Skin Miracle

I've always heard that you can buy great skin, but this is the closest I've come to actually doing it. I am a huge fan of DermaDoctor products because they WORK as promised and are free of fragrances and extraneous ingredients. They are quietly amazing, without a big ad campaign, but truly better than most other product lines I've tried. My latest miracle product from this line is Calm, Cool, and Corrected (the first one is Tease Zone). Calm, Cool, and Corrected is billed as a rosacea treatment (which I don't have), but is recommended for oily skin and acne if you use the DermaWizard interactive skincare advisor on the site. All the customer reviews are excellent, and I've also read about this product on Ms. Distressed Derma's blog. I'm constantly looking for something that will get rid of the stubborn breakouts that remain even after regular retinoid and AHA treatment. This is the latest product in that struggle, and the best so far.

This cream is rich and contains shea butter but is not at all greasy, and absorbs instantly with no oily or sticky feel. There's no fragrance. I found it very soothing and moisturizing on my retinoid-treated skin. After two weeks of twice-a-day use my skin looks calmer, with fewer blotchy spots and fewer small pimples. I got one major zit, about one week after I started using the product, but I'm guessing that pimple was in development under my skin before I actually started using the cream. Another month will tell whether it prevents my monthly breakout. I wanted to share it with you sooner, though, because of positive results thus far.

The catch, and why I say I'm definitely buying great skin right now - the price is $85. The tub is a good size and will likely last several months, so it doesn't seem terribly overpriced. But it's definitely, definitely the most I've ever spent on face cream. Oh well, you know what they say, buy cheap, buy twice...hopefully this will work and I won't have to buy anything else!

Warm Weather Comfort

It was really, truly warm here this weekend! I am extremely grateful not to be chilly and am looking forward to more of the sun. Warm weather requires its own set of tools for comfort and beauty.

Two of my favorite summer purse essentials are Boscia Fresh Blotting Linens and Caudalie Eau de Raisin spray. Whip out the blotting papers to minimize mid-afternoon shine, and follow with a mist of grape-extract-infused water to cool down your lovely face. Position yourself in front of a fan for a minute and zing! instant refreshment.

Even Pimples Can Be Glamorous

If you ever have breakouts, you're probably familiar with any number of "spot treatment" potions to dab on zits to make them go away faster. In my opinion these all work about the same, and none really make my zits go away as fast as I want them to, but I feel that I need to do something besides just sit and wait it out.

So after reading that lavender essential oil is a natural anti-inflammatory and anti-bacterial agent I started dabbing it on pimples. And you know what, it really does help them resolve more quickly than doing nothing. Like most pimple treatments it's much more effective on smaller zits than big ones, but it smells heavenly and soothing and makes treating pimples almost...pleasant. Or at least not bad. You float away from the bathroom mirror in a haze of lavender and feel glamorous. I know of no other pimple treatment that can do that.

My favorite essential oils are Young Living. Has anyone else tried this? Does it work for you?

All About Skin: Acne, Part II

So what to do about these skin changes that lead to acne? Let's break it down.

1. What to do about excess oil production?
A number of products handle sebum in different ways. First, mattifiers are products that control shine, but they don't all work the same! Pay attention here. Most desirable is a water-based lotion with oil-absorbing polymers such as Derma Doctor's Tease Zone. This type of mattifying lotion absorbs excess oil and lifts it away from the skin's surface, and works for a period of time (usually 8 hours or so) to keep skin looking un-shiny.

Another easy option is blotting papers. These are small squares of thin paper made of an absorbent fiber. Blot them on your face, and they absorb oil without disturbing makeup. I really like Boscia's Fresh Blotting Linens, but I also just found out that e.l.f. has blotting papers for $1 per box. I may have to try these.

Other mattifying products may contain alcohol or other astringent (drying) agents. These remove oil from the skin's surface temporarily, but don't control oil produced throughout the day. They are not recommended because wiping alcohol on your skin can cause over-drying, irritation, and can upset skin's pH balance and normal oil production.

Still other mattifying products are silicone- or dimethicone-based. According to Derma Doctor, these work by creating a barrier close to the skin's surface and trapping oil underneath. The skin stays looking matte, but trapping all that oil can lead to breakouts and other problems. This is not a good option for daily use on oily skin.

Second, topical retinoids decrease oil production, among other actions (more below). These include Retin-A, Differin, Tazorac, and over-the-counter retinol products.

Third, many other acne treatments also remove oil from the skin. Glycolic acid, salicylic acid, and benzoyl peroxide temporarily decrease surface oil (among other actions - see below), but they don't alter the underlying amount of oil produced by the skin.

Finally, birth-control pills and other hormone-altering medication (such as spironolactone, an anti-androgen) can decrease oil production by changing levels of the hormones that partly control sebum. My personal opinion (and I'm not a doctor!) is that taking hormones purely for cosmetic purposes is probably not the best thing for your body. I would try other products first to try and get oil/acne under control. Read on for more options.

2. What to do about retention hyperkeratosis (excess dead skin cells clogging pores)?
The star of this category may be the retinoids. They "normalize keratinization," meaning that they make skin cells act more like those of people without acne. Retinoids decrease the abnormalities that cause dead skin to hang on in your pores and cause blockages.

Glycolic acid, salicylic acid, and other alpha- and beta-hydroxy acids also promote cell turnover and decrease dead cells "sticking" around. Azelaic acid (prescription Azelex) may also normalize keratinization.

Many of these agents are available in multiple forms - cleansers, toners, moisturizers, treatment serums, and treatment creams. Usually you'll need to use some type of treatment that stays on your face for a while, rather than just a cleanser, in order to see results. Remember that any of these products can dry skin and make it sensitive! For that reason, start off using retinoids or alpha- and beta-hydroxy acids every other night, and do not layer them one on top of the other. You can use them at different times of day (morning and night, for example), but not at the same time.

Also sunscreen is a MUST if you use any of these products, as they increase your skin's susceptibility to sun damage.

3. What to do about bacteria?
As I mentioned in the previous article, bacteria does not cause acne. It does contribute, though. Several products are designed to kill bacteria on your skin in order to reduce blemishes. First are antibiotics. Systemic antibiotics (taken internally, in pill form) act throughout your body, including on your skin, to reduce the number of bacteria available to colonize clogged pores. Topical antibiotic creams or gels are applied to the skin and work to kill bacteria only where applied.

Antibiotics require a prescription and ongoing use. In my opinion (and again, I'm not a doctor!) systemic antibiotics are probably not the best thing for your body. We have all types of bacteria colonizing our bodies, good and bad, but antibiotics kill all of it. This can potentially lead to imbalances of beneficial bacteria and related problems.

Second is benzoyl peroxide. This is applied to your skin and is slightly different from other antibiotics. While other antibiotics contain some toxic compound that kills bacteria, benzoyl peroxide alters the environment on your skin so that P. acnes can't thrive. P. acnes is an anaerobic bacterium (lives in the absence of oxygen), and benzoyl peroxide is an oxidizing agent that makes more oxygen available. Thus it alters skin chemistry to provide more oxygen than P. acnes likes.

In my limited experience, benzoyl peroxide works well for some people and not at all for others. It's cheap and readily available over the counter, so try it for yourself and see if it works. This is the basis of the Proactiv Solutions line of products.

Third is sulfur, which works in an unknown fashion to reduce bacteria. Sulfur is a component of several prescription treatments and, again, some of the Proactiv products, and it's also available in some facial masks. It may decrease oil as well as controlling bacteria. One downside to sulfur is that it smells like, well, sulfur. Think matches or some chemistry experiments. It's not terrible, but it does linger on your skin.

Fourth, the Zeno Acne Clearing Device works by applying focused heat at a constant temperature to a blemish in its beginning stages. The heat purportedly kills bacteria and heads off the formation of the pimple. The product information says it doesn't work on cystic blemishes, and I found this to be true.

This is a fairly thorough but not exhaustive list of your options for managing acne. General rules for caring for acneic skin include:

• Wash only twice a day, or a third time if you've worked out.
• DO NOT use grainy scrubs to exfoliate. This will irritate blemishes. Instead, use an alpha- or beta-hydroxy acid product or retinoid. These exfoliate dead cells without mechanical friction.
• Start slowly and don't mix products on your skin. Pick one agent and try it for 8 weeks to see if it works. If not, try something else.
• If you have insurance or can afford it, by all means go to the dermatologist. They can really help in ways that poking around at the drugstore cannot.

Finally, for lots more information, check out Derma Doctor's Articles section. Granted, this is a website devoted to selling products, but I have found her articles to be full of non-product-related information and up-to-date on dermatological research and innovations.

Good luck with your skincare! You can manage acne; it's a matter of finding the right products for the acne contributors that are affecting your skin.

All About Skin: Acne, Part I

What is worse than pimples? Lots of things, I'm sure, but acne is so common and so unpleasant that it warrants its own article. Especially as spring and summer approach, we tend to want to wear less makeup and be outdoors more in the bright unforgiving sun, which can be embarrassing with a face full of blemishes.

So here is a synopsis of what causes acne, to the extent that we currently understand it. Information has been compiled from a variety of sources, including journal articles, the American Academy of Dermatology website, and online articles written by dermatologists. There's so much information out there about acne, and so many products claiming to treat it, that sorting things out and choosing a course of treatment can be confusing and overwhelming. This is my effort to clarify and simplify the morass.

1. How Skin Works
The basic unit of skin, for our purposes, is made up of a sebaceous gland, a vellus hair, and a duct, or pore, leading from the deeper layer of skin to the surface. The sebaceous gland produces sebum (oil) and delivers it to the skin's surface, keeping skin moisturized and potentially providing protection against invaders. Skin cells continually die, slough off, and regenerate.

2. What is Different about Acne-Prone Skin?
In general, 3 things happen differently with acne-prone skin.

First, more sebum than usual is produced. People with acne often have oily skin, and I'll explain why this is problematic in a moment. There is also some evidence that the sebum produced by acneic skin is "stickier" than normal sebum and therefore more likely to trap dead skin cells. Which leads to...

Second, the dead skin cells of people with acne do not slough off neatly, but rather remain stuck in the excess sebum near the skin's surface or deeper inside the pore. This is called "retention hyperkeratosis." This skin cell buildup creates a blockage that traps sebum in the pore. As the sebum builds up, the pore becomes enlarged and/or inflamed, and...

Third, the skin's normal bacteria grow and replicate abnormally well in the trapped sebum. Propionibacterium acnes, or P. acnes, is the name of this bacteria, and it grows well in anaerobic conditions (environments with little oxygen). The inside of a clogged pore is the perfect breeding ground, so the P. acnes goes wild. Interestingly, P. acnes is not the cause of acne on it's own, but rather a normal bacterium that lives in/on everyone's skin. The overgrowth of this bacteria is the problem, not the presence of the bacteria itself.

This proliferation of bacteria incites an immune response, which leads to inflammation of the clogged pore as the immune cells try to kill the bacteria. This inflammation leads to the redness and swelling often associated with blemishes. Significant inflammation can also result in scar tissue, leaving a lasting mark after the blemish has healed.

3. What Causes the Differences in Acneic Skin's Behavior?
This part is not terribly well-understood. A variety of factors have been identified as contributing to the changes:

First is hormones. Sebum production seems to be influenced most heavily by androgen hormones such as testosterone. Both men and women produce testosterone, which is metabolized in the skin to a more active form of the hormone. This metabolite stimulates oil production and hair growth.

Among adult women with acne, testosterone can play a role if:

(a) Testosterone levels are abnormally high due to an adrenal tumor (rare!) or imbalances of the reproductive system such as polycystic ovarian syndrome (PCOS). These instances are pretty rare and are typically associated with additional symptoms besides acne;

(b) Testosterone levels are normal but a decrease in estrogen allows more expression of testosterone's effects. Estrogen levels decline as we age. This is most often mentioned in the context of menopause, but I believe that estrogen levels decrease gradually throughout adulthood, so it may be that you have more facial hair/acne at 30 than you did at 20. Every woman is different.

(c) Or finally, most commonly, testosterone levels are normal but your skin is very sensitive to the effects of testosterone.

Progesterone can also play a role in acne, especially premenstrual breakouts, by causing the skin to swell slightly and therefore making pores more susceptible to blockage.

There's probably much more to the hormonal aspect of adult acne than we currently know. It is possible that hormones also contribute to the skin's inflammatory response or other aspects of the acne process. Further research will be needed to clarify this area.

A second contributor may be diet, after all. For years, dermatologists vehemently debunked the idea, popular in the 1970's, that junk food promoted acne. Now a recent study from Colorado State University has brought us back around to considering the role of diet in acne. Study results suggested that some people eating a high-glycemic-index (GI) diet are more prone to suffer from acne than those eating a low-GI diet. Basically, glycemic index refers to how rapidly a food is converted into glucose ("blood sugar;" the cells' basic unit of energy) in the body.

Refined carbohydrates like sugar, corn syrup, most flours, chips, pretzels, and refined grains of all types tend to have high glycemic indices, and are converted very rapidly to glucose. This rapid surge of glucose in the blood prompts the release of insulin, responsible for storing away the extra glucose in muscle or fat tissue. Chronic or impaired insulin reactivity is associated with androgen (testosterone) activity in women, though the nature of the relationship is not completely understood. In any case, it appears that eating a diet high in refined carbohydrates may contribute to acne. This is highly plausible, when you consider that acne is very rare among people eating traditional diets, but very high among those of us in the West eating highly refined diets. Food for thought.

A third contributor may be genes. The amount of sebum your skin produces, your body's inflammatory response, and your hormonal levels may all be influenced by your genetic inheritance, though your immediate family may not actually suffer from acne. In my family, for example, many people have related skin ailments such as eczema or skin allergies, and these may be related to my acne by an underlying genetic predisposition. Who knows. Remember, though, genes are not destiny. How you care for yourself and your skin can make a big difference.

Next time: Addressing the Contributors to Acne

Happy skin

This is personal, but I suppose one must be in a beauty blog. So here goes - I wax. Rather, I have someone else wax me, since other people are typically better at it and less sqeamish about ripping my hair out. The upside of waxing is smooth, lovely, hairless skin. The downside for me has always been post-waxing irritation - redness, breakouts, and the risk of looking worse afterward than before.

Last time I had my upper lip waxed (there, I admitted it!) the aesthetician used this serum by Yon-Ka called Juvenil. It's a light, fresh-smelling, deeply soothing substance made with calendula and other anti-inflammatory botanicals. The miracle of this product is that I had NO irritation an hour after waxing - no redness, no breakout, nothing. This is HIGHLY unusual for my skin and has never happened before. I'm seriously considering plunking down the $40 it costs and using it on my face (it's also made for preventing blemishes).

The fabulous aesthetician who did such a great job and turned me on to this product was Barbara at The Pearl Day Spa. I will definitely be going back.

Stunning and amazing

So, I have oily skin. At the end of the day I pretty much look like someone smeared Vaseline on my face. Except now I don't, because of this amazing mattifier, Tease Zone. This has been my first foray into mattifying products, but I did some research online and this got great reviews. It is a light, fragrance-free gel that doesn't dry skin but rather absorbs excess oil throughout the day. You can't tell you have it on, but it works from at least 9 to 5 so you end the day looking fresh. Highly recommended! I can't say enough good things about what this has done for the appearance of my skin.

The Good Skin Diaries: Volume I

I dream of having good skin - clear, glowing, happy, blemish-free skin. The reality, though, is that my skin is prone to oiliness, major breakouts, hyperpigmentation, and generally looking sort of rough and angry. I don't like that, so I keep trying to change it.

When I decided to "get serious" about clearing up my skin a couple of years ago - prior to that I'd experimented with various over-the-counter products and herbal supplements, to no avail - I went to the dermatologist and got a prescription for Differin. It's a retinoid (a vitamin A derivative) like Retin-A, but milder.

The decidedly unglamorous green-and-blue tube of stuff did actually help quite a bit, reducing frequency and duration of major pimples. Unlike some people, I haven't had irritation or excess sensitivity as a result of using it, but I am RELIGIOUS about sunscreen application (and hats, in the summertime), as it increases skin's susceptibility to sun damage. I've used it for about 2-3 years now and it's a must-have for keeping my skin somewhat clear.