Your Diet & Your Skin are Connected

Nutrition is important for health. An unhealthy diet can damage your metabolism, cause weight gain and even hurt organs, such as your heart and liver. But what you eat also impacts another organ – your skin.

In the past, we’ve advised about the “bad” things for your skin, like sugar, alcohol and smoking. As scientists learn more about diet and the body, it’s increasingly clear that there are many ”good” foods that can help you maintain and improve the appearance and health of your skin.

Make sure you’re getting enough essential nutrients to protect your skin. The foods on our RI Skin Doc list are just some of the great options readily available to you to keep your skin healthy, strong and attractive.

-Fatty Types of Fish, such as salmon, contain omega-3 fatty acids that can reduce inflammation and keep skin moisturized. They’re also a good source of high-quality protein, vitamin E and zinc.

-Avocados are high in beneficial fats and contain vitamins E and C, which are important for healthy skin. They also pack compounds that may protect your skin from sun damage.

-Sweet Potatoes are an excellent source of beta-carotene, which acts as a natural sunblock and may protect your skin from sun damage.

-Bell Peppers contain plenty of beta-carotene and vitamin C – both of which are important antioxidants for your skin. Vitamin C is also necessary to create collagen, the structural protein that keeps your skin strong.

 -Broccoli is a good source of vitamins, minerals and carotenoids that are important for skin health. It also contains sulforaphane, which may help prevent skin cancer and protect your skin from sunburn.

-Tomatoes are a good source of vitamin C and all of the major carotenoids, especially lycopene. These carotenoids protect your skin from sun damage and may help prevent wrinkling.

-Soy contains isoflavones, which have been shown to improve wrinkles, collagen, skin elasticity and skin dryness, as well as protect your skin from UV damage.

-Sunflower Seeds are an excellent source of nutrients, including vitamin E, which is an important antioxidant for the skin.

-Walnuts are a good source of essential fats, zinc, vitamin E, vitamin C, selenium and protein – all of which are nutrients your skin needs to stay healthy.

 -Cocoa contains antioxidants that may protect your skin against sunburn. These antioxidants found in dark chocolate may also improve wrinkles, skin thickness, hydration, blood flow and skin texture.

-Green Tea contains compounds known as catechins – powerful antioxidants that can protect your skin against sun damage and reduce redness as well as improve its hydration, thickness and elasticity.

-Red Wine contains resveratrol, the famous antioxidant that may slow your skin’s aging process by impairing harmful free radicals that damage your skin.

Seborrheic keratoses

Seborrheic keratoses are benign (noncancerous) skin growths that develop from skin cells called keratinocytes. These growths have a waxy or greasy look and can be tan, brown or black. They look like they have been glued or stuck onto the skin. Over time, the growths become rough and crusty looking.

They are usually found on the chest and back but can appear anywhere on the body, including the face, scalp and neck. No one knows what causes seborrheic keratoses, but they become more common with age. Most people will develop some as they get older, and children rarely have them.

Seborrheic keratoses tend to have a greasy appearance and look as though they were glued onto the skin, as opposed to growing from it. They may be tiny, or larger than 3 inches across. They rarely itch. They are not contagious and there is no way to prevent them from developing. Importantly, they do not go away on their own. If they are not removed, they will last a lifetime.

Physicians usually can diagnose seborrheic keratoses by looking at them. In rare cases, they may look like other skin disorders, including malignant melanoma. If the diagnosis is uncertain, your physician may want to do a biopsy, in which case a portion of the growth is removed and examined under a microscope.

Seborrheic keratoses do not require treatment. Although they may grow relatively large and can become dark, they are not dangerous. If they become irritated, itchy or unsightly or if they bleed, they can be removed in a doctor’s office. Treatment is mostly painless. The three main methods of removal are:

  • Curettage -After the skin is numbed, the growths are sliced or scraped off using an instrument called a curette.
  • Cryosurgery or freezing – Liquid nitrogen is applied to the growths. The growths crust over and then fall off a few weeks later.
  • Electrosurgery – An electric current burns the growths off.

 

Schedule an appointment if you develop any unusual skin growths, if existing growths start to change their appearance, or if multiple seborrheic keratoses develop suddenly. It may be a sign of another disease.

Remember, seborrheic keratoses do not go away on their own, but they can be removed if they become irritating or unsightly. There is no harm in not treating the growths, because they are benign (noncancerous) and do not become cancerous.

Keeping Your Hands Looking Younger

If age spots, wrinkly skin, or other signs of aging bother you, don’t lose hope. You can have more youthful-looking hands. Thanks to advances in dermatology, it’s possible to diminish these signs of aging safely and with little or no downtime.

Many adults develop age spots on their hands. These spots tend to gradually increase in size with age and time spent in the sun.

Our board-certified dermatologists and the skilled aestheticians and registered nurses at our Rejuvaderm MediSpa can effectively lighten or remove age spots on your hands with treatments ranging from laser therapy and chemical peeling to microdermabrasion and skin-lightening creams and lotions. The creams and lotions take the longest to deliver results, but they cost less.

When hands lose their youthful fullness, skin becomes lax and starts to develop a crepe-paper-like texture. With less fullness, the veins in your hands also become more noticeable. To restore lost fullness, your dermatologist can inject a filler or fat from another part of your body

Applying sunscreen to your hands every day can prevent wrinkly skin on your hands. Read the label and be sure your sunscreen contains zinc oxide or titanium dioxide. If you haven’t been applying sunscreen and now have wrinkly skin, treatment can help.

Your dermatologist may recommend a lotion containing a retinol or glycolic acid (apply before bedtime), a light chemical peel, every 1 to 3 months, or a laser treatment. When treating wrinkling, the lotion and light chemical peel are often used together. Laser treatment can also help diminish age spots.

As we age our skin holds less water, so our skin becomes drier. This can cause your skin to feel rough. To smooth rough skin on your hands, your a mild chemical peel can help. To maintain the results you get from treatment, it helps to apply a moisturizer every day. Your dermatologist can recommend an effective moisturizer.

Making your results from hand rejuvenation last.

While you cannot stop aging, there are things you can do to make your results last longer. Here’s what we recommend:

1. Protect your hands from the sun. This is essential if you want to maintain the results you see after treatment. To protect your hands from the sun, apply a broad-spectrum, water-resistant sunscreen with SPF 30 or higher that contains zinc oxide or titanium dioxide to your hands every day before going outdoors.

2. Wear gloves while cleaning and gardening. Hot water, detergents, and yard work can dry your skin, which can age your hands.

3. Moisturize, moisturize, moisturize. Applying a lotion or cream after washing your hands and bathing helps to trap water in your skin, which can plump up your skin.

4. Keep appointments for maintenance treatments. If your dermatologist, aesthetician or RN treated you in the office, getting follow-up treatments as recommended can help you maintain your results. For example, if you had a filler, you may need another injection in 8 to 12 months.

Retinol – A Proven Anti-Aging Ingredient

Retinol is another name for vitamin A in its most natural form. It’s hailed by dermatologists as a multi-purpose skincare product. With regular use, it can produce smoother, brighter, more even-toned skin overall.

The importance of retinol (vitamin A) was discovered during World War I and subsequent research showed that its deficiency gives rise to dry skin and other skin disorders.

The retinoid drug project was launched in 1968 to synthesize compounds similar to vitamin A by chemical manipulation of its molecule to improve performance and safety. The use of these substances in therapy dates back some 3000 years to ancient Egypt, where liver was used to treat night blindness. The modern history of retinoids, however, began in 1909 when an essential factor in the viability of an embryo in the fatty extract of the egg yolk, called vitamin A, was discovered. Retinoids finally were introduced into the treatment of dermatoses including photoaging more than two decades ago.

Retinoids teach aging cells how to behave like younger, healthier cells by encouraging them to turnover more rapidly. This makes way for new cell growth. Retinoids have also been shown to increase the production of collagen, the protein that gives skin strength and elasticity.

Retinoids are the catch-all term, but both Retin-A and retinol are essentially vitamin A in its most basic form. The difference between them lies in where you get them.

Retin-A is what you get from your dermatologist. It’s a prescription that is FDA approved, meaning it has been tested and OK’d for both safety and efficacy. Whereas, retinol that is available over-the-counter is not as closely regulated.

Over-the-counter products contain lower strengths of retinol than the prescription you get from your dermatologist, which includes emollient ingredients that help soothe and moisturize skin to cut down on much of the redness, dryness, and peeling that can be associated with Retin-A. These versions are best for sensitive skin that may be prone to irritation.

Those with sensitive skin or certain skin conditions, like eczema, may have trouble tolerating a prescription-strength Retin-A cream. Also, proceed with caution if you have a darker skin tone. Darker skin types can experience temporary dark patches if the skin gets too irritated. To be safe, ask your dermatologist for a product recommendation if you have compromised skin and you’re interested in retinol.

Heat Rash: Prevention, Symptoms & Treatment

Heat rash, also called prickly heat or miliaria, is a common condition in which areas of the skin feel prickly or sting due to overheating. Blocked sweat glands cause this. Because the sweat cannot get out, it builds up under your skin, causing a rash and tiny, itchy bumps. When the bumps burst and release sweat, many people feel a prickly sensation on their skin. It can itch a lot, but it’s not dangerous.

Heat rash looks like tiny bumps surrounded by red skin. It usually happens on clothed parts of the body, such as your back, abdomen, neck, upper chest, groin, or armpits. And it usually gets better once your skin cools off.

Heat rash happens most often in hot, humid conditions. It’s most common in infants. Active people, newborns in incubators, and people on bed rest with fever also are more likely to get it.

You can get a heat rash when you sweat too much. The ducts from the sweat glands in your skin become blocked. This causes the sweat to leak into the surrounding tissue, which leads to irritation and redness. You may feel the prickly, or stinging, sensation that gives this condition its name.

Symptoms of Heat Rash
- The rash may feel prickly, stinging, or burning.
- The rash is severe or painful or does not go away on its own within a few days.
- You develop an infection in an area where you recently had heat rash.
- You have a fever or any other signs of illness.
- The rash is bright red or has streaks.
- The rash starts after you have been taking an antibiotic or new medication.

Treatment and Prevention
- Move to a cooler, less humid place.
- Don’t scratch your skin, or it could become infected.
- Keep the affected area dry.
- Don’t use ointments or creams that keep your skin moist.
- You can put powder on the rash to feel more comfortable.
- Keep your skin cool by using fans, cool showers, and air-conditioning.
- Wear clothes that aren’t tight and don’t trap heat and moisture.

While these summer skin problems can dampen your fun, they’re usually not serious. Most go away in a few days to a few weeks. If a rash or other skin problem lingers or worsens, you should call your dermatologist’s office.

Bug Bites, Ticks & Mosquitoes: How to prevent and care for bites

Although most bug bites are harmless, some can spread dangerous diseases like Zika Virus, Dengue, Lyme Disease, and Malaria. Particularly if you’re visiting areas with known insect-borne diseases, it’s important to take steps to reduce your risk.

To help prevent bug bites, dermatologists recommend the following tips:

  1. Use insect repellent. To protect against mosquitoes, ticks and other bugs, we recommend you pre-treat outer layers of clothing (long-sleeved shirts & pants, hats, sneakers, shoes, seams) with insect repellent that contains 20 to 30 percent DEET or one with the active ingredient Permethrin. Follow the directions carefully and allow the clothes to dry for at least two hours before wearing them. We do not recommend applying insect repellant directly onto your skin as it can cause irritation. Do not use sunscreen that contains insect repellent.
  2. Wear appropriate clothing. If you know you’re going to be out at night or hiking in a densely wooded area dress appropriately to prevent bug bites. Cover exposed skin as much as possible by wearing long-sleeved shirts, pants, socks and closed shoes instead of sandals – once again, treat them with DEET or one with the active ingredient Permethrin. For additional protection, pull your socks up over your pants and tuck your shirt into your pants.
  3. Use bed nets. When sleeping in the great outdoors, use bed nets to protect against mosquitoes. Look for one that has been pre-treated with pyrethroid insecticide. If it doesn’t reach the floor, tuck it under the mattress for maximum protection.
  4. Pay attention to outbreaks. Check the CDC Travel Health Notices website and heed travel warnings and recommendations.

Sometimes, despite one’s greatest efforts, bug bites still happen. Fortunately, most bug bites and stings can be safely treated at home. To treat bug bites and stings at home, dermatologists recommend the following tips:

  1. For painful bites, such as a bee sting, take an over-the-counter painkiller, such as acetaminophen or ibuprofen. Always follow the directions on the label and use the correct dose.
  2. For bites that itch, apply an ice pack or an over-the-counter anti-itch cream, such as hydrocortisone. Another option is to take an over-the-counter oral antihistamine.
  3. To reduce swelling, apply an ice pack to the bite.

Although most bug bites and stings are harmless, some can be dangerous. This is especially true if you are allergic to the bug’s venom, or if the bug is carrying a disease. Here in the United States, it’s common to experience a bite or sting from the following types of bugs:

  • Mosquitoes
  • Fleas
  • Bedbugs
  • Biting flies
  • Mites
  • Bees, wasps and hornets
  • Spiders
  • Ticks

Most bug bites and stings can be safely treated at home with topical medication, such as hydrocortisone cream or ointment, or an oral antihistamine to reduce the itch. However, sometimes a bug bite or sting could turn into something serious – particularly if you have been bitten or stung by many insects at the same time.

Go to the emergency room immediately if you experience any of the following symptoms after a bug bite or sting:

  • Difficulty breathing
  • The sensation that your throat is closing
  • Swollen lips, tongue or face
  • Chest pain
  • A racing heartbeat that lasts more than a few minutes
  • Dizziness
  • Vomiting
  • A headache
  • A red, donut-shaped rash that develops after a tick bite: This could be a sign of Lyme disease, which should be treated with antibiotics.
  • A fever with a red or black, spotty rash that spreads: This could be a sign of Rocky Mountain spotted fever, a bacterial infection carried by ticks, which should be treated immediately.

Although most bug bites and stings do not turn into a severe or even fatal illness like Rocky Mountain spotted fever, it’s important to pay attention to your symptoms. If you feel tired all the time, you have a headache, fever or body aches, or you develop a rash after a bug bite, see a board-certified dermatologist immediately.

To remove a tick that is attached to your skin, dermatologists recommend the following tips:

  1. Use tweezers to remove the tick. Sterilize the tip of the tweezers using rubbing alcohol and grasp the tick as close to the skin’s surface as possible.
  2. Pull upward with steady, even pressure. Avoid twisting, squeezing or crushing the tick, as this can cause its head or mouth to break off and remain in your skin. If this happens, use tweezers to remove the remaining parts. If you cannot remove the rest of the tick, see a board-certified dermatologist.
  3. Dispose of the tick. Place it in a sealed bag or container; submerse the tick in alcohol; or wrap it tightly in tape. You may also want to save the tick in a sealed jar. That way, if you develop any symptoms after the bite, the tick can be tested for disease.
  4. Clean the bite area with soap and water.

Ticks can bite at any time, however they’re most active in April through September. Fortunately, there are many things people can do to protect themselves and their families against ticks.

To prevent tick bites, dermatologists recommend the following tips:

  1. Walk in the center of trails. Avoid walking through heavily-wooded and brushy areas with tall grass.
  2. If you must walk through heavily-wooded areas, wear long pants and long sleeves. Pull your socks up over your pants, and tuck your shirt into your pants to prevent ticks from crawling up your body. It’s also a good idea to wear light-colored clothes so that ticks can be spotted easily.
  3. Use insect repellent that contains 20 to 30 percent DEET on exposed skin and clothing. Make sure to follow the product instructions. Parents should apply this product to their children, making sure to avoid the hands, eyes and mouth.

Examine your skin after spending time in heavily-wooded or brushy areas. Conduct a full-body tick check to make sure that no ticks are crawling on you. Since ticks prefer warm, moist areas, be sure to check your armpits, groin and hair. You should also check your children, pets and any gear you used outside.

Proper Nail Care Begins at Childhood

Proper nail care is important to your health, your appearance and your self-esteem. Your nails can even help a doctor diagnose a medical condition. The good thing is that proper nail care is not difficult. Here are some do’s and don’ts for fingernail and toenail care.

Do:

  • Keep them short and clean. Use a good nail clipper or a small nail scissors to cut them every week or two. If you let your nails get too long, they’re more likely to break and to get germs under them that can make you sick.
  • Cut them in the shape of the tip of your finger, pretty straight across but a little round at the sides so they’re strong.
  • Cut your toenails straight across, using a clipper designated for toenails. This will help prevent an ingrown toenail.
  • Using a nail file or emery board to smooth the ends of your nails. Make sure that the file is not old and dull. It will work better if it is new. Rub it back and forth very gently along the end of your nail to remove any rough edges.
  • Dry your hands really well after washing them or getting them wet.
  • Rub lotion on your fingernails, especially when your hands feel dry.
  • Eating a healthy balanced diet keeps your nails strong.
  • Change your socks every day. 
  • Wear flip-flops in public showers and at the pool to prevent infections caused by a fungus that can get under your toenails.

 

Don’t:

  • Bite your nails or pick at the skin around your nails. It can cause an infection and it hurts, too!
  • Pry or poke at things with your nails. This can damage them.
  • Cut or push back the cuticles, the tiny sliver of skin where your nail grows out your finger. That can lead to infection.
  • Use nail-polish remover more than twice a month. It’s really hard on your nails.
  • Use acrylic nails (artificial nails). These can be very harmful to your nail and are not recommended.
  • Wear shoes that are too tight, which can cramp your toes.
  • Wear socks when you go to sleep.

If you’re having problems with your nails, seek a medical examination and the specialized expertise of a board-certified dermatologist.

Amazing facts about your skin, hair & nails

Acne (pimples & zits)

  • Acne is a very common skin problem, affecting about 40 million to 50 million Americans.
  • Nearly 85% of people have acne at some point in their lives. It usually starts in puberty but can affect people in their 20s, 30s, 40s and even 50s.
  • Acne usually appears on the face, chest and back.
  • By the mid-teens, more than 40% of kids have acne or scars from acne that need to be treated by a dermatologist.
  • In 2004, people spent $2.2 billion to treat acne.

Skin Cancer

  • More than 1 million new cases of skin cancer will be diagnosed in the U.S. this year.
  • 1 out of 5 Americans (17%) will have skin cancer at some point in their life.
  • Melanoma is the most serious kind of skin cancer, and one in 58 people will get melanoma at some time during their life.
  • Melanoma is the most common kind of cancer for young adults who are 25-29 years old.  It is the second most common kind of cancer for teens and young adults who are 15-29 years old.
  • One American dies of melanoma almost every hour. In 2008, about 8,420 people died from melanoma.

Tanning Beds

  • Even though they are bad for skin and can cause skin cancer, each day about 1 million Americans use tanning beds.
  • Almost 28 million people tan indoors in the U.S. every year; 2.3 million are teens.
  • Nearly 70% of tanning salon patrons are women, primarily aged 16 to 29 years.
  • Indoor tanning before the age of 35 has been associated with a significant increase in the risk of melanoma, the deadliest form of skin cancer.
  • Studies also have found that indoor tanning can make skin look old, hurt the immune system (the part of the body that helps fight infections), and damage eyes.

Hair & Nails

  • It’s normal to lose 50 to 100 hairs a day but anyone who notices thinning hair should see a dermatologist.
  • Hairstyles that pull the hair, like ponytails and braids, can cause hair loss.
  • Fingernails grow 0.1 millimeters each day and toenails grow 1 millimeter a month. Fingernails grow faster than toenails, and nails grow faster during the summer than the winter.

Tattoos & Piercings

  • When a group of 500 grown-ups ages 18-50 were asked about tattoos and piercings, 24% said they had tattoos and 48% had a piercing in the ears or another part of the body.
  • Almost one in five people (17%) with tattoos have thought about having them removed.
  • People with tattoos are six times more likely to have hepatitis C, a liver disease that kills 10,000 people a year.
  • Common problems with piercings include infections and allergies to metal.

FDA proposes updating sunscreen regulatory requirements

Whether you’ve been a longtime patient or a new one, you know our mantra – “Protect your birthday suit…use sunlock daily.”

Now, the U.S. Food and Drug Administration (FDA) has issued a proposed new rule that outlines the final detailed written study or monograph for over-the-counter (OTC) sunscreen products. It’s important for everyone to take notice.

The goal of the sunscreen monograph is to update nonprescription, OTC sunscreens – those that are marketed in the United States and grandfathered in without FDA-approved applications – to ensure that consumers have access to sun protection options that are considered safe and effective.

The proposed rule identified two ingredients – zinc oxide and titanium dioxide – as “Generally Recognized As Safe and Effective” (GRASE), and two others – PABA and trilomine salicylate – as not GRASE.

For an additional 12 ingredients, including oxybenzone, the FDA indicated that there is insufficient evidence to conclude that these ingredients are GRASE. However, in the proposed rule the FDA stated that this designation does not indicate these ingredients are unsafe for use in sunscreen, an assertion being made by the Environmental Working Group. The FDA is asking for more testing of these 12 ingredients.

In addition, the proposal puts forward a recommendation on SPF values on sunscreen labels, including raising maximum SPF from 50+ to 60+.

“Because sunscreen is an important tool in the fight against skin cancer, the American Academy of Dermatology Association (AADA) supports any and all regulations to ensure that the public has access to safe and effective sunscreens.

“We are encouraged that the FDA is taking this action on the Sunscreen Innovation Act, and we look forward to working with the FDA as it develops and finalizes the proposed rule,” said AAD President Suzanne M. Olbricht, MD, in a statement regarding the proposal.

“As the proposed rule is finalized, we encourage the public to continue protecting themselves from the sun’s harmful ultraviolet rays.” She added, “If you are concerned about the safety of the ingredients in your sunscreen, talk to a board-certified dermatologist to develop a sun protection plan that works for you.”

The AADA is currently reviewing the proposed rule and will submit comments to the FDA. The AADA continues to engage with the FDA to discuss our shared interest in promoting access to new sunscreen ingredients, including new and advanced UV filters, many of which are already available in other countries.

And, once again, please remember to “Protect your birthday suit…use sunlock daily.”

Ringworm – a treatable fungal infections common in children

To start, ringworm is not a worm. It is a type of fungal infection that derives its name from the ring-shaped red, scaly patches with clear centers that characterize its appearance.

Skin fungi live in the top layer of skin cells in moist areas of the body, such as between the toes or in the groin and diaper area. Sometimes, the normal balances that keep fungi in check are upset, resulting in an infection.

Some fungal infections cause only a small amount of irritation, while other types penetrate deeper and can cause itching, swelling, blistering, or scaling.

Different fungi, depending on their location on a child’s body, cause ringworm. The risk of contracting ringworm increases if the child:

-Is malnourished
-Has poor hygiene
-Lives in a warm climate
-Has contact with other children or pets with ringworm
-Is immune-compromised by disease or medication

How is ringworm diagnosed?
Ringworm is usually diagnosed based on a medical history and physical examination of the child. The lesions of ringworm are unique, and usually allow for a diagnosis simply on physical examination. The physician may also order a culture or skin scraping of the lesion to confirm the diagnosis.

The most common types of ringworm are:

- Athlete’s Foot
This common condition mostly affects teen and adult males, and is rarely found in children before puberty. Many things can cause athlete’s foot, include sweating, not drying the feet well after swimming or bathing, wearing tight socks and shoes, and warm weather conditions. Children are not typically susceptible to athlete’s foot unless present with a parent or there is ringworm infection in the nails.

- Jock Itch
This condition, tinea cruris, is more common in males and occurs more often during warm weather conditions. Although not as common, women can and do get jock itch.

- Scalp Ringworm
This is highly contagious, especially among children. It occurs mainly in children between the ages of 2 and 10, but rarely in adults. Ringworm of the scalp can also develop into a kerion, a large, tender lesion over the area of the initial ringworm and may be associated with a rash elsewhere on the body and tender lymph nodes in the neck.

- Nail Ringworm
This is an infection of the finger or toenail, characterized by a thickened, deformed nail. This condition is found more often in toenails than fingernails, and is more common in adolescents and adults than young children. Men suffering with nail ringworm are more likely to develop a recurrence, hence the rationale is to treat the disease aggressively.

- Body Ringworm
This skin infection is characterized by a ring-like rash on the body or the face. This occurs at all ages and is more common in warmer climates.

What is the treatment for ringworm?
Because the fungi can live indefinitely on the skin, recurrences of ringworm are likely, and treatment may need to be repeated. Specific treatment will be determined based on:

-The child’s age, overall health, and medical history
-Extent of the condition
-Location of the ringworm
-The child’s tolerance for specific medications, procedures, or therapies
-Expectations for the course of the condition
-Child or parent’s opinion or preference

Consult your dermatologist.