What's in your makeup? There's an app for that!

Are you worried about possible harmful ingredients in your cosmetics? Download this app on your phone!

#mcleanderm #cosmetics #makeup #thinkdirty #askdrlily

" I Have Sensitive Skin! " But Do You Really?

Q: What exactly does “sensitive skin” mean?

A: The term “sensitive skin” is a marketing expression that really has no medical definition.

With over 60% of the population claiming they fall victim to so-called “sensitive skin,” it is easy to see why so many cosmetic companies market their products to this group.

There are three types of skin that tend to make up the population of sensitive skin sufferers: subjects with rosacea, subjects with atopic dermatitis, and subjects with cosmetic intolerance syndrome.

Tips:

1. Avoid over washing of the face.

2. Avoid products with fragrance, formulated with propylene glycol, lanolin, and paragons.

3. Moisturize 2 x a day to preserve the normal layer of the skin.

4. Avoid treatments with retinol, glycol acid or peels.

5. Test it...before you buy it.

Is Your Birth Control Breaking You Out?

Are you breaking out and have no clue as to why? It could be your birth control...

Come in for an acne consult and find out if your monthly oral contraception is causing your acne.

The Epidemic of Over-Washing

“My skin is dry AND oily!”

 Do you find yourself constantly frustrated with the condition of your skin? You are not alone! There is an epidemic sweeping the nation - Over-washing.  As a dermatologist I have several patients come to me with skin issues that could easily be alleviated by actually decreasing the amount they wash their skin! Many believe washing their skin again and again is the only way to get rid of the oil and bacteria that covers their skin. Believe it or not, constantly washing is not the answer - it actually makes your skin more oily!

The oil your skin naturally produces acts as a barrier to protect your skin from the environment. When you wash your skin, especially with harsh soaps, cleansers, and hot water, it strips away all oil and leaves your skin with out any protection. Your skin then dries and cracks. Because your skin is too dry, it then overcompensates by producing MORE oil and the unfortunate cycle repeats itself.

So how do you break the cycle?

• Cleanse gently.
• Start by only washing your skin with gentle, non-foaming cleansers. If you have acne prone skin, try Glytone Mild Gel Cleanser. Dry skin? Try Neutrogena Extra Gentle Cleanser or Avene Trixera Gel Cleanser.
• Limit time under the water.
• Water, especially when it is hot, whisks away the protective oil barrier that protects and moisturizes your skin. Limit your time under the showerhead to only 5-10 minutes.
• Rebalance your skin.
• Use an exfoliating scrub to remove the dead skin cells. This is a great way to diminish the rough appearance of your complexion. SkinKure microdermabrasion is the best product I have found and is sold in our office! Simply use once or twice a week for fantastically smooth skin.

As a rule, if your skin feels tight after you wash or if it feels “squeeky clean”, the wash you are using is too harsh. It is a hard transition to make, but one week of limiting the over-washing cycle will make a world of difference in rebalancing your skin.

Don’t fall prey to the endless cycle of over-washing! End it today!

The Puzzling Relationship Between Diet and Acne

The relationship between acne and diet has been an ongoing debate. There are no meta-analyses, randomized controlled clinical studies, or well-designed scientific trials that follow evidence-based guidelines to elucidate a cause-effect relationship. However, for decades anecdotal evidence has shown that acne and insulin resistance, such as that seen in patients with polycystic ovarian syndrome (PCOS), are highly linked. Now the literature points to the growing relationship between nutrition and the prevalence of acne, especially to glycemic index and the consumption of dairy.

Glycemic index is a ranking system based on the quality and quantity of consumed carbohydrates and its ability to raise blood sugar levels. Foods with high glycemic indices such as potatoes, bread, chips, and pasta, require more insulin to maintain blood glucose levels within the normal range. High-glycemic diets that are prevalent in the United States not only lead to insulin resistance, diabetes, obesity, and heart disease but also to acne.

Several studies have looked at the glycemic load, insulin sensitivity, and hormonal mediators correlating to acne (Am. J. Clin. Nutr. 2007; 86:107-15; J. Dermatol. Sci. 2008;50:41-52). Foods with a high-glycemic index may contribute to acne by elevating serum insulin concentrations (which can stimulate sebocyte proliferation and sebum production), suppress sex hormone-binding globulin (SHBG) concentrations, and raise androgen concentrations. On the contrary, low-glycemic-index foods increase SHBG and reduce androgen levels; this is of great importance because higher SHBG levels are associated with lower acne severity. Consumption of fat and carbohydrates increases sebum production and affects sebum composition, ultimately encouraging acne production (Br. J. Dermatol. 1967;79:119-21).

A new study by Anna Di Landro et al. published in the December 2012 found a link between acne and the consumption of milk, particularly in those drinking skim milk and more than three servings of milk per week (J. Am. Acad. Dermatol. 2012;67:1129-35).

Dr. Di Landro et al. also found that the consumption of fish had a protective effect on acne. This interesting finding points to the larger issue of acne developing in ethnic populations that immigrate to the United States. Population studies have shown that non-Western diets have a reduced incidence of acne. Western diets are deficient in long-chain omega-3 fatty acids. The ratio of omega-6 to omega-3 fatty acids in our Western diet is 10:1 to 20:1, vs. 3:1 to 2:1 in a non-Western diet. Omega-6 fatty acids in increased concentrations induce proinflammatory mediators and have been associated with the development of inflammatory acne. Western diets with high consumption of seafood have high levels of omega-3 fatty acids and have shown to decrease inflammatory mediators in the skin (Arch. Dermatol. 2003;139:941-2).

In my clinic, the ethnic populations that immigrate to the United States often develop acne to a greater extent than they had in their native countries. Although factors including stress, hormonal differences in foods, and pollution can be confounding factors, we must not ignore the Western diet that these populations adapt to is higher in refined sugars and carbohydrates and lower in vegetables and lean protein. Every acne patient in my clinic is asked to complete a nutritional questionnaire discussing the intake of fast food, carbohydrates, juice, sodas, and processed sugar. We have noticed that acne improves clinically and is more responsive to traditional acne medications when patients reduce their consumption of processed sugars and dairy and increase their intake of lean protein. Similarly, our PCOS patients who are treated with medications such as metformin, which improves the body’s ability to regulate blood glucose levels, have improvements in their acne. So, is acne a marker for early insulin resistance?

The underlying etiology of acne is multifactorial, although now we can appreciate diet as one of the causative factors. Although there is no direct correlation between obesity or insulin resistance and the prevalence of acne, a low glycemic index diet in combination with topical and systemic acne medications can be a powerful method of treating acne. Nutritional counseling is an adjunct educational service we should provide to our patients in addition to skin care advice and medical treatments for acne.

No single food directly causes acne, but a balanced diet can alter its severity. Encouraging our patients to eat a variety of fruits and vegetables, lean protein, and healthy fats can prevent the inflammation seen with acne and also can protect against cardiovascular disease, type II diabetes, and even obesity.

It is unfortunate that the medical education system in the United States has no formal nutrition education. Nearly every field of medicine including internal medicine, cardiology, endocrinology, allergy, pediatrics, obstetrics and gynecology, surgery, and not the least, dermatology, is influenced in some realm by nutrition. As the population diversifies, so will the importance of dietary guidance. We need to educate ourselves and our residents-in-training to better appreciate the symbiotic relationship between diet and skin health and to provide this guidance to our patients.

By: LILY TALAKOUB, M.D., Skin & Allergy News Digital Network

You may have acne, but do you know which TYPE?

Whether you suffer from troublesome blackheads or embarrassing pimples, we all know the uncomfortable feeling acne can cause.

At McLean Dermatology, we are dedicated to both teaching you about the possible causes of your acne and how to treat it.

What most people don’t know is that there are several different types of acne, meaning not all products are “one size fits all.”

Comedonal Acne - the typical blackheads underneath the skin’s surface. These are essentially small non-inflamed, clogged pores.

Papular/Pustular Acne - develops as red bumps and pus-filled whiteheads. These bumps have a tiny opening to the skin’s surface.  So tiny, in fact, that it makes air hard to reach the follicle causing the white bubble.

Nodular/Cystic Acne - the most severe type of acne. These are hard (nodules) or fluid-filled (cystic) painful bumps. Cystic acne is known to take much longer to heal and often results in scarring and discoloration of the skin.

Hormonal Acne - the result of fluctuating hormones in the body. This type of acne can occur into late adulthood. Easily recognized by the bumps located on the chin and jaw, hormonal acne can also advance to the neck and posterior scalp. These develop into hard, painful bumps that can take weeks to heal.

Treatment options are available for each of these particular types of acne and can be addressed with various oral and/or topical agents. However, not all medications are a right fit.  If you suffer from acne and have yet to find relief, please call today to schedule an appointment.

Tips to Keeping a Healthy Glow during the Harsh Winter Months

Anyone can get dry skin, but with these tips everyone can avoid it.  We see it begin in the fall and by winter our skin is dull, flaky, and itchy.  The low temperatures, absence of humidity, and harsh winds all play a role in causing this unwanted dry skin.  Here are some tips to help your body keep moisture in.

1     -  Take warm, but not hot showers.  Yes, they feel great but they aren’t great for your skin.  Hot water robs your skin of its moisture, so try taking a lukewarm shower only once a day.  This rule also applies to washing your hands.

      - The best time to moisturize is right after showering.  Try to apply your cream within five minutes.  It is better to use a cream rather than a lotion because lotions are oil in water, whereas creams are water in oil.  Creams are thicker and are often in a tube or jar, not a pump.

3     - Invest in a humidifier. The winter air is in short supply of humidity, especially if your home has a fireplace.  A room heated by a fireplace has less than 10% moisture in the air.

4     -  Exfoliate, exfoliate, exfoliate!  I can’t say it enough.  Moisturizers work much more effectively when applied to exfoliated skin.  For facial exfoliation try Clarisonic’s Facial Cleansing Brush along with any glycolic acid face wash such as Glytone’s Self-Foaming Acne Cleanser, which can be purchased at your next visit.  For hydrated, smooth skin try our Avéne Emollient Cleansing Bath.

5    -  Skip the drying soaps such as anti-bacterial, bar soaps, and anything that lathers.  Stick to creamy cleansers with moisturizing ingredients like glycerin or petrolatum.  Aveeno Daily Moisturizing Body Wash is great for the body and for the face try Avéne’s Extremely Gentle Cleanser sold in our office. And don’t forget your lips!  Eucerin’s Aquaphor Healing Ointment works wonders for dry, cracked lips.