The do’s and don’ts of acne part 3

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Taking Care of Your Skin

Different people and different skin types need to do different things for their skin. We have an old expression in dermatology that still rings true: “If it’s dry, wet it; if it’s wet, dry it.” In recent decades, another truism has been added: “If it’s fair, shield it; if it’s dark, you’re probably very fortunate.” That’s because your melanin protects you from skin cancers, wrinkling, and keeps you looking young. If your skin is fair, if you burn easily, or if you have a personal or family history of skin cancer, you should protect yourself from the sun by wearing hats and caps, using sunscreens, and avoiding going to tanning booths. If your skin is dark, you may have other

reasons to protect it from the sun (I will talk about the dark spots that occur in dark skin  later on). People with dark complexioned or Asian skin may have other reasons to be very sensitive and prone to irritation and possibly less tolerant of many of the topical medications that are used to treat acne. The ultimate operating instruction: Whether you have dry, regular, or oily skin, a big acne breakout or smooth sailing on the pimple front, there’s something that’ll keep your face looking its best and most attractive to the rest of the world and is guaranteed to help you make friends and influence people. I suggest that you simply exercise your muscles of facial expression — smile!

Washing your face

Rocket science? Maybe not. But as a dermatologist, I have a few reasons for walking you through a little face-washing tutorial. First,I often begin my instructions for applying medications in later chapters with phrases like “Wash your skin . . .” or “To a clean, dry face, apply . . .” so, it seemed to make sense that I fill you in on thedetails. The second reason for this bit of Face Washing 101 is even simpler — many people screw it up. But don’t worry: I’m here to help. And, if you’re like many folks, my face-washing routine can simplify your mornings and evenings and save you some cash. These days, society as a whole is really into soap — the cleaner the

better! As little kids, we’re told to scrub, scrub, scrub with plenty of soap and water. As teenagers, we use more soap — to fight acne and oily skin. As adults, we tend to follow the same routines even though our skin has changed. And the range of different types of soaps available is mind boggling — super-fatted, deodorant, rejuvenating, oatmeal, avocado, citrus, aloe vera, sandalwood, wintergreen, peppermint, patchouli, and vitamin E to name a few. Many types of cleansers are also available. Some exfoliate as they clean, and the medicated ones generally contain benzoyl peroxide or salicylic acid in various concentrations. Over cleansing with these products can be irritating. More often than not, these items will only dry out and irritate your skin, particularly if you’re already applying a topical anti-acne medication  (see later) Washing excessively — more than twice a day — with any soap (regular soaps, acne soaps, antibacterial soaps, soaps with abrasives, or even gentle soaps) has little positive impact on your acne. In fact, if you have acne, your skin may be red and inflamed, and frequent washing only makes it redder. Washing your face with a mild soap just twice a day is the best tactic, regardless of your skin type or acne activity. I recommend the following

soaps and cleansers, depending on your skin type. These tried and- true recommendations may not sound as exciting as a Provencal honey-lavender soap with grape seeds, but they flat out work:

Oily skin: Ivory soap

Dry skin: Dove soap

Extra-sensitive skin or allergic reaction to soaps: Non soap cleanser such as Cetaphil, Aquanil, or Neutrogena Extra Gentle Cleanser At the risk of sounding like a parent — with the whole “wash behind your ears” thing — now that you have your soap, here’s how to use it:

1. Get the soap wet, using lukewarm water.

2. Using your fingertips or a soft washcloth, apply the soap to your skin and rub it gently into your skin using a circular motion. Don’t use loofa sponges, brushes, or sandpaperplease.

3. Splash your face with lukewarm water until the soap is completely gone. Expect to rinse your face for just a fewseconds — perhaps as long as it would take to sing “HappyBirthday.”

4. Pat — don’t rub — your skin until it’s dry. Use a soft cotton towel. And that is it!

Dealing with dry skin

If you have overly dry skin (known as xerosis in the medical world), it’s probably more of a problem for you when the weather is cold and the humidity is low. This occurs most often in the winter months in northern climates. In Western societies, our modern lifestyles also emphasize over bathing, which only serves to worsen the dryness.

On top of that, we often live and work in overheated spaces. If your skin is dry, keep it moist by using only mild soaps or soap substitutes as I recommend in the preceding section. You could also consider moving to a more humid climate — think rain forest. If you’re already using a mild soap (and assuming a move to the Amazon is out of the question), apply moisturizers regularly, particularly when your skin is still damp ( see the giving your skin a drink paragraph at the bottom of this page) Finding the right moisturiser for your skin may involve trial and error. Look for those that are labelled as non comedogenic. I happen to recommend Oil of Olay, but many other excellent products are available. Go ahead and use a moisturizer that contains a sunscreen if you think you need one. You can also use room humidifiers to help hydrate your skin. If you have acne and dry skin, you probably know that acne treatments can make your dry skin worse. Using moisturizers over your topical acne medicine can make these symptoms more tolerable. If you wear makeup, you can apply it over the moisturizer.

Some common recommendations for dry skin are of questionable or no value, including the following:

Ingesting copious amounts of water

Taking lots of vitamins

Coping with an oil glut

If you have excessively oily skin, that’s due to your sebaceous glands producing more sebum than you’d like them to. This is often the case if you also happen to have acne. But for now, here are some tips on caring for your oily skin:

Be happy that you’ll save a few bucks on not buying moisturisers.

Be happier because your skin will tend to stay more wrinkle free and younger looking!

Be even happier because your skin will tend to be less sensitive! But you probably want some more concrete tips, so here you go:

Even though your skin’s oily, don’t irritate it. Washing your face twice a day should be enough. I realize that you may have been told to wash 77 times a day with strong abrasive soaps, but that will only irritate your skin and make it redder — and if you have acne, all that scrubbing will only make it look worse! For advice on exactly how to wash your skin, checkout “How to wash your face.” above

If parts of your face feel oily during the day, the oil can be wiped away with a mild alcohol-and-water astringent such as Neutrogena Clear Pore Oil-Controlling Astringent, NoxzemaTriple Clean Astringent, or Clean & Clear Advanced Acne Pads.

Giving your skin a drink!

The next time you take a long bath or stay in a swimming pool for a long time, notice how soggy and rippled the skin on your palms and soles looks after a while. That’s because they’ve been immersed in water for a long period and your waterproof protective layer of sebum (the oily stuff that plays a large role in acne)got washed away, so water can now get readily absorbed into the outer layer of your epidermis. The rippling or wrinkled appearance develops because your skin has increased its surface area to accommodate all the water it absorbed during that time. It’s water logged !The “wrinkling” is so obvious on your palms and soles because they have the thickest stratum corneum. If you watch your hand for 5 minutes or so, you’ll see that the corrugated look disappears. That’s because the water soon evaporates from your overhydrated stratum corneum. Now, if you apply a moisturizer before the water evaporates, you can “lock in” the water that was absorbed while you were bathing or showering. Moisturizers don’t add water to the skin; instead, they reduce water loss by slowing its evaporation. Your take home message: If you have dry skin, apply a moisturizer while your skin is still damp.

Part 2

Part 4

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