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Monthly Archives: November 2016

Choosing the Right Skin Care for You

Selecting skin-care products can be a daunting task, what with all the choices filling pharmacy aisles. You’ll find dozens of over-the-counter products with such labels as “maximum strength,” “clinical strength,” and “original prescription strength” — plus seemingly identical products that are available only by prescription. What do all these labels mean, and how do you know which product is the best one for you? Here are some answers.

How Much Active Ingredient?

The active ingredient in an over-the-counter product is often the same as the one found in its prescription counterpart, but at a lower dosage. Over-the-counter dandruff shampoo contains a lower dosage of the active ingredient ketoconazole (1 percent), while the prescription-strength versions contain 2 percent. Inhydrocortisone anti-itch cream, the maximum over-the-counter dosage is 1 percent, while prescription-strength creams contain 2.5 percent. According to U.S. Food and Drug Administration (FDA) regulations, once a product’s active ingredient reaches a certain percentage — such as 1.5 percent for hydrocortisone, or 2 percent for salicylic acid in acne treatments — it requires a prescription from a doctor.

Sometimes It’s Just a Marketing Strategy

Because the FDA does not closely regulate over-the-counter skin-care products, a company can label a product “maximum strength” or “clinical strength” for any reason it sees fit — and the label is no guarantee that the product will actually be any stronger than others on the market. The best way to find out whether you are really getting the “maximum” strength of an ingredient is to check the ingredients label, says Robyn Gmyrek, MD, assistant clinical professor of dermatology at Columbia University College of Physicians and Surgeons. “Compare the label with other products on the shelf,” says Dr. Gmyrek, and check the percentage of the active ingredient in each product.

Although an increase in the active ingredient in a product of 1 percent may not seem as though it would significantly affect the strength, it can, says dermatologist Doris Day, MD, director of Day Cosmetic, Laser and Comprehensive Dermatology in New York City and a professor at NYU Medical School. For this reason, it’s best to test a new skin-care product by applying a dime-sized amount on your forearm, to see if it causes a reaction.

Prescription Products Must Be Approved by the FDA

For the FDA to approve a product’s switch from over-the-counter to prescription-strength status, regulations require a company to show that even a slight increase in the amount of active ingredient (for example, 1 percent) “changes the structure or function of the skin.” All prescription products are reviewed by the FDA and have gone through numerous clinical trials, says Debra Jaliman, MD, a New York City dermatologist. The FDA also decides what dosage level constitutes a prescription. Some OTC products may be labeled “original prescription strength,” which means a prescription from a doctor was once required, but the product is now available without one.

Finding the Right Product for You

How do you know which product to try? Stronger dosages can have harsher effects on your skin, so it’s generally safer to start with a lower dosage. Try the basic OTC product for a minimum of two weeks to gauge the results, then move on to a maximum- or clinical-strength product, if necessary, or request a prescription, says Dr. Day. For acne, you should expect to wait a little longer — from four to six weeks — to see results. And if any product irritates your skin or makes symptoms worse, see your doctor immediately.

Kick Dry Skin to the Curb

Winters here and with it come the harsh winds of irritated skin. The routine of cold and dry outside and hot and dry inside is wreaking havoc on our precious skin. So, what’s a girl to do? Thankfully, a lot according to Dr. Doris Day, MD, FAAD, New York dermatologist and author of Forget the Facelift (Avery Books) and Dr. Loretta Ciraldo Miami dermatologist and author of Six Weeks to Sensational Skin (Rodale) who share their winter-protecting secrets.

Be on a hot bath boycott.

In certain parts of the country, it’s chillingly cold. And it is precisely those cold temperatures that may lead many to a huge dry skin culprit:hot, long, baths. “Hot showers strip away your body’s natural oils,” says Dr. Day, leaving your skin dry and tight. Instead Dr. Day recommends taking not-so-hot showers, and then patting dry rubbing totally dry after so your body is a bit damp. “It’s about water retention,” says Dr. Day.

Still using summer products? Aint gonna cut it.

Using a rich cream instead of a lotion will make a huge difference in your skin,” says Dr Day, as lotions are thinner and not as emollient as their thicker cream counterparts. Instead, Dr. Day suggests switching out your light warm weather lotion for a richer, more penetrating cream.

Don’t worry about wrinkles.

“Women often see an exaggeration of wrinkles in the winter,” says Dr. Ciraldo, “because of skins dryness.” So if you look in the mirror and see more fine lines around your eyes and mouth, don’t add more stress to your sensitive skin by freaking out. It is most likely a temporary thing. Instead, defend yourself with a hydrating night cream and a good night’s sleep.

Soak in it.

“It’s important to put moisture back in your body,” says Dr. Ciraldo, and she means literally. Dr. Ciraldo recommends relaxing in a bathtub of tepid water until your fingertips are wrinkled, however long that takes “Your skin has a great capacity for holding water,” says Dr. Ciraldo, “it’s important to get re-hydrated.”

Read ingredients.

Because our skin loses lipids in the winter (the barrier that keeps water in) it’s important to use products that contain lipids, like the ever-popular Ceramides. Dr. Ciraldo also recommends looking for products with Stearic Acid (an animal fat) and Glyco-Lipids, that can also help in preventing moisture loss.

Get oily.

This is a good time to get on the Flaxseed oil and Fish oil bandwagon. Besides, being high in good-for-you Omega-3’s, these oils help keep the skin supple. Fish oil and flax seed oil supplements can also help improve skin’s appearance and reduce the pain of stiff sore joints, caused by the winter cold and possible the increase of you staying indoors and couch surfing.

Avoid Soap.

“Many soaps are drying, so it’s important to wash with a liquid non-soap cleanser,” says Dr. Ciraldo. In addition, Dr. Ciraldo suggests looking for cleansers or moisturizers that are possess botanicals, plant extracts like chamomile and lavender which are naturally body replenishing. Botanicals are often soothing as well; ideal for wind chapped or exposed skin.

The Best Care for Your Skin Type

Makeup experts and skin care specialists refer often to various skin types — dry, oily, combination — assuming you know which category you fall under. Your skin care regimen depends on your skin type, but not everyone has a good understanding of their skin. As a result, their skin care plan is more of the hit-or-miss variety.

Know Your Skin Type

Unsure of what skin type you have? See which description fits you best:

  • Dry skin. “Dry skin can be flaky and easily irritated. It’s more sensitive,” says Linda Franks, MD, director of Gramercy Park Dermatology and clinical assistant professor in the department of dermatology at New York University School of Medicine in New York. She says if your skin has these qualities and also tends to react to some (or all) of the skin products you have tried, you have dry skin. The extreme version of dry skin is sensitive skin.
  • Oily skin. The primary test for determining if you have oily skin is when you start to feel some oil on your face. Most people can feel a little oil by late afternoon, but if you feel oil around midday, you have oily skin. Oily skin rarely reacts negatively to skin products like dry, sensitive skin types do. It has slightly better natural sun protection, but is also prone to acne.
  • Combination skin. If the description of dry skin matches your cheeks, but the description of oily skin matches your “T-zone” (nose and brow area primarily), you have combination skin.

Matching skin care to skin type is important. Dr. Franks notes that there are two commonly used skin care products that just about everyone can steer clear of: toner and too-frequent exfoliation, both of which can strip away the protective layers of your skin. If you have a good skin care regimen, you don’t need either one, although you could plan for a semi-annual exfoliation as seasons change.

Caring for Dry Skin

Dry skin needs babying and lots of tender, loving care. Here are the key components of dry skin care:

  • Cleanse. Use a gentle cleanser. You should be able to cleanse at night and not have to cleanse again in the morning. “Mild cleansers are best for all skin types,” says Franks, who recommends Purpose, Dove bar soap, or Cetaphil cleanser. These cleansers should easily remove makeup as well as dirt.
  • Apply retinol. “Stick to a retinol for anti-aging. Retinol can be very good for dry skin,” says Franks. However, not everyone with dry skin can use retinol products due to sensitivity. If irritation appears, the frequency of use can be decreased.
  • Apply products with hyaluronic acid. “The other thing that can go on underneath a moisturizer is a hyaluronic acid product. That molecule is very hydroscopic — it pulls water in around it. That would be a great augmenting moisturizer for someone with dry skin,” says Franks.
  • Moisturize. “The stratum corneum, which is the dead skin cell layer that protects the surface of the skin, tends to get easily interrupted with dry skin. You want to try to repair that,” advises Dr. Franks. Look for moisturizers that contain phospholipids, cholesterol, and essential fatty acids. She recommends CeraVe Moisturize in the morning (with an SPF of 30) and more moisturizer before bed, using a thicker cream, such as Olay’s Regenerist.
  • Proceed with caution. It helps to take your time adding new products to your skin care routine, says Franks. Try them one at a time and wait to see if you get a reaction before adding another new product.

Caring for Oily Skin

If you have oily skin, you’ll have an easier time finding skin care products that won’t irritate, but your challenge is managing the oil:

  • Cleanse. People with oily skin or acne should wash with a gentle cleanser morning and evening. Franks offers this tip for cleansing properly: Use your fingertips and rub it in for 30 seconds before rinsing.
  • Use salicylic acid. Apply an alcohol-free salicylic acid product, such as a Stridex pad, or a salicylic acid medicated cleanser on the oily areas of your skin. Do this two or three times a week.
  • Apply retinol. Retinol products also cut down on oil production and reduce the appearance of large pores. They are a good anti-aging choice for those with oily skin, who are less likely to find them irritating than those with dry skin.
  • Moisturize. Use an oil-free moisturizer with SPF 30. “One of my favorites is Complete Defense in the Olay line,” says Franks.

Caring for Combination Skin

People with combination skin will follow the same basic routine, but have to make it a balancing act, drawing from skin care routines for both oily and dry skin:

  • Cleanse. Stick to gentle cleansers. “Do not use a medicated cleanser at all — keep it mild,” says Franks. Once a day should be fine unless you have significant oil in some parts of your face.
  • Spot-treat with salicylic acid. Apply this to the oilier areas of your face every other day.
  • Moisturize. Go for oil-free products with SPF 30 and spot-treat the drier areas of your face with richer moisturizer.

Take some time to develop the skin care routine that’s right for your skin type. If you are still unsure of how to care for your complexion, talk to a dermatologist about the products you are using and how they affect your skin. With a little work, you can achieve a healthy glow, no matter what your skin type.

Liposuction May Lower Certain Blood Fats

A new study suggests that liposuction — which plastic surgeons often use to sculpt the bodies of people who aren’t extremely overweight — can lower levels of a type of blood fat called triglycerides.

“High triglyceride levels are known to be associated with an increased risk of cardiovascular disease,” study author Dr. Eric Swanson, a plastic surgeon, said in a news release from the American Society of Plastic Surgeons. “The decrease in these levels after liposuction was surprisingly dramatic, and revealed that the permanent removal of excess fat cells by liposuction has a major impact on circulating levels of triglycerides.”

The research doesn’t definitively prove that liposuction caused levels to drop, however, and an outside researcher questioned the value of the study.

The study looked at 270 women and 52 men who underwent either liposuction, a tummy tuck (known as an abdominoplasty), or both. On average, the patients were slightly overweight, although they ranged from nearly underweight to morbidly obese.

The patients underwent fasting blood tests before surgery, one month afterward, and again three months afterward. At three months after surgery, triglyceride levels dropped from an average of 151.8 milligrams per deciliter (mg/dL) to 112.8 mg/dL in patients who underwent liposuction alone, representing a decrease of 25.7 percent; they fell by 43 percent in those with levels considered to be “at risk” — that is, 150 mg/dL or more.

Levels of white blood cells also dipped after liposuction and in patients who had both procedures. (High white blood cell counts are linked with an increased level of inflammation within the body and have been associated with coronary heart disease, high blood pressure and diabetes.) Levels of cholesterol and blood sugar didn’t change significantly.

Commenting on the study, University of Colorado researcher Rachael Van Pelt, who has studied the after-effects of liposuction, said the findings are “virtually meaningless” because triglyceride levels vary from day to day, and the researchers didn’t include a control group.

In addition, “changes in lifestyle (diet and exercise) over time would have profound effects on serum triglycerides, so without knowing how this changed over time in these surgery patients, one can’t attribute any improvements to the surgery per se,” said Van Pelt, an associate professor of medicine at the University of Colorado Anschutz Medical Campus.

The study is slated for presentation Sunday at the annual meeting of the American Society of Plastic Surgeons in Denver. The findings should be considered preliminary until published in a peer-reviewed journal.