Planning to Start a New Year’s Resolution to your Skincare? Here is where you should start.

What do you see on your skin?  Is it brown spot?  Do you see dilated/broken blood vessels?  Do you see fine lines/wrinkles?  Do you see sagging skin?  

Not to be depressing straight from the start here, but unfortunately all those changes can happen to our skin.  Now, depending if your skin tends to be more fair/blue eyed/light hair vs easily tans/brown eyes/darker hair you may gravitate towards more redness/broken blood vessels or more brown spots, respectively.  This is based on your genetics and background skin type. But that doesn’t mean you have no control over your future skin!

FIRST, begin with sunscreen.  SPF is an under-appreciated anti-aging tool!  Having more birthdays does generally tend to make a person begin to look older, however the sun is an accelerant.  It causes more visible blood vessels on our cheeks or sides of the nose.  The sun causes more brown spots, melasma, and uneven skin tone.  The big star in our sky causes collagen loss at a faster rate which can lead to more wrinkles, volume loss, and sagging.  So, as the song that was popular when I was in high school >20 years ago said….. “If I could offer you one tip for the future, Sunscreen would be it!”

After you have begun your morning routine of washing with a gentle cleanser, moisturizing if your skin is dry, and then putting on a lightweight SPF 30 or greater sunscreen, you have a few choices.  First, you could just continue to cleanse your skin…………don’t over-scrub, don’t use harsh astringents or gritty exfoliators, make sure your skin doesn’t feel too dry, and wear your sunscreen.  This by itself will cause your skin to look healthier and more youthful, especially as a lifelong habit.

However, if you want to protect and improve the quality of your skin because perhaps you are of the generation who would sunbathe with baby oil, iodine or foil… then you should definitely schedule an appointment with your dermatologist.  This is because first you want to make sure you do not have any pre-cancers(actinic keratoses) or skin cancers(basal cell carcinoma, squamous cell carcinoma, or melanoma).  Then, after you have been thoroughly examined for the most important and potentially life-threatening issues that could be caused by the sun, you can begin to work on the more cosmetic issues you are noticing.

Broken blood vessels usually need to be treated with a laser.  I wish there were a magic cream for these but laser works best.  Conveniently, one of our lasers also targets fine lines and brown spots as well as the blood vessels.

Brown spots sometimes can be treated with just creams.  In order for the creams to penetrate deep enough and work their best they should be combined with a retinol and/or with some chemical peels.  We luckily have glycolic acid peels (AHA) which have no down-time and can be used in combination with the above topical treatments.  Sometimes more aggressive peels or laser or liquid nitrogen may be needed.

Fine Lines/Sagging can be targeted with microneedling, fillers, or lasers.  All these treatments either promote the creation of your body’s own collagen(microneedling and laser) or inject filler for volume.

Your dermatologist will know which treatments are best for you, who to refer you to if they don’t perform some of these treatments, and in which order you should tackle your concerns.  

Written by Dr. Andrea LaTorre, Board Certified Dermatologist

Hottest Patient FAQ to wrap up 2023… learn what it is….

As we got further and further into the year 2023 and started heading towards the holidays, I noticed a sharp uptick in the number of patients asking me one question. It may have been due to holiday wish lists forming. It is most definitely due to social media and “influencers” becoming even more common amongst Generation Alpha individuals(those born between 2013 and today). This is also a big topic for Gen Z(which is 1997-2012). Can you guess what the hottest topic/patient FAQ I heard recently?

“What do you think about my child getting into a complex skincare routine at age 9/10/11/12/13 etc…?” or “My child is asking for a lot of beauty items they have seen on social media for the holidays, what is your opinion on those?” or another variation of the same question.

My initial answer is ….. whoa, I need to take a deep breath, gather my thoughts, and by the way do you have another 20 minutes to discuss this topic? It’s almost always a last minute question as we are finishing up mom’s appointment about whether the pre-teen age group should get into detailed beauty regimens and my answer is LONG …..or could be long, at least the answer in my head. Additionally, the questions are which products should that young age group be using, if any? It is a complex topic that involves me thinking as a scientist and dermatologist and then also putting on my mom hat and looking at the issue from multiple angles. That being said, obviously the parents need to decide on their own how they feel and what guidelines are to be in place in their own house. I will mostly address my thoughts on the pre-teen beauty industry craze from a dermatologist perspective but will touch on the parent aspect briefly acknowledging that it is my own opinion and that will vary in other families homes.

So, in dermatology we see patients who have oily skin, dry skin, and combination skin. There is no one product that will be just perfect for everyone. Therefore, when an influencer states that

“this cleanser, this toner, this serum, this moisturizer is AMAZING”

it must be taken with a grain of salt.  If the product is affordable to the person doing the purchasing, its not a terrible thing to try something new. However, it could cause the skin to be dry or irritating for some people, could cause an allergic reaction, or just plain not really seem to make any difference even when the advertisers were claiming it would. 

False advertising is one topic that could be discussed over time with your pre-teen so they understand that not everything on the internet is true and that influencers are trying to make money. Secondly, since this age group is heading towards puberty there will be a lot of variability in their skin type. If someone is age 8-10 years old they may have very little oil production to their complexion and therefore might not be able to tolerate astringents or products that strip oil off the skin. Conversely, a young patient who is 11-14years old may be getting some acne and could use a product that has something like salicylic acid or an alpha hydroxy acid in it. On the flip side, that same person could use an advertised oil or serum that causes them to break out even more with acne. 

If any product seems to be increasing the amount of acne or causing the skin to burn or be red, it would be wise to stop the product and go back to something your skin has tolerated before. If the acne or rash doesn’t resolve on its own, then consult a dermatologist to resolve the rash/acne and then inquire which products may be better suited for you.

The second group of dermatologist thoughts that I have on this topic is that I hope we can teach young individuals that they don’t need to be doing complex skin regimens for healthy skin. The very best thing we should be teaching is that using a daily oil-free, non-pore clogging sunscreen would be wonderful for their skin. Over their lifetime, they will have a more even skin tone, less wrinkles, and less sallowness to their skin. Just sunscreen doesn’t have to be all they use. As they begin to have more oil production or acne, it is a great idea to teach twice daily skin cleansing. This acts to remove dead, sticky skin cells to prevent acne. (they get sticky because of oil production in the double digit age group) Acne patients could use an acne cleanser but everyone else without acne can just use a gentle facial cleanser. The type of cleanser doesn’t make much difference to overall skin health. The act of cleaning the face matters more. However, if someone uses a lathering/foaming face wash and feels too dry, then they need to switch to a gentle cleanser that doesn’t lather(lathering agents remove natural oil and dry the skin out). Gritty cleansers that feel like sand is in them are really harsh on the skin and not great to use on the face EVER. If someone needs exfoliation, I prefer cleansers with salicylic acid(beta hydroxy acid for acne prone skin) or alpha hydroxy acids(like glycolic acid) to gently dissolve the bonds between the dead skin cell layer rather than ripping dead skin off with the gritty face washes.

Now to put on the mom hat. I will keep this brief because, again, this is a personal household decision regarding whether to allow them to look at social media, how much to get into the beauty craze, and at what age. I worry as a mom of 3 kids (two of which are girls) that on top of what we know about teen girls in particular being hard on themselves and their physical appearance, we also know that social media increases rates of depression by comparing oneself to others who are unrealistic body types/filtered images. 

So, first when moms were asking about their 10 year olds, I wondered how 10 years old girls were being exposed to all this information. Was it the parents or family member using complex beauty regimens and the youngster was watching while chatting in the bathroom? Were other friends talking about this at sleepovers or bringing their serums to sleepovers? Was it on social media and internet through influencers? Based on what I have learned from patients, they feel like most is from social media. 

So, I would urge you to have frank discussions with your child about how no matter how many serums from social media are purchased, it will likely not do anything that different than a well suited facial cleanser, moisturizer, sunscreen from a local store. If its a fun activity and budget allows then SURE try new things, but encourage them to appreciate their natural beauty. Keep those little ones young as long as you can before they inevitably criticize their skin/body because we all know how easy that is to do!

Written by

Dr. Andrea LaTorre, a board certified dermatologist

Will Sunscreen & Sun Protective Behaviors increase osteoporosis and fractures as I age?

Studies, including a 2021 study from JAMA Dermatology, documented no increased risk of bone fractures or bone mineral density loss in men and women despite using strict sun protection. The benefits of vitamin D are well known and are still being analyzed and our knowledge is ever increasing on this valuable vitamin. We know hat UV irradiation from the sun induces vitamin D synthesis within our bodies. Therefore, scientists, doctors, and patients have questioned if this means that vitamin D level and thus bone health with diminish if many people begin to avoid tans, avoid sunburns, avoid going outside without proper sunscreen or sun protective clothing on.

However, studies on this have been done, and even with optimal sunscreen application, vitamin D synthesis in our bodies in not compromised. We actually get a lot of our vitamin D from our diet. Therefore, we don’t need to be worried about lack of vitamin D and lack of vitamin D benefits when we apply our sunscreen, wear sunglasses, wear hats etc.

Okay, so maybe vitamin D can be at an adequate level from our diet, but, what about bone health/fractures? Bone health is complicated by many things including diet, sedentary/active lifestyle, age, gender, family history so it takes a lot of variables to be able to many any conclusions. Researchers, however, felt that the data revealed no increase in bone loss or osteoporosis fractures in most people with observed sun protective behaviors including sun protective clothing, seeking shade, and sunscreen. A few variables to consider is that some people who are cautious about sunburns may also do less risky behavior to acquire a fracture from sports/other adventures. Also, those who did have some bone loss as they aged may benefit from physical activity as sedentary lifestyles lead to more osteoporosis. Diet plays a large role too and foods such as salmon, eggs(yolk), milk, orange juice, yogurt, cheese, and more can raise our vitamin D levels and thus bone health.

Check out my other blog post about “Not buying Hair/Nail supplements until you do this first…”

Written by Dr. Andrea LaTorre, a board certified Dermatology at Central Ohio Skin & Cancer

Why “Retinol” Should Be On Your Mind and On Your Face!

Aside from sunscreen every morning (not just sunny days) truly 365 days per year, there are few things I feel more strongly about than Retinol for anti-aging. I could go on and on about it AND I DO every time a patient asks me about aging concerns.

Because I want to stress that there are so many benefits to Retinol that need to be considered before throwing too much money at weaker, less effective products I want to tell you in bullet points.

• BUILDS UP COLLAGEN (broken down by UV radiation/sunlight and aging)
• REDUCES FINE LINES AND WRINKLES (also caused by UV radiation and aging, smoking, and not taking good care of your face)
• SMOOTHES THE SKIN (improves skin texture and helps makeup glide over skin when applied)
• REDUCES BROWN SPOTS (subtle spots from sun exposure are in the very top layer of skin and can be encouraged to slough off more quickly when retinol is used along with sunscreen)
• HELPS IMPROVE ACNE (retinol or Retin-A is a very commonly used acne prescription, however often insurance doesn’t cover it for adults over 30 years old since it is such a powerful anti-aging medication)

Retinol is Pregnancy Category C so there are no studies showing it is safe in humans while pregnant. Therefore we recommend women do NOT USE retinol, neither over-the-counter nor prescription strength, while pregnant. Otherwise, I tell all women to begin using it as a teenager for acne and to try to never stop for the rest of their life.

Written by Andrea LaTorre MD, a board-certified dermatologist at Central Ohio Skin & Cancer.

Here are some OTC retinoid recommendations.  Best is RX, but these can be used as starters….

https://amzn.to/3WvVTMT

https://amzn.to/3hHtSTQ

https://amzn.to/3BUrIXJ

https://amzn.to/3VaDjZv

https://amzn.to/3WezHqO

Goodbye Fine Under-eye Crepey Skin!

If you are the right candidate, you could benefit from under-eye treatment with a wrinkle relaxer to smooth these fine lines/crepey under-eye skin! The orbicularis oculi muscle around the eye can cause the under-eye skin to pucker. The skin must still have good elasticity to benefit from this treatment though so your doctor may test the skin around the eye to be sure you are a good candidate.

If you do not have enough elasticity for this procedure you may want to consider a chemical peel (less downtime, less aggressive) or CO2 laser (more downtime, more results).

Written by Dr. Andrea LaTorre, a board certified Dermatology in Westerville, Ohio.

(Here is another photographic example of the area being discussed below. Both Photographs are shown BEFORE any treatment so accentuate the crepey skin. Both photographs from:

Kane, M. Illustrated Guide to Aesthetic botulinum Toxin Injections, 2013.)

You do NOT need to pay for a hair/skin/nails supplement if you do this instead….

Did you know a dermatologist is trained to diagnose and treat disorders of the scalp, skin, and nails? That means that we see patients who are having dry/itchy skin, sallow/aging facial appearance. We also see patients who are experiencing hair loss, hair thinning, itchy scalp or those with brittle nails, fungal nails, and irritated nail cuticles!

Any one of those concerns listed above can be caused by many factors. One of the first things a patient might begin to use to treat dry skin, thinning hair, or brittle nails can be a supplement found over the counter claiming to have all the necessary ingredients to help these problems. Indeed, they do have many vitamins and minerals that we need to build healthy hair shafts, regulate our skin cell turnover, and grow firm/strong nails.

Biotin is the most commonly used supplement OTC for these problems, and another favorite of mine is Nutrafol (amazon link below)

https://a.co/d/aMi0LHZ

BUT….. do you NEED to take these supplements? NO, you do not.

One alternative, besides coming in to see your dermatologist and getting accurately diagnosed so that another factor contributing to your poor hair/skin/nail health can be addressed, is to take a good look at what you EAT.

Here is what you need to make sure you are consuming on a regular basis and you will get ALL the nutrients found in the hair/skin/nail vitamins at a fraction of the cost.

-handful of raw carrots

-olive oil used in your salad or cooking

-avocado

-handful of almonds

-blueberries

-uncooked tomato

-pomegranate

-apple

-handful of grapes

-eggs once weekly for biotin

-dark chocolate for a treat

If you have most of the above daily in a couple snacks or for example:

LUNCH: spinach salad with blueberries, pomegranate seeds, raw tomato, raw carrot and olive oil based dressing. Throw in a handful of almonds and apple for a snack and you are almost done for the day with everything you need for strong hair/skin/nails. Plus then you get the other vitamins and fiber when you ingest these naturally instead of with a supplement.

This does not replace a consultation to make sure another cause cannot be found and addressed, but always a good idea to examine your diet and think about natural methods of benefiting your health.

Rather than reaching for a supplement, reach for an apple!

Written by Dr. Andrea LaTorre, a board certified dermatologist at Central Ohio Skin & Cancer

Tell Me About The Path That Led You To Medicine Series….. Featuring Dr. Tom Wenker

For Dr. Wenker, it was not a single experience or moment that led him to medicine as a career path. Rather, it was a calling. He knew he wanted to help people and was always a good student, particularly when it comes to science. Science education was fascinating and especially when taught by excellent professors in medical school, it has been known to give Dr. Wenker “full body chills during class”. The almost unbelievable power of our bodies and the intricate things it does for us constantly gave Tom a sense of awe and appreciation.

Medical school were a very enjoyable 4 years for Dr. Wenker. While some may think that the demands of tests, grueling hours, and extra years of school would be a deterrent to continuing education via medical school, it was the opposite for Tom.

Dermatology is a visual field and during various rotations during medical school, Dr. Wenker appreciated the ability to be able to have a window in to the body via the skin. Overall health including kidney health, liver health & more can be assessed by changes on the skin.

Dr. Wenker is immensely grateful for his medical school experience, his expertise in dermatology, and his ability to help people every day he comes to work. This is probably why he sometimes says a silent prayer while walking into the office in the mornings to express his gratitude that he is able to use his gifts and help others every single day.

Written by Dr. Andrea LaTorre, a board certified dermatologist at COSC

Treat Your Skin To Moisture!

Whether you are someone who struggles with dry skin year round, only in the dry/winter months, or recently have noticed some dryness and irritation with your retinol anti-aging treatment plan…. we have the answer for you! Our New Dermatologist Approved (Dr. Nash & Dr. LaTorre tested and approved this very moisturizer) Moisturizer will be available to add to your regimen beginning August 24th, 2022.

This Ultra-Light Soothing Facial Moisturizer has a very user-friendly pump dispenser, travels well in a purse or suitcase, and though it says Ultra-Light it leaves the skin feeling extremely hydrated. The investment for this moisturizer is $36.

Suggestions for use would be to use a small amount at night after all anti-aging products are applied first. For example use Tretinoin and/or Bioserum or Emepelle first then apply this moisturizer last in your evening routine. If you feel dry in the morning despite applying any anti-aging product like Bioserum or Emepelle or Vitamin C as well as your daily facial SPF then you could also apply some in the morning.

Feel free to stop by either our Westerville or Powell locations to pick this moisturizer up beginning 8/24/2022. Please contact your dermatologist if you have additional questions about whether this might be a product for you.

Written by Dr. Andrea LaTorre, a board certified Dermatologist at COSC.

Tell Me About The Path That Led You To Medicine Series…Featuring Dr. LaTorre

Dr. Andrea LaTorre

If I had to pick an exact moment when I knew my life was headed towards some type of career in the medical field it would be in middle school at a genetics conference. My science class attended a lecture at the school one day that featured a scientist who sparked my interest in the human body and it’s amazing power and mystery. This man spoke about the Human Genome Project which began around 1990. The goal of the Project was to sequence all the base pairs that make up human DNA. Additionally, and even more life changing, was when the scientist talked about what they were capable of doing in the lab at that point. He said they could take undifferentiated cells and create heart cells. Once a group of heart cells was substantial in number and growth they would spontaneously begin to beat synchronously! I was floored! That was the moment for me. From that point on, I was very interested in taking as many science classes as I could. I knew that wherever my life path took me, I would want to study medicine so I could learn all the intricacies of the human body.

I went to the University of Notre Dame and then to Indiana University School of Medicine before finishing Dermatology training at The Ohio State University Medical Center. As for how I discovered my interest in Dermatology, I used job-shadowing. I observed family medicine physicians, cardiologists, dermatologists, pediatricians, and more. Dermatology is the absolute best specialty (though I am biased!) because I get to work with every single age patient(from birth to 100+), I do surgery every day but I can talk to my patients during the whole procedure(they are awake!), and my schedule allows me to spend a significant time at home with my 3 kids. Dermatology allows me to do treatments like laser/Botox, mixed in with all the basics: warts, acne, rash, skin checks, eczema & surgery. No two days are the same EVER!

Particularly in the last few years, patients of all ages and genders are wanting to start effective skincare regimens early for aging prevention or discuss supplement/nutritional plans to achieve their skin goals whether it be for acne, skin cancers, hairloss, or anti-aging. Dermatology still feels like its always changing/evolving and that makes it fun to keep up with the latest literature.

Lastly, Dermatology is a visual specialty. I enjoy looking at a rash or lesion on the skin: the distribution, timeline, symptoms etc….and often knowing exactly what is going on and what we need to treat it with within seconds rather than waiting on labs/CT scans/X-rays/specialty consultations. I love my dermatoscope(see above picture). It is a modern tool most dermatologists use to magnify and add light to evaluate a lesion and determine what the diagnosis is and/or if it needs a biopsy. I definitely work hard at work, but the beauty of dermatology is I have time to pursue things I love outside work.

I have begun the process of using Rosetta Stone to dabble into Italian and refresh my memory on French & Spanish, I am a reading fanatic(about 80 books a year and am always looking for good suggestions), and really enjoy my Peloton workouts every day!

Written by Dr. Andrea LaTorre, board certified Dermatologist at Central Ohio Skin & Cancer

Tell Me About The Path That Led You To Medicine Series… Featuring Dr. Zyniewicz

Dr. Kelley Zyniewicz

Life Long Learner….. That is a characteristic that has defined Dr. Zyniewicz from an early age. School was always something she enjoyed. Dr. Zyniewicz explored other college majors, double majoring in Biology and Sociology, but eventually knew she wanted to be a physician. Although she didn’t have any close family members to influence her choice, she was able to witness outstanding, compassionate, and considerate medical care given to her close family members while growing up. She appreciated the personable, professional, and intelligent interactions and this was a major factor in her choice to attend medical school.

Internal medicine physicians have to know about every single organ system and manage complex patients with a multitude of medications. That is tough! However, Dr. Zyniewicz found satisfaction in caring for critically ill patients in the Intensive Care Unit. She completed a residency in Internal Medicine residency which takes 3 years after medical school. Despite excelling in that, she still had a strong interest in Dermatology. Though she would have been an excellent internal medicine doctor, she made a tough decision to leave internal medicine as a career and pursue Dermatology even though it would take 3 additional years of training. If that doesn’t say dedication and lifelong learning, I don’t know what does!

Dr. Zyniewicz acknowledges that our skin is basically a window into the general health of the body. Hairloss, fingernail changes, skin pigmentation changes, and more can signify Cushings Disease, Addison’s disease, liver disease, thyroid disorders, lupus, occult malignancies, kidney disease and so much more! Dermatology really is a medical specialty. So though we as dermatologists do perform many procedures, when we see a patient we have to take into account our visual findings, their medical history, their medications etc when making a plan. It can lead to complicated management plans similar to critical thinking in Internal Medicine.

But Dr. Zyniewicz doesn’t just care for her dermatology patients in private practice, she also takes pride in giving back to those in the next generation of medical training. She is an assistant professor at The Ohio State University Medical Center teaching dermatology residents all she knows in her spare time.

Oh, and she is a reading fanatic with book recommendations always ready for you! Who knows, maybe one day she will even be a published author or take a course in architecture or art history because once a lifelong learner… always a lifelong learner!

Written by Dr. Andrea LaTorre, a board certified dermatologist.

Tell Me About The Path That Led You To Medicine Series… Featuring Dr. Smialek

Dr. Smialek

“It’s all I can remember wanting to do”

Dr. Smialek sat down with me to discuss what led to him to medicine as a career. He said he was the first one to always try to help an injured friend. He had no family influence, but always wanted to help anyone in need/injured. He was singularly focused on medicine, never consider firefighting or paramedic etc. This passion led him to Villanova for pre-med and Kansas City Osteopathic College of Medicine for medical school. There were only about 5 Osteopathic medical schools in the United States at that time.

Once he was doing rotations and working nights in the ER, he was exposed to surgeries and suturing as first assist. He remembers seeing “a young girl who had fallen face first into a window fan that was on the floor. She was cut from forehead down to her lower cheek.” This three and a half hour surgery made a real impression on Dr. Smialek. From that point on, he know Plastic Surgery would be his specialty. He saw many cleft lips/palates and port wine-stains (vascular facial birthmark) during his training. Dr. Smialek participating in many cleft lip/palate repairs but was frustrated that nothing could be done for the port-wine stains.

Right around 1980 the first pulse dye lasers were developed. He talked his local hospital here in the Columbus area into purchasing one of the first pulse dye laser. His practice became a regional referral center for cleft lip/palates. He almost traveled to Nicaragua for Operation Smile to fix congenital anomalies in countries in need, but internal unrest in Nicaragua cancelled the trip and subsequently Dr. Smialek and his wife started a family. Instead, he helped so many children and adults here in Ohio with his surgical skills and did indeed work for Operation Smile here in Ohio.

His laser passion “just sort of snowballed.” He “adopted laser therapy as a complement to his surgical cosmetic practice, never thinking it would become {his} retirement/exit strategy” but it did! That is how he came to Central Ohio Skin & Cancer. Dr. Smialek does laser treatments for redness, brown spots, skin tightening, acne scars, wrinkles & more! We are lucky to have someone so respected and such a trail blazer in cosmetic laser treatments at our practice.

Written by Dr. Andrea LaTorre, a board certified dermatologist.

Why does my skin tear from a bandage? Why do my parents have frequent bruising on their forearms? Your questions about aging skin answered….

Our skin ages no matter what we do, but we can preserve the integrity and the cosmetic appearance of our skin through some healthy choices! Our skin ages due to intrinsic and extrinsic factors. Intrinsic aging is inevitable and we are lucky to have more birthdays! But extrinsic aging really has to do with the sun, photo aging. The sun’s UV radiation causes permanent destructive changes that become more obvious over the years.

Have you wondered why your own or your parents skin is more itchy or bruises easily? Has a bandage torn their skin when removed? Does it seem like it takes longer for a wound to heal? All these things can happen as we age. The reason older adults have more itchy skin is often due to the thinning of the epidermis(top layer of skin). The epidermis has peaks and valleys where it joins the dermis(below epidermis) in youthful skin. When the skin ages and is damaged by sun, it loses the peaks and valleys and is more flat at the junction to the dermis. This causes the epidermis to be easily separated from the dermis with minor injuries. Adhesive bandages and minor injuries causes skin tears. Do your arms bruise easily, with no known injury? This also happens again because of skin thinning and being more fragile with sun damage. Minor injuries that don’t even hurt when they happen can cause bruising. The forearms are the most common site to see a lot of bruising. That is because they are used all the time for all our activities of daily living so they get more bumps/bangs, but also because they have seen way too much sun over our lives (rather than our abdomen that has mostly been protected from the sun over the years). Wound healing also takes longer the older we get. Elastic fibers and collagen production slows after age 40. This is one reason why we recommend Emepelle serum which is a non-hormonal estrogen to increase collagen production in our patients over 40 years old who are interested in anti-aging skincare recommendations.

DNA damage happens and leads to mutations in our skin every time we are sun burned. Our DNA repair mechanisms are constantly fixing mutations over our lifetime, but our repair mechanisms slow down with age too which leads to more skin cancers the older we get. Anti-oxidants in anti-aging serums are one way to improve your DNA repair mechanisms and reduce reactive oxidative species.

Vitamin D can be low in our patients. We produce vitamin D from our skin when exposed to daily sunlight, our diet when we eat vitamin D rich foods, and vitamin supplements. Our skin produces vitamin D at a much slower rate as we age. It is important to get your vitamin D levels checked regularly and supplemented if needed. We need vitamin D for bone health and hair health. We see many patients who complain of hair loss and have low vitamin D. Hours spent in the sun do not necessarily keep your vitamin D at a healthy level. You may have a tan while also having low vitamin D.

Most dramatic and devastating esthetic changes in our skin come from extrinsic aging: SUN, not from intrinsic(natural) aging. What does the sun do to the skin?

Mutations, wrinkles, pigmentation/brown spots, dryness, sallow coloring, blackheads/enlarged pores, white spots, pre-cancers/skin cancers, redness to the face/dilated-broken blood vessels, collagen loss.

Aside from sun, other extrinsic age factors including smoking, poor health/dietary choices, and air pollution.

So, in summary, we recommend sunscreen on the face in particular 365 days a year. Broad spectrum UVA/UVB SPF 30+. Tinted sunscreen is best if you are prone to melasma or brown spots on your face.(but I love it for all my patients!) Hats/sun protective shirts are great too.

Vitamin C and/or Bioserum is perfect in the morning for anti-oxidants. Evening I love Rx retinoids but also advise those patients over 40 to begin to consider Emepelle because of the loss of collagen after that milestone birthday.

Written by Dr. Andrea LaTorre, a board certified dermatologist.

Does My Dermatologist Recommend a Facial?

Every single day I have patients directly ask about skincare. They may want a recommendation on sunscreen, on anti-aging products, or whether or not to get routine facial treatments.

The short answer is “No” I do not recommend facials. Do I think they are dangerous? No, not likely. Do I think they are a good value for your skincare benefits? No, I do not.

But…… many, many patients do indeed see benefits from getting regular facials. I do NOT try to talk someone out of paying for facials. Instead, I offer them some options that can offer an exfoliation, a smoothening of their skin that they can do at home.

The reason I do not recommend them as a good value for benefits is because many are almost $100+ and do not cause permanent improvement in the skin. They are like a band-aid for chronic anti-aging, not a real “fix”. A good prescription retinoid given to you by your dermatologist can last at least a year and costs less than $100. So $1200+ for monthly facials for a year or ~$80/year for retinoid. See my articles about anti-aging and retinoids previously posted. “Way Too Many Skincare Options” article, “Retinol Fact vs. Myth” article, “Why Retinol Should Be On Your Mind” article.

Using a Glycolic Acid wash a few times a week is useful for skin rejuvenation, ridding your skin of its top layer of dead skin cells for a more luminous look. Clay face masks are also one of my favorite things to do monthly, especially for my acne patients. These masks are anti-inflammatory, anti-bacterial and lead to an amazingly smooth texture to the skin afterwards. Last, but NOT least, everyone who follows my blog should know how much I love retinoids! They offer so many benefits. Skin rejuvenation including improvement of texture, evens pigmentation, boosts collagen, minimizes pore size, reduces oil, improves fine lines/wrinkles.

Here are some links for some of the things I mentioned, but see your dermatologist for a retinoid Rx. And by all means, please get a facial every so often if it makes you feel better, but do not do so anticipating long-term skin benefits.

https://amzn.to/3atx8OP

https://amzn.to/3nLk0YC

https://amzn.to/3yOpwjs

I do not ship or sell the above products, they are Amazon links.

Written by Dr. Andrea LaTorre, a board certified dermatologist.

OTC Skincare for the Novice

“So Doc, say I want to reverse the signs of aging I am seeing on my skin. It looks more sallow, where is the shine? Brown spots and facial redness are increasing over the years. I really need to see my dermatologist and get a tailored regimen to maximize my results, but I want to start YESTERDAY! What can I begin doing now, while I wait to fine tune my plan with my doctor?”

I am so glad you asked! Begin in the morning with a vitamin C topical. It helps brown spots and brightens overall skin appearance. Plus its an antioxidant! Make sure you get vitamin C in your diet and in your vitamin too for most antioxidant benefits.

https://amzn.to/3xT86l3

https://amzn.to/3NYgdT0

I have the first one in my skincare routine now, but have not tried the second one. CeraVe always has good products though.

You need to begin with 365 days a year of a tinted mineral sunscreen!

Here is an example:

https://amzn.to/3zWebir

https://amzn.to/3OgyiM6

I currently have both of the above tinted mineral sunscreens. I usually use the first one because it conceals the very best for a flawless look, but love both! The second sunscreen is lighter if you aren’t used to wearing makeup.

In the evening, I use micellar water and cleanser to get makeup and environmental grime off my face.

https://amzn.to/3N9DnoB

https://amzn.to/3QrehEa

See my other blog posts about how much I LOVE retinol! The benefits to the skin are endless! Here are two OTC options, however all the studies that show all the benefits are done with prescription strength. So, after your skin becomes used to an OTC brand, you can begin a prescription retinoid with your dermatologist.

https://amzn.to/3aRETxV

https://amzn.to/3QmkSzT

https://amzn.to/3tE9g1j

MORNING: Cleanse, vitamin C, SPF, makeup

Evening: Cleanse, retinol

It’s always okay to moisturize too. Here are some moisturizers I like.

https://amzn.to/3zD98mL

https://amzn.to/3Qn0tL8

https://amzn.to/3QhTjro

https://amzn.to/3NYXMOj

I do not sell, ship, or produce the above products. They are links to amazon products for your convenience. Your dermatologist will have better ideas for a regimen tailored for your specific concerns, gender, and age.

Written by Dr. Andrea LaTorre, a board certified dermatologist in Columbus Ohio.

WAY TOO MANY SKINCARE OPTIONS! What is right for me?

We are so excited for this coming week and our Spring Mother’s Day Sale! It isn’t just for mothers though. Whether you are looking for a gift idea for a mother, daughter, yourself, or an early father’s day present we have the perfect combination of skincare products for you.

We understand everyone’s skin is different though. Some may be oily, some dry, some very easily irritated. Some people are concerned with wrinkles, some with brown spots, and others prefer the simplest routine possible. I will give some guidelines below to consider for a variety of ages and skincare routine preferences.

Remember, everything is 20% off and if you purchase a Bioserum you will receive a free Hyalis, eye, or neck cream(~$100 value). Every purchase enters you into the raffle for the $600 value skincare basket!

20’s & 30’s

-Neocutis Bioserum (antioxidants, growth factors)

-Lumiere Eye Serum(free if purchase the bio serum above)

-EltaMD SPF- tinted or non-tinted options available (purchase EltaMD Clear if you are acne prone)

-vitamin C serum (start with 10% if you have not already previously been using a higher concentration)

-Rx strength Retinol: Tretinoin (start with 0.025% which is the lowest strength using only 2-3 times a week until you see how your skin adapts to it)

40’s

-Emepelle Serum (non-hormonal estrogen serum is a MUST when over 40yo and we start to lose our collagen at a faster rate!)

-Neocutis Bioserum (antioxidants, growth factors)

-Lumiere Eye Serum(free if purchase the bio serum above)

-EltaMD SPF- tinted or non-tinted options available (purchase EltaMD Clear if you are acne prone)

-Vitamin C serum (start with 10% if you have not already previously been using a higher concentration)

-Rx strength Retinol: Tretinoin (start with 0.025% which is the lowest strength using only 2-3 times a week until you see how your skin adapts to it)

-Also Botox/Dysport wrinkle relaxer treatments as no creams can smoothen our upper facial expression lines like these can!

50′s & 60’s+

-Everything as above for 40+ in addition to annual photoaging laser treatments or Pico Clear Lift or microneedling to stimulate collagen

-Emepelle Serum (non-hormonal estrogen serum is a MUST when over 40yo and we start to lose our collagen at a faster rate!)

-Neocutis Bioserum (antioxidants, growth factors)

-Lumiere Eye Serum(free if purchase the bio serum above)

-EltaMD SPF- tinted or non-tinted options available (purchase EltaMD Clear if you are acne prone)

-Vitamin C serum (start with 10% if you have not already previously been using a higher concentration)

-Rx strength Retinol: Tretinoin (start with 0.025% which is the lowest strength using only 2-3 times a week until you see how your skin adapts to it)

-Also Botox/Dysport wrinkle relaxer treatments as no creams can smoothen our upper facial expression lines like these can!

What if my skin is very sensitive? Most of what I have suggested above is not extremely irritating. If you are sensitive skip RX strength Tretinoin and skip vitamin C serum for now.

-Sensitive skin usually does well with laser treatments as they don’t require nightly application of irritating anti-aging creams: annual photoaging laser treatments or Pico Clear Lift or microneedling to stimulate collagen

-Emepelle Serum (non-hormonal estrogen serum is a MUST when over 40yo and we start to lose our collagen at a faster rate!)

-Neocutis Bioserum (antioxidants, growth factors)

-Lumiere Eye Serum(free if purchase the bio serum above)

-EltaMD SPF- tinted or non-tinted options available (purchase EltaMD Clear if you are acne prone)

-Try our alpha-ret night cream which is less irritating than Rx strength Tretinoin. Or try Differin gel OTC a few times a week. Consider adding Obagi Hydrate Luxe to really repair and hydrate skin that is easily irritated.

-Also Botox/Dysport wrinkle relaxer treatments as no creams can smoothen our upper facial expression lines like these can!

What if I do not want to use many products? I don’t have time! I want the very most effects with littlest effort! My husband won’t do all these complicated things, what can men do for their skin?

SPF SPF SPF!

Sunscreen is MOST important. I find that the EltaMD daily facial sunscreen is acceptable to teens, men, and women. Most don’t think it is too greasy, even patients who don’t wear many skincare products.

Next best bang for your buck is RX strength Tretinoin. Start with 0.025% unless you are particularly oily and begin applying it 2-3 times a week. If you tolerate this well and your skin becomes less dry as you are used to it, then gradually increase applications to 7 nights a week. After you have accomplished 7 nights a week then you may increase to the next strength level. I advise Men and Women to begin SPF 365 days a year no matter what your plans or the weather may be. Also nightly Tretinoin for all ages and genders!

Brown spots? You will need a rx from your dermatologist in your chart but Obagi has a few brown spot reducing topicals. Obagi sunfader, clear or blender all have brown spot lighting ingredients! Combine this Obagi lightening cream with bimonthly Glycolic acid peels ($40 each) with no down-time. This helps your topicals work better and more quickly. If you can afford a week of down-time consider the Perfect Peel or a TCA peel with your physician.

————————————————————————————–

An excellent question was asked regarding how in the world to layer all these excellent products on AM and PM. It would seem that you wouldn’t receive benefits of the 6th cream you apply after you have 5 other previous layered serum/creams. When I was listing the most important skincare categories I did not mean for it to be an exact recipe. Everyone will have to have an individualized skincare plan based on their needs, goals, and skin type.

However, I can list an example of how I actually use these categories in real life on my skin.

AM:

Vitamin C

Emepelle Serum (apply to neck also)

Eye serum

SPF (apply to neck also)

PM:

Rx Tretinoin (may apply to neck but caution because it can be too irritating to use frequently on neck, BONUS points if you use it nightly on the back of your hands!)

Bioserum (apply to neck also)

Eye serum

Written by Dr. Andrea LaTorre, a board certified dermatologist at Central Ohio Skin & Cancer.

Time to Breakout those Sunless Tanning lotions but which is best….

Keep scrolling down to learn all the ins and outs of sunless tanning lotions! Here are a few photos and links to some of my favorites for you to refer back to!

https://amzn.to/37BLwmH (with mitt so you don’t stain hands)

https://amzn.to/3uZOhXX (w/o mitt, just tanning foam)

https://amzn.to/38b4gJM (Basic version)

https://amzn.to/3Ez6vCX (EXPRESS version: when in a hurry to develop the tanned look!)

https://amzn.to/3v45ks4

As we approach some warm weather finally this spring, we will need to get out shorts, tanks, sundresses & pretty soon bathing suits! As dermatologists we know all tans obtained by the sun (UV radiation) causes permanent DNA damage and free radicals in your skin. A sun tan is a way for your skin to try to protect itself from the assault of strong, damaging radiation from the sun. In the same way, a callus can develop on runners toes to protect from the repetitive trauma of slamming into the shoe with each step. Our skin can do extraordinary things to protect us but it can only do so much. So what can we do to help our skin?

Well, of course we recommend using sunscreen SPF 30+ every 2 hours and, when possible, to be in the shade and wear hats/loose fitting sun protective clothing when able during peak sun hours, between 10am-4pm.

But what about sunless tanning lotions? Are they bad? Do they offer any protection from sunburning? Sunless tanning lotions are a great way to give your skin a slight tan without the DNA damage. I think its a great solution for my patients who will feel more confident over the summer or on a vacation if they have a tan prior to going. This will allow them to not feel the need to “tan” at all whether it be artificially indoors in a tanning bed or sunbathe outdoors on a vacation with the intent of getting a tan. A real tan from UV exposure is so fleeting anyway, it is gone as soon as your skin sheds but the DNA damage stays forever. Our skin immune system is pretty good at repairing DNA damage as fast as it can, but often especially as we age, our skin immune system is unable to keep up with all the DNA damage and allows some mutations to accumulate and lead to skin cancers.

A sunless tanning lotion tan also does fade as the skin exfoliates but without the permanent cellular damage. Additionally, a sunless tanning lotion gives your skin a very slight SPF equivalent so it might actually protect you slightly from a sunburn on vacation. It does NOT take the place of sunscreen though and you can definitely still sunburn with sunless tanning lotion on.

I have recently tried 3 different sunless tanning lotions and here are my thoughts. The first “Coco & Eve” was darker faster in my opinion, more like the 4th link “St. Tropez express”. All had some scent but I felt Coco & Eve was probably a slightly stronger tanning lotion scent. All last a long time and were easy to use! Definitely use a mitt or use disposable gloves so you can avoid staining your palms! Links are just to Amazon below associated with each picture. I don’t sell, produce, or ship the products myself.

https://amzn.to/37BLwmH (with mitt so you don’t stain hands)

https://amzn.to/3uZOhXX (w/o mitt, just tanning foam)

https://amzn.to/38b4gJM (Basic version)

https://amzn.to/3Ez6vCX (EXPRESS version: when in a hurry to develop the tanned look!)

https://amzn.to/3v45ks4

Written by Dr. Andrea LaTorre, a board certified dermatologist.

How to Brighten & Rejuvenate the Under-Eye Area….

Every day I have discussions regarding under-eye rejuvenation. Why does everyone ask about the eyes? Just take a look at a few of these common sayings…..

“The eyes are the windows to the soul”

“You can tell whether someone is happy or sad just by looking them in the eyes”

“You can tell she is tired by her eyes”

Obviously we are evaluating whether someone is stressed, over-tired, or aging fast based on their peri-ocular/eye area appearance.

So, what are the resources for helping us look more refreshed, relaxed, and rested?

Below, I have a photo taken immediately after wrinkle relaxer injections. As you can see, there is no down-time. Within a few minutes the hive-like bumps begin to disappear and minor bruising is possible but can be covered with makeup. I love to inject the 11’s, the forehead, shape the Eyebrow with a few injection points, and treat crows feet. I even add a little more to the delicate under-eye area to soften the crepey skin. In about 3-7 days this treatment will be in FULL-EFFECT creating smoother skin and opening up the eye area!

Unfortunately, there is no perfect eye cream/serum to fix all eye troubles.

My go-to routine is daily facial sunscreen 365 and sunglasses even on overcast days. Here are my current favorite daily tinted and non-tinted sunscreens and favorite re-application sunscreen.

https://amzn.to/3KfIZg8

https://amzn.to/3j9L4hV

https://amzn.to/3JdRWFt

Then I also use a multitude of eye serums. It is important to keep the eye area HYDRATED!

Caffeine serum twice daily: https://amzn.to/3Kj6XY2

Hyaluronic acid serum twice daily: https://amzn.to/3r7narF

ISDIN Eye cream twice daily: https://amzn.to/3DPo55m

NEOCUTIS and COSC brands shown above are available at our Westerville & Powell offices!

After I apply my eye serums each morning I then apply sunscreen and finally under-eye concealer as well. Wrinkle relaxer treatments are approximately 3 months apart and the cost of treating my whole upper face was $330 but every patient is different and needs more or less in certain areas based on their individual concerns and anatomy and age.

Some patients will benefit from Filler injected to improve volume loss and under-eye chemical peels as well. Call for an appointment with your dermatologist for an evaluation and regimen perfect for your needs.

Above LINKS are links to shopping on AMAZON for these eye products. I do not sell and ship the items myself.

Written by Andrea LaTorre MD, a board certified dermatologist at Central Ohio Skin & Cancer.

Your Doctor Recommends…. (Best OTC Skincare Products LINKED here)

After your dermatologist appointment, do you often realize you forgot to ask what lotion will improve cracks in your heels, what vitamin will help your hair grow more full and stop shedding so much, which sunscreen is best to re-apply on-the-go? Here are some of those suggestions. I will be adding to this list over time so keep checking back for more helpful tips!

MORNING Tinted SPF: https://amzn.to/36v7pDf https://amzn.to/3toC6mW

RE-APPLICATION Tinted powder SPF: https://amzn.to/37Ja1OH https://amzn.to/3JmOSI3

SAFE Benzene-free sunscreens can be found at the following links:

https://amzn.to/352ZxJb

https://amzn.to/3IstKzB

https://amzn.to/3tcDWWn

https://amzn.to/3BQdtCa

Better comprehensive skin/hair/nail supplement: Nutrafol Skin/Hair/Nails https://amzn.to/3DtdXyQ

All men and women who suffer from hormonal/age-related hairless should consider using Rogaine https://amzn.to/3iViDUS

Perfect starter treatment for Rosacea patients: Start this topical twice daily for best results. Azaleic Acid https://amzn.to/3uKlJQT

Have you had a skin cancer diagnosed and treated? Do you want to prevent more skin cancers? Talk to your dermatologist and find out if you are a candidate for this vitamin that reduces skin cancer! Nicotinamide Flush-Free https://amzn.to/3IV35e3

Want to reduce the risk of DNA damage and sunburns on vacation? This plant-based supplement does exactly that! Talk to your dermatologist and find out if you should begin taking Heliocare Capsules https://amzn.to/3wUtM0q

Scar Treatments:

Strataderm recommended by our Mohs surgeon: pick some up after your Mohs surgery at our office https://amzn.to/3t3gjAK

Silicone Gel Sheets: https://amzn.to/36fha8N

Vitamin E Oil: https://amzn.to/3CEHbKD

Mederma Gel: https://amzn.to/3hX1MjY

Best FootCare Products:

https://amzn.to/3pA7AUS

https://amzn.to/3K5Jnxo

(I don’t produce, sell, or ship any of these items. All links are from Amazon)

Morning Routine: Iron Oxide is much more important than you thought! Learn why its such a hot topic in dermatology!

Light reaching our eyes or our skin is a broad spectrum of light. It is not just Ultraviolet but also Visible light too. UVC does not make it down through the atmosphere to our skin, but UVB and UVA do. I like to think of UVB as Burning rays and UVA as Aging rays. So in the late 1990’s and early 2000’s, sunscreens began to be broad spectrum and cover both UVB and UVA. Previously, they only protected from UVB.(burns rather than aging radiation)

However, only about 45% of the light that affects our skin is Ultraviolet light. A good portion is in the Visible Light Spectrum. What does that mean? What does visible light do to our skin? Visible light causes brown spots, hyperpigmentation, melasma(brown patches on our face especially during pregnancy). Does sunscreen block visible light? Usually the answer is …….. NO!

So, how do we know if our sunscreen is blocking visible light too? It will block visible light, (about half of the light that reaches our skin!) if it has something like IRON OXIDE in the sunscreen. (aka TINTED SUNSCREEN) There are a few things used in producing sunscreen that can give the sunscreen a tint. IRON OXIDE is the most common one. So, tinted sunscreen offers a subtle camouflage to our skin that can mask some minor imperfections in our complexion AND it is important to block visible light. Tinted sunscreens have really advanced and offer so many different variations in pigment to match any skin tone.

Who should be using a tinted sunscreen? Anyone who is bothered by melasma and brown spots MUST use a tinted physical(zinc) sunscreen or they will not attain nor maintain the results they are looking for. Brown spot corrector creams, chemical peels and lasers can only do so much. If you are treating brown spots but failing to wear a tinted zinc sunscreen on your face daily, you will not maintain your results.

Our phones and other electronic devices emit visible light too, however the amount is a bit too low to actually cause the harm to our skin/pigmentation like natural light outdoors does.

Listed below are some tinted zinc sunscreens for daily use that I personally like using. Also, under re-application I added two powder sunscreens that are handy for re-application on the go (Think: keep in your purse or car without needing to get your hands greasy when you want to re-apply on-the-go) I do not create, ship, or sell these items listed below, they are amazon links for your reference in case you are looking for some ideas for tinted zinc sunscreens!

MORNING:

https://amzn.to/36v7pDf

https://amzn.to/3toC6mW

RE-APPLICATION:

https://amzn.to/37Ja1OH

https://amzn.to/3JmOSI3

Written by Dr. Andrea LaTorre, a board certified dermatologist in Westerville, Ohio.

Scars: “What I wish I knew before it was too late”

First of all, it really isn’t ever too late to improve a scar, but there are ways to encourage the best possible looking scar to form and not the thickened, bright red, widened scar we dread!

One of the most important things after a wound, whether it be traumatic (bike accident or fall) or surgical (skin cancer removal, knee replacement etc) is to keep the wound moist. Years ago you may have heard people encourage each other to let a wound “dry out”. That is old information and we now know that moist wounds covered in Vaseline, Aquaphor, or even coconut oil will heal better and faster than wounds that continue to form a scab.

So after your injury or planned surgery keep the wound clean with soap and water daily. Stay out of swimming pools or hot tubs at first, especially if you have sutures, as those are very bacteria-filled places!

Keep your wound covered if possible. This keeps the Vaseline where it needs to be and not on your clothing. It also protects sutures from being torn out and keeps clothing and the environment from irritating your healing wound.

Wounds will usually form granulation tissue which looks yellowish in the center of the wound. This is normal and not a sign of infection. Signs of infection include worsening pain after having been pain-free, spreading redness, hot skin around the wound, increased drainage, odor.

When the sutures are removed or the skin is intact over the wound, it is time to start applying topical preparations that can improve the appearance of the scar. These include:

Strataderm recommended by our Mohs surgeon: pick some up after your Mohs surgery at our office https://amzn.to/3t3gjAK

Silicone Gel Sheets: https://amzn.to/36fha8N

Vitamin E Oil: https://amzn.to/3CEHbKD

Mederma Gel: https://amzn.to/3hX1MjY

If all of the above items are not helping your scar, you could have a thickened or Keloid scar. That will need treatment by your dermatologist.

If your scar is too red, our Vascular Laser is the best option for you. Call for an appointment.

If your scar stands out from surrounding skin too much we can use Microneedling to minimize the scar and even out the pigmentation.

AND of course, minimize SUN exposure. Sun on a healing wound can cause it to remain pink much longer and it can cause scars to develop hyperpigmentation. That means the scar will turn more brown and last longer than if you had avoided sun exposure. Here are some good facial sunscreen options.

I use this tinted SPF every day. It has lasted me over a year and will probably expire someday before I even use it all. https://amzn.to/3hYY890

Non-tinted La Roche Posay SPF 100 https://amzn.to/3t6gTOu

All above Links are to Amazon, I do not create, sell, or ship any of the products.

Click on the LINK below to share with everyone on social media who might benefit from learning how to best heal their latest Mohs Surgery scar, knee replacement scar, scrape on their child, or recent oven/curling iron burn!

Written by Dr. Andrea LaTorre, a board-certified dermatologist at Central Ohio Skin & Cancer