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

How does Cancer Prevention Month fit into the subject of Dermatology?

As we get ready to escape the cold month of February soon and look forward to spring I thought I would mention that February is notable for being “Cancer Prevention Month”. On a daily basis we are screening for cancer. During a full skin exam, we evaluate head to toes looking for anything that is suspicious for a Basal Cell Carcinoma, Squamous Cell Carcinoma, or pre-cancer. We also look at moles(aka Nevi) for any asymmetry of edges or uneven pigmentation that might suggest Melanoma. Most skin cancers are due to sun exposure as children and young adults. This damage to our skin DNA doesn’t show up until many years later when our skin surveillance/DNA repair mechanisms fail to control the rapid multiplication of abnormal cells into a skin cancer.

How can we prevent this? We can start by protecting our children from sunburns. This does not mean that they cannot play outside, but big bursts of sun that cause burns lead to more DNA damage and more risk of skin cancer.(think florida vacations where someone gets a terrible burn, getting caught out on a boat without sunscreen one day, being out at a baseball game on an overcast day and not wearing sunscreen resulting in a burn) We can wear sun protective bathing suits while on vacations or enjoying summer pool time locally to minimize risk of burning. Adults can set good examples too. Adults are allowed to continue to wear sun protective shirts around the pool, it isn’t just made for children!

If you do have fair skin, freckles, history of skin cancer in your family, history of tanning bed use in the past(even if you have stopped going to tanning beds long ago), history of sunburns, or any new/changing growth/mole then you should be checked by your dermatologist.

SPF 30+ is great to re-apply every 2 hours. It doesn’t matter if its a lotion or aerosol spray but BOTH NEED TO BE RUBBED IN. Don’t spray an aerosol sunscreen like hairspray and assume it will settle evenly over the body. It won’t and you will be missing spots and won’t be achieving the SPF number the bottle displays.

Here are some recommendations for sunscreens that are SAFE. Check out my article on “CARCINOGEN DETECTED IN SOME SUNSCREENS-MUST READ!” It was written last summer when benzene was detected in some(not most, just some) sunscreens.

https://amzn.to/352ZxJb

https://amzn.to/3IstKzB

https://amzn.to/3tcDWWn

https://amzn.to/3BQdtCa

and below is my new fave for that back of my hands to prevent burns (& aging!)…. also love using it on my kiddos faces for re-application so I don’t get my hands all greasy!

https://amzn.to/3M01ZAy

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

(links are from Amazon, I don’t personally sell any of the above products)

Dry Feet anyone?

This winter weather is dragging on way too long. If you have dry feet like me this time of year check out this product. I use it on my feet twice a day usually, once a day if I rush and forget!

Check out the link below to be sandal ready! Your feet will thank you!

http://Amzn.to/3hgCyfT

This is also a special treat for feet! Tip: do not do it after just getting a fresh manicure…. do it prior to a manicure for longer lasting results. This product will make you feet so smooth prior to summer or beach vacations! Use at least two weeks before your trip so you have time for your feet to finish peeling before travel!

https://amzn.to/3pvDB0b

Link is Amazon, I do not personally sell the products.

LET’S REVIEW OUR ABCDE’S…..

Vitamins are essential for our bodies to be healthy but how much of a role do they play in our skincare? You can find almost all the above vitamins in one form or another in skincare preparations. They all have slightly different benefits and should all be used/consumed for a well rounded skincare regimen.

Vitamin A: This vitamin slows the aging process, blocks cancer formation, and is an antioxidant as well. Beta-carotene and other carotenoids can be obtained through eating some carrots and raw tomatoes. However, my other favorite way to benefit from vitamin A is through “retinol”. Prescription retinoids have the ability to boost collagen, minimize wrinkles, brighten the skin tone, improve skin texture, minimize pores, & reduce acne. Prescription retinoids work much better than over-the-counter versions and are manufactured to be the exact concentration prescribed vs the high variability in actual retinol in OTC products.

Click Link for OTC prescription strength retinoid. When you can tolerate this one, then you need to come see us for stronger RX strength. This one used to be available Rx only.

https://amzn.to/3M2FaMH

Vitamin B: There are many B vitamins but two in particular which are very helpful for our skin health is Niacinamide (form of B3) and Biotin. Biotin is in most skin/hair/nail vitamins. Vitamin B3 is found in many topical preparations. They can give an instant healthy glow, improve hydration, and reduce inflammation. Niacinamide is helpful for acne/rosacea prone skin. Oral Niacinamide has been investigated for reducing skin cancers. Talk to your dermatologist about whether you would benefit from an oral supplement containing this B vitamin.

Ask your dermatologist if you want to learn about the oral supplement. A topical niacinamide is in this product which can soothe dry skin and is applied nightly as a moisturizer.

https://amzn.to/3C0zjD6

Vitamin C: This vitamin is helpful as an anti-oxidant as well as our immune system health. Take about 1,000mg daily of vitamin C by mouth, eat a healthy diet, but also consider a serum containing this vitamin to maximize its benefits. Vitamin C is found in many products that brighten the skin and reduce brown spots.

Click Link for OTC vitamin C recommendation. Obagi vitamin C is great too & available at our office.

https://amzn.to/3sl9t9t

Vitamin D: Vitamin D supplementation should be taken daily particularly if you are good at your sun protection. Even those who live in sunny climates or who do not wear sunscreen can have a low serum vitamin D. It is important to have your Vitamin D levels checked by your physician regularly and take oral supplements at the amount prescribed based on your gender and age.

Vitamin E: This vitamin should be obtained through a healthy diet or multivitamin but can also benefit the skin as an anti-oxidant. Some serums contain both vitamin C and vitamin E for daily application to the skin. Scars can be improved by applying vitamin E as well.

Click LINK for Vitamin C & E serum, second LINK for scar cream.

https://amzn.to/3LWCX5v

https://amzn.to/33QY73E

Hopefully you have learned a bit more about your vital ABCDE’s. Supplement or apply your vitamins beginning TODAY, your skin will thank you!

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

EAT YOUR WAY TO HEALTHIER, YOUNGER LOOKING SKIN!

What does food have to do with our skin? Does your diet actually affect your acne, your psoriasis, your wrinkles???

The short answer is YES! All the details will be spelled out below so you can get started on building healthier, younger looking skin.

Even children in elementary school can identify which food are considered healthy and which foods are classified as un-healthy or “special treats”. However, it is not as simple as just “avoid sugar and eat fruits/vegetables”. There are so many aspects of a healthy diet that work in synergy. It is not one single food group or ingredient that offers everything we need for our skin to function at its optimal healthy level.

Anti-inflammatory and Antioxidant are the two main categories we need to consider during every meal or snack.

Anti-inflammatory foods will reduce inflammation. Antioxidants also reduce inflammation, reduce oxidative stress, and minimize free radical damage. This allows our cells to repair DNA damage more effectively which can reduce carcinogenesis in our skin as well as other organs. Conversely, pro-inflammatory foods will lead to an increased risk of insulin resistance/diabetes, accelerated rate of aging, more acne, worsening psoriasis, & more. Chronic inflammation can contribute to wrinkles, sagging, discoloration, & enlarged pores. Foods that raise our blood sugar too much lead to glycosylation of our collagen causing brittle collagen and loss of elasticity.

Make sure to eat MANY foods from this list EVERY DAY to maintain younger, healthier skin, slow the aging process, reduce cancer risk, lower diabetes risk, and promote stronger hair/nails.

olive oil

avocado

legumes

whole grains

raw tomatoes

fruits especially blueberries or grapes

carrots

leafy vegetables

fish

almonds or walnuts

flaxseed

green tea (2-4 cups per day) is superior to coffee in anti-aging benefits

If you need a sweet treat, the best would be dark chocolate in moderation. If you consume alcohol, then red wine in moderation is best due to its high antioxidant activity.

For example, consider implementing this meal plan a few times a week to begin:

Breakfast: Avocado on whole grain bread and handful of blueberries

Lunch: Salad with dark greens(not iceberg lettuce), olive oil/vinegar dressing, raw tomatoes, handful of carrots and nuts(walnuts, almonds, cashews)

Dinner: Fish, broccoli, brown rice

Dessert: dark chocolate and red wine

Bon Apetit!

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

CARCINOGEN DETECTED IN SOME SUNSCREENS-MUST READ!

CARCINOGEN DETECTED IN SOME SUNSCREENS-MUST READ!

Benzene is a colorless, flammable liquid that forms naturally from volcanoes and forest fires but can also be found in materials we are exposed to.  It is found in rubber, dyes, plastics, lubricants, varnish, pesticides, gasoline, and cigarette smoke.   Benzene exposure has been linked to leukemia.  OSHA, EPA and FDA agencies limit the amount of benzene in workplaces, gasoline, drinking water etc but this carcinogen was found above acceptable levels in a few sunscreens by a company called Valisure. 

SAFE sunscreens can be found at the following links:

https://amzn.to/352ZxJb

https://amzn.to/3IstKzB

https://amzn.to/3tcDWWn

https://amzn.to/3BQdtCa

Valisure is a company that checks the quality of drugs on the US market.  They are the company who identified benzene in hand sanitizers leading to the recent recall you may remember.

I will point out which sunscreens have over 0.1ppm(parts per million) level.  They did find some that had <0.1 but I will focus on those that were 0.1 and above.  The FDA states benzene should not be used in manufacturing unless absolutely necessary.  Benzene is restricted to 2ppm per the FDA when necessary in production.  Benzene is indeed avoidable in sunscreen manufacturing thus we would hope to seen NO benzene detected in these testing results.  Valisure tested hundreds of sunscreen batches, many different companies, and many different types of sunscreen products. 

Let me be sure to point out that out of hundreds of batches MOST CONTAINED NO BENZENE!  I will say that again to make sure I don’t mislead anyone into thinking all sunscreen has any threat to their health.  MOST sunscreens DID NOT have benzene in them.  While Valisure petitions the FDA to create a concentration limit for standard drug products, including sunscreen, we should limit use of the sunscreens with the highest benzene concentration(They are listed below).

Skin cancer IS caused by UV radiation and sunscreen does protect our skin from sunburns and thus skin cancer.  We can feel great knowing that the majority of sunscreens did not contain benzene.  I will list the top offenders containing benzene and list some of our favorite brands that did NOT contain benzene.

While we do have EltaMD Sunscreen products for our patients at COSC, the only EltaMD sunscreen that had any benzene was Elta Aero(the spray) and it was about 0.14ppm, must less than the <2ppm recommendation. However, Elta is looking into this result as they do NOT use benzene in their manufacturing. They are investigating the possibility this is a contaminant for their single product. We will update you later with any additional info.

BENZENE CONTAINING SUNSCREENS-to avoid for now! (These had 0.11-6.00+ ppm concentrations)

NEUTROGENA Ultra Sheer Weightless Sunscreen Spray SPF 100+

NEUTROGENA Ultra Sheer Weightless Sunscreen Spray SPF 70

NEUTROGENA Beach Defense Oil-free body Spray SPF 100

NEUTROGENA Invisible Daily Defense Body SPF 60+

NEUTROGENA CoolDry Sport Water Resistant SPF 70

NEUTROGENA Ultra Sheer Dry Touch Water Resistant SPF 70

TopCare Everyday Ultimate Sheer Sunscreen SPF 70

Banana Boat Kids Max Protect & Play SPF 100

Banana Boat UltraMist Deep Tanning Dry Oil Spray SPF 4

Banana Boat Ultra Sport Clear Sunscreen SPF 100

EltaMD UV Aero SPF 45

Sun Bum Cool Down Gel

Raw Elements Lotion

Raw Elements Eco Formula SPF 30

Fruit of the Earth Aloe Vera Gel

CVS Health Spray After-sun Aloe Vera Soothing Spray

CVS Health Spray After-sun Aloe Vera Moisturizing Gel

Sunburnt After Sun Gel

Goodsense Lotion SPF 30

OUR FAVORITE NON-BENZENE CONTAINING SUNSCREEN RECOMMENDATIONS

EltaMD Lotion SPF 40

Elta MDPure SPF 47

Elta MD Daily SPF 40

Elta MD Clear SPF 46

Bare Republic Vanilla Coconut Mineral Spray SPF 50

Neutrogena Ultra Sheer Dry-Touch Lotion SPF 30

LaRoche Posay Anthelios Kids Gentle Sunscreen lotion SPF 60

LaRoche Posay Anthelios Melt in Milk SPF 100

Neutrogena Ultra Sheer SPF 100+ Lotion

Aveeno Ultra Calming Facial SPF 30

Neutrogena Lotion Ultra Sheer Dry-Touch SPF 55

Sun Bum Lotion SPF 30

Sun Bum Spray SPF 30

Sun Bum Moisturizing Sunscreen Lotion SPF 70

Neutrogena Pure & Free Baby SPF 50

Neutrogena Lotion Beach Defense Water plus Sun Protection SPF 70

Coola SPF 50 Lotion

Blue Lizard Lotion SPF 30

Supergoop! Powder Mineral SPF 45

Pacifica After sun Body Spray Coconut Vanilla

Things I bet you never realized were happening under your skin….. keep reading!

The sun is out, it’s springtime! Our neighbors come outside, we feel happier, and we spend more time outdoors working/playing. This means we are increasingly vulnerable to both the good and bad aspects of our sun. The sun’s rays do have helpful benefits. They can improve some dermatological conditions such as eczema, generalized itching, psoriasis, and acne.

We even use narrow band UVB light therapeutically in small doses in our office at Central Ohio Skin & Cancer to treat psoriasis, eczema, itch, skin lymphomas, and vitiligo to name a few. We have a Blue-Light unit to treat acne as well in our office. Light can have powerful helpful effects when used correctly and not when overly exposed to UV radiation.

UV radiation is a carcinogen. We know that too well in dermatology. Every single day we remove skin cancers. The most common kinds due to UV radiation are Basal cell carcinoma, Squamous cell carcinoma, and Melanoma. Our skin relies on active DNA repair mechanisms to keep the mutations in check from our childhood sun damage. However, in many people, eventually our immune surveillance system cannot keep up and skin cancers develop.

5.4 million cases of Basal cell or Squamous cell carcinoma diagnosed each year in the United States.

Some SAFE sunscreens can be found at the following links:

https://amzn.to/352ZxJb

https://amzn.to/3IstKzB

https://amzn.to/3tcDWWn

https://amzn.to/3BQdtCa

Over 100,000 cases of Melanoma diagnosed in the U.S. It is the 5th most common cancer in men and women in our country.

Why did I look tan right after I came inside from doing some yard work last weekend? UVA radiation causes immediate pigment darkening through using existing melanin pigment. This is short lived however and it’s really the UVB that can cause melanocyte activation and new pigment synthesis peaking a few days after a particular sun exposure.

Remember UVA Ages, UVB Burns.

Why does my skin look so bad now that I am 60 years old? It may not! But if it does look different to you, it most likely has to do with cumulative sun exposure. Photoaged skin is characterized by uneven pigmentation, sallow appearance/yellowing, laxity to skin, visible red blood vessels, wrinkles, dryness, and a leathery appearance.

So, what can we do about our skin cancer risk or our photo-aged skin? A LOT!

Talk to your dermatologist about an approach to address all your needs.

Topicals can improve the texture and skin tone. Blood vessels can be removed by laser. Laxity can be improved with our Clear Lift Laser or Radiofrequency device. Ask about a plant based extract that can be taken to help prevent DNA damage from UV radiation. Another supplement has been found to decrease Non-melanoma skin cancers by 25%! Besides sunscreen, sun protective clothing, hats, and sunglasses there is more you can do too!

Green tea is an antioxidant helps protect against reactive oxygen species and DNA damage. Alpha-hydroxy acids(which we have at both our COSC locations) help improve wrinkling, roughness and uneven pigmentation within months of using regularly!!! That’s fast! Topical prescription strength retinols and topical antioxidants help treat and prevent photoaging too. I could go on and on but that is a great start. The green tea I drink daily can be found here:

https://amzn.to/33UViia

I particularly LOVE the following over-the-counter items (However I still use our Rx strength retinol, bioserum, vitamin C, and our tinted facial sunscreen daily as well and all those can be purchased at one of our office locations. If you can’t wait and want to get started with OTC first, take a look at these recommendations)

Colorscience sunscreen powder, Supergoop CC Screen, and LaRoche Posay anti-aging sunscreen primer.

https://amzn.to/3t8qSkT

https://amzn.to/3tde4JY

https://amzn.to/3t9Vxyl

Under BEST OTC ANTI-AGING I love LaRoche Posay Serums (all of them! love them! vitamin C, niacinamide/hyaluronic acid) Skinceuticals Retinol.

https://amzn.to/3pk54ls

https://amzn.to/358981b

https://amzn.to/35vsjld

https://amzn.to/3hnccsA

My GO-TO Lip sunscreens are Sun Bum and Coola brands.

https://amzn.to/3JQt3jQ

https://amzn.to/3tcFIH1

(I don’t own or sell any of these products myself! Links are on Amazon.)

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

Cosmetics, Oil Diffusers & SLIME…. OH MY, CONTACT DERMATITIS!

What is Contact Dermatitis?

It is an extremely common type of skin rash we see in our dermatology practice. There are multiple types: allergic & irritant are common subtypes. Allergic contact dermatitis(ACD) is a severe reaction to something that causes swelling, redness, and blistering reactions. Poison ivy dermatitis is an allergic contact dermatitis. Most things in our environment could be causes of ACD, however most never pose a problem. For example, neomycin in Neosporin ointment over-the-counter has been a top allergen. Most people will never be allergic to neomycin, but 10-15% of us will over our lifetime. We do not know whether that will be when we are children, adults, or never. It is more common the more exposure you have and especially when its placed on open wounds, which is the most common reason one would apply this ointment.

But, back to ACD which causes sleepless nights, intense itch, visible embarrassing rash and even blisters. Your physician wants desperately to be able to instantly diagnose the offending chemical or exposure, but can we always do that instantly.

No. Unfortunately not.

We need to play detective to get to the bottom of it. Nail polish can cause eyelid dermatitis. Diffusing oils in your home can causes airborne dermatitis on the eyelids and face/neck areas. Painting your walls in your home can causes a dermatitis. Personal care products containing fragrance, preservatives or even plant/natural elements can cause Allergic Contact Dermatitis.

Does Unscented mean I am safe?

No. Fragrance free is a safer terminology to look for, but unscented doesn’t mean there are no fragrances in an unscented product.

Does Natural or Organic mean I am safe?

No. Lavender, witch hazel, sunflower, and other ingredients are all culprits of contact dermatitis as well. You just don’t know if you will react until you have a reaction to one of those ingredients and then need to forever avoid it going forward.

Nail polish and even other creams used for other ailments can be transferred to eyelids. Even after you wash your hands, some other medicated or non-medicated cream residue on your fingertips can cause eyelid dermatitis. Shampoo/conditioners can cause contact dermatitis on eyelids and lateral necks due to small bits of residue remaining on that sensitive skin. As almost a rule, a shampoo allergy does NOT present with scalp itch! A shampoo can be fine for years and on the 1,001 application it begins to causes an allergic reaction for you. That is always very hard for patients to understand. It makes sense if you tolerated your same shampoo for 5 years with no trouble it will never causes trouble, right? WRONG. It can become something your skin becomes allergic too upon more exposure. The company can also change ingredients and add lavender or a different lathering agent or preservative and suddenly you may be allergic.

If your physician cannot identify what is triggering your ACD they may send you for patch testing. That is a specialized test that tests your skin to over 100 personal care products ingredients and other ingredients your body contacts all the time in our environment.

The above article photo is from the journal Pediatric Dermatology.

Methylchloroisothiazolinone ingredients are hard to pronounce but found in many things from moistened toilet paper wipes, baby wipes, and school glue. This is becoming a VERY common contact allergen. It is often a cause of hand dermatitis secondary to SLIME made with school glue.

The above article is from An Bras Dermatol. 2018 Nov-Dec; 93(6): 944.

So what could a bad SLIME reaction look like. As above, a child could develop redness and blisters on their hands. It could also affect the parents helping the child make the SLIME product.

What should I do if I cannot identify what is causing my rash?

Make an appointment with one of our board certified dermatologists to evaluate your rash and your current products/exposures. We can help you get relief and get to the bottom of what is causing your eruption so you can avoid future exposures.

Written by Dr. Andrea LaTorre, a board certified dermatologist at CENTRAL OHIO SKIN & CANCER

SKIN CANCER IN SKIN OF COLOR

True/False? I do not sunburn easily therefore I do not need to get my skin checked regularly.   True/False?  I have darkly pigmented skin so I cannot get skin cancer. All of the above are FALSE statements! You may not hear as much about skin cancer in patients with darker skin types but many skin cancers are, in fact, MORE common in skin of color.  Also many diagnoses are made at a later stage of the cancer making it harder to treat/cure.  This is due to many reasons.   The typical patient who asks for a full skin exam is a patient with fair skin who has had many bad sunburns over their lifetime.  Don’t get me wrong, that type of patient is at significantly higher risk for skin cancers than patients who have never had burns.  However, if we only worry about those who have had bad sunburns we miss a large portion of people who could present with a treatable skin cancer.   Many patients with skin of color are not aware of the types of skin cancers that they are at an increased risk for thus unaware that full skin exams could benefit them.   I hope to educate on skin cancer in skin of color and save some lives in the following paragraphs by bringing more attention to what skin changes need attention.  If you or a friend or loved one has something like this on their skin, encourage them to see their board certified dermatologist.  Basal Cell Carcinoma (BCC) The MOST common skin cancer in caucasians but less common in patients with darker skin types like African Americans, Hispanic, Asian populations.  It often is described as a pink, pearly, shiny bump, BUT in darker skin types it can be a shiny DARK bump(a pigmented Basal cell carcinoma). Squamous Cell Carcinoma (SCC) The SECOND most common skin cancer in caucasians but more common than BCC in African Americans/Asians/Hispanic patients.  This can present as a crusted bump, often tender, and can grow slowly or quickly.  Sometimes HPV Human Papilloma Virus is found to be the cause of the cancer. Other risk factors are burns, radiation, old scars. Squamous cell carcinoma can be deadly if not treated especially if on the lip or ear.  It can also be found on a finger or around a nail and get mistaken for a fungus or other rash for a long time before being accurately diagnosed.  So if you have a crusted bump on your leg that is tender or a single finger with redness and scaling skin, you should call your board certified dermatologist to be checked. Melanoma Melanoma is the most life threatening of the skin cancers mentioned so far.  Though the number of new cases is higher for caucasians than patients of color, the prognosis is often worse for skin of color patients because the diagnosis is not made early enough.  Melanoma can be a dark expanding mole anywhere on the body.  It can occur where the sun has never shined.  It can occur beneath underwear, beneath a bra, on the palm/sole skin, or in a nail.  If you have a new dark band on a single nail you should call to have it checked.  Some patients with more skin pigment can have pigmented bands on multiple nails and this can be normal, but still worthwhile to get it evaluated. Cutaneous T Cell Lymphoma (CTCL) Overall this is rare but this skin lymphoma is more common in African Americans than in Caucasians.  It appears as subtle scaling patches around the hips.  It can be asymptomatic especially at this early stage.  It can be hypo pigmented (meaning slightly lighter than your skin color)  Anyone with scaling patches around the midsection, especially if you are >50 years old, should be evaluated. Kaposi’s Sarcoma Again, African Americans have a higher rate of this skin sarcoma than caucasians.  It can be endemic to patients from African/Middle eastern countries.  It can be related to HIV/AIDS and in general is seen more often in immunosuppressed patients.  Similar to CTCL(lymphoma above) it can be asymptomatic and present as dark patches of skin especially on the lower legs/feet that never resolve.  If you have dark patches that remain on your legs/feet you need to be seen by a dermatologist. Dermatofibroma sarcoma protuberans (DFSP) This represents 10% of skin cancers in African Americans.  It often presents as an enlarging deep, firm bump.  If you have any atypical appearing “keloids-esque” lesions in non-traumatized areas these should be evaluated.  It can be very difficult to get clear margins during surgical treatment.  Please get your skin checked. In summary, please do not hesitate to ask for a full skin exam.  Even if you have more concerns than can be addressed in a single visit, make that next appointment to be checked from head to foot.  The same sun precautions apply to all skin types.   Perform routine self skin examinations so you can know your own skin. Wear Sunscreen SPF 30+ and reapply every 2 hours Avoid sun between hours 10am-2pm when possible Wear UV absorbing sunglasses(you can get ocular melanoma) Avoid tanning beds SAFE sunscreens can be found at the following links: https://amzn.to/352ZxJb https://amzn.to/3IstKzB https://amzn.to/3tcDWWn https://amzn.to/3BQdtCa Written by Andrea LaTorre MD a board certified dermatologist at Central Ohio Skin & Cancer

WHEN A ‘CYST’ ISN’T A CYST!

WHEN A ‘CYST’ ISN’T A CYST!
Most people have not heard of the term Merkel Cell Carcinoma before. It was first described in 1972, which isn’t all that long ago, and is an uncommon, aggressive tumor. Merkel cells are found in the basal/lower layer of the epidermis in normal skin.  They are thought to function as part of our touch receptors. However, when they grow as irregular masses they can be deadly.
Most Merkel cell carcinomas are found on the head and neck with extremities being next most common. This dangerous tumor often presents as a bump beneath the skin that seems cyst-like. The high predisposition for head and neck leads us to believe that the highly sun-damaged skin is most vulnerable. Approximately 400 cases are diagnosed each year in the United States. Most of these 400 cases are found in men in their 60’s-70’s. However, it rarely has occurred as young as 7 years old and some studies have found more equal male:female ratio. Patients with a history of basal cell carcinoma, squamous cell carcinoma, or melanoma are more at risk for Merkel cell carcinoma than someone with no history of a prior skin malignancy. Immunosuppression also increases the risk.
If a Merkel Cell Carcinoma is suspected and/or a biopsy is performed on a suspicious growth, a dermatopathologist will evaluate the lesion under a microscope. Merkel cells have certain diagnostic markers that aid in making the diagnosis.
Frequently, the diagnosis is made when a patient already has metastatic disease present. Survival is 58-79%. Merkel Cell Carcinoma is the deadliest skin cancer with a higher fatality rate than melanoma. Certain risk factors are associated with a lower cure rate: head/neck location, male gender, over 10+ mitoses(dividing cells) per high power field, and blood or lymphatic invasion.
This informative post is meant to increase awareness that not all ‘cyst’-like bumps are benign. Though this is a rare tumor, I want to stress these take-home points.
-It is ALWAYS okay to get a presumed cyst checked by a dermatologist.
-NEW cyst-like bumps in MEN in their 60-70’s should ALWAYS be checked!
-Any bump that is changing or causing symptoms(pain, itch etc) should be checked
LINK to our favorite sunscreens
Written by Andrea LaTorre MD, a board certified dermatologist at Central Ohio Skin & Cancer

Retinol Fact vs Myth

Sunscreen and Retinol:  The MOST Essential Ingredients in any skincare regimen Sunscreen should be a no-brainer at this point.  Everyone has heard that the sun’s UV radiation causes sunburns, skin cancer, and photoaging.  Sunscreen is an essential morning skincare routine to implement if you have not already.  Do not spend hundreds of dollars on neurotoxins(Botox, Dysport), lasers, and fillers if you are not prepared to also wear sunscreen.  The sun breaks down our collagen causing more sagging, yellowing skin over the years.  Lasers and microneedling can encourage your own body to make new collagen to recover from the sun’s damage, but prevention with sunscreen is essential.  Fillers rejuvenate by adding volume and contouring where our aging depletes volume.  Bone structure, facial fat pads, and collagen loss all happen with each passing birthday but the sun speeds up these aging changes. As mentioned above, sunscreen is vital, but my absolute favorite thing to talk about is probably retinol with my patients.  Retinol is an under-appreciated addition to a skincare routine.  Retinoids are synthetic derivatives of vitamin A. The retinoids that have been designed in a laboratory are adapalene, tazarotene, and retinoic acid(tretinoin, retin-A).  These laboratory derived retinoids are more stable than the over-the-counter retinoids.   What can Retinol do for me?  Retinoids regulate growth of epithelial cells, suppress tumor promotion, inhibit breakdown of collagen, stimulate skin cells(fibroblasts) to increase collagen synthesis, improve acne, diminish pores, remove blackheads/whiteheads, improve mottled hyperpigmentation, improve tactile roughness, and improve fine lines/wrinkles.  In summary, it helps facial concerns from age 12-100+years old, in men and women.  It begins by being useful in treating acne and then it becomes helpful for preventing aging changes on the face as the years go by.  I try to encourage all young patients to continue on their retinoid regimen even after their acne is improved.  Insurance often does not cover prescription retinoids after teens/20’s because they are viewed as anti-aging.  Our office has all strengths of retinoids for approximately $70-95.  Just a single tube of Rx strength tretinoin can last 6-12 months depending on how often it is used so it is a crucial, small investment for the payoff…. beautiful skin! So how do retinoids differ? Why can’t I use something I find at the grocery store that says anti-wrinkle or retinol on it? Over-the-counter ‘anti-aging serums’ or ‘brown spot correctors’ often ONLY have sunscreen in them.  I feel I need to say that again……Over-the-counter ‘anti-aging serums’ or ‘brown spot correctors’ often ONLY have sunscreen in them!!  Sometimes patients bring in serums they have paid $30-$100+ for only to find out their only active ingredient is sunscreen.  The reason these can be marketed for anti-aging is because the sun causes aging, so if you wear a sunscreen routinely you will have better looking skin than if you did not.  Additionally, over-the-counter retinoids often have ingredients such as retinyl palmitate and retinaldehyde.  These have less efficacy due to decreased penetration in to the skin.  Only prescription retinoids like tretinoin are approved by FDA to treat photoaged skin, not the over-the-counter retinoids.   Formulation considerations include what type of packaging the retinoid contained in.  Retinol must be manufactured and packaged properly to avoid oxidation and loss of potency.  It should be in an aluminum tube with a small mouth.  If air and light have access to your topical retinoid it will NOT remain effective!   Rx Tretinoin is becoming a vital component in the regimen for my patients with pre-cancers and skin cancers as well.  It has shown to remodel skin and cause increased cell turnover which allows DNA damage and pre-cancers to be sloughed off at such a fast rate that my patients develop less of these dangerous growths.   Lastly, a common myth is that retinol causes photosensitivity and that you will need to stop it during the summertime.  Animal studies in the past showed poor stability upon UV light exposure so retinoids are best applied at night as some(not all) do have less efficacy if applied during a morning skincare regimen.  However, retinoids are now known not to have photosensitizing or phototoxic properties and may actually prevent the skin from dangerous DNA changes and damage from UV sun exposure.  So, someone who wears their retinoid all summer may develop less damage than someone who does not.  Keep this in mind as spring/summer approaches and talk to your dermatologist about which retinoid is right for you. Written by Andrea LaTorre MD, a board-certified dermatologist at Central Ohio Skin & Cancer Shop my Favorite Safe Sunscreens: https://amzn.to/352ZxJb https://amzn.to/3IstKzB https://amzn.to/3tcDWWn https://amzn.to/3BQdtCa

PMLE, CAD, AKs, NMSC… these are just a few acronyms that Dermatologists learn about. The sun can cause so much more than a sunburn.

sun

Dermatologists are medical doctors who spend 4 years after medical school in what is called residency.  That is an intense period of learning about general internal medicine in a hospital setting for 1 year and then 3 additional years specializing in dermatology only.  Given the vast amount of skin disorders that are possible and the complex terminology for naming them, dermatologists have created acronyms to abbreviate many.

However, interestingly, the sun can cause so many other reactions aside from a sunburn.  Your dermatologist is the person to determine what type you may have.  That is why we spent 3 additional years learning!  Some reactions are due to oral medication making someone more susceptible to a sunburn.  These can include immunosuppressive medications, antibiotics, or blood pressure medications among others.  Another type of reaction involves an allergic response when the sun and certain types of oral medications are combined.  One of most common and fascinating is a phytophoto response where certain plant based products on the skin cause a blistering reaction when sunlight is present.  Children can get an eruption on their ears from sun and rarely genetic disorders can cause blisters and scabs when in the sun.  Chronic actinic dermatitis plagues older patients after way too many years of sun damage. It is extremely itchy!

I recently discussed PMLE with a patient who suffers from this rash.  The long name is Polymorphous Light Eruption.  It happens most often to women and most commonly occurs in the springtime.  If you develop an itchy rash on your next vacation or early spring here in the Midwest you might also be someone who has PMLE.

Why is PMLE more common in the spring?  So, ideally you would never get too tan or that means you are receiving too much sun and sun damage…… BUT typically over the first few weeks or stronger springtime sun we have a “hardening” effect on our skin towards the sun.  Basically, our skin gets used to the sun again.  Most times when our skin “hardens” or gets used to stronger sun again over the course of spring into early summer, PMLE reactions become less likely.  Unfortunately sunscreen doesn’t prevent PMLE, clothing dose though.

So, if you develop a rash as you are enjoying your summer family time, make sure you bring your whole medication list as well as sunscreen or beauty products applied to your skin.  Take a photo and save to show your dermatologist if the reaction doesn’t last long after sun exposure.

Most importantly, wear your sunscreen, hats, sunglasses, and sun protective clothing!

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