Shanah Gavia, PA-C

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Best Sunblocks for Your Unique Skin

The best sun protection is the one that you actually will use! Depending on skin types and the situation, people can be unmotivated to use it. We know that the sun, as lovely as it feels, does cause skin cancers and premature aging. When I was young I didn’t want to wear sunblock, in fact I would tell my mom that I wanted to have leather skin. I thought it looked tough and cool. It wasn’t until 20 years ago when I started working in dermatology that I decided I didn’t want the leather skin or the skin cancers. Perhaps if I had a tinted sunblock that I liked many years ago I would have been motivated to use it. I’ve always recommended physical (mineral) blocks over chemical blocks. Remember our skin absorbs everything we put on it so when we have a choice I recommend using ingredients that will less likely will be carcinogenic or allergenic. Active ingredients should be Zinc Oxide or Titanium Dioxide. Here are some categories to try and break it down, but of course they all overlap somewhat.

Sunblock for different skin types — Photo by Armin Rimoldi on Pexels.com

People of color– It isn’t motivating to rub on a sunblock that leaves a white cast on darker skin. Just because the sun damage isn’t as obvious in POC it’s still very important. I recommend Black girl sunscreen or Elta MD clear. Recently I discovered a great mineral sunblock that has multiple shades called Suntegrity if a tint is desired.
Fair/lighter skin- My personal favorite sunblock to use on face is the physical sunblock, Elta MD Elements or Suntegrity. They are very motivating to use because of a tint which gives just enough coverage and provides a glow. They don’t clog pores so is great for acne prone skin as well. For those who do not want a tint I like Elta MD Restore. For the body I like Babo Botanicals Sheer Zinc Continuous Spray.
Babies/Kids– For babies and kids sun protective clothing is really the best option. Think rash guards, hats, and umbrellas! If over 6 months use zinc based sunblocks on the areas you can’t cover. The zinc oxide mineral sits on top of the skin and scatters/absorbs the UVA/UVB and won’t absorb into the bloodstream. I recommend Badger & Blue Lizard. Sticks are very convenient for the face and on the go; California Baby , Badger & Babybum face sticks are good ones. It’s all a bit like rubbing in crayons, but be grateful that young kids don’t notice the white residue until they are older.
Active Runners/swimmers– Sweating can really be a problem when trying to keep sunblock in place but you active outdoor people really need protection! In addition to finding a sunblock, there is an oral supplement which does offer some protection, it is derived from a marine plant called Polypodium leucotomos fern, called Heliocare. A sunblock I recommend for athletes is Thinksport mineral sunblock. A good spray is Blue Lizard, but always be mindful not to inhale these sprays.
Lips– Let’s not forget our delicate lips. Skin cancers from sun like squamous cell carcinoma can be very aggressive on this area so lets try to prevent that. Again we want to find a mineral block that we enjoy using. I’ve found a couple that I love; Elta MD lip balm and Suntegrity Mineral Sunscreen Lip Gloss. My favorite colors are Beach Bonfire and Skinny Dip!
Men/Those who “Don’t like sunblock feel“- I have to say several men I’ve come across really don’t like using sunblock because it feels “greasy” or “sticky”. A few that really seem to sink in are La Roche-Posay Anthelios Melt-In Sunscreen and Elta MD clear. For those with some balding don’t forget the scalp, use a hat or Sun bum scalp mist.
On a budget– Some sunblocks can get pretty expensive especially when using more natural high quality ingredients. It’s great that more and more companies are getting on board making mineral sunblocks so you don’t have to use chemical sunblocks. Banana Boat, Cetaphil, Blue lizard, and Neutrogena have some mineral options now. A fun fact: mint, the herb that grows freely & easily can help support sun protection when ingested, so add some yummy mint to your water or food!

Remember to seek shade whenever possible, reapply every 2 hours at least, and use enough sunblock for each area. We should be using a lot more than we think! Another little bit of info is that the SPF number isn’t something to focus on. This is a number given for UVB wavelengths not UVA- it has to do with how fast you will turn red. Instead focus on the ingredients in the sunblock to be sure you’re blocking both wavelengths A & B. Happy Sunblocking!

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5 Ways to Reduce Chronic Inflammation

Inflammation is the root cause of many skin diseases as well as diseases of other organs. Inflammation is a normal reaction that our amazing bodies do to protect us. If we have a cut or a virus our inflammatory cascade comes in and does it’s thing, heals us then it goes away. It’s when this inflammation continues to happen that it becomes a problem. It’s like a fire that starts spreading wild all over the body. We can use many lifestyle solutions to help fight that “fire”

Reduce Stress: Stimulate your parasympathetic nervous system (calm mode). Stress stimulates our sympathetic nervous system (flight of fight mode). Stress increases stress hormones (cortisol and adrenaline) in the body that help us to do things like run from a tiger. We don’t want these hormones hanging out all the time because it adds to inflammation. There are many ways to help manage stress; meditation, warm bath, being in nature or doing a hobby you enjoy. The main thing is don’t get on a thinking train. Keep bringing your mind back to the moment where you are now; forget the past and the future. The more you practice doing this the easier it gets.
Reduce certain foods: Certain foods increase inflammation; sugary foods/drinks, refined carbohydrates, dairy, processed meats, excess alcohol and caffeine. It helps to not focus so much on what you can’t have. Replace sugary drinks with herbal teas and spa water! Replace sugary treats with berries. It’s all about habits and doing little by little. Let your intuition guide you and stick to the grocery isles on the ends where there are less processed foods.
Sleep: Try to get a full 7-8 hours a night. There are lots of habits we get into around bedtime that can affect our sleep. Try to wind down an hour before bedtime, that means turning screens off. Make sleep the priority that it should be and your body and mind will thank you.
Gratitude: Being grateful reduces inflammatory markers in the blood! This is very exciting and there are actual studies proving it. Practice listing things you are grateful for daily. There are countless things to be grateful for we just have to focus our attention on them and let the happy neurotransmitters rush in. When we are feeling gratitude what we already have suddenly becomes enough.
Movement: Exercise has so many benefits including reducing inflammation. The good news is it doesn’t have to be hours to work! Studies show 20 minutes of moving the body will do the job. So take a walk, jog, swim, bike ride, hike, dance, or do yoga. There are lots of free resources on YouTube that teach lots of exercises, for example yoga classes.

6 Concerns/Complications with Cosmetic Injectables

I’ve decided to share some of the complications/concerns that I’ve seen or know of when it comes to Botox & fillers. This is not to scare anyone but to just get more information out when it comes to these procedures. I’ve seen people treat getting injectables like getting a haircut (which can also be a temporary disaster). Just wanted to remind you these are medical procedures and there are some pretty devastating complications that can happen. If you choose to do cosmetic procedures it’s important to go to an experienced & qualified injector that has a plan if a problem does occur. It’s not the time to shop for the best bargain, sale or deal. I’ve listed 6 concerns & complications although there are others.

Photo by Tima Miroshnichenko on Pexels.com

Vascular Occlusion– This should be on every injectors mind. When injecting it’s important to know anatomy and steps should be taken to avoid causing this potential disaster. The injector should know how to recognize signs of this early and treatment should be implemented if needed. A vascular occlusion is when a filler is injected into a space that blocks blood flow. This can lead to scarring and blindness. In my 20 years of practicing I haven’t seen this until recently. I had a patient come in who was “treated for Botox from a doctor and was in pain and her skin was developing darkening”. When I saw her I immediately knew she had an occlusion. She had severe pain in her right eye/face and a dusky red patch that went from her eye area to her lip. Upon further questioning she did have a filler done in smile line/lip area as well. Thankfully, I was able to treat her with an enzyme that breaks down the filler (she had immediate improvement) & got her into an ophthalmologist to get her eye checked. Her injector should have caught this and been able to help her instead of avoiding her.
Over-injecting fillers– We live in a society where sometimes we think more is better. Over filling the lips and face has become the norm for some folks and people are starting to think this alien look is fine and normal. Many areas of the face can be overdone- this happens when someone is focused on one particular area/wrinkle. It’s up to the injector to educate the patient that chasing the area is not the best way to go because it results in artificial looking results. We need to look at the whole picture. The lips are a common area that gets over done. Some people want this look and some say they don’t. Commonly, I see lip filler that migrates to the upper lip skin area and the contour of the natural lip is gone. Injecting fillers and botox (neuromodulators) is both a science and an art. Remember what the normal face looks like and aim for a fresher look v.s. a non-human look. Lately, I’ve seen more and more filler around eyes that is bulgy creating a pillow like face. This can be from over filling or from using the wrong type of filler. On several occasions I have told people I wouldn’t inject them and I wish more injectors would do the same.
Over-injecting Botox- Botox and other neuromodulators can also be over done. The placement is crucial. The most common thing I see is too much in the horizontal brows (frontalis muscle) which can result in heaviness in the brows taking away the natural arch. In most men this isn’t an issue but women hate when brows drop! You can always add more but you can’t take it out.
Bruising and swelling– When a needle is being injected into the skin this is always a possibility. There are a few precautions the patient and the provider can do to reduce risk of this. Avoiding anything that delays the blood to clot a week before treatment can help. This includes fish oil, Ibuprofen, Aspirin, Exedrin, and certain herbs, like garlic, ginger, & ginko. Supplements like Arnica & Bromelain can be taken a day or 2 before treatment to reduce risks. The injector can reduce risks by moving slow and changing needles often. The good thing is bruising/swelling is temporary. Masks are good for this these days!
Cold sores– If you have ever had a cold sore (herpes virus) on face/around mouth it’s important to tell your injector. They can prescribe an anti-viral medicine to take before the treatment to prevent an outbreak. The trauma of an injection can trigger this.
Counterfeit products– This is a frightening one but it is out there. When you see fillers/Botox for super cheap prices and in non-medical settings it should be a red flag. What comes to my mind is the chiropractic doctor and his wife who ended up paralyzed in the hospital because a doctor injected them with raw botulism toxin instead of cosmetic Botox. There are knockoff products out there that can lead to disfigurement. So beware of this dangerous business of buying cheap fillers online that can lead to horrific outcomes.

6 Ways to Prevent Mosquito Bites

It’s that time of season that the deadliest animals, mosquitoes, are out looking for our blood. How crazy is it that there are over 3,000 species of these blood sucking insects and that they kill 700,000 people annually?!? The good news is only about 200 of the species carry the mosquito-borne diseases we know of like, Zika virus, yellow fever, dengue, chikungunya, West Nile virus, malaria, lymphatic filariasis, and EEE (Eastern Equine Encephalitis). The little female pests use their high tech proboscis to jab us and get our blood for protein to help support their offspring & their saliva helps blood flow easy but makes us itchy! The “Tiger mosquito” or “Ankle Day Biter” Aedes aegypti is the recent species we are concerned with as its known to carry disease and has made its way to America. What can we do to prevent them on us??

Avoid– This is a tough one for me but it is a way to prevent bites. Most mosquito activity is at dusk and dawn so it is possible to stay inside at these times. I love the summer evenings outside so I may opt for other solutions. Also, they are mostly living in tropical/humid areas so you can avoid traveling to those areas, again not an option I’d prefer. If you do decide to stay indoors they can still get you! So be sure to have windows closed &/or good screens, as well as door screens and block gaps around doors. They are attracted to white lights so you maybe want to switch to yellow lights by the doors. Life in a bubble will prevent bites but that doesn’t sound like good life quality.
Chemical Repellents– There are two big ones out there, DEET and Picardin. Which one is best? DEET has been around a very long time. Picardin is newer to US since 2005, it’s been in Europe/Australia since 1998. Both are synthetic but Picardin mimics piperine a natural compound found in black pepper. Both are effective at repelling mosquitoes. It’s really about weighing your risks. Chemical vs Mosquito diseases/bites.. it’s a balancing/moderation act. When I choose these chemicals I go with the lower chemical and spray more often, unless I’m traveling to tropics I may opt for higher strength. My go to DEET spray is Cutter Skin Sensations. For Picardin I’d use Sawyer or Natrapel. Permethrin spray can be used on inanimate objects like clothing, shoes, & gear which is a good idea when camping.
Natural Repellents– There are some options that smell amazing to humans and horrible to mosquitoes so that is the key. My go to are Murphys, Repel and Babyganics, these need to be sprayed at least every 2 hours and used in higher amounts than chemicals. As long as you’re not allergic to the essential oils that’s the active ingredient in these, it just feels right when using on kids or just relaxing outside in twilight hours. Citronella candles and incense tend to help when there is not to much of a breeze (and it is a plus for atmosphere). If you do have a breeze or some wind that is good because mosquitoes are slow/bad flyers even though their wings flap at 300-600 mph! They don’t like wind- so fans are good too. I’ve tried to make my own mosquito repellent but haven’t had much luck with the Pinterest recipes I’ve come across. I haven’t given up, as this seems like a fun challenge. I promise to link or write a blog to share if I find one that works.
Stagnant water– As we know stagnant water is breeding grounds for mosquitoes. Stagnant water in pet bowls and bird baths should be changed every 2 days. Holes drilled on recycle/trash cans can help drain if water collects in them and gutters should have shield to properly drain water. These Aedes species are pretty scary because they lay eggs so quickly in the tiniest amounts of water, like in a plastic water cap, saucer on potted plants or tin can. Pools can be a huge problem if not treated and ponds as well. There are BTI pellets that can be added to standing water that kill larvae- pretty interesting as it infects them with a bacteria.
Traps- Doing this research I discovered these and they look pretty cool. Ovitraps lure pregnant mosquitoes and traps the offspring before they can be released. They need to be placed every 25 feet. This actually kills them vs just repelling. Do we want to eliminate them completely? Sometimes it seems that way but crazy to think of the whole food chain and what a nice snack mosquitoes provide for some. Insectacides/pesticides are another option but they are toxic to the environment and people, so lets not.
Biologic technology– This is super fascinating stuff to consider. With our knowledge of genetics we can alter the mosquitoes to not reproduce. This would lower mosquito population and has already been done in Brazil and shown to reduce mosquito borne diseases. Since its a GMO the US is hesitant to entertain this, particularly Florida where mosquito problem is big issue. It’s something to think about. We have to really weigh it all and again I think its a balancing act. We are told GMOs are bad, but are they always bad in all situations? Maybe mosquitoes are here for population control…

8 Ways To Reduce Stress

Stress is a normal part of life. We are always going to have stressors it’s how we respond to them that matters. There are many helpful tips to get you out of stress mode. Stuff happens; relationship problems, job insecurity, social injustice, kids not behaving, politics, illness, pipe leaks, crazy puppies, and pandemics just to name a few. If we process these stressors and don’t let the stress continue to spiral and grow we can avoid the negative effects that stress causes, like inflammation. The chronic stress is what we want to avoid. So here are some tips/tools to help get you out of your head when aggravation strikes.

Meditation– There are many different forms of meditation and it’s whichever style that resonates with you that can help you manage your stress. Meditation is like a cozy space that can bring peace in hectic moments- the more you practice, the easier it gets. It’s basically focusing on something that gets you in the present moment. Focus can be on breath, a mantra, a word, vision, sound, body, compassion, gratitude, chakras or even whatever is coming up. If you have never meditated or are new to it, guided meditations are very helpful. There are lots of free guided meditations on youtube or you can use apps like Calm, Headspace, or Breethe. Once you get the hang of it, the focus gets easier and you could be in a constant meditative state with whatever you are doing and in return your choices will be more intuitive or from the heart.
Nature– This can go two ways; getting out into nature or remembering that you are nature. When we are outside in nature we can see and experience the chaos and beauty that is ordinary and organic. Connecting with nature can help you realize you are part of nature including your life with all the stressors. This can help you to let go and see that everything is okay already. There are studies that show biomarkers for stress are reduced when outside in nature.
Action– Stress can spiral into anxiety that can be crippling & create a feeling of paralysis. Action can be doing something to fix the situation and getting you out of the mind spiraling thought train. Many actions can be helpful as long as you aren’t in your head thinking of things that already passed or what’s going to happen. Some examples are writing lists, prioritizing, making phone calls, volunteering, bonding with pet, praying, donating, journaling, asking someone for help, therapy, connecting with a person, taking a hot bath, drinking herbal tea, laughing, creating art or doing a hobby you love. Just avoid multitasking as that is stressful. Remember to shift and focus on one task at a time.
Movement– Many studies show physical exercise can reduce stress and stimulate endorphins & other happy brain chemicals. So swim, bike, dance, run, walk, hike, do aerobics, weight lift, climb stairs, play sports or do yoga. There are many benefits to exercising and reducing the stress hormones is one of them. It can be as little as 10 minutes a day to have an affect on stress.
Consume Less– There are certain things that can induce stress. A big one is watching/listening to negative media. Try to reduce the amount of news/media/TV consumed. We want to stay informed but it may be helpful to put a limit on it so it doesn’t affect our mental health or productivity. Alcohol, sugar, processed carbohydrates, & excess caffeine are also stress inducers to limit. I’m also gonna throw in clutter/materialism in here because I believe less is more for lots of folks. Clearing your surroundings can help you clear your mind.
Aromatherapy– This is breathing in aromatic essential oils from plants which can relieve stress. To inhale these oils you can use a diffuser, spray, steam bath or breath straight from the bottle. There aren’t loads of studies to prove this works but there are some. You can always try and see if it makes you feel calmer. My favorite for reducing stress are; lavender, sweet orange, clary sage, cedarwood, & frankincense. Be aware some people can have skin allergies if used topically so I don’t recommend that unless you know how to do it properly.
Yoga– I know I brought this up under exercise but I bring it up again because it really is so much more than exercise. Yoga is an ancient practice from India that focuses on uniting the mind and body. There are many types/styles of yoga and yoga is for everyone, you just have to find the one you prefer the most. Like exercise, there are many benefits of practicing yoga including stress reduction.* If you are new to yoga there are yoga studios, free youtube videos and subscription online classes available. My favorites for virtual yoga are Yoga with Chaz, and Yogagirl. These pandemic days I’ve found a way to go in person on Sarah’s (yoga instructors) deck.
Let it go– Easier said than done, I know. When someone is anxious or stressed and you say “calm down” I think it makes them feel even more stressed. The key here is just knowing that whatever the pain/frustration is just know it will pass. Everything is temporary, so if you are in the current moment of feeling pain, anger, sadness, or overwhelmed just feel it and don’t try to avoid it. But do know it will be over and then you can let it go. This reminds me of a cute acronym I heard in yoga class the other day: H.O.P.E- Hold On Pain Ends.

Disclaimer:

No content on this site, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

DIY Bentonite Clay Mask Recipe for Acne

I absolutely love this natural homemade remedy for acne, especially for teens. It is super simple to make and results are very quick as well. Bentonite clay comes in powder form so you will need to mix it with a liquid to create a paste. I add a bit of essential oil for smell and that’s all! Bentonite clay is a healing remedy from ancient times and works as a detoxifying agent. It’s rich in minerals such as, magnesium, iron & calcium. The clay works particularly well for pustular acne because it absorbs and binds the oils and secretions from the skin. Apple cider vinegar is perfect to mix with it since it is anti-inflammatory. I like to use a few drops of citrus essential oil to cut the ACV smell or tea tree oil can be used which is also beneficial for acne.

Ingredients:

1 teaspoon bentonite clay
2 teaspoon apple cider vinegar
few drops of citrus or tea tree essential oil

Instructions:

Mix clay powder, apple cider vinegar and essential oil in a non-metal bowl with a non-metal spoon. (metal can take away the ion benefits of bentonite clay). Once a paste is formed spread a thin area on affected areas. Avoid eyes, nostrils and mouth. Leave on for 10-15 minutes- the mask will harden a bit and feel tight. Remove with a warm washcloth. This can be repeated weekly but check with your dermatologist provider, especially if you are using acne medications.

Hair Loss from Telogen Effluvium: 4 Reasons Why and What Can You Do?

A very common reason for hair loss is Telogen Effuvium (TE), it’s second after Androgenic Alopecia (which is genetics/age). It’s normal to lose about 100-150 hairs a day over the entire head, but if you are noticing much more than normal it could be TE. To get a correct diagnosis it’s important to visit a Dermatologist or Dermatology PA, as there are many causes that bring on hair loss & some can be more serious. This type of hair loss occurs when the body brings in lots of stress (physicially, mentally or spiritually). The hair goes into a resting (telogen) phase and stops growing. Our body doesn’t focus energy on hair growth and instead goes toward the stress.

Why: These are the common triggers.

Medications/Hormones: There are several medicines which can trigger T.E. Instead of listing all of them, it would be wise to look up the package insert on the medications you take. If you noticed the hair loss is about 3 months after you started the med, then it’s worth investigating.
Diet Change: A drastic diet can put the body under stress and put your hair growth into this resting phase. So, if you recently were on a major diet this can be the culprit. Think back about 3 months… did you lose a lot of weight suddenly? Protein, iron, zinc and B-vitamins are nutrients the hair requires to flourish.
Stress: A stressful event can be the trigger. Especially, a death, divorce, job loss, finance problems, illness, moving or depression. Covid-19 is an example of an illness that commonly triggers this type of hair loss. Thyroid problems can also be a cause.
Childbirth: Postpartum hair shedding is also telogen effluvium. It usually starts about 3 months after giving birth and is temporary. It’s due to estrogen levels dropping. By the baby’s 1st birthday the hair is usually back to normal.

What can you do?

Remove: When the thing that is triggering the telogen effluvium stops so will the resting phase of hair growth. If it’s a medication talk to the prescriber about stopping or switching. Sometimes it’s worth staying on the medication so always check with your provider. Also, remove applying conditioner that is super heavy to roots as this can way hair down not helping the look of hair loss.
Time: It will pass!! TE usually lasts under 6 months. Please be reassured that T.E. is totally temporary and you will not lose all your hair. If the trigger has been removed it is common for hair to start returning within 3-6 months. If it’s lasting over 6 months it’s considered chronic T.E.
Labwork/Provider: Getting bloodwork to check thyroid, iron and a basic panel to rule out other illness is a good step to find the cause. When you find the cause it’s easier to correct.
Nutrients: Getting enough protein, iron and certain supplements can support healthy hair. If you decide to take a supplement I’d recommend Anirva Hair Radiance. We also offer platelet rich plasma (PRP) treatments to stimulate hair growth. These are injections directly into the scalp.

Photo by Karolina Grabowska on Pexels.com

3 Treatments for Hyperpigmentation (Dark Spots)

When we are young freckles seem cute but with lots of sun exposure & normal aging they start to coalesce and we don’t consider them cute in our society. Hyperpigmentation is darkening of normal skin color. This can look like macules (small flat spots) or patches (larger flat spots). There are different reasons for these so it’s a good idea to get checked at a dermatology office to be sure of the diagnosis. Any spot that stands out and is different that the others, like an ugly duckling, should definitely be checked by a professional. The most common causes of hyperpigmentation are spots from the sun, hormones, or from previous inflamed areas. No treatment will work for any hyperpigmentation without proper sunblock. This means putting on a physical sunblock and reapplying every 2 hours. A wide brim hat and umbrella is also a good idea. Now lets talk treatments!

Bleaching creams: Hydroquinone 4% is a common bleaching cream that can be prescribed or sold in dermatology office. Usually it’s formulated with other ingredients like kojic acid or retinol. It should be used at night on spots for no more than 2 months. It works for lots of folks but hyperpigmentation can really be a battle especially when its from hormones (melasma). So I like to tell my patients not to give up and fight the battle with all these weapons we have. For those that can’t tolerate hydroquinone or want a more natural alternative, luckily there are other options available. Burts Bees Dark Spot Corrector is a good one which has an active ingredient Bakuchiol. Bakuchiol is from a plant & is natural alternative to retinol and this is also a great product to use in between stronger treatments. Azelaic Acid 15% can also be prescribed which can improve pigment and is gentle.
IPL: Intense Pulsed Laser treatments can do wonders for certain types of hyperpigmentation. For the “liver spots” that happen on fair skin it can be a very quick and a satisfying treatment. Sometimes they disappear in one treatment. For melasma & post inflammatory hyperpigmentation it can be a bit more resistant. But combined with the right products we can usually head in the right direction. With darker skin types extra care must be taken when using the IPL, such as lower settings & a test spot to be safe. Typically IPL treatments take 3 to 5 treatments 3 weeks apart.
Peels: A peel is when a chemical solution is applied to the skin and washed off after a certain amount of time, depending on what solution is used. I use a combo of acids including TCA (trichloroacetic acid) and Vitamin C. This causes the outer layers of skin to shed revealing clearer glowing skin. Since the outer compact dead stratum corneum (outer layer of skin) is gone, this also allows your products to penetrate and work much better. That’s why its important to combine some of these treatments for stubborn hyperpigmentation. It’s usually recommended to do a series of 3 peels one month apart.

6 Steps to Do at Home to Improve Acne

Cleanser- Keep it simple! Over-washing can dry out skin and trigger skin to produce more oil. Avoid harsh cleansers with sodium lauryl sulfates. Tap water can dry the skin out as well, as it contains chlorine. A gentle cleanser or an oil cleanser can be used no more than twice a day with a warm wash cloth. You can use one of my favorite products, Thayers Witch Hazel without alcohol to cleanse your face morning and night. The rose scent is lovely! Be sure to use with cotton rounds, not cotton balls otherwise the product absorbs too fast. To be extra kind to our planet try the re-usable cotton rounds. If you didn’t use make up or get too sweaty, sometimes the Thayers is all you need. The idea is to keep the skin barrier balanced, especially if using acne medicines, the over-washing can really make things worse. It’s all about balance and keeping the skin microbiome intact.

Moisturizer- It seems counter intuitive since a lot of people with acne have oily skin. Again we want to keep the skin barrier intact. I’d suggest an emollient at least once in the evening. Oils are very nourishing to the skin and some are non-comedogenic (non acne causing). The oils I recommend are Argan oil or Sunflower Seed oil (organic cold compress). Avoid coconut oil on acne prone areas. If you don’t like the feel of an oil, CeraVe lotion can be used or a moisturizer with CBD would make your skin very happy.

Over the counter acne treatments. Differin gel (Adapalene) .1% used to be a prescription and now it is available over the counter. It is a topical retinoid (vitamin A derivative). La Roche-Posay has a version as well called- Effaclar Adapalene Gel 0.1% Acne Treatment. A pea size amount should be used on the entire face each evening. Using too much can cause irritation. The big mistake patients make is using too much or using acne medication as spot treatments. It’s always best to prevent the pimples before they form so that is why it’s important to treat the entire face. Be consistent for at least 4 weeks before giving up on a treatment. In the morning a niacinamide/zinc formula can be helpful.

Sun protection- Protecting skin from harmful UV rays is a must. Get into the habit of using sunblock every morning. EltaMD makes sunblock that feels elegant and won’t clog pores. I always recommend physical sunblocks versus chemical ones. Look for the ingredients: zinc oxide or titanium dioxide. My favorite is EltaMD Elements, it’s great if you want a tint and your skin is on the lighter side. I wish it came out with more shades! Elta MD also makes great clear versions. A wide brim hat and sunglasses are key to use as well when outdoors. Most acne treatments can make skin more prone to sunburns so don’t forget this step.

Sleep- Try for 8 hours a night! It’s important for so many of our organs to function properly, not only the skin. Make it a priority.

Foods- Dermatologists used to say food had nothing to do with acne but that is clearly not true. The foods we eat are very important in our wellness, including skin. Try to start by reducing sugar and dairy products. Sugar is an inflammatory food and inflammation is the source of several diseases. Dairy has hormones from the cow which can contribute to acne. Focus on what foods you can eat, not what you shouldn’t eat. Try to eat more veggies and naturally colorful foods. And of course drink 8- 8oz glasses of filtered water per day.

If your acne is more severe and you aren’t getting improvement with home treatments make an appointment with a Board Certified Dermatologist or a Dermatology Physician Assistant (like myself) for a more customized plan. My office is offering telemedicine visits so you don’t even need to leave home. For those who are on prescription medicines, skip the over the counter retinoids as you don’t want to overdo your treatment.