Right about now that New Year’s Resolution enthusiasm might start falling off.  I’m noticing, for example, that it’s getting easier to find a parking spot at my gym.  My own resolution (to use my power exam tables to always move a patient into a good position for my back before I begin a procedure) didn’t get done 100% of the time yesterday. My nurse gave me a gentle reminder and it helped.  We know what’s good for us, let’s stick it out.  We need to support each other, and I’m hoping this post helps to support you.  I care, and if improving your diet was your 2012 New Years Resolution, hang in there, your skin will reward you.

‘You are what you eat’ and now, more than ever, there’s mounting medical evidence that this is true for your skin.  You probably have at least one skin problem that you’d love to fix – include diet in your treatment plan.  Really???  YES!

We know:

• Acne improves on a fruit & veggie rich diet low on junk, sugars, meats & dairy,
• Psoriasis in now linked to the same diet risk factors as heart disease and diabetes,
• Beauty is rated more highly when a person has beta carotene rich skin (which comes from eating orange and green leafy veggies),
• UV skin damage is lessened when skin is loaded w/ dietary antioxidants,
• Non-melanoma skin cancers thrive when you eat a high fat diet,
  

Dermatologist’s Diet Advice For Healthy Skin

Eat organic and fresh because nutrients start breaking down the minute food is harvested.  Organically grown foods have more to begin with (they ‘are what they eat’ too).  Click here to read Diet Recommendations for Healthy Skin

Eat lots of beta carotene foods because they make you beautiful (and healthy).  My absolute favorite nutritional ingredient for beauty is beta carotene because it functions like a self-tanner, giving your skin a beautiful golden glow.  I always eat a healthy dose of carrots, winter squash or dark green veggies to keep my pale skin naturally ‘bronzed’. Believe it or not it works!  Click here to read Skip The Tan And Eat Your Veggies For Beautiful Skin Color

Eat lots of omega 3 rich foods because they rock for fighting inflammation.  Inflammation is the instigator of all sorts of mischief from psoriasis and acne to heart disease and strokes.  The modern western diet is low in omega 3 and high in it’s evil counterpart Omega 6.  Tip the balance in your body and see how different you look and feel.  Click here to read Age Beautifully, Fight Cancer and Prevent Heart Disease By Adding Flax Seeds To Your Diet

Eat your vitamin D.  Don’t damage your skin with sun exposure in pursuit of this important vitamin.  This is the one vitamin I actually take in capsule form.  Click here to read Are You really Getting Vitamin D From The Sun Or Just Nuking Your DNA?

Eat a diet that has more veggies than anything else to reduce inflammation (including skin inflammation like rosacea, acne, eczema, psoriasis).  We diet geeks believe that a plant based diet loads your body with vital, bioavailable nutrients in exactly the form that your human body is designed to use.  No multivitamin pill can compare!  Click here to read The Alkaline Mediterranean Diet, A Magic Wand For Overall Health And Beauty

Eat naturally fermented, probiotic rich foods every day to keep your digestive track healthy.  I suspect that this little secret is one of the biggest under-appreciated necessities for physical health.  Your digestive track helps you absorb the right nutrients and excrete any harmful toxins in your food (like mercury).  My favorite probiotic food is naturally fermented kefir because it’s loaded with beneficial probiotics. Click here to read Kefir, The Best Probiotic For Healthy Skin.

Eat less refined carbs, dairy and junk food to prevent acne. Yes, we dermatologists finally have diet advice for you if you suffer from acne.  Click here for 4 Diet Changes That Can Help You Improve Your Acne, Dermatologist’s Advice

Eat foods rich in natural spices! Yes, I’ve never posted on the subject of spices and health, but the scientific evidence is mounting. Spices are starting to join the ranks of healthy diet super heroes.  Some of the best are turmeric and cinnamon.  I try to cook with turmeric every week and I add cinnamon to my morning cup of green tea matcha.  I promise to post on spices later this year.

So, let’s stick it out with our New Year’s Resolutions.  We know what’s good for us.  I’ll use my power tables and demonstrate excellent ‘self care’ at work.  If diet was your resolution, hang in there.  You’ll like the results on your skin, I promise you!

Photo: Thanks and Gratitude to TheBittenWord

The Best Diet for Healthy Skin In 2012 is a post from: Dr. Bailey's Skin Care Blog

In the lab we see big differences between dry skin and hydrated skin in both the composition of the chemistry of the skin layers and the way they look structurally when examine under a microscope.  The structural and chemical characteristics of dry skin translates to skin that’s also more vulnerable.

We call this vulnerability of dry skin an impaired barrier function.  For you, dry skin means that:

• your body’s water, which is normally present in your skin, is escaping more easily (called transepidermal water loss).
• soaps and solvents are better able to penetrate deeply into your skin and pull out your natural skin oils.

You can see why the problem compounds, getting worse and worse, and you’ve undoubtedly experienced it.  The most common example is chapped hands.  Once your hands are chapped they get worse and worse every time you take them outside into harsh weather or do the dishes without gloves again.  Your skin becomes rougher, dryer, itchier, starts to crack, hurts, becomes rougher and dryer etc…

What’s happening is that your impaired barrier can’t stand up to the usual insults of weather and soaps.  Harsh weather ‘pulls’ water out of your skin into the dehumidified wind.  Soaps seep into chapped skin  ‘cleaning-out’ more of your skin’s natural oils.  Unless you intervene, your skin gets drier and drier and its barrier weaker and weaker.

The intervention is actually simple – stop exposing the skin to situations that decrease its water and oil content, and instead do something to increase these important components of healthy skin.

Dermatologist’s advice to heal dry skin:

1.  For starters, wear gloves, clothing or facial mufflers to protect skin from harsh weather so that water isn’t ‘pulled’ out so rapidly.

2.  Increase the relative humidity of the air that you expose your skin to by adding an indoor humidifier. (Or, hello Hawaii!).

3.  Minimize the exposure of your skin to harsh solvents and soaps that ‘clean out’ the oils you need for a healthy skin barrier.  This means wearing protective gloves when you must come into contact with these things, such as when doing the dishes.

4. Use only gentle cleansers when you wash your skin because skin cleansing also ‘cleans out’ your natural skin oils.  Have only gentle cleansers handy at your sinks and in the shower.  Rinse them off well too because soap residue can irritate skin and even gentle soaps will pull oils out of your skin given hours of opportunity.

For chapped dry skin care I recommend only skin cleansers with a high glycerin content and no sodium laurel sulfate foaming agents.  Safe options include pure glycerin bar soaps and naturally made bar soaps that retain their natural glycerin.  Whole Foods 365 brand glycerin bar soap is a deal at about $2 and is a great all-purpose skin cleanser.  Other commercially available liquid cleansers that meet this criteria include Toleriane Cleanser, which is my ‘go-to’ cleanser for cleansing dry sensitive facial skin.

5.  Apply a high quality skin moisturizer that’s rich in oil immediately after washing or bathing skin.  This will add oil back and help to trap water. Water enters your skin during water exposure and oils prevent its evaporation by sealing it in.  The oils will also seep into your skin to replace your lost natural oils. Find a product you like and use it as often as possible.

Most commercial moisturizers have petrolatum or mineral oil as their therapeutic oil ingredients and many scientific studies over the years have proven the effectiveness of these oils for repairing skin barrier impairment.  There are also products with natural oils that work beautifully too such as almond oil, shea butter, olive oil, jojoba oil etc.  Other moisturizing oil ingredients that can be helpful are ceramides which more closely resemble your skin’s natural oils and are important for healthy skin barrier.

Moisturizers that also contain humectants (water binders) are even more effective than those based solely on their oil content.  Look for humectant ingredients such as

• urea,
• the alpha hydroxy acids called lactic acid and glycolic acid,
• glycerin
• hyaluronic acid.

These humectants boost skin water content by binding water in the skin, thus preventing it’s loss.  Urea and alpha hydroxy acids however can irritate severely chapped skin and you need to heal your chapped skin before you start using them.

It’s possible to find products that specifically heal and protect dry, chapped, barrier impaired skin and that are not heavy or oily.  For example, my favorite humectant containing hand moisturizer is Intensive Hand Cream with glycerin, dimethicone (a skin protecting ingredient added to prevent water loss and protect an impaired barrier) and the palm oil emollient isopropyl palmitate.  It’s a cleaver, non-greasy formulation that protects and hydrates hand skin.  I keep it in my lab coat pocket and I apply it numerous times a day to prevent dry skin from washing. 

The bottom line is that to treat and prevent dry skin you need to protect it from water robbing circumstances.  You also need to moisturize it after bathing or washing to help recreate the water and oil content of healthy skin.

References:

Lodén M.”Role of topical emollients and moisturizers in the treatment of dry skin barrier disordersm” Am J Clin Dermatol. 2003;4(11):771-88.

Imokawa G. Stratum corneum lipids serve as a bound-water modulator. J Invest Dermatol. 1991 Jun;96(6):845-51.

Cho HJ. “Quantitative study of stratum corneum ceramides contents in patients with sensitive skin.” J Dermatol. 2011 Oct 31. [Epub ahead of print]

Photo: Thanks and gratitude to Hanaan Rosenthal

Dermatologist Explains What Causes Dry Skin? is a post from: Dr. Bailey's Skin Care Blog

How do they get so beautiful?

What are their tricks?

When you look in the mirror after you’ve done your hair and makeup, why don’t you look like them? Do you feel a little pang of disappointment and inadequacy?

You look different than the models and celebrities who are constantly photographed flaunting their otherworldly beauty? Does a brief excuse run through your mind?  Is it because you’re getting older, they have access to all the best tricks, you always had skin problems, weight problems or a facial shape that just wasn’t perfect.  Is that why you can’t ever seem to look like them?

But wait, do you wonder where these gorgeous people are?  Why isn’t there at least one in your town from time to time?   They have to grow up somewhere.  Don’t the ones in pictures go to the grocery store, yoga class, drive cars?  How many have you personally seen in the last 10 years?

Here’s the secret. This really beautiful woman is on billboards.  She’s one of the modern icons of beauty that we all measure ourselves against.  In this brief video she shows you how she does it. Watch it and learn how you too can be a flawless, model-gorgeous beauty for the camera.

How To Look Like a Model is a post from: Dr. Bailey's Skin Care Blog

I am 42 with quite good skin and not a big problem yet with wrinkles.  I do suffer from tight feeling skin and lumpy skin with blackheads.  My skin mainly looks very dull and uneven.  My skin is quite tolerant.

I’m confused what products would be best.

I am ordering some of your body care products but would love to know what skincare products would be suited for me to order.

Many thanks for your help.

Kind regards
Helen W

Hello Helen,

One of my favorite places to start with skin care that brightens skin and decreases blackheads is glycolic acid.  It also helps to even skin color and reduce wrinkles, which are otherwise part of everyone’s future as our skin ages.

The simplest way to add glycolic acid to your skin care is to use one of my Glycolic Acid Anti-Aging Kits such as this one for ‘normal’ skin.   I have different kits based on skin type (normal and combination, oily or dry).  These kits come with the Buf Puf Facial Sponge that gives an instantly brighter exfoliated look to skin.  Patients love this product combo.

Glycolic Acid Anti-Aging Kit For Normal Skin

Remember, it’s also important to use a mineral sunscreen every day to help prevent darkening of uneven hyperpigmentation and worsening of wrinkles.  My favorite mineral zinc oxide sunscreen is Citrix, which I’ve personally worn every day for years.

The product sequence of this regimen is:
Morning:

1. Cleanse with Glytone Mild Gel Wash and the Buf Puf Facial Sponge
2. Apply Citrix Sunscreen

Evening:

1. Cleanse with Glytone Mild Gel Wash with or without the Buf Puf
2. Apply the Glycolix Elite 15% Face Cream with glycolic acid

Eventually, as skin adjusts to the glycolic acid, it’s often possible to apply the Glycolix 15% Face Cream under the Citrix Sunscreen during the day too.  It takes at least few weeks for skin to adjust and be ready for twice daily glycolic acid so I typically start patients once a day.

For the ultimate state-of-the-art skin care regimen though it’s possible to use the Glycolic Acid Anti Aging Kit and an Antioxidant Kit. This gives all the benefits of antioxidant skin care (reduces inflammation and potential free radical skin damage, reduces wrinkles by acting on at the cellular level in your skin and further evens skin color), includes the Citrix Sunscreen mineral sun protection, plus you’re getting the skin brightening and blackhead reduction that comes from the glycolic acid products.

For example, a person with normal skin would use the Glycolic Acid Kit for Normal Skin that I mentioned above, and an Anti-Aging Antioxidant Kit

Anti-Aging Antioxidant Kit

The product sequence of this regimen is:
Morning:

1. Cleanse with Glytone Mild Gel Wash and the Buf Puf Sponge.  Twice a week use the Replenix Scrub in place of the Glytone Gel Wash
2. Apply Replenix CF Cream
3. Apply CRS
4. Apply Citrix Sunscreen

Evening:

1. Wash with Glytone Mild Gel Wash without the Buf Puf sponge
2. Apply Replenix CF Cream
3. Apply Glycolix Elite 15% Facial Cream with glycolic acid

With this regimen, the Glycolix is not added during the day because the CRS is applied instead.

The final option to this regimen is to add a moisturizer during the day if you find that there are parts of your skin need even a little more ‘thirst quenching’.  For blackhead prone skin I like Glycolix Elite Face Cream (not to be confused with the one that has glycolic acid!).

Glycolix Elite Face Cream Ultra Lite

This moisturizer goes on just before the Citrix during the day.  At night the Glycolix with glycolic acid doubles as your moisturizer.

These are the building blocks of complete skin care; the products each play a role in improving your skin problems by fighting the signs of aging, protecting your skin, keeping your pores clean and giving you instantly improved skin appearance.   Equally importantly, all the products and ingredients are compatible so you’re not wasting your money on products that counteract each other.  Building skin care regimens like this is what I, as an MD skin care professional, do all day – and I love it!

Thanks for a great question.

Cheers,

Cynthia Bailey MD, Dermatologist

If you have questions about skin care or skin health please send them to me using the Contact Dr. Bailey button at the top of the page.

Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only.

What’s The Best Over 40 Skin Care To Brighten Dull Skin? is a post from: Dr. Bailey's Skin Care Blog

It’s the middle of winter and a lot of my dermatology patients have dry skin, even in our relatively mild climate here in Coastal Northern California.  Many are perplexed about it because they’re drinking plenty of fluids. 

Unfortunately, drinking water won’t fix dry skin any more than taking a bath will quench your thirst.

To hydrate your skin you have to add water and oil from the outside.  Bathing actually becomes therapeutic if you moisturize right after you towel off.

Taking a bath or shower actually adds the water your dry skin needs.  If you apply a moisturizer right after you towel off then you trap that moisture and – presto – moist skin!  If you don’t apply a moisturizer then all that water evaporates, leaving you with even dryer skin.  The key is the moisturizing step!

The only way to treat dry skin is with hydrating skin care.  Here’s how I explain it to my dermatology patients

Step 1: Bathe

Take a shower or bath in warm water, not hot, and ideally for 5 or more minutes to load your skin with water.

Water temperature is important.  To treat dry skin use warm, not hot, water to bathe.  Washing your skin is just like doing the dishes in that hot water cuts oil better and you don’t want that because it dries out your skin.

Step 2: Mild soap only and use it sparingly!

Bathe with only mild soaps and warm water.  Strong soaps remove too much of your natural skin oils, just like hot water does.  I recommend naturally made soaps that have natural soap glycerin still in them, or soaps made from glycerin alone.

Glycerin based cleansers are different than regular soap because they help hold water to your skin and they’re less efficient at removing skin oils.  Unfortunately most commercial soaps have the glycerin removed, leaving a very drying product.  Adding an oil or ‘cold cream’ to a drying soap doesn’t compensate, so don’t fall for the sales pitches, just find a glycerin rich product.  Good choices include Whole Food’s 365 brand glycerin bar, which is a deal at about $2.  L’Occitane has nice glycerin rich, natural bar soaps that are quite elegant.  A great liquid glycerin skin cleanser is Toleriane Cleanser.  It’s a richly hydrating, ultra-mild glycerin skin cleanser that’s great for severely dry skin anywhere on your body including your face and hands.  I’ve used it for years in my dermatology practice.  Click below to read more about it.

Toleriane Cleanser

Also, just soap up the parts of your skin with body odor glands unless you’ve gotten really dirty.  That means armpits, groin, buttocks and feet.  Be sure to rinse well too to remove all the soap residue.

Step 3: Apply your moisturizer within 3 minutes after toweling dry after every bath or shower.

Bathing loads your skin with water.  Trapping it with a moisturizer is how you treat dry skin.  You don’t need a heavy, thick layer of moisturizer to do the job.  Just cover your skin with a nice, thin layer of product that it can easily absorb.  It traps the water and the oil soaks into your skin.  This is what moist skin is, really!

If your skin is so dry that it’s cracked, itchy or painful then use a moisturizer with soothing water binding ingredients like rich oils, glycerin and possibly also lanolin.

If your skin is just dry and flaky then get all the hydrating and skin softening benefits of AHA’s (alpha hydroxy acids) by picking a moisturizer with glycolic acid or lactic acid.  It will work even better than plain moisturizers.  My Anti-Aging Body Kit has everything you need for soft, healthy, hydrated skin year round.  Use it every other day alternating with your favorite soothing moisturizer and have healthy skin that stands up to the elements.  Click below to read more.

Anti Aging Body Skin Care Kit with Glycolic Acid

The Bottom Line: You treat dry skin from the outside in.  Don’t get me wrong, drinking water is good for your body, so do it.  But don’t look for ‘8 glasses of water a day’ to fix your dry skin.  Only in the extreme, when a person is massively dehydrated to the point that their level of dehydration is a health risk, will their skin be limp, flaccid, lusterless and dry because they’re thirsty. The dry skin that most people suffer from is caused by dryness on the outside and the fix is with the right skin care.

Photo: Thanks and Gratitude to tommerton2010

Does Drinking Water Help Treat Dry Skin? is a post from: Dr. Bailey's Skin Care Blog

Just a few simple daily changes to your skin care regimen can really bump up the health of your skin in 2012.

Take good care of your skin this year – it’ll show!

• Your complexion is the face you meet and greet the world with.
• Your skin is what covers the hand you shake with when you meet new friends, the feet you show to the world when you wear sandals, the décolleté you reveal in that little black dress, the forearms that don’t get covered by your summer clothing.

Healthy skin matters to you, not just because living inside healthy skin feels better, but because you can’t always hide your skin problems, and frankly, who wants to.

Follow through with these few simple skin care resolutions and have healthy skin that you’ll be proud of.  Let’s make 2012 the year!  I’ll help you.

3 Simple Health Skin New Year’s Resolutions

1.  Wear mineral zinc oxide sunscreen on all your exposed skin – every day, all year, don’t ever miss

Put wearing sunscreen right up there with brushing your teeth or combing your hair.  Don’t try to guess if you’ll be in the sun today, just apply your sunscreen.

It makes a huge impact on how your skin looks now and over time.  Every skin type and skin color suffers wear and tear from the sun. It finally adds up to sun damage (not to mention skin cancer) with irregular pigmentation, wrinkles, age spots and skin thinning.  Just say no.  Your skin will start looking younger by mid summer, really.

Why do I specify a zinc oxide sunscreen?  Because I think it gives you the best, most broad spectrum and most trustworthy protection, and that makes it totally worth the effort.  Science has made zinc oxide particles so transparent on your skin that a high quality zinc oxide sunscreen won’t leave a weird white coating once you rub it on in a fine layer.  I’ve worn Citrix Sunscreen everyday for years and it’s always invisible.  I hear it everyday too from patients who are taking good care of their skin and thrilled with how easy it is to depend on Citrix Sunscreen for anti-aging sun protection.

The Citrix Sunscreen is a dream come true!  I can apply it all around my eyes and it never burns, it never feels heavy and my foundation goes on over it fabulously.  Now there’s no excuse to not wear sunscreen everyday! Hannah D Sonoma Co

My recommendation,

• wear Citrix Sunscreen every day on the exposed skin of your face, ears, neck, decollete etc
• use a more water resistant product (Solbar Zinc) on areas like your hands that will be in and out of water all day.

My Sun Savvy Daily Wear Sunscreen Kit has both these well-priced, trustworthy mineral sunscreens.  They’re the sunscreens that I, a dermatologist, have relied on everyday for years and I’m thankful for how well they’ve taken care of my skin.

Sun Savvy Daily Wear Kit

2.  Moisturize after every bath or shower

Even if you think you don’t need it!  Almost everyone’s arms and legs are too dry. Dry skin is itchy, flaky, rough and could look so much better with this simple little skin care step.

Moisturizing traps shower and bath water IN your skin that would otherwise evaporate.  Moisturized skin looks better and is healthier. Keep a moisturizing body cream, lotion or oil handy so you’ll use it every day right after you towel dry.  See my Complete Guide To Dry Skin Care for the whys, wherefores and step by step how-to’s about moisturizing.

If you’ve got

• really rough and scaly skin,
• brown or crusty age spots,
• or if regular moisturizers never really keep your skin hydrated,

then tackle those skin problems by doing a little exfoliation when you wash your skin in the shower.  When you towel off, apply a moisturizer with glycolic acid.  It’s like magic, really!

My Anti Aging Body Skin Care Kit will whip your skin into shape and keep it dewy, soft and healthy. I put this kit together for my 40th birthday when I found an age spot on my right upper arm.  It got rid of that unwelcome little birthday reminder and it’s kept age barnacles off my skin for the past 13 years.  I love this product combo!

Anti Aging Body Skin Care Kit

3.  Target your specific skin problems

Do you have acne, athlete’s foot, scalp or facial dandruff, rosacea, crusty age spots, chapped hands etc?  Type the term into my search bar on the right side of this page or click on the topic category and see the skin care treatment tricks I recommend to my dermatology patients with your same problem.  I’ve included some links to more common problems on the bottom of this post too.

Many common skin problems are easily treated once you’re using the right treatment products. Helping you find the right treatment for your skin problems is what motivates me to keep writing.  Even with the pleasure I get from my wonderful full time practice, you’re comments, coming in from all over the world, are soul satisfying for me.  Just yesterday a reader named Jill sent in a ‘thank you’ through our website email.

Dr. Bailey -
I was looking on the web for a source for ZNP soap, to no avail.  This product was very drying to my skin, but better than nothing.  I found a link to your website and read about your Calming Zinc ® soap. I placed an order and the product was here in a matter of days.  This soap does EXACTLY what you indicated it would do.  My facial flaking was gone within a couple of days and my skin did not feel tight and drawn, as it did with the ZNP.  Your website it very informative and I appreciate your attention to detail.
Kind regards – Jill

Jill, thank you, it rocks that I could help!  So,

To all my readers,

With a few simple skin care refinements we’re off to a ‘New Year and new skin for you’ adventure in 2012.  I’m excited to put my dermatology ‘know-how’ to the task and help you do it.  I also want to take this opportunity to personally wish you a Happy New Year!

Warm Regards,

Cynthia Bailey MD, Dermatologist

Photo Thanks and Gratitude to Doctordee

Dermatologist’s 3 Simple New Year’s Healthy Skin Resolutions is a post from: Dr. Bailey's Skin Care Blog

I am curious about the potential of seborrheic dermatitis (dandruff) to spread.  If it does spread then can you tell me how this happens?  Also, if someone has it in one place, is it likely they will get it in another?

Thank you,  Rebecca B

Hello Rebecca,

Seborrheic dermatitis (aka dandruff) spreads out from its areas of initial involvement, but it’s not because of contagion. Like many rashes, dandruff starts small and gets bigger.  We don’t know what causes seborrheic dermatitis and so we don’t know why it does what it does when it does it….. it’s just what it does.  We do know that it’s more likely to do it now in the winter though.

Dandruff usually occurs on the scalp where it’s important to differentiate it from ‘ring worm’ of the scalp (fungus infection), psoriasis and other more ‘exotic’ scalp rashes. For my patients with scalp seborrhea I start treatment with my zinc pyrithione shampoo and body cleanser called OTB SKIN Medicated Cleanser #2.

OTB SKIN Medicated Cleanser #2

This is a great professional strength, medicated shampoo as well as a back and chest acne cleanser.  If the medicated pyrithione zinc alone doesn’t do the trick then we rotate through 3 different medicated shampoo ingredients as I outlined in my scalp dandruff treatment post titled Remedies For The Dry Itchy Scalp Of Seborrheic Dermatitis. In that post I also explain how to use medicated shampoos most effectively for successful dandruff treatment.  It’s worth having a look at that post if you have scalp dandruff.

On the face, dandruff usually starts around the nose, eyebrows and chin. It works out from there to the forehead, mid cheeks and in front of the ears.  It’s often mistaken as skin dryness because of the flaking.  People tend to put gobs of moisturizer on the rash, to no avail.  Treatment needs to target the rash and my favorite way to do this is with the products in my Facial Redness Relief Kit.

Facial Redness Relief Kit

I have additional skin care suggestions for facial dandruff and you can find them in my post titled Dr. Cynthia Bailey’s Tips For Facial Seborrheic Dermatitis Control.

Dandruff can also involve the mid chest and back and even the skin folds.  For chest and back treatment I usually recommend the same OTB Medicated Cleanser/Shampoo #2 treatment applied with a Body Buf Puf Sponge with Handle.

Buf Puf Body Sponge

As for the evolution of a typical case of dandruff (seborrheic dermatitis), in most cases the rash starts as dryness and itch on the scalp, then the face jumps in, then the back and chest.  I rarely see it in the body folds though.  Even though it seems like the rash is ‘spreading’ it’s really just the rash getting worse and ‘evolving’.

I hope that helps your understanding of this common and frustrating skin problem.  I also hope it gives you some ideas about the treatment approaches that I recommend to my dermatology patients who have dandruff.

Warm Regards,

Cynthia Bailey MD, Dermatologist

If you have questions about skin care or skin health please send them to me using the Contact Dr. Bailey button at the top of the page.

Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only

Does Seborrhiec Dermatitis (Dandruff) Spread? is a post from: Dr. Bailey's Skin Care Blog

I’m wondering if you can answer some general information questions about the skin condition pityrosporum folliculitis.  Is it necessary to wash clothing, bedding, and other items that come into contact with the infected skin on a daily basis?  Also, I am wondering what your success rate is for treating patients with this condition with products containing pyrithione zinc, as opposed to topical and/or anti- fungal medications, especially if the condition covers a significant part of the body, i.e. the face, neck, shoulders, and chest?  Is it important to continue using the zinc products after the condition has gone away for some recommended time period, generally speaking?  And last, does the zinc address the itch associated with this condition?

Thank you and I greatly appreciate your help if you are able to answer any of these questions.

-Amanda G

Hello Amanda,

Pityrosporum folliculitis is one of the most common forms of back acne and it’s really challenging.  Your questions are what I would consider the ‘advanced’ questions for pityrosporum folliculitis treatment and they’re really intriguing – and fun!.  I’m going to outline general educational information for each of your questions based on how I take care of the patients in my dermatology practice who have this type of back and chest acne.

For my patients with really stubborn pityrosporum folliculitis type of acne I recommend they take care to keep clothing and bedding clean.  The main important goal is to remove the skin oils from the cloth.  After working out it’s also important to change into dry, clean clothing so that the skin drys off quickly because the yeast organism that causes this condition loves moist, oily skin.

Regarding my topical treatment success, yes, I have a very high success rate treating this condition topically, both for acute intervention and chronic management of new outbreaks.  My ‘go-to’ treatment is a pyrithione zinc cleanser and an exfoliating sponge.  I often add benzoyl peroxide cleanser too which is why the ingredient combo is in my Back Acne Kit.

OTB SKIN Back Acne Treatment Kit

To control really stubborn cases of pityrosporum folliculitis type of back acne though I often need to prescribe a course of oral ketoconazole.  This is a medicine with a lot of drug interactions and of course it has a bunch of side effects too.  Patient need to be fully informed of all this important information before choosing this therapy.  It’s also important that they have an accurate diagnosis made by their dermatologist.

Also, there is no complete ‘cure’ for pityrosporum folliculitis so we always continue topical care to maintain skin clearing.  We still occasionally need to retreat with another course of oral ketoconazole when the skin flares up in spite of our best efforts.  Sometimes oral tetracycline works too and if I’m using tetracycline to treat a patient’s acne vulgaris we often ‘kill two birds with one stone’.

I don’t usually use topical antifungals for pityrosporum folliculitis because I have not been impressed with the results and the topical cream application is inconvenient (to impossible) given that the condition is on the back.

The itch of this condition is due to the folliculitis (yeast and white blood cell party in the pore) and so controlling the outbreak is how I address the itch.  The zinc is not in and of itself an anti-itch treatment.

On a final note, for pityrosporum folliculitis I always recommend showering asap after sweating, keeping the skin degreased as much as possible and making supportive dietary changes like cutting carbs, greasy foods, diary and junk.  That’s all outlined in some of my other acne and pityrosporum folliculitis posts below.

These are good questions.  I can see your giving this some really good and detailed thought, I love it!

Warm Regards,

Cynthia Bailey MD, Dermatologist

If you have questions about skin care or skin health please send them to me using the Contact Dr. Bailey button at the top of the page.

Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only

Back and Chest Acne Treatment is a post from: Dr. Bailey's Skin Care Blog

I have a question concerning my 5 month old son. Around 3 weeks of life he developed normal baby acne that has subsequently resolved itself.  However, he has a patch of milia on his chin that do not seem to be going away. I am not sure if we should just wait it out longer or is there some sort of treatment we can use to help it go away?
Thank you,

Stephanie D

Hello Stephanie,

Milia are little pockets of dead skin cells that have gotten trapped. The skin actually folds over to encase the dead skin cells in a little sphere within the top layer called the epidermis.  I tell my patients to think of them just like a pocket in your jeans, there is a lining made of your normal skin and it’s filled with the same dead skin cells that form and drop off of your skin every day.  When milia are new, the dead skin cell collection is soft.  The longer the milial pocket of dead cells stays trapped in the skin the harder the milia becomes.

Milia can form in skin spontaneously, but they are even more likely to form when the skin heals after a rash. The skin of babies and children can form milia after any sort of a rash, including baby acne.  The skin of these tender and sweet little people is much finer than our tough adult skin.  This means that milia in babies and children are not covered by the same thick, tough outer skin layer that they are in adults.  It also means that they may well work themselves out just by the friction and rubbing of the skin that happens during the natural course of daily activities.  To help assist these little milia in working their way out sooner rather than later, I often recommend doing the routine daily skin cleansing step with a wash cloth. By gently sudsing and rubbing the skin with the wash cloth and a very mild soap such as Toleriane Cleanser there will be a nice bit of exfoliation.  The milia are so close to the surface they may gradually open and come out.  I also recommend applying a simple moisturizing cream after washing so that the skin stays soft and well hydrated, which will also aid in the natural opening and resolution of the little milia.

Really stubborn milia that refuse to come out on their own can be opened and expressed by a dermatologist, but it hurts and never makes us popular with children or babies.  Fortunately, most of the time simply adding the hydrating and gentle exfoliation that I mentioned above does the trick.

Warm Regards,

Cynthia Bailey MD, Dermatologist

If you have questions about skin care or skin health please send them to me using the Contact Dr. Bailey button at the top of the page.

Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only.

Baby Milia from Baby Acne is a post from: Dr. Bailey's Skin Care Blog

I’ve got just the right product combos to transform skin and solve frustrating skin problems for the people on your gift list.  Be the one to find that unique solution.  My regimens are affordable and make a much more thoughtful and surprising gift than the usual candle, slippers, chocolate or bottle of wine that you were going to fall back on again this year.

It’s not too late either – we can ship your gift UPS 2 day air so that if you place your order by 2pm Pacific Standard Time your package will arrive by the 24th in the continental United States.  In the holiday spirit, I’m giving you 10% off your order through the 24th  by using coupon code GR8SKIN in the shopping cart.

Dr. Cynthia Bailey’s Picks For The Best Professional Skin Care Gifts

Click on the highlighted link to see more!

AHA Facial Skin Care Kits For Frustrating Facial Hyperpigmentation

Got an intimate friend or family member who you know is frustrated with lots of uneven facial skin pigment?  Age spots, melasma, and sun damage leave unyielding pigment that really impact a person’s complexion unless a person uses the right products. Be the one that finds the miracle.  One of my glycolic acid facial kits may be just that and will thrill anyone frustrated with blotchy facial hyperpigmentation. I’d also add a Citrix sunscreen to your gift to help stop the sun from re-darkening all that pigment they lighten with these pretty darn magic products

AHA Facial Kits

Citrix Mineral Zinc Sunscreen to fight pigment darkening

AHA Body Skin Care For Soft Smooth Skin

Soft, sexy skin is fun at any age.  I’ve got the kit that turns the usual dry, rough skin we all tolerate into new wonderful skin we’ll all love.  The kit is called’ Anti-Aging’ but it works for anyone with rough skin (including keratosis pilaris, the rough bumps on the back of the arms of many teens and young adults).  Plus, everyone can use velvety elbows, soft hands and smooth calves.

For those gift recipients that use self-tanner, this is also the ultimate product combo for the perfect self-tanner application.  Add the Avene Self tanner to your gift for folks who would have fun with evenly golden-bronze skin (minus the sun’s aging rays).

Anti-Aging Body Skin Care Kit

Avene Self Tanner

Facial Redness Relief Kits

Know someone who’s really frustrated with their facial redness?  My Redness Relief product combo is bar none the best regimen to soothe facial redness that I’ve found in my 25+ years of dermatology practice.  Thrill someone on your gift list who suffers this tough complexion problem.  Whether it’s rosacea, seborrhea, sun damage or even atopic eczema, these products have helped my patients.  I love their gratitude and you can have that too when you turn someone onto this skin care duo.

Facial Redness Relief Kits

A Gift Certificate For A Heavenly and Therapeutic Professional Facial

Until Jan 1 we’ll give your recipient a certificate for one of our $90 facials for the price of $75; you pay $75 and they get a $90 facial!   We wrap your gift certificate in a pretty little gift box too.  Check out our menu by clicking the link below then call the office at 707 829-5778 to purchase your gift certificates (maybe even one for yourself???!).

Heavenly & Therapeutic Facial Menu

Photo: Thanks and gratitude to Mysza

The 4 Best Professional Skin Care Holiday Gift Ideas is a post from: Dr. Bailey's Skin Care Blog