The Biggest Skin Care Mistake Every Woman Makes—Yes, Even You

By Megan McIntyre, Photographed by Winnie Au

Your skin care routine — not that hard of a concept to master, right? Wash your face, slap on some moisturizer, maybe a treatment every now and then? In theory, skin care is supposed to be idiot-proof, provided you have a super-simple routine. For those of us who have expanded our regimens beyond the usual soap-water-moisturizer approach, there's actually a bit more to it.

As we've gotten more involved with our skin, the question of which order to put on our products is a vexing one. "I think it's the most confusing issue in all of skin care, not only to consumers, but to professionals, too," says Dr. Neal Schultz, an NYC dermatologist and founder of DermTV. According to Dr. Schultz, if you don't put your products on in the proper order, not only will the products not work effectively, it's a waste of time, money, and effort. "Nothing bad will happen to your skin [if applied incorrectly]," he explains. "But, if you are going to the store, spending your money, and spending your time, you may as well do it right."

Determining that proper order is where things start to get tricky. Since marketers have gotten more and more clever with their product names (a gel-cream here, a serum-oil there, whatever the heck a liquid lotion is), the actual type of product isn't want matters. According to Dr. Schultz, it's the weight of the products you need to be concerned with.

What does that mean? "It comes down to the very fundamental principles of physics and chemistry," says Dr. Schultz. "After you apply your first product, the second product has to have the ability to go through it in order to penetrate the skin." In other words, the first things you put on your skin should be the lightest texture, then work your way up to the heaviest, hard-to-penetrate textures last. So, anything that is water- or alcohol-based should come first, followed by your gels, then your light lotions, then heavier creams, thick serums, and, finally, anything ointment-based (i.e. water-free). One way to tell how heavy the product is? Dr. Schultz says to read the ingredient list. Find out where the oils, lanolins, and petrolatums fall — the higher up they are, he says, the harder the product is to penetrate and the later in your routine it should go.

Dr. Schultz says that getting the right order will take some trial and error, as often it can be difficult to determine weight if two products are very similar in texture. One way to know for sure: If the product is just pooling on the skin and not absorbing, then it's not penetrating the skin, and, therefore, not doing your complexion any good. If the product is setting and you don't have any residue, then it has penetrated. According to Schultz, no skin care product (other than an ointment) should just lay on top of your skin — everything should penetrate.

Now, according to Dr. Schultz, there are two exceptions to this weight rule: sunscreen and acne products. While it may seem intuitive to do sunscreen last, Dr. Schultz says SPF needs time to set — about 20 to 30 minutes — so he almost always recommends patients apply a lightweight SPF lotion first. Another reason SPF needs to go on bare skin? "Sunscreen molecules must align and orientate parallel to each other, creating a grid that absorbs UV energy," he says. Creams can interfere with this grid, both on physical and chemical sunscreens, because the product can create bumps and ridges on the surface of the skin. In addition, most sunscreens were tested on bare skin, meaning you don't know how applying a cream first will impact the efficacy and duration of your sun protection. So, either apply a light sunscreen first, followed by products that are heavier than that, or skip that whole mess by opting for a moisturizer with sunscreen, or Dr. Schultz' personal favorite, a BB cream.

As far as your acne products go, Dr. Schultz says that those product are only really effective if they are applied directly on the problem area of the skin, meaning you don't want other products to interfere with that. So apply them lightly first (even before your sunscreen), then add the rest of your regimen.

See, we told you this skin care thing was more complicated than it looks. The good news is, now that you know how to get the most out of your lotions and potions, you might just find your existing products work that much better for you.

Beauty » Skin Care » 

The Right Way To Apply Skin Care Cream

 

New Sunscreen Guidelines & 20% off our sunscreens!

The FDA will be mandating new sunscreen guidelines starting June 2013.

On the front label of your sunscreen look for:

• Broad Spectrum
• SPF >30 (the FDA requires SPF >15 but dermatologist and the American Academy of Dermatology recommend  SPF >30)
• Water Resistant

In Order for a sunscreen to be classified as "Broad Spectrum", to cover UVA and UVB, the sunscreen must pass a critical wavelength  test. Most current sunscreen has a SPF factor that protects against UVB. Unfortunately, UVA radiation goes deeper into the skin to cause cell damage and increases your risk for skin cancers. UVA radiation also causes most of the hyperpigmentation, suntan and stimulation of melanocytes (which can contribute to melasma). The new "Broad Spectrum" designates UVA and UVB protection. 

The back label of your sunscreen should read:

• helps prevent sunburn
• if used as directed with other sun protective measures (see directions) decreases the risk of skin cancer and early skin aging caused by the sun.

"Directions include":

• Apply liberally 15 minutes before sun exposure
• reapply after 80 minutes of swimming, immediately after towel drying, and at least every 2 hours

Sun Protection Measures:

     Spending time in the sun increases your risk of skin cancer and early skin aging. To decrease this risk, regularly use a sunscreen with a broad spectrum of 15 or higher and other sun protection measures including:

• limit time in sun, especially from 10 am - 2 pm
• wear long sleeve shirts, pants, hats, and sunglasses

Before using sunscreen on children under 6 months consult your physician.

All skin is not created equally....MEN VS WOMEN

Men and Women Skin Are Not Created Equal

Men’s skin is different from female.  The biggest difference between male and female skin is due to male sex hormones known as androgens.  The main androgen is testosterone.  Although females also produce testosterone, males produce 10X more than females.  Beginning with middle age, testosterone levels steadily decline every year.

Male skin is oilier due to more sebaceous oil glands and more sebum production.  The big upsurge in testosterone during puberty causes an increase in oil secretion and sebum production.  Men using anabolic steroids, a testosterone-like substance, can develop “steroid acne.”  Sebum is produced by the sebaceous gland.  This provides a perfect breeding ground for the bacteria Proprionibacterium acnes.  The presence of this bacteria and excess pore-clogging sebum contributes to acne.  Sebum in the sebaceous glands also causes more inflammation in males.  Acne in young males is more severe than females.  By young adulthood, most men normalize their oil production.  However the damage from the inflammation can cause acne scarring.  At Southside Dermatology we have specific products to improve oily skin and acne.  At Southside Dermatology we understand that the type, nature and severity of acne/acne scars are different between individuals.  This is why we offer different modalities to treat acne  and acne scarring including medical treatments and procedures, minor surgical procedures, chemical peels, microdermabrasion and lasers. 

Men’s skin is thicker due to a denser and firmer elastin and collagen network.  This is why males tend to age at a later stage than females.  Denser, thicker facial hair growth on men also protects them from the damages of the sun.  The damaging UV rays are not able to penetrate as much to the skin dermis to cause collagen degradation.  Fair-skinned men with finer hair will display photo-damage more easily than darker haired men.  Because men tend to age at a later age they do not tend to think about protecting their skin at an earlier age.  They do not think about sunscreens use.  This may be why American men have a greater incidence of skin cancers than women.  Men also have a higher death rate due to melanoma, the deadliest of the skin cancers.  Men should be encouraged to use sunscreen at a younger age not to just prevent aging but to prevent skin cancers.

Men can have sensitive skin.  The top layers of the skin contain a mixture of ceramides, cholesterol and fatty acids to impede water loss.  Testosterone can have negative effects on epidermal barrier function.    Increase in epidermal water loss can lead to dry, flaky skin.  Older men are also not able to heal their skin wounds as quickly as women.  This is why it is important for men’s skin care to be formulated to effectively protect the epidermal barrier and to replace moisture.

Men tend to have darker, coarser facial and body hair.  Facial hair is thicker than scalp hair and have a flatter shaped follicle, making it curlier.  The curlier hair can reenter the skin, causing inflammation, razor burns, and ingrown hairs.   Darker ethnic men may also experience bumps due to these ingrown hairs.  This condition is called PseudofolliculitisBarbae (PFB).  The skin sees the ingrown hairs as a foreign body and will initiate a foreign body response causing redness, itching, irritation and keloids.  Ingrown hairs can be the result of shaving against the direction of growth or shaving too close.

Men’s lifestyles also effect their skin.  Men tend to spend more time in the sun, get less sleep, and experience more stress.  Men also tend to more likely have a history of smoking.  These extrinsic aging factors can greatly accelerate skin aging with deeper facial lines and creases.  During the middle aged years they start experiencing a decline in their testosterone levels.  They lose more collagen at a rapid rate after the age of 30 then women.

How can you slow down this aging process? 

• ·       Protect your skin from the sun.
• ·       Do not smoke.
• ·       Avoid stress.
• ·       Eat a healthy diet.
• ·       Make sure you drink a sufficient amount of water daily.
• ·       Use a good moisturizer every day.
• ·       Get a good night’s rest.

At Southside Dermatology we offer products and procedures specifically targeted towards creating natural and healthy skin for men.  Our products have the necessary ingredients to help moisturize, exfoliate and protect your skin.  Our procedures produce natural looking results with minimal down time. 

Procedures that we offer for men:

• ·       Chemical Peels
• ·       Microdermabrasion
• ·       Photodynamic Therapy
• ·       Photofacial (Photorejuvenation)
• ·       Botox (“Brotox”)
• ·       Fillers (skin rejuvenation, wrinkle treatment, face contouring; natural looking)
• ·       Laser hair removal (can be used to treat PFB)
• ·       Lasers for blood vessels and brown spots
• ·       Treatment for acne scarring (different modalities)
• ·       Pelleve (non-invasive procedure for eye wrinkles)
• ·       Thermage
• ·       Ultherapy (skin lifting and tightening…. sagging jowl, sagging foreheads and brows, jawline definition, neck tightening)

Please call 904-880-0622 for a free consultation with one of our skin care experts.

FDA Strengthens Warnings on Tanning Beds

By Toni Clarke | Reuters 

Washington (Reuters) May 06 - Tanning beds and sunlamps will be required to carry stronger warning labels under new regulations proposed by the U.S. Food and Drug Administration, which is also recommending the machines not be used by people under the age of 18.

The FDA said on Monday that it plans to reclassify sunbeds from low-risk to moderate-risk products, meaning they will need to be cleared by the agency before being allowed onto the market.

Faulty equipment has led to patients being burned or exposed to too much radiation, Jeffrey Shuren, director of the FDA's center for devices and radiological health, said in an interview.

Skin cancer is the most common form of cancer in the United States, according to the Centers for Disease Control and Prevention. Basal cell and squamous cell cancer, the two most common forms, are generally curable; but melanoma, the third most common type, is deadly.

In 2009, the most recent year numbers are available, 61,646 people in the United States were diagnosed with melanoma and 9,199 people died, according to the CDC.

The FDA's proposed regulations stop short of recommendations made by the International Agency for Research on Cancer, part of the World Health Organization, which in 2009 concluded that commercial tanning devices were more dangerous than previously thought and recommended people under 18 be banned from using them.

The FDA's regulations also stop short of new rules being developed by some U.S. states.

More than 30 states regulate the use of tanning facilities to differing degrees. Delaware, New Hampshire and North Dakota, for example, ban the use of indoor tanning by anyone under age 14 unless medically necessary and they require parental consent for those between the ages of 14 and 18.

Some states, including Georgia, Illinois and Maine, ban tanning beds for children under the age of 14, and eighteen states require tanning bed operators to limit exposure time to a manufacturers' recommendations and provide eye protection.

In January 2012, California became the first state to ban tanning beds for all people under 18.

The Indoor Tanning Association argues vigorously that the decision on whether a teen is allowed to suntan is one for parents, not government, and it supports parental consent. But it is fighting the growing number of states issuing bans.

"Is the next step to ban teens from sun bathing at public beaches and pools?" the association asked in a statement last year in opposition to New Jersey's proposal to ban tanning bed use for those under 17.

"You also have to consider the health risks associated with banning teenagers from using tanning salons," it said. "They will just go outside with no adult supervision and no trained staff where they are much more likely to get sunburned."

The FDA's actions follow a 2010 meeting of a federal advisory panel which unanimously recommended that the agency reclassify tanning devices. Panelists had mixed views on whether to implement a ban on minors.

An estimated 5.6% of U.S. adults reported indoor tanning at least once in 2010, with the highest rates among white, female 18 to 25-year-olds, according to the CDC, which notes that frequent exposure to UV rays for people under the age of 35 increases the risk of developing melanoma by 75%.

"For right now our proposal tries to focus on providing better information for consumers," Shuren said, "including a warning on the tanning beds themselves that they shouldn't be used in people under 18," he said.

Depending on the feedback the agency receives to its proposal, it may make changes to the final order, he said.

Ultherapy comes to Southside Dermatology

Ultherapy in Jacksonville

 The Non-invasive Solution to Lift, Tighten and Tone Skin on the Face and Neck

It’s been featured on national television shows such as Rachael Ray, The View and The Doctors. It’s been touted by big-name beauty editors from Vogue, Harper’s Bazaar, Marie Claire, Shape and more…

It’s Ultherapy, a non-surgical face and neck treatment that uses ultrasound to actually lift and tone loose skin -- on the brow, on the neck and under the chin -- without any downtime. And, it’s offered here in Jacksonville at Southside Dermatology.

Ultherapy Uses Ultrasound?

That’s right! Ultherapy is the only cosmetic procedure to use ultrasound imaging, which allows us to actually see the layers of tissue we target during the treatment, to ensure that the energy is delivered precisely to where it will be most effective.

Leveraging this tried-and-true technology, we can specifically target the deep foundation below the skin – the one typically addressed in cosmetic surgery – without cutting or disrupting the surface of the skin. That means after a 90-minute non-invasive treatment, you’ll be able to return to your everyday life without interruptions…and, without hiding behind those “post-treatment” glasses or scarves.  

Ultherapy Creates Collagen and Elastin Naturally

Ultherapy is so unique because it refreshes your collagen by jumpstarting a repair process. It relies on the body’s own regenerative process to stimulate the natural creation of new collagen and elastin – yes, new collagen and elastin. This results in an actual lift of skin overtime – and just better-fitting skin.

Many people notice an immediate effect following the treatment, but the ultimate lifting and toning takes place over 2-3 months, as tired collagen is replaced with new, stronger collagen. And, as this collagen-building process continues, further improvements can even appear up to 6 months following a procedure!

Ultherapy – an Uplift not a Facelift

 Ultherapy is a non-surgical option for people with mild to moderate skin laxity – those who want some lifting for skin that has lost elasticity, but are not ready for surgery, either mentally, financially or logistically. It’s also a great option for those who want to “stay ahead of the game” as well as those looking to prolong the effects of cosmetic surgery.

Ultherapy may cause some discomfort while the energy is being delivered, but it is temporary and a positive signal that the collagen-building process has been initiated. Of course, we offer a number of options to help make your Ultherapy treatment as comfortable as possible. Our patients who’ve had Ultherapy typically leave comfortable and excited about the benefits to come!

Ask us if Ultherapy is right for you!

If you’re looking for a lift to counter the effects that gravity takes over time, it may be just the treatment you’ve been waiting for.

What is the BEST sunscreen for me?

The best sunscreen for you is the one that you will use everyday.   But why is sunscreen important?  Sunscreen helps protect against the damaging effects of ultraviolet radiation from sun exposure.  We are increasingly exposed to UV radiation as we spend more time with outdoor activities, wear less clothing, and practice more indoor tanning.  In addition, the ozone layer is diminishing.

UV exposure has a direct effect on the incidence of skin cancers.  Skin cancers represent over 50% of cancers in the United States.  Melanoma, a deadly form of skin cancer, has tripled in the past two decades.  The aging population is also increasingly aware of the photo aging effects of sun exposure that causes premature wrinkles and dyspigmentation.

The UV radiation wavelength that causes cutaneous damage comprises of UVB (290 nm-320 nm) and UVA (320 nm- 400 nm).  UVB mainly causes the classic sunburn.  UVA can penetrate window glass and causes deeper damage in the skin.  UVA causes tanning and dyspigmentation and is relatively unchanged by time of day or season.  Because it penetrates deeper into the skin, it can cause more DNA damage that is related to skin cancers and photo aging.

An ideal sunscreen should protect against UVB and UVA radiation.    Sunscreens are divided into chemical sunscreens or physical sunscreens.  The physical sunscreens are titanium dioxide or zinc oxide.  Physical sunscreens protect against UVB and UVA rays.  Most chemical sunscreens protect only against UVB radiation.  The SPF factor in a sunscreen measures UVB protection.  For example, if you usually get burn in 10 minutes without sunscreen, then applying a sunscreen with a SPF factor of 30 will confer protection for 300 minutes.  This assumes that you apply enough sunscreen at a thickness of 2 mg/cm² to an area of 50 cm².  For an average adult, a total of 35 ml of sunscreen for each application is required.  A shot glass is 30 ml.  The SPF factor can be increase by adding chemical sunscreen ingredients.

UVA radiation absorbs at 320-400 nm.  The active ingredients that protect against UVA include titanium oxide, zinc oxide, avobenzone, and ecamsule (Meroxyl^TM SX).  Trade names such as Helioplex^TM contain avobenzone and oxybenzone and Anthelios^TM SX contains ecamsule, avobenzone, and octocrylene.  Recently the FDA started requiring a UVA rating protection factor on sunscreens similar to current SPF rating for UVB protection.  This rating ranges from “+” (least effective) to “++++” (most effective).

The effectiveness of sunscreens not only applies to the active ingredients but also to the correct application.  Sunscreens should be applied 15-20 minutes before sun exposure and reapplied every 2 hours and after swimming, towel drying, or sweating.  Sunscreens can be physically rubbed off after these activities. 

There are very few adverse effects from sunscreens.  If a person has sensitive skin then the physical sunscreens like zinc oxide or titanium oxide are the best choices.  Most allergic reactions to sunscreens are from the chemical sunscreens.  Sunscreens have also been implicated in Vit D deficiency.  Currently, there is no conclusive evidence to support this risk with the regular use of sunscreen.  Studies have shown that even small amounts of sun exposure can provide adequate vitamin D and that some UV rays still reaches the skin even when wearing sunscreens.

A comprehensive sun protection program consists of the right sunscreen, wearing protective clothing and limiting time out in the sun especially between the hours of 10 AM- 2 PM. 

What is the best sunscreen?  There are different formulations and will depend on the preference of the individual.  More expensive sunscreens will contain extra ingredients for photo aging and will be more cosmetically pleasing. The best sunscreen is the sunscreen that an individual likes to use and will regularly apply on their skin.

Fat Reduction with Injections???

Fat Reduction With Injections?

What if you can melt away the double chins, love handles, upper thighs saddle bags, flabby arms, lower tummy pouch, or back fat pads with localized injections?  This procedure is called mesotherapy.  Mesotherapy is a general term for both cellulite reduction and spot fat reduction.  This procedure has been in existence since the 1950’s in France.  There are many formulations that have been injected but most of these “cocktails” are not safe. 

There may be one formulation that is safe and effective.  This formulation is called ATX-101.  It is a synthetically derived form of sodium deoxycholate (deoxycholic acid).  ATX-101 causes rupture of the fat cells, which your body naturally reabsorbs, similar to the way blood is removed within a bruise.  Fat cells that are dissolved by the process are permanently loss. 

ATX-101 produced by Kythera Biopharmaceuticals is currently undergoing rigorous FDA (US Food and Drug Administration) studies for approval.  The studies involve injections of the deoxycholic acid into the submental fat (fat under your chin).  These are microinjections spaced several weeks apart.  The results are promising with significant improvement in fat reduction in the submental area (double chins).  The side effects are mild to moderate and most importantly, transient.  Patients have reported temporary bruising, numbness, pain, swelling and redness.  The symptoms did not last long and did not bother the patients.

Current methods to remove fat include surgery, liposuction and certain lasers.  These methods can be costly with associated surgical risks.  Hopefully ATX-101 will be approved by the FDA and available on the market soon.  We may be able to see fat just melt away from these difficult to treat areas under our chin, love handles, tummy pouch, saddle bags, and muffin tops.

Will Self-tanning Lotions Help Protect Me From the Sun?

     Self-tanning lotions and solutions have dihdroxyacetone (DHA) as an active ingredient. DHA causes a browning reaction when exposed to your skin. It usually comes in a 3-5% concentration in your self-tanning preparations. The lower percentage produces mild tanning (lighter shades) and the higher percentage produce a darker color (darker shades). So if you want a darker tan pick a higher concentration preparation. The depth of the color is also affected by thicker skin (with more protein content). Therefore, rough skin growths and thickened skin on your elbows, knees, palms, and soles will stain a darker color. DHA can also stain hair and nails but does not stain mucous membranes (wet part of your lips, mouth and eyes)

     DHA is colorless and stable. It is nontoxic if ingested and has rare side effects. There are only a few case reports of an allergic skin reaction. Self-tanning lotions have a comparable SPF of 3-4 for only up to 1 hour. Most dermatologists recommend a SPF of 30 or higher. Therefore, self-tanning lotions DO NOT offer you adequate sun protection.. You still should apply sunscreen with a SPF > 30. Check back with us for more on sunscreens later. 

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What is the Ugly Duckling Sign?

 When a dermatologist examines your skin to look for  melanoma, a deadly form of skin cancer, they look at each mole for certain characteristics. Generally, they follow the ABCDE"S of melanoma detection.

A = Asymmetry (one half of your mole does not look like the other half)
B = Border (irregular, scalloped, or poorly defined border)
C = Color (color variation within a mole; shades of tan and brown, black; sometimes white, red, or blue)
D = Diameter (melanomas are most often greater than 6 mm (the size of a pencil eraser) but they can be present as a small dot.
E = Evolving (changing in size, shape, and color)
S = Symptoms (a mole becomes painful or begins to bleed or itch)

What if all or most of your moles have an irregular shape or have a color variation? What if you were born with large moles? I start looking for the "Ugly Duckling" sign. This represents a mole that is different in appearance than all of your other moles. Moles (nevi) in the same individual tend to resemble one another and that melanoma or an atypical mole (nevus) is often the "ugly duckling", different from the other moles. This is not used as the sole criteria but is helpful to pick out which moles may need biopsy. In my opinion, another very important criteria are ANY changes in a mole. Make sure that you do periodic self-exams and see your dermatologist immediately if you notice anything changing, growing, or bleeding. Also, if you spot an "ugly duckling" tell your dermatologist!