Archive for June, 2009

Skin Issues Go More Than Skin Deep - Notes from a San Francisco Bay Area Dermatologist

Tuesday, June 30th, 2009

As highlighted in Dermatology Times, people with skin problems of all kinds are most likely to also experience depression, anxiety or psychosis, according to a study presented at the annual Society for Investigative Dermatology meeting.

The study, conducted by the National Health Interview Survey, found that 30 percent of people with skin diseases reported depression versus 15 percent without skin problems.

I am so glad the devastating mental and physical effects of skin diseases are finally being recognized. I often see depression in patients with skin problems, especially those with scarring acne conditions. The medical community is now viewing acne as a potentially life-altering disorder, not just a phase to get through during puberty. Teens and adults alike do not need to put up with acne, but should seek care from a dermatologist. The best course is immediate treatment and a long-term plan to reduce the acne and prevent scarring. Proper treatment can also help alleviate the psychological effects acne can have on a person’s well being and keep their self-esteem up!

Test Your Sunscreen IQ: Notes from a San Francisco Bay Area Dermatologist

Wednesday, June 24th, 2009

Know enough about sunscreens? Test your sunscreen knowledge by taking the following short quiz, recently published in the Skin Cancer Foundation Journal. You may be surprised by how much you do or do not know about this important topic. See answers at the end of the blog.

1. A sunscreen’s SPF, which stands for Sun Protection Factor, measures protections against the sun’s ultraviolet B (UVB) radiation. SPF numbers indicate

a. How long the skin will take to redden in the sun when using the sunscreen, compared to how long the skin would take to redden without sunscreen

b. The percentage of active ingredients in the sunscreen

c. The number of hours you can stay out in the sun

2. A sunscreen with an SPF of 15 protects against approximately 93 percent of the sun’s UVB rays. A sunscreen with an SPF 30 protects against

a. 93 percent of the sun’s UVB rays, and 93 percent of the sun’s UVA rays

b. 97 percent of the sun’s UVB rays

c. 100 percent of the sun’s UVB rays

3. If you apply a sunscreen with an SPF of 20, and then apply another sunscreen with an SPF of 30, what is the total value of the SPF you’ve applied?

a. SPF 25

b. SPF 30

c. SPF 50

4. How many sunscreen ingredients are currently available in the US?

a. 12

b. 15

c. 17

5. Sunscreen ingredients fall into two broad categories, inorganic/physical and organic/chemical. The two inorganic ingredients are:

a. Titanium dioxide and cinoxate

b. Cinoxate and zinc oxide

c. Titanium dioxide and zinc oxide

6. Doctors recommend applying one ounce (two tablespoons) of sunscreen to the body 30 minutes prior to sun exposure, and then again

a. After one hour outside

b. After one hour outside on sunny days

c. After two hours outside

7. Because children have delicate skin, sunscreen should not be used on babies

a. Under three months

b. Under six months

c. Under one year

8. For a sunscreen to provide adequate UVA spectrum protection, it must include one or more of the following ingredients:

a. homosalate, octinoxate, PABA, octisalate

b. avobenzone, titanium dioxide, zinc oxide, ecamsule (Mexoryl)

c. cinoxate, ensulizole, octocrylene, Padimate O

9. Water-resistant sunscreen:

a. Has to be reapplied after 40 minutes in the water

b. Has to be reapplied after 90 minutes in the water

c. Does not need to be reapplied

10. When stored properly, sunscreen should last for how long after the manufacturing date stamped on the package?

a. 9 months

b. 1 year

c. 2 years

Hope you found this quiz fun and educational! Check your answers below.

1=a; 2=b; 3=b; 4=c; 5=c; 6=c; 7=b; 8=b; 9=a; 10=c

Eyelids and Skin Cancer, an Overlooked Danger: Notes from a San Francisco Bay Area Dermatologist

Monday, June 22nd, 2009

Did you know that the eyelid region is one of the most common sites for non-melanoma skin cancers? Recently, and article was published in the Skin Cancer Foundation Journal bringing attention to this important topic.

The thinness of the skin around the eyes and the lack of proper sun protection, makes it very susceptible to skin cancer and sun damage. Basal cell carcinoma and squamous cell carcinoma are the most typical cancers we see in the eyelid area.

Generally on the body, non-melanoma skin cancers appear as spots or sores that don’t heal. However, skin cancers in the eye area may present with a scar-like appearance or texture or as a mass or tumor-like growth. These cancers must be removed to keep the cancer from spreading into other ocular structures and causing further damage. If caught early, you can minimize the amount of tissue that needs to be removed to treat the cancer, giving a more pleasing cosmetic result. The Moh’s micrographic surgery technique used for removal has a five year cure rate of 99 percent for basal cells and 98.1 percent for squamous cells.

The best way to prevent skin cancer in the eye area is to examine the area yourself often or take pictures on occasion for comparison and see if any changes have occurred. If you notice any differences have them checked out by a dermatologist as soon as possible.

Wearing sunglasses that block 99-100 percent of the sun’s UV rays helps prevent cataracts and skin cancers. Broad-spectrum sunblock is also important on your eyelids. If you find lotions too irritating, choose a dry sunblock and lightly dust it over the area. We carry Colorscience mineral sunblocks and makeup that would be a good choice to protect the eyes. They also make a product specific for the eye area called Colorscience Eyescreen that is silky, light and provides good protection. Contact our office for more details.

Savvy Sunglass Wearing: Notes from a San Francisco Bay Area Dermatologist

Tuesday, June 16th, 2009

We are lucky to have an array of choices when it comes to sunglasses, but where do you start to find the right pair?

Begin by choosing lenses that block 99-100 percent of the sun’s ultraviolet rays as our eyes are susceptible to cataracts, macular degeneration and cancers of the eye and eyelid. UV-blocking lenses will also prevent squinting, which helps reduce wrinkle formation and eye strain. To know that your lenses are 99-100 percent UV absorbing, purchase them from reputable companies, specialty sunglass stores or from an optical professional

Next, look for a shape that flatters your features. In general, the frame shape should contrast with the face shape and the frame size should be in scale with the face size. Keep these simple rules in mind when trying on sunglasses: square or cat-eye frames complement an oval face; rectangular frames look great on a round face; rounder oval cat-eye frames look best on a square face; and frames with a straight, flat top, like aviator frames work well on a triangular or heart-shaped face.

For the frames, choose a lightweight material that does not slip down your nose. The stems of the sunglasses should fit comfortably around your ears. Avoid heavy frames and a fit that is too snug, which can feel annoying over time. I have found that patients looking to prevent wrinkling around there eyes do best with slightly larger lenses or wraparound style frames which help block peripheral sun rays.

Certain lens colors can also enhance certain activities. For example, polarized lenses reduce glare, making them a good choice for driving or water sports. Yellow lenses show more contrast and depth, useful for golfers and bikers. Brown lenses create greater color contrast, providing better visibility on solid-color surfaces such as ski slopes.

Grey lenses are the most popular choice and provide the most natural color vision. Green lenses provide a cool, soothing tone to colors. Pink, orange, rose and blue colors should only be used as fashion sunglasses. These tints can distort colors and are unsuitable for driving or tasks where color recognition is important. Whatever color the lens, make sure the tint is not too dark as it could impair vision. If you prefer no tint, clear lenses are available that have 100 percent UV protection, just ask an optical professional.

Quality sunglasses are available in all price ranges, so find your best style and start protecting your eyes today!

Sports & Sun Safety: Notes from a San Francisco Bay Area Dermatologist

Monday, June 15th, 2009

As a sports enthusiast myself, I know how enjoyable it is to get outdoors and be active. So you can continue to enjoy your sport now and for years to come, it is especially important to protect your skin during your activity from burns and long term sun damage.

While the basics for sun safety always include a broad spectrum sunblock that you apply every two hours, outdoor sport fans should take extra precautions to ensure they remain protected. Below are a few tips from the Skin Cancer Foundation Journal on the steps you should consider for your activity.

Golf: A sweat resistant sunscreen with at least SPF 30 that should be reapplied every nine holes or two hours. Remember to apply on the ears, top of head, backs of hands and neck - areas often overlooked. Even better, wear a hat with at least a 3 inch brim to give extra protection to these areas and in general from the sun’s rays.

Running: Even on overcast or cloudy days, 80 percent of the sun’s ultraviolet rays can still penetrate through. Wear clothes with a UPF or ultraviolet protection factor rating of 30 or above. You can find a wide selection of UPF clothing at most sporting good stores. You can also help overheating by choosing fabrics that wick away moisture and keep you drier.

Swimming/Surfing/Windsurfing/Kiteboarding: Any water sport will require a water resistant sunblock. The best choices are those containing zinc oxide or titanium dioxide. These physical sunblock ingredients are more resistant to water exposure. Make sure to reapply your block after toweling off and in between getting out and going back in the water. Wear a swim shirt to protect your your back - an area that is difficult to apply sunscreen on your own.

Sailing: Reapplication of sunblock is key when sailing. Spray from the water and moisture in the air can degrade your sunblock more quickly, so be sure to keep it handy. Also, wear sunglasses to protect your eyes as the water reflects ultra violet rays.

Tennis: Wearing a sun visor will help shade your face in addition to your sunblock. If you use a towel to wipe your face or body in between sets, be sure to reapply.

Another commonly forgotten area to protect is your lips. Sun damage can cause this area to become constantly dry and peely. Carry a lip balm containing a broad spectrum sunblock and reapply often to avoid future issues.

It is also important to know that NSAIDS like Ibuprofen (Advil, Motrin) and Naproxen (Aleve) make your skin extra sensitive to the sun. So if you are take medications for aches and pains, be especially cautious about your sun protection.

The sun’s UV rays are the strongest between 10 am and 4 pm, so if possible, try to schedule your activity around this time frame.

Enjoy your sport safely this summer and contact our office with any questions!

You Can Leave Your Hat On: Notes from a San Francisco Bay Area Dermatologist

Tuesday, June 9th, 2009

The most underrated sunblock these days is hats! In addition to your regular sunscreen, hats are a quick, easy and stylish way to protect your skin even more this summer. This is especially true for areas like our scalp, ears and back of the neck, which we tend to forget when applying our sun lotion. You simply need to put one on to enjoy the additional benefits of sun protection that hats provide. Hats also keep you cooler and instantly give you a more finished and glamorous look. They protect our eyes and keep us from squinting - another way to prevent the worsening of crow’s feet and frown lines!

Look for hats with a brim of at least 3 inches, but remember wider is even better at keeping the sun’s harmful rays off your skin. Try on a few different styles, making sure to change up the angle of how it sits on your head - sometimes a slightly asymmetrical of off-center angle will look just perfect. Use a full length mirror and you will quickly see what shapes flatter your features and your outfits.

Our office has a wonderful selection of hats from the famous San Francisco Hat Company this summer, so stop by to try them on and see what makes you look your best. Mention this blog and receive 10 percent off any hat purchased in our office. Stay cooler, look more chic and protect your skin better with a new hat today!

Glow-How: Notes from a San Francisco Bay Area Dermatologist

Monday, June 8th, 2009

What can I do to have that certain “glow” and make my skin look radiant? This is a question I hear all the time as a dermatologist in San Francisco. The answer is luckily more simple than people think! Below are highlights from a recent article in The Skin Cancer Foundation Journal that summarized the topic well along with some tips of my own.

Let’s start with the big picture…

If you have any tan, let your skin fade back to its normal tone. Playing up the coloring mother nature gave you is how to best get your glow-on.

If you have any obvious sun-spots or broken capillaries on your face, a trip or two to a dermatologist’s office can help to diminish their appearance and give your skin a more even-tone.

Maintain the integrity of your skin by wearing sunblock daily.

If you wear makeup, match it to the skin along your jaw-line as closely as possible. To add a bit more glow, you can apply bronzer or blush to the areas where natural highlighting occurs like the apples of the cheeks, center of forehead, bridge of nose and chin. Less is more, so don’t overdo or you’ll turn your glow into an obvious mask of makeup. Pale skin looks best with a light pink blush, whereas darker skin looks best with deeper shades. A fluffly, densely bristled brush works great to apply blush/bronzing powders.

As part of your daily routine….

Cleanse your face morning and evening. You can even use cleansing cloths, if it is more convenient. Cleansers do not have to foam up to be effective, so ask your dermatologist what is best for your skin type.

In the morning apply an anti-oxidant after cleansing. There are many good choices these days, including Skinceuticals Vitamin C serums, Obagi C Clarifying serum, RevaleSkin coffeberry or Prevage MD. Not only will they help protect the skin from free radical damage, but they will help to repair damaged skin cells.

Next apply a broad spectrum sunblock, with at least a 30 SPF. If you are out all day long, be sure to re-apply your sunblock to maintain its protective benefits. If re-applying a lotion is not to your liking, ColorScience makes a dry sunscreen that can easily be dusted on top of your makeup throughout the day.

Cleanse at night to remove the makeup, sunblock and oil build up from the day.

After your skin is dry, apply a Retin-A product sparingly to promote exfoliation of dead skin cells and really get your skin glowing. The less build up of dead skin cells, the less dull the skin will look. It will also help alleviate plugs in the skin, which can lead to acne and blemishes. And best of all, it increases collagen production to prevent and diminish fine lines and wrinkles.

Next up apply a moisturizer. This will relieve dryness associated with Retin-A products and help the skin maintain its natural moisture barrier. Skin that looks dewy reflects back light, adding to your glow.

If you cannot stand the idea of not having some color on your body, be sure to at least choose one of the self-tanning options. Tanning booths will only increase your risk of skin cancer and, really, who wants their skin to look like leather anyway? When applying a self-tanner to your body, make sure to prep the skin by using an exfoliating scrub or loofah, moisturize, then apply the self-tanning lotion. If your skin is dry in certain areas (like elbows and knees) it will absorb more of the lotion and look uneven. Make sure to wait at least 12 hours after shaving your legs to follow these steps. Self-tanners may aggravate certain skin conditions, so if you suffer from eczema or other skin issues, please check with your dermatologist before using any self-tanning methods.

Through my patients, I have seen that the tanning lotion application services offered at salons work very well. They will exfoliate your skin and apply the lotion much more easily and evenly than applying it yourself. I also like the look of Jergens Natural Glow moisturizer. This type of product moisturizes the skin and gradually encourages it to develop a natural color, without looking fake or orange.

Please feel free to contact our office with any questions about products or makeup. Start with these simple tips to get your glow-on today!

Sunblocks - What you need to know about Ingredients and Amounts

Tuesday, June 2nd, 2009

Choice can be overwhelming, especially when it comes to sunblock. There are so many bottles, tubes, sticks, wipes and powders lining store shelves that it’s easy to be confused about what works best.

To help wade through the sea of options, it is most important to know that the Sun Protection Factor or SPF rating you currently see on labels relates only to protection against the sun’s UVB rays. UVB rays cause reddening and burning of the skin, which contributes to skin cancer. At this time, SPF ratings do not relate to UVA rays, which actually penetrate the skin more deeply, contributing to wrinkles, photodamage and skin cancer. New labeling rules may be finalized by the FDA in September, forcing companies to also rate their sunblock’s UVA protection (if any) on the label within 18 months.

In the meantime, Dermatologist David Pariser, MD, president of the American Academy of Dermatology, recommends that “for now, consumers should look for labels that tout ‘broad spectrum’ protection and list ingredients known to screen UVA rays.” Specifically, consumers should “look for avobenzone, oxybenzone, titanium dioxide, zinc oxide or ecamsule (also known as Mexoryl SX).”

In addition to using a broad spectrum product, it is also necessary to use the right amount. Studies show that most people apply only a quarter of the amount they should, which means the actual SPF they have on their body is even lower than advertised. According to the Skin Cancer Foundation, you should use 1 oz. (shotglass sized amount) of sunblock to get the full SPF. During a long day at the beach, for example, one person should use around one half to one quarter of an 8 oz. bottle. Sunscreens should be applied 30 minutes before sun exposure to allow the ingredients to fully bind to the skin. And, no matter what the SPF rating, sunscreens should be applied every two hours, especially after swimming, toweling off or excessive sweating.

There is also no substitute for shade and keeping the sun off your skin. If you are out at the beach or park, choose shady areas whenever possible. Wear a hat, sunglasses and SPF rated clothing to give yourself the best protection possible. We only get one skin, so do your best to take care of it! If you have any other questions regarding sunblocks, give our office a call - we will be happy to assist you.

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