What’s Our Secret: Your Guide to a Seamless Skincare Regimen
PUBLISHED ON May 16, 2016 https://dimensionaldermatology.com/
Lacey Beth Elwyn, DO
SKINCARE HAS NEVER BEEN EASIER. USE THESE SIMPLE TIPS TO DESIGN YOUR PERSONALIZED SKINCARE REGIMEN. GET READY TO UNLOCK YOUR SKIN’S FULL POTENTIAL!
Secret #1 – Back to the basics with a gentle face cleanser
Face Cleansing for Anti-Aging
Stop spending countless dollars on over the counter (OTC) anti-aging products. OTC products may have some benefit, but looking at the big picture, they don’t work. Vanicream cleanser is free of dyes, lanolin, fragrances, masking fragrances, parabens, and formaldehyde; all ingredients that could be potentially harming your skin! However, if your face tends to be more on the dry side, CeraVe hydrating cleanser is the right choice for you.
Basic Cleanser: Vanicream bar soap, Free and Clear liquid soap, CeraVe hydrating cleanser
Face Cleansing for Acne
Soaps and face washes with salicylic acid, exfoliating beads, or sand are really harsh on your skin, very drying, and should not be used. One OTC acne product that I like to recommend in my acne patients is benzoyl peroxide (BP) face wash. I recommend a 4-5% BP wash for the face and a 10% BP wash for the chest and back. Benzoyl peroxide is also
very drying, so always follow with a moisturizer. Be sure to rinse well, as BP can bleach towels and clothing. BP wash should always be used as your facial wash if you are using a prescription topical antibiotic. It helps prevent antibiotic resistance. Only wash with benzoyl peroxide in the morning if you are using a tretinoin topical at night. Benzoyl peroxide can deactivate your tretinoin and should never be used at the same time.
Basic Cleanser: PanOxyl Creamy Face Wash, 4% BP
Secret #2 – Don’t underestimate the benefits of an electric brush
The Clarisonic Skin Cleanser is awesome! Research supports that it improves the cleansing
of your face, removing more dirt and oil than regular washing. Therefore, it is great for helping to prevent breakouts! It also increases the efficacy of your topical prescription products up to 80%! Meaning, it will make your morning acne products and nighttime anti-aging products work better! It can also help decrease pore size and improve the overall smoothness of your skin! The Clarisonic system is the best. It
is the only one with patented sonic technology. When you first start using, you may only tolerate washing with this cleanser once a day, recommended at night. However, after repeated use, you may use twice a day to wash your face, both morning and night.
Secret #3 – Moisturizers are a must
A wonderful brand to use for facial moisturizing is CeraVe Facial Hydrating Lotion AM and CeraVe Facial Hydrating Lotion PM.
The AM facial lotion has broad spectrum SPF 30 to start your day off right! CeraVe is formulated with ceramides, which help to protect and build your skin barrier as well as provide optimal hydration for your skin. Ultraviolet damage from the sun is the number one contributing factor to accelerated aging, fine lines, and wrinkles. Moreover, most acne treatment regimens are slightly irritating and drying to your skin and some may even induce a slight photosensitivity. CeraVe facial hydrating lotion AM is the perfect moisturizer. CeraVe facial hydrating lotion PM is for nighttime use, as it lacks the SPF needed during the day.
Basic Moisturizer: CeraVe Facial Hydrating Lotion AM and CeraVe Facial Hydrating Lotion PM
Secret #4 – Vitamin A is not just for nutrition
Everyone, starting as early as their teenage years, should use a topical retinoid (tretinoin), prescribed by their dermatologist, on their face at night! Retinoids are vitamin A derivatives. They normalize follicular keratinization or teach our skin to shed appropriately. Tretinoin is FDA approved for the treatment of acne and the ONLY FDA approved product to decrease and prevent fine lines and wrinkles. Because it is teaching our skin to shed appropriately, it is like giving yourself a micro-peel every single night. It can help erase dark spots on your face from sun damage or acne spots, which will give your skin a smooth, even color. It helps prevent breakouts and can also improve pore size. Topical tretinoin tightens and brightens your facial skin! With the exception of sun block, tretinoin IS the miracle cream for your face. It is the product on the market that ALL the other products WANT to be. There are many vitamin A derivative retinol creams available OTC, but the BEST is prescription tretinoin! Why? Well, the over the counter anti-aging creams are RetinOLs. Retinols are still vitamin A derivatives, but they are not as strong or effective as the retinOIDS, which is the tretinoin prescription from your dermatologist. When you first start using topical tretinoin, it will be irritating. It can cause redness and drying/flaking. This should only last for about a week. The trick to help prevent excessive drying is to use CeraVe facial lotion PM in conjunction with the tretinoin at night. Always put on the moisturizer. It will not decrease the efficacy of your tretinoin. You want to use only a pea size amount, dab onto your forehead, nose, both cheeks, and chin. Don’t waste your product or your money. Using more of your product will not make it more effective. A pea size amount of the tretinoin is sufficient and then you can use your moisturizer to help
spread it evenly over your face. After using consistently, your skin will achieve that beautiful, smooth, creamy glow that you have always wanted! Tretinoin may not be covered under your insurance plan and can be expensive, but think of all the money you have spent on OTC product lines for acne and anti-aging purposes, none of which worked… This WILL work and IS worth it! Your skin is worth it!
Secret #5 – Acne is not your enemy
You should stop using all OTC washes and lotions for acne and let your dermatologist treat your acne! A basic face cleanser and moisturizer, as described above, is all you should use. The standard of care in treating acne involves specific treatment modalities targeting the dominant pathogenic mechanism. For example, hyperkeratinization is targeted in the treatment of comedogenic acne (white heads and black heads), inflammation in inflammatory acne (red pimples and cysts), and androgen induced sebum production in hormonal acne (lower face acne in females or acne that worsens around your menses). White heads and black heads are best targeted with topical tretinoin. Remember, tretinoin normalizes follicular keratinization and is therefore the best topical for comedonal acne. Inflammatory acne is treated with topical and/or oral antibiotics. Topical clindamycin is a common first choice, and should always be used in conjunction with a benzoyl peroxide to prevent antibiotic resistance. If topical antibiotics are not working, an oral antibiotic will typically be prescribed. Oral antibiotics from the tetracycline class, such as minocycline or doxycycline are the antibiotics of choice for treatment of inflammatory acne. They are pretty specific to the skin. They are lipophilic drugs, which means oil loving, so the oil glands in the skin absorb the medicine like a sponge! It works great to clear up the acne. These antibiotics must be taking with food, or they will cause significant gastrointestinal upset. It is also important to be aware that these antibiotics will make you more sensitive to the sun, yet another reason to remember your SPF daily. Acne spots left behind, after your acne has cleared, can stay on the skin for up to 6-9 months. Spots can be faded away with the topical tretinoin that you use at night. If you have severe nodulocystic acne, oral isotretinoin, is the answer for you. It is a last resort, but if nothing else is working, it is worth it to go through with the treatment, as failure to effectively treat your acne will result in the possibility of permanent acne scarring. Isotretinion is a retinoid (Vitamin A derivative) that is systemic, so it works from the inside of the body outward. There are many side effects associated with isotretinoin which has prompted a mandatory enrollment and monitoring via the iPledge system. Your Dermatologist will see you monthly to check blood work and ensure adequate contraception. About 20% of patients will relapse and require a second treatment course.
Secret #6 – Mineral makeup matters
The make up that we use is very important! We should be using a mineral makeup that has titanium dioxide and zinc oxide. It is very good for the skin and looks so amazing on! Zinc and titanium are actually what is used in creams for diaper rash in babies, so it is very soothing for the skin and great for preventing and helping acne. My favorite mineral makeup is by Jane Iredale.
Mineral Makeup: Jane Iredale liquid minerals foundation and the amazing matte loose finishing powder
Secret #7 – Always be keen on the sunscreen
SO, the miracle for anti-aging, besides your retinoid, is broad spectrum SUN BLOCK!!! Now, notice I say BROAD SPECTRUM. You need to use a broad-spectrum physical sun block on your face, which blocks out both the UVA and UVB rays from the sun. UVB rays are the rays that cause your skin to burn! UVA rays go deeper into your skin, causing DNA damage, leading to skin cancer and are also the ones that most contribute to your brown age spots!
My favorite broad-spectrum physical sun block for the face is called TIZO.
Sun Block: Solar protection formula TIZO facial mineral fusion SPF 40 UVA/UVB very water resistant sun block
It is an AWESOME product! It has this creamy, very light consistency so you can use it as your moisturizer on your face in the morning. Moreover, it actually comes in a tinted color so you can use in replace of makeup if desired!
Powdered Sun Block: Colorscience Pro loose mineral powder brush sun protection SPF 50
This is a loose mineral powder brush sun protection SPF 50 tinted color to carry in your purse to re-apply your sun block in powder form through out the day! It is also great for shine and oil control. You can also brush on your hands and left side of your face while driving in your car to prevent those age spots!
Skin Regimen, The Basics
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Morning |
Night: |
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1. Wash, Clarisonic Cleansing system (optional) |
1. Clarisonic Cleansing system to wash |
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2. Prescription topical antibiotic for acne if needed |
2. Prescription topical tretinoin |
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3. Moisturizer with sun block |
3. Moisturizer |
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4. Mineral foundation (Optional) |
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5. Mineral powder (Optional) |
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6. Re-apply sun block throughout the day |
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I would like to inform all of you about a brand new blogging website called Dimensional Dermatology, founded in May 2016 by Dr. Paul M. Graham, St. Joseph Mercy Dermatology in Ann Arbor, Michigan. This website provides concise, up-to-date, easy to read articles on varying topics in general, surgical, and cosmetic dermatology as well as aesthetic medicine, cosmeceuticals, and plastic surgery. This blog is built upon the concept of digesting complicated research data, technologies, procedures, and innovative treatments into succinct, easy-to-read articles with the target audience focusing on the general public, consumers, patients, medical staff and providers. I welcome all of you to check this out at https://dimensionaldermatology.com/.
*The information contained in this publication should not be used as a substitute for the medical care and advice of Dr. Hoffman. There may be variations in treatment that Dr. Hoffman may recommend based on individual facts and circumstances.