Dear Dr. Bailey,
I’m 32 years old and have sensitive combination skin with mild acne and seborrheic dermatitis. I still don’t have any wrinkles but I want to use something that will prevent them. I tried some anti-age creams but they seemed to aggrevate my acne and they didn’t go well with my seborrheic dermatitis. On the other hand my creams for seborrheic dermatitis and acne don’t do much to prevent wrinkles. What should I use? I envy people with normal skin who can use Retin A to prevent wrinkles. I’m worried because I can’t find anything to fight both wrinkles and seborrheic dermatitis. Please help.
I like to start my patients on good anti-aging skin care in their 20’s because prevention works so much better than reversal! My favorite anti aging product combo is Retin A and a broad spectrum zinc oxide sunscreen. I am able to get most people with dandruff to tolerate Retin A if I first control the dandruff completely. To do this I have them use Calming Zinc Bar (formerly called Noble Zinc) twice a day followed by Replenix CF Cream or Power of Three (not the serums found on other web sites, and always with the caffeine). If their skin needs more moisturizing then we add Daily Moisturizing Face Cream for Oily to Normal Skin on top of the Replenix Cream. Then wear Citrix sunscreen during the day on top of the Daily Moisturizing Face Cream for Oily to Normal Skin.
If this alone does not control the seborrhea, then I have them use Lotrimin and possibly hydrocortisone cream like I mentioned in my post on facial seborrhea. We wait at least 2 months and then I see them back. We then gradually try to add Retin A at the lowest strength according to my instructions, which are also in a post on my blog. We may need to avoid the parts of the face most prone to dandruff (around the nose and the eyebrows). Anytime the dandruff flares up we stop the Retin A, get out the lotrimin and/or hydrocortisone until it’s clear then resume the Retin A.
We sometimes add BBL/IPL treatments, microdermabrasion treatments and calming facials as ‘in office’ procedures to enhance the anti-aging benefits and calm the dandruff.
Of course, this is all supervised by me and is medical treatment. I cannot guarantee that it is right for you. I would recommend that you print out this post and take it to your dermatologist to see if my approach might be right for you. They, of course, would be responsible for initiating and supervising your treatment.
I hope this helps you better understand how I approach my patients with these two conditions.
Cynthia Bailey MD, Dermatologist