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Acne for Dummies Excerpt from Acne for Dummies

by Herbert P. Goodheart, M.D.

Ten Tips for Healthy Skin

That's right. You don't see the word acne in the title of this chapter. And although the subject comes up here, it's not my primary focus. As a dermatologist, healthy skin is my thing. So, I wanted to provide you with some tips and tricks to keep your skin healthy throughout your life. Just think -- you're going to get your acne under control one day, but you'll have the skin you're in for the rest of your life. So, treat it right. In this chapter, I show you how.

1) Steering Clear of Excessive Sun Exposure

The sun is an immense nuclear reactor. As well as producing heat and light, it also sends out other types of radiation that can sometimes damage your skin. The Earth's atmosphere filters out much of the more dangerous solar radiation, but some of it gets through -- mainly in the ultraviolet (UV) band. The UV radiation in sunlight can cause painful sunburns and certain types of skin cancer, and can also age your skin.

If you have a personal or family history of skin cancer or you have very fair skin that never tans but always burns, do whatever possible to minimize sun exposure. If you have skin of color or are naturally very dark complexioned, you can probably ignore the following advice unless you develop allergic reactions from the sun, take medications that may make you extra sensitive to the sun, or have a medical condition that sunlight worsens.

The best way to prevent skin damage from the sun besides moving to the Antarctic -- oops, never mind, I forgot about the hole in the ozone layer there -- is to avoid excessive exposure to UV and the sun. You can accomplish this by following these tips:
  • Shun the sun between 10 a.m. and 4 p.m, especially during late spring and summer when the sun is most intense.
  • Wear protective headgear such as a hat with a wide brim to protect your face, head, and the back of your neck. You can also wear a baseball cap, long-sleeved shirts, and long pants.
  • Be aware of reflected light from sand, water, or snow.
  • Avoid tanning parlors.
  • Slather on the sunscreen with an SPF of 15 or greater -- at least 30 minutes before sun exposure, even on cloudy, hazy days.
  • Reapply sunscreens liberally and frequently at least every two to three hours, and after swimming or sweating.
  • Choose a broad spectrum sunscreen that blocks both UVB (the burning rays) and UVA (the more penetrating rays that promote wrinkling and aging).
TIP: If you're a person of color and have the dark spots of PIP, they're often further darkened by sun exposure. A broad-spectrum sunscreen will offer you the best protection. (I cover PIP in Chapter 12.)

2) Opting for Sunless Tanning

Sunless tanners, sometimes referred to as self-tanners or tanning extenders, are promoted as a way to get a tan without the sun. You can try:
  • Self-tanners: These artificial tanning preparations contain dihydroxyacetone (DHA). DHA interacts with dead surface cells in the outermost (horny) layer of your epidermis and produces a color change. As the dead skin cells naturally slough off, the color gradually fades back to your normal skin color, typically within five to seven days after a single application. DHA-containing products are available as lotions, creams, sprays, and gels and aren't considered to be harmful. Airbrush tanning using DHA is now offered in salons.
  • Bronzers: The term "bronzer" refers to a variety of products used to achieve a temporary tanned appearance. These products contain a transparent color additive that also stains the outermost layer of your skin. You can choose a bronzing gel or cream that enhances your own skin color. The chemicals in bronzers may react differently on various areas of your body, producing a tan of many shades. It can be washed off with soap and water at the end of each day. Bronzers are also considered to be harmless.
WARNING: Although self-tanners and bronzers give the skin a golden brown color, these products don't offer protection from the damaging effects of UV radiation unless they also contain sunscreen ingredients.

Clinique, Estee Lauder, Clarins, and Bain de Soleil all offer sunless tanning products. Neutrogena has foams that are easy to apply to areas with body hair.

Other means of producing a tan without the sun, including tanning pills (which contain color additives) and tanning "accelerators" (which contain other chemicals), should be avoided. According to the FDA, there is a lack of scientific data showing that they work; in fact, at least one study has found them ineffective.

3) Dimming the Shine of Oily Skin

If you have oily skin -- you're lucky! Oily skin has great advantages. Your skin will probably be less likely to wrinkle, age, and sag. On the other hand, it may feel greasy and develop shiny patches even a short time after you wash it. The highest concentration of sebaceous glands is in the T-zone, and the excess sebum from this area plus the sweat glands on the skin can make your skin look even greasier and shinier. (Take a look at Chapter 4 to see the T-zone.)

But you can temporarily squelch the shine with many products now available such as blotting papers, oil-absorbing powders, and foundations. Even the application of medicated prescription products such as retinoids and benzoyl peroxide are temporary cosmetic maneuvers that remove the surface oil. The deeper oils (sebum) are bound to keep flowing despite what you do to the surface.

You can try tackling T-zone oiliness with Clinac O.C. (Oil Control) Gel, which can be purchased without a prescription. It mops up excess sebum without drying the skin. In addition, if you're looking for a matte finish, you can try a "mattifier," a shine-stopping product that helps absorb oil on your face and, ideally, prevents oil from breaking through. The following are a few suggestions:
  • Neutrogena Pore Refining Mattifier Shine Control Gel
  • Lancome Pure Focus T-Zone Mattifier
  • Loreal Hydra Mattify
4) Humidifying Dry Skin

If your skin is excessively dry, it may be due to a diminished production of sebum, reduced sweat activity, and environmental factors.

Xerosis, or dry skin, can affect anyone, but it tends to be more severe in certain folks, especially those with a hereditary predisposition. Modern lifestyles are also a contributing factor. In Western societies, we tend to over-bathe; use of harsh soaps and hot water also contribute. Xerosis is a common occurrence in winter climates, particularly in conditions of cold air, low relative humidity, and indoor heating.

Use moisturizers to help with dry skin. Moisturizers don't add water to the skin, but they help to retain or "lock in" water that was absorbed during your shower or bath. Therefore, apply a moisturizer while your skin is still damp. The choice of product is based on personal preference, ease of application, cost, and effectiveness.

TIP: You can find numerous over-the-counter preparations in ointment bases, cream bases, and lotions. Eucerin, Nivea, Aquaphor, Oil of Olay, Moisturel, and Curel are just a few of the popular name brands. Am-Lactin (ammonium lactate 12 percent) lotion or cream is applied after bathing. It is very effective and is used for more severe cases of xerosis and may be purchased over the counter. If your skin is really scaly and dry, you can also get special, heavy-duty moisturizers that are available by prescription only.

5) Soothing Sensitive Skin

Acne medications, many of which are irritating in the first place, can wreak havoc with sensitive skin. Applying bland moisturizers such as Oil of Olay and Cetaphil Lotion over acne medications and using soap-free, gentle cleansers designed for sensitive skin is particularly important for people who have an underlying skin condition such as eczema (atopic dermatitis).

TIP: Women who have sensitive skin or eczema should discard cosmetics that have been on the shelf for a long period. That's because they can become contaminated if some of their preservatives break down or oxidize over time.

6) Promoting a Youthful Glow

If you're looking for ways to promote that "youthful glow" of your skin, there are many new skin-care developments designed to do just that:
  • Renova: Available only by prescription, this is an anti-aging cream that contains the active ingredient retinoic acid. Retinoic acid has been sold for years under the brand name Retin-A and used for the treatment of acne, which I cover in Chapter 9. The drug is approved by the FDA for the treatment of sun-damaged skin. Precautions for use of Renova are the same as those for tretinoin and the other retinoids.
  • Fruit acids: Products that contain natural fruit acids (alpha hydroxy acids or AHAs) such as glycolic acid are now very popular. They claim to "rejuvenate" the skin by encouraging the shedding of old, sun-damaged surface skin cells, which promotes a fresher, healthier look with a more even color and texture. There are many products with varying concentrations of various fruit acids in differing bases. Those available from medical practitioners are stronger than those at pharmacies and beauty therapists. AHAs can be alternated with other topical anti-aging preparations including retinoid creams. Check out Chapter 14 where I talk more about AHAs.
7) Caring for the Bumps

Use the gentlest skincare products available if you have acne, rosacea, or razor bumps. Tender loving care is the byword. Treat your skin as gently as possible. Often, people suffer from their own overtreatment. Strong soaps, harsh exfoliants, loofahs, and rough washcloths are much too irritating.

Soap cleansers such as Basis soap, Eucerin Bar, Purpose Soap, and Neutrogena Cleansing Bar are all mild enough for daily washing.

Non-soap cleansers include Liquid Neutrogena Cleansing Formula, Aquinil Lotion, and Cetaphil Lotion.

8) Minimizing Stress

Easier said than done, I realize. Although stress doesn't cause acne, many believe that it can trigger flare-ups. That's because when the body encounters stress, it steps up production of cortisol, which causes the sebaceous glands to produce more oil.

The best course of action is to keep tabs on your own personal response, and to try to make time every day for the things that make you feel relaxed and happy. Exercise, meditate, get a good night's sleep, and eat a healthy diet. You've got nothing to lose.

9) Visiting a Dermatologist

If you may permit me to brag, we dermatologists have the important skills that come with focused, repetitive, visual scrutiny and education regarding your skin. The ability to make diagnoses and to identify benign versus malignant lesions is our specialty. And, of course, we're the experts when it comes to treating acne.

So if you can't manage your acne on your own or you're not getting very far with prescription medications given to you by your healthcare provider, make an appointment to see one of us.

After you have a dermatologist, if you wake up one morning with a big zit and you have an important day coming up, call her office. Tell the person at the appointment desk about your problem. If it's during the week when your doctor has office hours, she'll be more likely than not to ask you to come in for an intralesional cortisone injection. It can flatten the bump within 24 to 48 hours. I describe this procedure in Chapter 10.

If that big day is today, do your best to hide the zit with makeup. Creative use of cosmetics can help conceal the redness of pimples, and green-tinted makeup can offer extra coverage.

10) Giving Yourself a Break

New products are constantly introduced to "correct" our "flaws," and draw us into an attempt to reach an impossible standard of beauty. Movies, advertisements, and TV present unrealistic images of youth and beauty in our image-obsessed culture. Infomercials, Internet ads, magazines, and yes, doctors, may promote -- and sometimes exploit -- the latest "miracle" cosmetic, diet, or plastic surgical techniques and promise you the "fountain of youth."

There is profound truth to the old proverbs -- "beauty is only skin deep" and "it's what's inside that counts."

TIP: Relax and look at the glass as half full, rather than the idea that it is half empty. And remember -- zits and pores get bigger the closer you look at them!

The above is an excerpt from the book Acne For Dummies by Herbert P. Goodheart, MD. The above excerpt is a digitally scanned reproduction of text from print. Although this excerpt has been proofread, occasional errors may appear due to the scanning process. Please refer to the finished book for accuracy.

Excerpt from Acne For Dummies by Herbert P. Goodheart, M.D. provided with permission by John Wiley & Sons. Available wherever books are sold.