Timeless, Ageless, Beautiful Skin

Shirley Chi, M.D.Board Certified Dermatologist

Director, Dermatology Resident Education, OliveView-UCLA

Center for Advanced Dermatology, Arcadia, CA

Goals for Today

• Debunk some common myths• Learn about some important skin problems • Get tips on skin care products• Learn what’s new in cosmetic dermatology

Fact vs. Fiction: The Sun

True or False?

• “The only time I am outside is when I’m driving, and since my windshield protects me from the sun, I don’t need to wear sunblock.”

FALSE

Myth #1: Windshields as sunscreens

• Windshields only block out SOME of the sun’s harmful rays

• The rays that contribute to aging and wrinkling, or UVA, still reach your skin in the car

• These rays cause deep skin damage and can cause skin cancers

The effects of sun through windshields

• Left side of the face gets more skin cancers• Left side of the face is usually more wrinkled

Left sided sun damage

Photo from New England Journal of Medicine

Basics of Skin Cancer

• Think of skin cancer in 2 major categories:– MELANOMA– NON-MELANOMA SKIN CANCER

Melanoma

When you think of melanoma, think of the ABCDs:

Melanoma

• Risk factors include: history of severe sunburns, light skin, freckles, and family history of melanoma

• Asian and African skin types – hands and feet• Make sure to get annual dermatology

checkups• See your dermatologist if you notice any

changing moles, new or bleeding moles

Non-melanoma Skin Cancers

• Basal Cell Carcinoma and Squamous Cell Carcinoma

• Both caused by a history of excessive sun exposure

• Bumps and crusty scabs that don’t go away

Basal Cell Carcinoma

Squamous Cell Carcinoma

Skin cancer bottom line

• See your dermatologist if you notice a new or changing mole, or a bump or scab that doesn’t heal

True or False

• Since one way to get vitamin D is from sun exposure, it’s okay to not wear sunscreen if you have low vitamin D levels.

FALSE

Dilemma: sunscreen or vitamin D?

• Studies show that three-quarters of U.S. teens and adults are deficient in vitamin D (2009)

• This is also true of people who live in sunny climates such as California and Hawaii.

• Recent evidence links low vitamin D levels with a number of diseases: – cancers of the colon, breast and prostate, high

blood pressure, arthritis, multiple sclerosis

Low Vitamin D in diet increases stroke risk in

Japanese-Americans

Dr. Gotaro Kojima et. al., published May 2012

Dilemma: sunscreen or vitamin D?

• 1 person dies of melanoma every hour in the U.S., and the rate of skin cancer in general is increasing

• Even people who live in sunny climates have been shown to have low levels of vitamin D

Bottom Line on vitamin D debate

Take your supplements, eat foods rich invitamin D, and WEAR YOUR SUNSCREEN!

Picking a sunscreen

• In general, must be at least SPF 30• Look for “Broad Spectrum Protection”- blocks

both UVA and UVB rays• If your skin is sensitive to irritation and

burning, use products with titanium dioxide and zinc oxide ONLY

My favorite sunblocks for oily skin:

• La Roche Posay Anthelios 50 Mineral Ultra Light Sunscreen Fluid– New tinted version for sheer coverage

• Vanicream SPF 35 Sport Sunscreen– For extremely sensitive skin types

My favorite sunblocks for dry skin:

• Neutrogena Healthy Defense SPF 30 Daily Moisturizer (tinted or untinted)

• Eucerin Sensitive Facial Skin Extra Protective Moisture Lotion with SPF 30

• LaRoche-Posay Anthelios 60 Face Melt-In Sunscreen Lotion– Contains Mexoryl, the newest sunscreen

ingredient on the market– Velvety soft finish

Sunblocks for acne-prone skin:

• TIZO3 Facial Mineral Fusion– Goes on like a make-up primer– Slightly tinted

• Consider facial powder with sunscreen:– Neutrogena Healthy Defense Protective

Powder SPF 30

COMMON SKIN PROBLEMS

We are like fine wines, getting better with age…

…EXCEPT…• Our skin is getting drier • Our faces are getting blotchy and wrinkled • And on top of that, we still get acne!!!

“Wait a second, that’s not fish food… it’s flaky dry skin!!”

Dry skin

• Our skin loses its ability to be a moisture barrier as we age

• More prone to eczema- itchy, red rash usually triggered by irritant or allergen

• Especially noticeable in dry, cooler winter temps

Tips on Treating Dry Skin

• Take shorter showers and avoid extremely hot water

• Moisturize immediately after towel drying to trap humidity

Moisturizers for Dry Skin

• CeraVe Cream– Lotion is lighter for face– Light feel– Good for sensitive skin

• Amlactin– 12% lactic acid– Comes in lotion or cream– Great for bumps on arms

and thick heels, too

Adult Acne

• Becoming more common, possibly due to dietary factors, stress, and pollution

• Hormones play a role• Can lead to scarring if not treated properly• To illustrate this point…

Adult acne products

• Cleanser:– Neutrogena Oil-free Acne Wash or Fresh Foaming

Wash – LaRoche-Posay Effaclar line

• Moisturizer: – Only to dry areas!

• Spot treatment:– Eucerin Clear Skin Formula Conceal & Heal Treatment

Pencil

Other acne tips

• Be careful of products containing benzoyl peroxide(BP)- they may cause redness and irritation in adult skin

• If you like Pro-Activ, use the generic line “Acne-Free”

• If you like masks- sulfur as active ingredient

Other Treatments for Acne

See your dermatologist if your acne is uncontrolled for:

Chemical peelsThe new “Silkpeel”- less downtimeOral and topical prescriptionsBlue Light Treatments

Adult Acne- Blue Light• Dermatologist administered,

FDA-approved treatment for acne and oily skin

• Helps make skin less oily and decreases acne breakouts with series of treatments

Let’s talk about wrinkles…

Should we buy expensive “Anti-aging” creams at the department store?

• Here’s where there are plenty of myths!• Many ingredients found in anti-aging

creams simply cannot be absorbed into skin• Other ingredients may irritate skin too

much• At up to $400 for a tiny jar, it pays to know

what works!

Bestselling ingredients (that don’t work)

• Hyaluronic acid• Collagen• Elastin• Oligo-peptides (Strivectin)• These molecules are simply too large to

penetrate into the skin

Here’s what DOES work

• Retinoids, a class of medicines which are related to vitamin A– Rx: Renova, most effective– OTC: RoC Retinol Correxion Day or Night Cream,

LaRoche-Posay Redermic R Intensive Anti-Aging Corrective Treatment

– Best bet: Use nightly after moisturizer, with daily sunscreen

True or False

If a product line contains “natural” ingredients such as plants and botanicals, then it is likely safe for your skin.

FALSE!Photo from website of Arbonne International

Here’s a plant you might recognize:

Poison Ivy

On that note…

LET’S TALK ABOUT THE FUN STUFF!!!

• What’s the difference between Botox and Restylane?• What lasers are out there and what can they do for

me?• How about my ugly spider veins?• Should I see a dermatologist or go to my local medi-

spa?

Botox vs. Restylane

• Bottom line on Botox: – Temporarily paralyzes muscles that cause wrinkles– Lasts about 4 months

• Restylane/Juvederm/Radiesse:– Considered “Fillers” or “Filling Agents”– Are injected into lines in the face that you don’t

want paralyzed to temporarily smooth wrinkles

Filler: Sculptra and Restylane

Sculptra

Lasers and light treatments

• Technology moving toward treatments with little or no “down time”– IPL (Intense Pulsed Light)– Fraxel– PDT (Photodynamic Therapy)

• Treats sun spots, fine wrinkles, blood vessels, overall sun damage

• Need series of treatments

IPL Treatment for Rosacea

IPL for sun spots and fine lines

IPL

Fraxel

IPL/Fraxel around the eyes

Spider Vein Treatments

• Gold standard treatment: Tiny injections of solution into individual vessels (Sclerotherapy)

• Laser treatment only when vessels become too tiny for injections

• A series of treatments necessary

Sclerotherapy: 3 monthly treatments

Should I see a dermatologist or go to my local spa?

BOTTOM LINE:Treatments at spas are NEVER as strong as what

your dermatologist can doSafety issues have become a major concern

So skip the facials at the spa…

Get that massage you really need instead!

Leave the skin care up to your dermatologist. It is safer, more effective and will be a better value in the long run.

THANK YOU!

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