Purchasing products is often daunting from sunscreen to moisturizers to other cosmetic topical products, the choices are endless. Stores are littered with products from many companies, at many price points, and with many claims.  In this article, we will try to make a simple user’s guide to dissect what some of the issues to consider when buying products are.

SUNSCREEN

If there is one product that is most important for your skin it is without question sunscreen. Most products are trying to reverse the damage that occurs from the sun but sunscreen allows you to prevent the damage from happening in the first place.  Having brakes in a car to prevent accidents is far more effective than having a great body shop to fix a car once an accident occurs. Your skin is the same way, prevention is key and should be the cornerstone of you regimen.

Sunscreen ingredients can be confusing. Many sunscreens are physical blockers (reflect UV rays) and some are chemical blockers (absorb UV rays). Some people prefer physical blockers because they want something chemical free. Chemical sunscreens have been used for many years without issues, however some ingredients can be problematic and more likely to cause photoallergic reactions. These include PABA, benzophenones (oxybenzone), cinnamates (cinnamon derivatives), and dibenzoylmethanes (avobenzone). For this reason, in choosing a sunscreen it is best to stick with physical blockers, or chemical blockers that avoid the above listed ingredients.

What SPF? I would recommend SPF 30 or greater. Even though SPF 15 blocks a majority of rays, most people do not apply enough to get this effect and for this reason higher SPF is more effective.

MOISTURIZERS

In patients with atopic dermatitis and eczema moisturizing is key. Additionally, moisturizing is an important element to anyones daily routine. There are a large number of moisturizers. It is important to avoid moisturizers with elements that cause skin sensitivity and allergy particularly in those patients with eczema.

Many patients like to buy organic or all natural products but the issue with these is they often have ingredients containing lavender, peppermint, cinnamon, or other floral or fruit extracts. While these are natural and smell nice, they are not ideal for the skin as they can trigger allergy and eczema in sensitive individuals. For this reason, it is best to avoid these types of products. Natural is not always better when it comes to moisturizing your skin. If natural products are a goal, stick to simple products such as coconut oil or similar products.

ANTIAGING

There are numerous antiaging products on the market, each suggesting they have found the secret of antiaging. So how do we sort through the slew of products? It is best to focus on those ingredients we know can be helpful.

Hyaluronic acid – this is found in antiaging products and is an ingredient to look for. Hyaluronic acid is naturally found in the skin and helps hold moisture as well as other properties. Therefore, hyaluronic acid topically can help restore moisture to the skin. It is also commonly used in injectable fillers.

Vitamin C, E, niacinamide – these antioxidants are often found in products and can be helpful in preventing free radical damage that can occur in the skin as a result of aging and sun exposure. Therefore, in looking at antiaging products these are useful ingredients.

Retinol – this is found in many products and helps with collagen turn over and can be helpful with wrinkles and skin imperfections.

Hopefully this helps you in trying to sort through the numerous products available today. At California Dermatology Specialists, we find patient education to be extremely important and if you have any skin questions we would be happy to see you and answer them!

Skin cancer is becoming more and more prevalent in recent years. It is important to know what to look for and the facts to protect ourselves from these conditions and to know when to seek the advice of a board certified dermatologist.

There are many forms of skin cancer, but there are three that are more common and essential to know.

1. Basal Cell Carcinoma – this skin cancer is the most common skin cancer and is becoming increasingly common with over two million cases a year in the United States. It typically occurs as a small pink shiny bump on the skin that does not heal, grows, and occasionally bleeds. However, while this is the most common presentation it can also be seen in many other ways. One of which is as a pigmented bump particularly in patients with darker skin types. This skin cancer rarely spreads to internal organs but does cause localized damage and destruction of tissue. For this reason, these skin cancers need to be treated and removed to prevent complications.
2. Squamous Cell Carcinoma – this is the second most common type of skin cancer and is most commonly found in patients with the most extensive sun exposure history. These
   present as scaly red patches and bumps. These skin cancers are more aggressive and have a higher risk of spreading to lymph nodes and internal organs than basal cell carcinomas. However, if treated quickly this is rarely an issue. About 1 million cases of squamous cell carcinoma are diagnosed in the US each year.
3. Melanoma – melanoma is much more rare than basal cell carcinoma and squamous cell carcinoma but also far more aggressive. They account for fewer than 1% of skin cancers
   but most of the fatalities. Melanoma typically presents as a new or changing mole. Some concerning features are asymmetrical shape, variation in color or concerning colors such as black, red, or white, size greater than a pencil eraser (though small lesions can be a problem as well), or any symptoms or changes. It is important to see your dermatologist with any new or changing moles as melanoma can commonly spread to internal organs if diagnosed late. It is important to diagnose melanoma early as they can be treated in early stages as melanoma in situ (typically treated with surgical excision) up to stage 4 metastatic melanoma possibly requiring chemotherapy or other more aggressive therapies. There is significant research in the field of melanoma and continual advances but even so aggressive melanoma is very difficult to treat and it is very important to have regular skin checks to try to catch these skin cancers before they become more aggressive.

Prevention is key for all skin cancers and this includes sunscreen and sun avoidance during peak hours from 10AM-4PM. This is critical as there are more harmful UV rays during these hours. Also, it is important to have regular skin checks with a dermatologist to identify any concerning lesions.

If you have any questions or would like to schedule a skin cancer screening we are happy to help here at California Dermatology Specialists in Brentwood, Los Angeles. With summer here have fun but stay informed and protected!

It is Rosacea Awareness Month so I thought this would be a good opportunity for rosacea education.  Rosacea or acne rosacea is a condition where you develop pimples as well as redness and broken blood vessels mainly on the face. This condition is similar to acne but is different in that you do not develop blackheads or whiteheads. Additionally, it is most common after the age of 30, whereas typical acne is more common in teenagers.

What causes rosacea?

There are many theories about what triggers rosacea including sun damage which breaks down collagen and blood vessels as well as the skin’s blood vessels being highly sensitive. Others have argued that demodex, a mite found on the skin’s surface, is the trigger. Rosacea is very common and ranges from very minor to severe.

What triggers rosacea?

Rosacea is often worsened by sun exposure, spicy foods, stress, alcohol, heat, or exercise. It is therefore important to wear sunscreen daily and avoid those triggers that you are most susceptible to as each individual will have unique triggers.

Types of rosacea and treatments

Erythemotelangiectatic rosacea – this type of rosacea is very common and causes redness and broken vessels on the cheeks, forehead, chin, and nose. It does not typically have any pimples associated. The treatment is primarily lasers targeting the blood vessels. This type does not respond particularly well to topical treatment but can benefit from green tinted products as well as products with niacinamide. Additionally, some products constrict the vessels of the skin and this can help with lessening of redness though can come with rebound and worsening of redness if stopped.

Papulopustular rosacea – this form of rosacea is most similar to acne with pimples predominating. This is treated very similar to acne and there are a number of topical and oral therapies that can help this form of rosacea.

Glandular rosacea – the most severe form causing rhinophyma. This results from increase in size of the glands of the nose primarily, and can result in significant deformity of the nose. This form can be treated with oral medicines but very commonly requires more aggressive laser and surgical measures.

Ocular rosacea – some patients develop eye symptoms including scratchy eyes, red eyes, or other eye issues. This type of rosacea is best treated in conjunction with an ophthalmologist as there are a range of treatments that are useful in this condition.

If you suffer from any form of rosacea, you should seek the guidance of a board certified dermatologists. At California Dermatology Specialists in Brentwood, Los Angeles we would love to see you and help you with this common and troublesome condition.

Many patients are interested in laser treatments for skin rejuvenation, treatment of brown spots, treatment of acne, treatment of blood vessels, and scars among other concerns. There are many lasers from many manufacturers of different wavelengths but what does all this mean?

First off, what is a laser? A laser is a device that emits light at a specific wavelength. This means that it may emit visible wavelengths such as red or green or it may emit wavelengths in the infrared spectrum (longer wavelengths than visible light). Why is this important and why do we care? In the skin there are targets that the laser is trying to destroy. For instance, if someone has a lentigo (brown spot) that he or she does not like, we could target it with a laser wavelength that is absorbed by the brown pigment cells but not by other cells. As the laser light is absorbed it heats the target and destroys it. This allows lasers to be precise. Some lasers target water. Since most of our skin is made up of water, these lasers are typically used to treat the top layer of skin in a controlled manner to allow for rejuvenation (resurfacing lasers).

Red blood cells in vessels absorb light in the visible spectrum (typically near green). By using a laser such as PDL at 585nm or KTP at 532nm, the red blood cells selectively absorb the laser heat and destroy the vessel. Similarly, lasers that target melanin (responsible for brown spots) heat up the melanin and destroys pigment. This is also how hair removal lasers work. They target the pigment cells of the hair. This is the reason you may be told that gray hair or blonde hair will not be able to be removed with a laser.

A unique category is the IPL “laser” used commonly. In actuality it is not a laser but rather emits a range of wavelengths. It is for this reason that it can be used for brown and red spots but is slightly less specific than lasers that target specific wavelengths.

So this is a small snapshot of laser physics. There are many other parameters that have to be accounted for to properly operate a laser but I hope that this will allow you to ask questions and understand why a certain laser will be helpful for your unique skin type. It is also the reason that it is important that laser operators understand all the fundamentals of lasers and how they work.

If you have any questions about lasers or laser treatments, please contact us at California Dermatology Specialists and we will be more than happy to explain this further. We also offer a wide range of lasers and are happy to discuss them with you as well!

I hope everyone had a fantastic Holiday season. Now that the New Year has begun it is resolution season and what better resolution to have than to take care of your health and skin. Here are some tips to take care of your skin simply that can serve as a foundation to a healthy regimen:

1. SUNSCREEN –  this is the most important item in any skin regimen. This not only serves to decrease the risk of skin cancer but also decreases the risk of wrinkles and brown spots. It is important to wear sunscreen every day particularly peak hours of 10-2, and also to reapply every 2 hours. Photoaging occurs from a variety of factors one of which is collagen degeneration and free radical formation which are triggered by the sun. Also, DNA changes can occur resulting in skin cancers as a result of UV exposure. UV exposure increases certain inflammatory processes which can negatively affect your skin as well. In terms of which sunscreen to select, I favor PHYSICAL BLOCKERS which means that they only contain zinc and titanium. These are naturally occurring metals and this means less allergic reactions and less burning of the eyes. Also look for OIL FREE, this is essential with sunscreen as this will reduce acne break outs that can occur from occlusive sunscreen.
2. YEARLY SKIN CHECKS – this is important to prevent skin cancers from being neglected. Skin cancers are very common and typically easily treatable if caught early. It is therefore very important to have a skin check yearly as it is often hard for patients to identify what spots are of concern. Melanoma in particular if caught early is far easier to treat than later in the course.
3. GENTLE CLEANSERS – another critical element to a skin care regimen is using gentle, non-scented cleansers. Fragrance is a major cause of skin irritation and allergy. Even natural products can cause problems. Think of poison oak, though natural it causes severe skin irritation in most people. For this reason, I recommend fragrance free cleansers that are formulated for sensitive skin.
4. MOISTURIZE, MOISTURIZE, MOISTURIZE – this is an essential staple to any skin regimen. Moisturizer helps to repair skin barrier and prevent eczema. Our skin forms a natural barrier between the environment and our bodies. If this is broken down, it will allow the environment to cause eczema and allergies. This is the reason it is essential to moisturize at least once to twice daily particularly after bathing. This will help replenish your natural barrier and prevent dry skin and eczema. Also moisturized, hydrated skin will show less wrinkles.
5. AVOID THICK MAKEUPS – many make-ups and cover ups are thick and filled with oils that occlude follicles triggering acne. It is important to minimize thick cosmetics as this can form a vicious cycle where you are developing acne as a result of the very thing you are using to cover it up!
6. RETINOIDS, ANTIOXIDANTS – if you have done all of the above and want to give your skin an extra boost speak to your doctor about retinoids and antioxidants topically. This can help maintain your skins collagen and keep it young and healthy longer.

If you would like to learn more about skin health or have any questions about your skin you can contact us here at California Dermatology Specialists. Have a happy and healthy New Year!

Following the Thanksgiving feast, we can now reflect back upon all the delicious foods we ate. One thing we may not consider is how diet can affect our skin.  This is a topic that has been extensively researched but the answer does remain somewhat unclear.

Many of use grew up told that chocolate, milk, and other sweets caused acne, but is this true or just a tale to make us avoid these tempting foods?  Well, studies have not been definitive, however the evidence available does seem to suggest that high glycemic meals as well as dairy products can trigger acne and worsen acne. What is a high glycemic food? These are foods that are easily broken down by the body into simple sugars that cause peaks in our insulin and glucose levels. These would include  fruit juices with added sugars, breads, potatoes, and other candies and high sugar, processed foods. Low glycemic index foods include nuts, beans, as well as foods with a mixture of fiber, fats, and proteins.

Additionally, dairy products influencing acne has been studied and found to have a possible connection. Why this causes increased acne is unclear but it could be its effects on hormone levels as this has been shown to have a direct effect on acne.

So what does this mean? Should you avoid these foods? Based on the data available, it is unlikely that a single factor triggers acne. In terms of diet, high glycemic foods tends to have the strongest evidence and given its link to other diseases like diabetes it would not be a bad idea to lower ones intake of these foods.

But remember, diet alone will not treat acne. Acne is triggered by a number of factors involved in oil production, cell turnover, and bacteria. That is why it is important to maintain a healthy skin regimen including a gentle oil free cleanser as well as an oil free sunscreen, as sun can also cause inflammation and exacerbate acne. In patients with active acne, this may not be enough and it could require more therapies.

If you have questions or concerns about your skin and acne, we are happy to see you here at California Dermatology Specialists where your skin health is our priority.

Happy Holidays!

We are approaching the winter and with the holidays and time off from work, we also must acclimate to cold, dry weather. This makes the winter an important time to not only wear your warmer clothing but also to accessorize with moisturizers.

The cold weather makes our skin prone to dryness and eczema. This makes it that much more important to moisturize daily or twice daily to keep your skin from drying and cracking. Asteatotic eczema or “winter itch” is more common during this time. Also remember that although hot showers feel nice during the cold times, they also make our skin dry and prone to eczema.

Also packing a lip balm is important to keep your lips moisturized. The cold weather, as well as wind, are a perfect recipe for dry, chapped lips.

If your skin is becoming dry or you are having trouble keeping your skin in check during the holidays, we would be happy to help you here at California Dermatology Specialists for a consultation and to make sure that your skin is at its best for the holidays!