Tips & Wisdom
Acne Treatment with Topical Retinoids
Bleach Baths for Atopic Dermatitis
The Acne Diet Connection
Adults Acne Treatment
Treatment of Basal Cell Skin Cancer
Wrinkle Treatment Options
Topical Retinoids (vitamin A related creams) play an integral role in the treatment and also prevention of acne. The most well known retinoid is Retin A®, now available as a generic. Many other brands are available, all of them by prescription. These include Differin®, Epiduo®, Tazorac®, Ziana® (which combines a retinoid with a topical antibiotic), Tretin-X®, and a few others.
The over the counter retinol is much weaker than prescription retinoids, because the retinol must get absorbed into the skin and then be converted into the retinoid. The skin will convert only a small amount into the active ingredient.
The basic lesion of acne is the microcomedone, which essentially means a blockage in the pore. This causes a back up of skin cells and oil. Bacteria in the pore feed on this oil and then a pimple results. Retinoids are the most effective way to eliminate these microcomedones, thus allowing the pores to eliminate the dead skin cells and oil. Once you have taken care of these, you have basically handled the acne.
Almost all acne patients will benefit from a topical retinoid. As many of the doctors have already expressed, the process of unblocking these pores takes time and patience, often months. However some results are seen almost immediately, they just continue to improve over time. Retinoids can also be irritating, causing the skin to dry out or peel, especially if not used correctly. Only a small amount is needed, about the size of a Tic Tac or two, depending on the size of the face.
There are different strengths of retinoids, so it is best to start on the weaker end and let your skin adjust to that, and then build up to as strong a level as the skin can tolerate.
There is a myth that you cannot be in the sun if you use a retinoid. This is false, and you can be in the sun, but it is always a good idea to use some sunscreen, especially if you are out a long time. Studies showed that even though the skin got redder in those people using retinoids, there was actually less damage to the cell's DNA and the skin healed more rapidly. Retinoids have an added benefit of helping the body rid itself of damaged and precancerous cells, in addition to the famed anti-wrinkle benefits.Learn More
I do not recommend bleach baths for atopic dermatitis. The rationale for bleach baths (very dilute bleach in the bathtub) is that the bleach helps to kill the bacteria on the skin. This does seem to work, but I believe it is toxic. Atopic dermatitis (eczema) can get very itchy, and due to scratching, the skin can get secondarily infected with bacteria. This infection tends to flare the rash and make it worse.
I prefer to have patients sprinkle 5-10 drops of pure essential lavender oil in the bath, instead of the bleach. This is a natural antibacterial and antifungal compound, and it also smells much better than bleach. For those individuals who prefer to shower, they may take a damp wash cloth or tissue, sprinkle about 5-10 drops of lavender oil on it, and pat the skin all over after showering. You may also sprinkle some drops of lavender oil onto the sheets before bedtime. Lavender is reported to help relax the body for sleep.Learn More
Most of us can relate to acne—who hasn’t had it to some degree. However, unlike many of us who outgrow it in our teens, about fifty percent of individuals with acne still suffer well into adulthood and sometimes even in our older years. While many treatments—ranging from cleansers to creams to pills—help clear our skin, some individuals do not adequately respond to therapy.
We know that with acne, the skin cells become stickier and block the pores, excessive oil is produced in those pores, bacteria feed on the oil and the bacteria then multiply. This results in inflammation surrounding the pores, seen as redness, swelling, tenderness and pus.We have observed that in a number of populations who eat a diet free of refined grains, sugars, and other processed foods, there is virtually no acne! When those same people move to an industrialized city and adopt a more “civilized” diet, they now become subject to acne.
Here’s what happens.
A diet high in refined, processed foods, such as breads, cereals, pastas, candy, etc, creates an environment in our bodies that causes a cascade of adverse effects on our hormonal system. These types of foods stimulate a surge in our blood sugar level (a high glycemic index*). To compensate, our pancreas pours out insulin to “neutralize” the sugar. The elevated insulin triggers our body to secrete androgens (male hormones), which are known to activate the oil producing glands in the skin. In addition, these high insulin levels trigger more inflammation in our skin as well as stimulate production of IGF-1 (insulin-like growth factor 1). This causes excess production of skin cells with further blockage of the pores, and also plays a role in aging, diabetes and cancer.
Cutting out these refined and processed foods will go a long way in keeping you blemish free. For further improvement, we recommend avoiding artificial sweeteners (Xylitol or Stevia are ok) refined vegetable oils (they also produce inflammation) and dairy products (they add to imbalances in the hormone system). Finally, supplementing with omega-3 fish oils helps to calm the inflammation. As an added benefit, this type of diet will help you to control obesity, diabetes, heart disease and high cholesterol!
* Glycemic index is ranking system assigned to foods based on their effect on blood sugar (glucose). Carbohydrates that break down rapidly and cause a rapid increase in blood sugar have a high glycemic index. Carbohydrates that break down slowly, releasing glucose gradually into the blood stream, have a low glycemic index. A lower glycemic response equates to a lower insulin demand, better long-term blood glucose control and a reduction in blood lipids.Learn More
While it is true that acne most commonly appears during the teenage years, it is just as true that a large percentage of individuals suffer from adult acne. In fact, figures show that as much as 25 percent of men and 50 percent of women in their twenties up to their fifties still experience pimple flare-ups. Adult acne can have just as much negative psychological effects as adolescent acne — perhaps even more so. The stress of having a career or raising a family is bad enough. Having to deal with an unsightly skin problem at the same time would be even worse.
Adult acne can be caused by several things, one of which is mental stress. The body can react to stress by increasing the secretions of the skin’s sebaceous glands or by releasing more hormones from the adrenal glands. Oils from the sebaceous glands can block pores, while a greater amount of hormones in the body can cause hormonal imbalance — both of which can give rise to acne flare-ups or exacerbate an existing acne condition.
It is not surprising that women suffer from adult acne more than men do, since women are more prone to hormonal imbalance. It is known that changes in hormone levels can occur during menstruation and pregnancy. But men, too, are subject to hormonal changes, though not to the extreme level that most women undergo. In any case, hormones play a great role in the occurrence of acne in adults.
Lifestyle and environmental factors also contribute significantly to the emergence of adult acne. A diet that is poor in the necessary vitamins and minerals can wreak havoc on how the body’s organs functions. The skin, being the largest organ in the body, needs nutrients in order to work effectively. If the skin is unable to metabolize or secrete the waste products that it needs to because of poor nutrition, acne can result. Habits such as smoking and drinking can also affect the skin’s condition and its resistance to diseases like adult acne.
What is the best way to deal with adult acne? Like many other ailments, prevention is the key. Make sure that a proper diet is being followed; get enough rest; try to find ways to alleviate stress; maintain proper hygiene to prevent dust from accumulating and blocking the pores. Washing the face once or twice a day and using hypoallergenic or noncomedogenic cosmetics and other personal care products can go a long way towards preventing adult acne.
Treatment options abound for persons with adult acne, however mild or severe their condition may be. Dermatologists may recommend anti-acne medications to be taken in conjunction with other skin care products. More severe cases — such as those involving infection — can be treated with antibiotics to prevent complications. Very severe cases of adult acne have several therapeutic regimes, such as microdermabrasion and laser surgery. A person suffering from adult acne, whatever the level of severity should consult a dermatologist or other qualified professionals to get the treatment option that is the most suitable for him or her.Learn More
The most common methods for removing basal cell carcinoma (BCCs) are surgical excision (cutting it out) and curettage and desiccation (C&D) (scraping and burning).
Larger skin cancers and difficult to treat areas, such as the nose and other areas of the face, would be the likeliest candidates for Mohs Surgery
The major advance in treating BCCs is the use of topical immune system booster, imiquimod for skin cancer.
I have had very good success with many skin cancers using this Zyclar (imiquimod) cream. The advantage is that surgery is avoided, including surgical scars. The disadvantage is that the cream does create a strong immune reaction, which means the area typically gets very red and scabby for a couple of months.
Ultimately, each patient should discuss with his or her doctor which treatment option is best for the type of skin cancer, the size and the location.Learn More
Who doesn’t love a baby’s skin – so soft, smooth and perfect. But as we grow, our skin loses that perfection of youth and reflects our life experiences. Wrinkles, age spots and saggy skin can be signs of wisdom and experience, but they can also make us look older than we care to appear. The good news is that today we have more and more non-surgical alternatives that help us to look - and feel - younger. Additionally, non-surgical procedures have minimal recovery times, and can provide instant results!
Dermatologists offer many non-surgical approaches to restoring or maintaining beautiful and youthful skin, including:
Injectables for Wrinkles (Botulinum Toxin and Dermal Fillers)
There are two types of injectables: relaxers and fillers.
Relaxers, such as Botox®, relax the muscles so that the skin that lies over them becomes smoother. It can take from a few days to two weeks for the full effects of a Botox® treatment to be seen, but the results last up to four months. Patients using Botox® report looking up to five years younger and less stressed.
Fillers, such as Juvederm®, Restylane®, Radiesse®, Perlane® and Collagen replace lost volume by plumping up wrinkles and firming sagging spots. Local or topical anesthetic creams minimize any discomfort involved. Bruising and swelling are temporary side effects, so fillers should not be used for several days before important events. However, the results can last up to six months, and fillers can unwrinkle deeper lines than Botox® can reach, as well as work in areas that are not a candidate for Botox®.
Lasers for Wrinkles
Non-ablative lasers are intense, focused beams of light that lessen signs of aging like brown spots, acne scars and wrinkles. They can also help remove unwanted hair. And unlike ablative laser treatments, which are more aggressive and can cause superficial burning, non-ablative lasers are less invasive and conduct heat to deeper dermis stimulating collagen synthesis.
Examples of non-ablative lasers include: IPL, Fotofacials, Trinity and ReFirme. The abalative lasers, such as Active FX/Deep FX will affect deeper lasers of the skin, and thus provide even better results with the fine lines and wrinkling.
Chemical Peels for Wrinkles
There are many different types of peels, and results depend on both the ingredients and how long the peel is left on the skin. Chemical peels can enhance your appearance by reducing blotchy and uneven pigmentation, fine lines and renewing sun-damaged cells. Many offices offer antioxidant brightening and lightening peels, which boost the skin using vitamins C & E, Green Tea Extract and other ingredients to fade stubborn dark patches and restore your skin’s natural smoothness.
Chemical peels take 20 minutes and are done once a month until the desired results are obtained. Other types of peels include Green Peel (a 5-day deep herbal peel), Vi Peel, Mesoclat, Fruit Peels and Glycolic Acid Peels .Learn More
Lisa Benest, MD, is a Board-Certified Dermatologist providing care to patients in the Burbank, CA area at Advanced Dermatology Center.
Dr. Benest has been in private practice for over 15 years, specializing in general and cosmetic dermatology, as well as skin cancer surgery.
Dr. Benest received her medical degree at UC Irvine and completed her residency at New York Medical College, where she served as Cheif Resident.
Education & Training
- Residency: New York Medical College
- Internship: VA Medical Center
- Medical School: University of California Irvine School of Medicine
Lisa Benest M.D.
1624 W. Olive, Suite B,
Burbank, California, 91506