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!

 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.

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.

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. 

Father’s Day is around the corner so today I am sharing my top skin care tips for the men out there.  Men experience many of the same skin conditions as women (acne, eczema, dry skin, etc) and can learn a lot through other posts I’ve shared on my page.  However, there are some conditions in men that have more specific advice. 

Razor Burn

This is one of the most common complaints of my male patients.  Facial hair is quick to grow and most men have to shave every day or

two.  The sensitive nature of facial skin combined with the razor will often result in some irritation, called razor burn.  To prevent razor burn, it is important to properly prepare your face before you begin shaving.  This means washing your face with warm water before you shave and use a lubricant (shave gel or soap) to help the razor glide over the skin.  Make sure that your razor blades are new and sharp and follow the grain of hair with short strokes.

If you find that your skin is uncomfortable after your shave, instead of using plain moisturizer, apply an aloe-based cortisone cream.  This will help to calm your skin and reduce any irritation.

Ingrown Hairs

Ingrown hairs occur when hair curls and then grows back into your skin, instead of away from the skin.  Also, when dead skin clogs a hair follicle, the hair will grow sideways under the skin.  These will appear as bumps which may resemble small pimples.  There is usually some irritation the bumps can be uncomfortable.  Some people can see pus inside of the bumps, and may actually be able to see the hair that is ingrown.

For men, ingrown hairs are very common on the chin, cheeks and neck.  Facial hair tends to be coarser and therefore is more likely to become ingrown, especially after it has been shaven.

Ingrown hairs usually resolve on their own.  If not it can become infected – and if you scratch or pick at the area it will leave a scar.  When you notice an ingrown hair that is bothersome or infected, contact your doctor for treatment.  Your doctor may release the ingrown hair with a small cut into the skin and may prescribe treatment to help with your skin and any infections. Crows Feet Treatment

Preventing ingrown hairs is not entirely possible but you can take some measures to help limit them.  The same steps outlined above for razor burn will also help with ingrown hairs.  In addition, you can try to tease out ingrown hairs by rubbing your face in a circular motion with a wet washcloth.

Problem.

Hair Loss

Two-thirds of American men will experience a significant level of hair thinning by the age of 35.  There is a huge market for hair loss products but sadly many of them fall short of their claims.  In terms of routine, there isn’t much you can do to prevent hair loss.  Good health and nutrition will help to slow the process.  If you aren’t into the bald look, I’ve seen patients have good luck with a medication called Finasteride (commonly known as Propecia).  Rogaine has more limited results and but is sometimes good to use in combination with Finasteride.  If you can afford them, hair transplants are a great options where strips of hair are removed from fuller parts of your head and grafted into bald areas.

Jock Itch

Jock itch, also known as tinea cruris refers to an itchy rash in the groin area.  This is generally seen in jocks and people who are more active.  A fungul infection is the most common cause of jock itch.  This infection is treated with antifungal cream medication over the course of two to four weeks but may need an oral medication as well.

Fungus will grow in warm and moist environments so taking care to keep the groin area clean and dry is important.  Dry off after bathing or excessive sweating and wear loose cotton underwear.  After swimming, take off wet suit right away.

Itching and irritation in the groin area should be presented to a doctor for treatment as soon as possible.

Aging

I want to take a moment to call out aging in men specifically.  Women tend to spend more time obsessing about wrinkles and sagging skin but trust me, the men are asking about it too!  Women tend to start utilizing anti-aging products from a younger age, and therefore the wrinkles appear later on.  I know that many men prefer a simple, easy skin care regimen.  However, the advice I share in Dr. Ip’s Tips for 4 Decades of Beautiful applies to all genders.  It’s never too early to start a skin care regimen that will help with anti-aging. 

Share this with the men in your life, and encourage them to visit a doctor for any concerns.

As we grow more and more concerned about harmful UV rays and the risk of skin cancer, we are taking better precautions when outdoors.  Sunscreen, extra clothing, and avoiding the sun all help to keep you protected from UV rays.  The side effect of all this is that we are seeing more people with vitamin D deficiencies. 

Vitamin D is an important component to overall health.  Your body uses vitamin D to manage the amount of calcium in your blood, bones and gut.  There is also new compelling research that shows that Vitamin D plays a important role in how our immune system functions. Vitamin D is unique in that your body makes the vitamin when your skin is exposed to sunlight.    There are some foods that will provide small amounts of vitamin D, but you likely won’t be able to get the amount that your body needs just from food.  

Vitamin D Deficiency

When your body doesn’t get enough vitamin D to keep it healthy, this is called a vitamin D deficiency.  In severe cases, this can result in soft, thin, and brittle bones (called rickets in children and osteomalcia in adults).  

People with darker skin are more at risk for vitamin D deficiency because darker skin requires more sun to get the same amount of vitamin D as fair-skinned people.  It is also more common to see vitamin D deficiencies in people who spend a lot of time indoors during the day and in people who cover their skin all of the time.  

Symptoms of vitamin D deficiency are not always apparent but will sometimes appear as tiredness and general aches and pains.  Vitamin D deficiency can also contribute to hair loss.  I often hear people finding out about a deficiency through a routine blood test during an annual exam with their physician.  In severe cases there may be pain in your bones and frequent infections.  Your physician can offer a blood test to check your vitamin D levels.  

Vitamin D Sources

Sun exposure is the natural source of vitamin D but as a dermatologist I wouldn’t suggest exposing bare skin to the sun in order to increase your vitamin D levels.  There is a healthy balance – moderate but frequent sun exposure is ok but when your exposure to the sun becomes too intense, the risk of skin cancer increases dramatically.   If you do plan to spend more time outside for the benefit of vitamin D, don’t over-do it.  You don’t need to get a tan (or sunburn), in fact your body can produce a large amount of vitamin D in a short amount of time.

Fun fact:  If your shadow is longer than you are tall, you’re not making much vitamin D (the angle of the sun’s rays are resulting in the atmosphere blocking the UVB part of the rays). Wrinkle Remover Cream

Supplements are a good way to get vitamin D when you are worried about exposing your skin to the sun.  Your physician can provide a specific recommendation on the amount you would require.  I use Adora Calcium Supplements (purchased from Whole Foods) which provide a boost of D3 to help absorb calcium.  These provide an added bonus of a nice chocolaty treat! How do you supplement Vitamin D in your diet?

Summer is almost here and my motto is ‘Healthy Skin Is In’.  Show your body some love with some Body Therapeutics Skin Care from Hydropeptide.  I’m running a giveaway at the moment and one lucky person will win one of these kits.  Click here to enter!

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This is the third post in my series, “Cure Your Acne Once And For All”.  My goal is to educate and support people in their mission to achieve clear skin.  A huge part of controlling your acne is understanding why we get acne.  One important element to how acne develops oily skin that our body produce naturally and get help with Vibrant Dermatology to cure this. 

If you notice that your skin is really greasy throughout the day you likely have overactive sebaceous glands.  As I discussed in my first blog post about acne (Step 1, Making A Diagnosis), we have sebaceous glands attached to follicles and when these follicles become obstructed the oil does not have a way to get out and a comedone will develop.  Bacteria begin feeding on these oils and skin cells and the body reacts with an inflammatory response creating pustules.  In some cases, the sebaceous glands will go into overdrive and create excess oil which leaves your skin looking greasy (and makes you more prone to acne).  

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There are a number of things that can cause the sebaceous glands to go into overdrive.  For some, oily skin is hereditary or hormonal (or both!). It’s important to have a better understanding of why sebaceous glands go into overdrive, and what you can do to ameliorate this process.

• Teenagers and women who have PMS likely notice extra oil because of a spike in androgens which results in increased sebaceous secretions.  Take extra care of your skin during this period to help prevent breakouts.  By extra care, I mean make sure you are washing twice a day (no more!) and keeping your skin well hydrated.  You may need to switch to a face cleanser that targets acne (see Step 2, The Best Face Wash For Acne Prone Skin for some tips here).  Proper nutrition will also help during these times.  
• If you suffer from polycystic ovaries syndrome (PCOS) you will likely notice oily skin because of the extra sebum being produced.  PCOS presents extra challenges for many women. When a woman has PCOS her hormones may be out of wack. She may have excess androgen production that leads to oily skin, acne, and even unwanted hair growth. In this instance, hormonal measures such as oral contraceptives and a pill called spironolactone are two medications that can help get hormone levels back to normal. Many women with PCOS also have insulin insensitivity, otherwise known as metabolic syndrome, this can results in weight gain. Eating foods with a low glycemic index (meaning avoiding white, refined starches) can go a long way to controlling the hormonal fluctuations seen in PCOS. When the hormone levels are better regulated, the sebaceous glands chill out and your skin appears less oily.

If your oily skin is not caused by hormones or a specific disorder, it is likely caused by your lifestyle.  Even if you identify with some of the things I mentioned above, the tips below may help you too.  

• Over washing – Scrubbing your face multiple times (more than twice) every day with a harsh product will strip your skin of its natural oils.  Once the oil is stripped away your body will create more oil to replace it.  The more you strip, the more you create.  Washing twice a day with a gentle facial wash will ensure that your skin is balanced and healthy.  It will take some time for the oil production to slow down once you cut back on washing so be patient with this.  
• Diet – If you consume a lot of dairy, sugar, refined carbs or hydrogenated oils, you may notice an increase in oil.  These foods all increase the amount of androgens in your body so cutting back and eating a cleaner diet will certainly help, as will eating enough essential fatty acids (like salmon, walnuts and flaxseeds). Also, be sure to stay hydrated from the inside (drinking water) and the outside (moisturizing) as your skin will go into overdrive oil production mode when it is dry.
• Stress – An increase in stress will increase the amount of cortisol in your body which will cause an increase in oil production.  Be sure to take time for yourself – yoga, meditation, or a regular fitness routine will help keep your stress hormones down. Instant Wrinkle Remover Cream

To achieve clear, healthy skin you will need a skincare regimen that is gentle yet effective and a lifestyle that supports overall health and general well being.  Managing your oily skin will help to prevent future breakouts and is an important step in the process of clearing your skin.  

Do you suffer from oily skin?  Acne?  Be sure to sign up below so that you don’t miss any of my future posts about acne.  

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