine and saltwater will dry out the skin.  
   • Travel with your own products.  Don’t rely on hotel toiletries if you are accustomed to products that you know work well for your skin type.  Even a day or two of different products can wreak havoc on your skin.
   • Continue using a thick cream, even if you think a thin lotion is more comfortable when the heat and humidity strike.  Thin lotions lack the humectant properties needed to protect your skin.
   • If you are using topical steroids, avoid sun exposure.  This is also true for oral steroids which can be photosensitizers and increase risk of a sunburn.
   • Only use physical sunscreens (titanium dioxide or zinc oxide) on inflamed skin since chemical blockers can burn on cracked, inflamed skin.
5. Hot Tub Folliculitis – If you’ve ever found yourself with a skin rash after using a hot tub, you likely have hot tub folliculitis, also known as hot tub rash.  This is an infection in the hair follicles and can occur in any part of the body that has hair growth and is caused by a bacteria called pseudomonas that live in warm and wet areas.  The rash will appear like acne and may turn into red nodules in the affected area.  The nodules may have pus and cause itching or a burning sensation.  Symptoms will usually appear within a few hours of coming into contact with the bacteria, up to about 3 days after.  There is no treatment required for a hot tub rash and symptoms should resolve on their own in about 10 days, but if not you should see a dermatologist for anitbiotics.  To prevent itching, a warm compress will help and will promote quick healing .  
6. Margarita Rash – Yes you read that correctly, margarita rash is a thing!  Known as Phytophotodermatitis, this condition occurs when your skin comes in contact with certain substances at the same time s sunlight.  Symptoms can range from mild redness to blisters and second-degree burns.  As the burns begin to fade they leave behind a characteristic brown patch on the skin.  The brown patches will disappear on their own over time and can be lightened with hydroquinone.  A severe burn will require observation by a doctor.  Limes are the most likely fruit to cause this condition but it can also be caused by carrots, parsnips, parsley, celery, figs, wild dill, lemons, and oranges.  If you plan to enjoy margaritas in the sun, you can still enjoy the fresh squeezed lime juice, just be sure to wash your hands thoroughly after preparation!  

In Part 1 of this series we covered the top 7 complaints ‘down there’.  In this post I’m going to drill into the fifth item on that list, Sexually Transmitted Diseases.  It’s summer time which means more people are out and about having fun, leading to more sex.  The CDC estimates that 19 million new sexually transmitted infections occur each year, almost half among 15-24 year old’s.  So go on, share this blog post with your kids!

Vaginal irritation can be caused by a number things, but if you have recently had a new sex partner, then an STD is likely.  The most common STDs include:

1.  AIDS / HIV

AIDS is a condition where the immune system begins to fail, weakening a person’s ability to fight infections.  There are 60,000 new infections each year.  Symptoms can include fatigue, inability to fight infections, blotches on or under the skin, diarrhea, and swollen lymph glands.  AIDS is transmitted through blood and bodily fluids.

2.  Herpes

With 45 million infected annually Herpes Simplex is a common STD.  It is a viral disease that is transmitted by skin to skin contact and appears as blisters, ulcers or sores.  Symptoms include swelling, itching or tingling areas on the body along with body aches and pains and abnormal discharge and pain during urination.   Many people are infected with a common herpes virus that HSV1 that leads to the common cold sores. Depending of sexual practices, HSV1 can also affect the genitals as a result of oral sex. Another common place to find herpes is on the buttocks, as a result of spooning after sex. The challenge with herpes is that is not curable.   Another challenge is that a sexual partner can be actively shedding the herpes virus without evidence of a blister on the mouth or genitals.

3. Chlamydia

With 4 to 6 million people infected each year, chlamydia is the most common sexually transmitted bacterial infection in the developed world.  Although you may notice body aches and pains, swelling, itchy or tingling areas, or abnormal discharge and pain during urination, chlamydia is often asymptomatic.  Chlamydia is transmitted through bacteria passed through sex – in bodily fluids and on the skin.  Chlamydia can have an unusual presentation called Reiter’s syndrome.  Individuals may experience arthritis, conjunctivitis, and a rash on the palms and soles called keratoderma blennorrhagicum.

4.  Gonorrhea

Gonorrhea is a contagious bacterial infection that infects about 700,000 people each year.  It is most often transmitted through sexual contact and symptoms may include swollen lymph glands, body aches and pains, or abnormal discharge and pain during urination.

5.  Hepatitis B&C

Hepatitis is a serious liver infection caused by the Hepatitis B virus.  Symptoms of Hepatitis include fatigue, swollen lymph glands, body aches and pains, diarrhea and blotches on or under the skin (flu-like symptoms).  Approximately 300,000 people are infected each year through contact with bodily fluids or skin and shared items.   It is important to diagnosis Hepatitis, because left untreated it can results in liver cancer.

6.  Syphillis

Infecting 50,000 people each year, Syphillis is a bacterial infection caused by Treponema Plidum and is spread primarily through sexual activity.  Symptoms can include fatigue, swollen lymph glands, and body aches and pains.  Syphillis is spread through sex and close contact.  Syphillis is on the rise again. Early detection is key, because left untreated syphilis can affect the heart and the nervous system.

7. Genital Warts

Genital warts present in about 3 Million people in the United States every year.  Caused by the Human Papillomavirus (HPV), genital warts are spread through sexual contact and will present as small bumps on the genitals.  There are vaccines available to protect against many genital-wart causing strains of HPV.  Although there is no cure for genital warts, treatment can help to reduce symptoms.  Treatment can include application of a prescription medication or surgical removing of the warts.  A dermatologist can help you with treating warts. Sometimes several months of treatment can be required

8. Molluscum contagiosum

Molluscum contagiosum is a skin disease caused by the molluscum contagiosum virus (MCV) and will usually cause small lesions or bumps in the infected area.  Molluscum contagiosum was once a disease that primarily affected children, but it has evolved to become a sexually transmitted disease in adults.  Molluscum will usually resolve on its own although lesions can last up to 4 years (or as little as 2 weeks).

Diagnonis of a Sexually Transmitted Disease

Just like with other medical conditions, there are various tests performed for STD’s.  When you visit your care provider they will do a general intake and ask you about your concerns and health history.  If there is a concern of STD’s you will likely have a variety of testing performed (exam, swab, blood and urine test).  It is important to have routine STD screening. I recommend testing every 6 months if you are not in a monogamous relationship.

• Urine Test:  Chlamydia and Gonorrhea
• Blood Test:  HIV, Syphilis, Herpes, and Hepatitis B
• Swab Test:  HPV, Herpes, Chlamydia, Bacterial Vaginosis, Gonorrhea, Genital Warts, Molluscum, Syphilis, and Trichomoniasis
• Oral (Cheek) Swab:  HIV
• Physical Exam:  Genital Warts, Molluscum, and Bacterial Vaginosis

Treatment of STDs by a dermatologist

 Dermatologists are well versed in STD care and have advanced knowledge of skin care and effects of STDS which can be very beneficial during treatment.  Treatment will usually include antibiotics or antiviral drugs.  A single dose of antibiotics is usually enough to treat many parasite or bacteria induced STDS.  Antiviral drugs cannot cure STDs but they can help to impact the course of the disease. 

There is no over the counter treatment option for STD’s.  If you suspect that you may have and STD, your best bet is to see your doctor as soon as possible for correct diagnosis and treatment.  By treating STDs early, you can avoid any permanent damage.

Prevention of Sexually Transmitted Diseases

It’s time for the ‘Sex Talk’.  To protect yourself from STD’s, ALWAYS use protection when having sex, and use it correctly.  Until you and your partner are both tested with a clean report, condoms are a MUST.  Also, don’t share needles or sex objects since many STD’s can be spread via contact.

As a dermatologist I see many women (and men) who come to me concerned with the appearance of their skin as they age. Basically, they don’t want their skin to make them look their age – or older. The aging process is inevitable. Although not everybody starts showing the signs of aging at the same age, everybody will at some point show signs of aging.

I believe that every person should be allowed to age in whatever way they want. Aging with grace – in my opinion – means that women take action to lift themselves up and strive to live a confident, healthy, and meaningful life. This could be taking measures to physically reduce the signs of aging (things like coloring grey hair, using Botox to minimize appearance of wrinkles, etc), eating well and exercising to maintain health, or even taking advantage of learning and social opportunities to keep the mind and body active. If Botox and Filler make a woman feel better about herself, then I support that 100%.

When patients come to me looking for advice and treatment for the signs of aging we discuss a number of possible treatment plans. I like to focus on making minor adjustments to simply minify the signs of aging versus going overboard and changing the appearance of any one feature. For example, Botox in small quantities will simply help to reduce the appearance of the eleven’s – the lines that form between your eyebrows and the horizontal forehead lines. When you use too much Botox, the forehead will appear stiff and unnatural. Non-Surgical Nose Job

In an attempt to be authentic and honest, I think it’s important that I “come clean” with respect the anti-aging procedures that I have had. I am now in my late 30’s (although I know I don’t look it!!). I fuel my body and my skin with lots of clean, whole foods, starting the day with an antioxidant packed green smoothie. Since I started residency almost 10 years ago, I use a nightly retinoid. Retinoids are an anti-aging power house, helping to prevent fine lines and wrinkle. Now that I am well into my 30s, my skin care routine also includes an anti-oxidant serum and an eye cream. I also moisturize my skin twice a day (up from the once a day that I did in my 20s and early 30s when my skin was oilier), and I wear sunscreen daily.

Around the age of 32 I tried Botox. Let me tell you—once you try Botox, you’ll never go back!! Forehead lines are some of the first signs of aging

and all my patients feel so much more confident without them. This is a quick and almost painless procedure. Botox typically lasts 3-6 months, depending on your age and the amount of wrinkles you have. This year, I started exploring fillers. The next place that often shows age is the under eye area. People in their 30s and older often complain about dark circles under the eyes. Most of the time, this is actually coming from a loss of volume in the cheek area. It starts out subtly and becomes more pronounced with time. Last February, I had filler placed in my tear trough. It is a quick procedure, numbing cream made it almost painless, but there was significant swelling lasting about 5 days. I noticed an improvement to my under eye area, but still had a depression under my eyes and in my mid cheek when I smiled. So, this year, I took the plunge and got Sculptra. Sculptra is an amazing collagen stimulator. It is injected like filler but then stimulates your body to make its own collagen. It takes 3 months to see the full effect. I can’t tell you how happy I am after this procedure. While it was painful, it was so worth it for me. I now look about 9 years younger and feel more confident in pictures. The best thing about all of the procedures that I have done is that nobody knows. I make sure to do things in a way that will make me look like a natural, more relaxed, more youthful version of myself. No artificial faces here!!! The key to a natural look is to get a skilled board certified dermatologist to perform your procedures. They will sit down with you in a consultation, and help you map out a plan that makes you feel comfortable medically and financially.

In my Before & After photo above you can see darkness in the area under my eyes and my cheeks aren’t quite as full. In the image on the right, the area below my eyes is smooth and bright and my cheeks are fuller.  These images were taken from video footage from two video’s that I published on my Facebook page (link).

As a woman, I want to break down stereotypes that say that women should appear flawless without any help. That is a lie. I work hard to keep my body healthy and I work hard to keep my face looking youthful. There are a number of non-invasive procedures that, when used correctly, can make a subtle difference in the appearance of signs of aging. I am not ashamed to share what I have done to age gracefully. However, nothing replaces a healthy lifestyle. I exercise 4-5 times a week, eat right, and meditate daily. Even though it can be challenging to find time to take care of myself with a busy practice and with small children, I know that the greatest gift I can give my family and my patients is a happy, healthy mommy and doc. Check out the blog to see what treatments I recommend for your age group and stay tuned to my next blog on nonsurgical fat loss techniques… yep. I’ve tried that too!!

My top tips for anybody that wants to master the fight against aging.

• General health is the first step in fighting aging – eating healthy, nutritious foods and exercising offer many benefits towards healthy, vibrant skin.
• SPF is your best friend. Every. Single. Day! UV rays cause wrinkles and premature aging along with skin cancer.  Also, invest in a good pair of sunglasses and wear them anytime the sun is out (even in the winter) to help cut down on wrinkles caused by squinting.
• It’s never too early to begin the fight against aging. Check out this blog post where I share anti-aging tips for every age (link to blog post).
• Facial Creams and serums can only do so much and there is no magic solution to make wrinkles disappear.

If you are concerned with fine lines and wrinkles and want to get back on track with your skin care and health routines, check out my FREE Clear Skin Challenge. This e-book provides 30 days of tips and recommendations that will set you on the path to clear skin.

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Petroleum jelly is a common item found in the medicine cabinet, and for good reason.  The product is gentle, hypoallergenic and non-comedogenic (meaning it won’t clog pores) and is commonly used to protect minor cuts, scrapes, and burns and to protect skin from windburn and chapping.   Most people know petroleum jelly by the brand name “Vaseline”. 

Do you struggle with dry, itchy skin in the winter? Find relief with tips from Surviving Winter Itch. Be sure to enter the giveaway there too!

Vaseline works by creating a sealing barrier between cells, locking in moisture which helps to speed up your skin’s natural recovery from dryness.  For people that suffer from dry skin, irritation, minor cuts, chapped lips, diaper rash, or eczema, Vaseline is likely to bring relief.  However, Vaseline has gotten some bad press over the years and I know a number of people avoid using it.  Which brings me to the great Vaseline debate!

Why The Debate?

Vaseline is a byproduct of the oil industry.  During the refinery of crude oil, the leftover residue is purified and turned into petroleum jelly.  Given that this is a byproduct of the oil industry, it is considered to be not eco-friendly.  The concern is that it is not a sustainable resource and therefore not good for the planet. Non-Surgical Nose Job

Is Vaseline safe to use?  Generally, petroleum jelly is regarded as a safe product but the components that are removed from the oil during the refining process are carcinogenic in some cases.  As stated on the Vaseline website, Vaseline is a triple-purified product and regarded as non-carcinogenic.  However, there are plenty of petroleum jelly imitators out there and you don’t always know the extent of purification. 

Finally, some people voice concerns about the safety of petroleum jelly on your skin.  Petroleum jelly is water-repellant and not water-soluble which means that it creates a seal on the surface of the skin so that moisture does not leave the skin.  However, the thick texture makes it difficult to cleanse from the skin (so never apply on an unwashed face or you will be sealing in the dirt).

My Opinion

Personally, I use Vaseline on myself and my children.  I trust the brands purification process and think that the environment concerns are not directly related to the demand for Vaseline.   When used properly, Vaseline is a great product to include in your home medicine cabinet.  A few of my favorite applications:

• Eczema –  vaseline for eczema apply a thick cream followed by Vaseline to help seal in moisture.
• Patches of dry skin will benefit from a layer of Vaseline – I like to slather my feet in Vaseline and then put socks on before bed – my feet are so soft in the morning!
• Lips – when your lips are dry and cracked, Vaseline helps to smooth them and makes a great base before applying lipstick.
• Prevention of infection: after surgery, I recommend that Vaseline (not bacitracin or Neosporin) be applied to the surgical site. Studies show that Vaseline prevents just as many if not more infections that Bacitracin and Neosporin without the risk of contact allergies that those two medications have.

Is there anything I can use instead?

As we become more and more educated about eco-friendly products and gain a better understanding of clean skincare I get many questions about product replacements.

​​A colleague of mine recently sent me a product to test out as a Vaseline alternative.  Dr. Rogers RESTORE healing balm is a petroleum-free ointment that contains Glycerin.  The ointment has a similar texture to petroleum jelly although I found it to be a bit lighter in consistency.  Glycerin hydrates and promotes healing.  The inactive ingredients in RESTORE include Castor Oil and Castor Wax which (reduce irritation and protect raw or sensitive skin.  Microneedling serum

I think that RESTORE  is a great clean alternative to Vaseline. However, you will have to pay a lot more for this product. A small 0.5oz jar of RESTORE is $30 while a small jar of Vaseline is closer to $3. 

If you are looking for a natural alternative to Vaseline, RESTORE is definitely something you should check out.

Another option is Vanicream Vaniply. Check out how Vaniply helps me reduce irritation, especially in the wintertime in my blog post on Surviving Winter Itch.