Summer Skincare Recommendations for Teen Acne

Summer can be a minefield for acne-prone tweens and teens. Sebum is an oily substance produced by the sebaceous glands. Our skin needs it in order to function, but too much of it can lead to acne, and an overly oily complexion.

Sebum production is more pronounced in the summer and fall. Increased sebum production, brought on by heat and humidity, can increase the growth conditions for skin bacteria. This all adds up to a need for adjustments in acne regimes in summer months.

Tip 1: If skin feels oily, use a foaming cleanser.

In general, bar soaps and foaming cleansers are better at removing sebum and are good choices for oily skin. Sensitive skin types should still use liquid cleansers formulated for sensitive skin. Be sure not to irritate the skin by scrubbing too hard or over-cleansing.

Tip 2: Choose non-greasy moisturizers and sunscreen.

Sunscreens and moisturizers are important for photoprotection and barrier maintenance. Oily complexion products are generally composed of water and dimethicone or cyclomethicone, which are noncomedogenic, hypoallergenic, and non-greasy, providing
the basis for “oil‐free” moisturizers. Gel or lotion formulations have less oil and will be better choices for oily skin.

Tip 3: Choose your facial care products carefully.

There are many over-the-counter products luring you in with the promise of a beautiful porcelain complexion – toners, masks, pore strips, to name a few. If you or a loved one are acne-prone, a good rule of thumb is to ask us if a certain product is good for you. Like advanced treatments, new and improved products formulated for clearer skin are on the market and can help. We offer many of them in our office, so please be sure to ask.

Tips on Dealing with “Spring Skin”

The thought of Spring can leave some less fortunate individuals with a dreaded promise of an ensuing runny nose; red, puffy eyes and itchy, sensitive skin.

In Spring, the skin is exposed to invisible airborne allergens, such as pollen, which in some individuals can lead to the release of histamine, a neurotransmitter that dilates blood vessels and leads to inflammation. Higher levels of histamine can lead to the skin being more reactive and can even trigger eczema and allergies. The most readily effected areas for this to occur on the face are on the cheek and the skin surrounding the eye.

Due to climate change and the weather we’ve been experiencing lately, experts are predicting a worse-than-average spring allergy season and expect the situation to escalate as time goes on. The reason being that concentrations of carbon dioxide in the atmosphere have risen, which increases the release of allergen levels such as pollen and types of fungal growth, such as mold, and the spores they release.

Here are a few handy tips that we can provide as part of a prevention plan:

Reduce Stress Levels
Stress has been found to actually make your response to allergens worse. A short 15-minute back massage can actually be an anti-inflammatory skin treatment.

Change Up Your Routine
If you tend to be someone who suffers from seasonal allergies or experiences some of the symptoms of “Spring Skin” then you may want to consider a Spring skin care program that can actively target skin inflammation, puffiness and irritation while repairing the barrier function of the skin.

Products to look for in your “Spring Skin Care” program should be those proven to have natural anti-irritant and anti-redness properties. The delicate eye area is often the first to show signs of irritation, so try using a lightweight, gel-based eye cream formulated to limit inflammatory mediators, thereby significantly reducing eye puffiness, redness and attendant itchiness.

RI Skin Doc recommends TriXera, a lightweight, nourishing formula that provides 48-hour hydration to nourish and protect dry, sensitive skin. For longlasting moisturizing and protection, we also offer Theraplex Emollient, especially formulated to treat severely dry, cracked skin (including hands, feet, elbows and knees) and chronic skin conditions.

Reduce Your Alcohol Consumption
Many may not be aware that there is naturally occurring histamine in alcohol, which is made during the fermentation process. Wine, beer and champagne contain the highest concentration of histamine, which could exacerbate your symptoms.

Eat Right
Avoiding certain foods and adding more of others can affect your likelihood of developing seasonal allergies, as well as the severity of your symptoms.

German researchers from the University of Bonn published an article in 2007 in the “American Journal of Clinical Nutrition” (AJCN) that identified high-histamine foods. Common foods high in histamines include beer, tuna, mayonnaise, vinegar, wine, pickles, olives, and yogurt, to name a few.

According to the Michigan Allergy, Sinus and Asthma Specialists (MASAS), fermented, aged and processed meats like bacon, hot dogs, pepperoni, luncheon meats and cheeses are also high in histamines – hard to avoid, buy try during this critical part of the year.

It would be always be advisable to consult and allergist and/or nutritionist to get some expert advice in regards to what food to avoid and include in their diet.

Hiding from the Sun? Not all Shade is Equal.

While shade is a potentially valuable means of protection from the damaging effects of the sun’s ultraviolet (UV) rays, not all shade is equally protective.

People can spend long hours in the shade while still receiving quite a lot of sun exposure and risking skin damage. This is because UVB rays, often considered the most harmful part of sunlight, can reach the skin indirectly. Indirect or diffuse UV light is radiation that has been scattered by the clouds and other elements in the atmosphere, and/or bounced back from UV-reflective surfaces like dry sand or concrete. We can rely only on deep shade (where we cannot see the sky and no UV penetrates) to offer truly complete protection.

Skin cancers are disproportionately concentrated on the head compared with other parts of the body. Faces, the nose in particular, are especially at risk. For men, the ears are a focal point for melanoma, the deadliest form of skin cancer. Although the head is easy to protect, too often it is left bare. Even when hats are worn, many provide only minimal shade – especially for the nose, ears, and neck.

Hats with broad brims all around and those with brims angled downwards provide the greatest UV protection. Unless they are very large, umbrellas provide relatively little UV protection. A single umbrella on a sandy beach by the sea provides limited sun protection because so much UV is reflected under the umbrella from the surfaces of the sand, water and sky.

Shady trees are always inviting on a hot, sunny day, and those with large spreads of dense foliage best protect us from the sun. If you can, choose a tree near other trees or buildings to further block out the sky.

Factors that increase the amount of scattered or indirect UVB, such as reflective surfaces, will decrease the protection trees can provide. The same tree actually gives less protection earlier and later in the day, when the proportion of diffuse UV is high, than it does in the middle of the day when the sun is more directly overhead.

Shade structures such as roofed areas, shade-sails, and pergolas vary widely in the amount of protection provided. Factors that determine how well a structure provides shade include the size of the structure, its orientation, and where it is in relation to other structures, such as buildings, trees and other vegetation.

Shade alone can rarely provide full UV protection, especially for prolonged periods. However, it is one important element in a comprehensive sun protection program that includes covering exposed skin with clothing (particularly clothes made of bright- or dark-colored, tightly woven fabrics), wearing hats and sunglasses, and regularly using sunscreen containing zinc oxide and/or titanium dioxide with an SPF of 30 or higher.

All these steps taken together will help ensure that we are adequately protected from the sun’s rays when we are outdoors.

Shingles and the new preventive vaccine

Anyone who has had chickenpox can get shingles, also called herpes zoster. After the chickenpox clears, the virus stays inside the body. If the virus reactivates (wakes up), the result is shingles – a painful, blistering rash.

In October 2017, the U.S. Food and Drug Administration (FDA) approved a new vaccine that can prevent shingles. This is the second vaccine that the FDA has approved to prevent shingles.

Insurance currently covers the cost of getting the shingles vaccine that the FDA approved some years ago. Who pays for the cost of this new vaccine, however, is causing confusion. Here’s what you should know.

While this new vaccine is available, it takes time for insurance companies to cover the cost. It’s expected that insurance will cover the cost of getting this new vaccine, which requires 2 shots, in 2018.

The risk of getting shingles increases with age. A vaccine can reduce your risk of getting shingles. Your doctor may recommend getting this vaccine after your 50th birthday or once you reach 60 years of age. There’s another, and maybe even more important, reason for getting the shingles vaccine. If you’ve had chickenpox, you can still get shingles after getting the shingles vaccine. Despite that downside, the vaccine will still lessens your risk of developing serious complications from shingles, such as life-disrupting nerve pain.

The nerve pain can last long after the shingles rash goes away. Some people have this nerve pain, called post-herpetic neuralgia (PHN), for many years. The pain can be so bad that it interferes with your everyday life. The shingles vaccine reduces your risk of developing this nerve pain, even more than it reduces your risk of getting shingles.

An anti-viral medicine may also prevent long-lasting nerve pain if your get shingles. It’s most effective when started within 3 days of seeing the rash. The anti-viral medicine can also make shingles symptoms milder and shorter.

To diagnose shingles, a dermatologist will look at the skin and ask some questions.

If there is any doubt, the dermatologist may scrape a blister to get a sample. This sample will be examined under a microscope. Also, the dermatologist may send the fluid from a blister to a laboratory for testing.

Without treatment, the rash may clear in a few weeks. Dermatologists, however, strongly recommend treatment. Without it, many people get pain, numbness, itching, and tingling that can last for months and even years.

It’s best to get treatment immediately. Treatment can include:
- Pain relievers to help ease the pain: The pain can be very bad, and prescription painkillers may be necessary.
- Anti-viral medicine: This medicine may be prescribed when a doctor diagnoses shingles within 72 hours of the rash first appearing. The earlier anti-viral treatment is started, the better it works. They can lessen the pain and the amount of time the pain lasts.
- Nerve blocks: Given for intense pain, these injections contain a numbing anesthetic and sometimes a corticosteroid.
- Corticosteroids: To lower swelling and pain, some patients may get corticosteroid pills with their anti-viral medicine. This treatment is not common because it can make the rash spread.

Those Tiny Bumps That Don’t Go Away

Many parents reach out to us concerned about tiny bumps that suddenly appear on their young child’s skin and don’t go away. Some say they look like goose bumps or mistake them for small pimples. In all likelihood, it’s a common condition called keratosis pilaris.

These rough-feeling bumps are actually plugs of dead skin cells. The plugs appear most often on the upper arms and front thighs. Children may have these bumps on their cheeks.

Keratosis pilaris is harmless. If the itch, dryness, or the appearance of these bumps bothers you, treatment can help. Treatment can ease the symptoms and help you see clearer skin. Dry skin can make these bumps more noticeable. In fact, many say the bumps clear during the summer only to return in the winter.

People of all ages and races have this common skin condition. For most, it begins before age 2 or during the teenage years. Fewer adults have it because keratosis pilaris can fade and gradually disappear.

The bumps may clear by the time a child reaches late childhood or adolescence. Hormones, however, may cause another flare-up around puberty. When keratosis pilaris develops in the teenage years, it often clears by one’s mid-twenties. Women are a bit more likely to contract it.

To diagnose this condition, a dermatologist will examine your skin, looking closely at the skin that shows signs of the condition. Since it’s harmless, you don’t really need to treat it. If you do wish to treat it, a creamy moisturizer containing urea or lactic acid can soothe the itch and dryness.

To diminish the bumps and improve your skin’s texture, we often recommend exfoliating (removing dead skin cells from the surface of your skin) with gentle rubbing with a washcloth, loofah (not on the face) or at-home microdermabrasion kit.

A laser or light treatment may work when moisturizer, medication or exfoliations don’t meet the result you hope for. We may recommend a type of laser to reduce the swelling and redness…or another type to improve your skin’s texture and reduce discoloration, including the brown spots that may appear when the bumps clear.

It’s always best not to take chances. A dermatologist can properly diagnose a condition you are concerned about and recommend a treatment plan that best meets your needs.

Treat Hair Loss Early

Because so many things can cause hair loss, a dermatologist acts like a detective. Like a murder mystery, the slightest clue can solve the case.

Did the hair loss happen suddenly or gradually? They will ask what medicines you take, what allergies you have, and whether you’ve been dieting. Women may be asked about their periods, pregnancies, and menopause.

The dermatologist will also carefully look at your hair and scalp. During an exam, the dermatologist may pull out a hair to get evidence. Sometimes the evidence lies in your scalp. A small piece of scalp may be removed for a scalp biopsy, which can be quickly and safely performed during an office visit to solve the case. Sometimes, a blood test is necessary.

Because so many things can cause hair loss, it can take time to find the cause and you may need to make a few appointments.

Once the cause of the hair loss is identified, your dermatologist can tell you what to expect. Sometimes hair loss does not need treatment. The hair will start to re-grow on its own. In some cases, changing what you do will stop the hair loss, allowing your hair to start re-growing. Sometimes treatment can restore hair.

Just as there are many causes, there are many treatments for hair loss. Dermatologists recommend treating hair loss early. Early means before you lose a lot of hair. Hair loss is harder to treat when a person has a lot of hair loss.

There are several ways to treat hair loss. Among the most popular are:

- Prescription pills and injectable medications to slow hair loss
- Over-the-counter topical drugs to stimulate hair growth on the top of the scalp
- Laser devices, like light-emitting brushes and combs, which may stimulate hair growth
- Hair transplantation, moving good hair growth to areas that need growth
- Scalp reduction, removing bald scalp and bringing hair-bearing scalp closer together

10 Winter Skin Care Tips

This is our annual reminder that maintaining healthy skin all winter can be as simple as making just a few small lifestyle changes. You want to protect your skin, moisturize, avoid known irritants, and control your environment to prevent red, cracked, itchy, irritated skin.

Cold air holds less moisture, so skin can become dry and even cracked or painful in winter months. Some common sense and, perhaps, a little product assistance can help skin stay moisturized and healthy when temperatures drop and the cold winds blow.

Although steps are always easier said than done, it really doesn’t take much effort to improve your skin’s health by following some of our 10 tips to maintain a healthy glow all winter long

1. Wear the proper clothing – protect skin when outdoors from wind and cold with gloves, hats, scarves.

2. Hydrate - drink enough water. It is easy to forget in winter, when you tend to be less thirsty, that skin needs to be moisturized from the inside out as well as from the outside in.

3. Moisturize - at least once a day, and more often as needed. Avoid fragrances and dyes that can cause skin irritation.

4. Pat dry – don’t scour, after shower or bath and apply moisturizer while the skin is still damp.

5. Avoid overexposure to water – limit showers or baths to 15 minutes in lukewarm water. The hotter the water and the longer you stay in it, the more moisture is depleted from your skin.

6. Use mild soaps – that don’t strip moisture from your skin, such as Dove.

7. Wear sunscreen – because even though the sun doesn’t feel as strong in winter, UVA and UVB rays can still be damaging.

8. Moisturize lips – which are particularly sensitive to cold and wind..

9. Moisturize hands – they, too, are particularly susceptible since they suffer frequent hand washing to avoid sickness in the winter

10. Humidify – because not only is cold air naturally less humid, it becomes even drier when heated in our homes. Nasal sprays can help keep nostrils moisturized.

Seek Out “Beneficial” Ingredients

“Ninety percent of the diseases known to man are caused by cheap foodstuffs. You are what you eat.” Nutritionist Dr. Victor Hugo Lindlahr, 1942

Yes, you are what you eat. I’m sure you’ve heard this old adage directed toward the choices we make for what we put “inside” our bodies. However, it’s also true that we are susceptible to the choices we make for the products we put “on” our bodies, including our face.

Today, there is a proliferation of products filling our drugstore shelves containing ingredients we should avoid. At the same time, there are products with ingredients we should be looking for – ingredients that can improve our appearance, our health, and our lifestyle. Be sure to read your cosmetic, sunscreen, skin treatment, and skin care products labels and look for these most-effective ingredients:


- Antioxidants

Look for free-radical fighters like vitamin E, green tea, and niacinamide. These are great counterparts with sunscreens for protection against UV damage.


- Hydroxy Acids

Alpha and beta hydroxyl acids are go-to ingredients if you’re seeking light exfoliation and to stimulate collagen. I especially like glycolic and lactic acids for gentle peels.



These are amino acids. They’re especially good for building collagen and improving the appearance of wrinkles around the eyes.


-Hyaluronic Acids

Look for this lightweight but powerful moisturizer to hydrate and instantly plump the skin.



One of the best anti-aging ingredients, the proven benefits of this vitamin A derivative are many, including pigment lightening, exfoliation, and acne control.


-UV Protection

My mantra has and always will be “Protect your birthday suit…wear sunscreen daily.” Look for ingredients like zinc oxide, titanium dioxide, and dimethicone in broad-spectrum formulas that shield against both UVA and UVB rays.

The Future: Personalized Vaccines to Prevent Skin Cancer Relapses

Vaccines personalized to fight patients’ specific tumors may be the future of cancer treatment. Researchers recently developed vaccines tailored to individuals that successfully fought off skin cancer tumors in two small studies.

Two papers published by two different teams in Nature this past July showed that personalized vaccines were able to get rid of tumors in most patients who were tested. The content of each vaccine was tailored by the mutation characteristics of that patient’s own tumor.

These vaccines are a form of immunotherapy, which work by stimulating the immune system to attack cancer. The researchers chose to study melanoma, the most serious kind of skin cancer, because it has one of the highest mutation rates of cancers. While research in immunotherapy has shown promising results, doctors have found it can also pose serious risks to healthy organs.

The vaccine developed by one of the teams aimed to expand the number of T-cells targeting the cancer, personalizing it so that the T-cells target the specific makeup of the patients’ tumors. T-cells are a type of white blood cell that play an important part in our immune systems. This vaccine helped keep the cancer in check.

The team tested the vaccine on six patients whose tumors had been removed surgically, but were at risk of them growing back. Four of the six vaccinated patients had no cancer recurrence more than two years after the vaccination. The results showed that these vaccines are effective both by themselves and when combined with other types of immunotherapy.

In the other study, the team created a personalized vaccine based on RNA (nucleic acid), which converts the information stored in DNA to proteins.

Eight patients were tumor-free more than a year after treatment. Five other patients’ tumors had already spread by the time they received the vaccine. One patient became tumor-free after receiving a PD-1 inhibitor, and two patients’ tumors shrank, although the tumors resurged in one of them.

These vaccines, as with many other types of therapy, would be more effective in early stages of cancer. The research teams plan to continue strengthening the vaccine and applying it to other types of cancer, as well as combining it with other types of immunotherapy to test the most effective ways to fight tumors.

One challenge is cost, currently an estimated $50,000 to $100,000. Automation and digital solutions could rapidly make the price more affordable as standard treatment. And, although the teams took about three months to produce these vaccines, it has been predicted the process can be shortened to an acceptable six weeks.

Viagra Poses Possible Higher Melanoma Risk

According to a new meta-analysis, men who use phosphodiesterase type 5 (PDE5) inhibitors, commercially branded as Viagra, Cialis and Levitra, have a slightly increased risk of developing melanoma and basal cell carcinoma.

These oral PDE5 inhibitors, such as sildenafil (Viagra) and tadalafil (Cialis), have proved to be safe, effective treatments for erectile dysfunction (ED) disorders and have fostered further research into the underlying mechanisms of such drugs. Side effects are typically headache, flushing and lightheadedness due to low blood pressure.

Researchers at Indiana University investigated the possible association between use of PDE5 inhibitors and the risk for development of skin cancers in data pooled from three cohort studies and two case-control studies involving a total of nearly 1 million participants.

The use of PDE5 inhibitors was associated with a 12% increase in the odds of developing melanoma and a 14% increase in the odds of developing basal cell carcinoma, but there was no evidence of any increased risk for development of squamous cell carcinoma.

The higher melanoma risk was significant in the studies done in Europe, but not in those from the United States, and it was evident only in cohort studies.

Meanwhile, in the Journal of the American Academy of Dermatology, published online this July, it was reported that there was no association between PDE5 inhibitor dose and the risk for development of melanoma.

Possible alternate explanations were put forth that men who use PDE5 inhibitors may be more likely to have increased sun exposure, which increases their risk of multiple skin cancers, or that men who take PDE5 inhibitors are more likely to see the doctor where they also get screened for skin cancer.

It’s important to know that association does not necessarily equal causation. Just because two things are seen more often in the same group of people does not mean that one causes the other. Dermatologists will still screen for melanoma risk, but they do not need to add the use of Viagra and similar drugs to the specific list of screening criteria.