Questions you should be asking your dermatologist

BY CARRIE
MADORMO, RN, MPH
With summer approaching, I
can’t help but start thinking more about my skin. I’m noticing a few more fine
lines than I’d like to admit to, and I want to make sure I’m protected in the
hot summer sun.
Most of us think about
visiting the dermatologist if we’ve been experiencing an acne problem, but our
local dermatologists can offer us a wealth of knowledge about every aspect of
skin and health. Next time you’re headed to the doctor, keep some of these
questions in mind.
Do
I really have to wear sunscreen for a quick errand?
This is a question that I’ve
never asked, because I didn’t want to know the answer. I assumed the answer
would be yes, but it seems silly to glob on sunscreen so that I can walk from
my car into the coffee shop. However, it truly is a question that needs to be
considered.
“It’s a good idea to
apply sunscreen every morning before you apply your makeup. Sun damage is
cumulative, so an hour here and an hour there adds up over the years,”
Dermatologist Margaret Ravits, M.D. told me. “Take a bottle of sunscreen
with you in your bag so you have it ready when it’s time to reapply later.
Reapply every two hours or so and more often if you get sweaty or wet.”
Is
indoor tanning okay?
Now come on, we know what the
dermatologist’s answer is going to be to this one, but so many bright young
women still worship the tanning bed. If you’ve been indulging in a little extra
UV action, talk to your dermatologist about the real dangers.
“The UV rays from a
tanning booth are harmful to your skin and increase your chance of developing
melanoma and other forms of skin cancer,” Dr. Ravits told me. “They
also cause premature signs of aging such as wrinkles and brown spots.”
In fact, people who try a
tanning bed before turning 35 have a 75 percent increased risk of developing
melanoma over the course of their lives! Tanning is responsible for more cases
of skin cancer than smoking is for cases of lung cancer. Bottom line? It’s just
not worth it.
How
can I treat my acne?
This is one of the most common
questions dermatologists receive, and patients often ask it later than they
should. So many of us waste time on over-the-counter products and home
remedies, when we could just go right to the experts.
“If you get a pimple, be
sure to treat it right away. If you try to ignore it, it will grow and become
more difficult to treat,” Dr. Ravits told me. “Don’t pick at a pimple
or it could cause scarring. See a dermatologist who can provide effective
treatments such as a topical antibiotic lotion, oral antibiotic, retinoid, or
cortisone shot.”
Do
I need sunscreen on cloudy days?
It’s easy to remember
sunscreen when you’re hanging at the pool and the sun is beating down on you.
However, if you’re standing outside on a gloomy day watching your daughter play
soccer, it just doesn’t seem as important. However, the weather truly doesn’t
matter when it comes to wearing sunscreen.
“You should wear
sunscreen everyday, even on cloudy and cool days to help protect your skin from
sun damage, premature signs of aging, and skin cancer,” explained Dr.
Ravits. “You may not realize it, but even on cloudy days, up to 80% of the
sun’s UV rays can shine through the clouds.”
Sure, putting on sunscreen is
an extra step, but you probably aren’t showing that much skin on cooler, cloudy
days. “On cooler days, that might mean only the face, ears, neck, and back
of the hands,” Beverly Hills Dermatologist Tsippora Shainhouse, MD, FAAD told
me. “Warmer weather usually means shorter sleeves and open necklines.
Don’t forget to apply sunscreen to your chest, shoulders, and arms, even if you
are not hitting the beach that day.”
How
can I protect myself from skin cancer?
Skin cancer is all too common
for young women. I asked several dermatologists their number one tip for
avoiding cancer, and they all said the same thing.
“You should apply broad
spectrum sunscreen (SPF 30 or higher) and lip balm (SPF 15+) everyday, rain or
shine, to protect your skin from the sun’s harmful UV rays and to minimize your
risk of skin cancer,” recommended Dr. Ravits. “Also wear a
wide-brimmed hat, sunglasses with UV protection, and sun protective clothing.
Seek shade during the peak sun hours (10AM-4PM). Don’t tan outside or do indoor
tanning.”
What
are the signs of skin cancer?
In addition to shading
yourself from the sun, the next step in beating sun cancer is catching it
early, and that means keeping a close eye on your skin. “Check your skin
each month to see if your moles have grown or changed. It is important to book
an appointment with a board-certified dermatologist if you notice any warning
signs such as moles which are asymmetrical, have uneven, irregular borders, a
variety of colors, a diameter larger than 6 millimeters, or if the color or
size are evolving,” explained Dr. Ravits. “If you notice that a mole
is bleeding, itching, or changing, get it evaluated by a dermatologist. The
sooner that skin cancer is diagnosed, the greater the likelihood of being able
to successfully treat it.”
While checking yourself for
changing moles or marks is important, nothing replaces a visit with an expert.
“People should visit a dermatologist at least once a year to get a full
body skin exam where the doctor does a thorough examination of your skin and
looks for signs of skin cancer,” said Dr. Ravits.
What
is the best way to monitor my moles?
So you’re now committed to
doing regular skin cancer checks. That’s great, but it can be a little
challenging to know where to start. Did that mole really change or am I just
imagining that?
“It can be difficult to
recognize changes in moles that you have had for a while, or even notice if a
new one pops up. I teach my patients to create a mole map, in which they
photograph each body part and print it on paper to create a map of their
moles,” Dr. Shainhouse told me. “They can use this map as a guide to
check their moles every month or so and to look for a new lesion or if any have
changed from the pictures. That way, they can come in to have specific lesions
evaluated and treated promptly, if needed.”
What
should I look for in a sunscreen?
Not all sunscreens are created
equal, so it’s a good idea to talk with your dermatologist about the best one
for you and your skin. “Look for the words ‘broad spectrum,’ and your
sunscreen should have an SPF 30 or higher,” said Dr. Shainhouse. “Sunscreen
should be reapplied every two to three hours if you are spending time
outdoors.”
Do
I need sunscreen if my makeup has SPF in it?
This is a big question for
dermatologists, and most of the doctors I interviewed told me they wished more
patients would ask that. “The sunscreen in your moisturizer or foundation
is not sufficient on bright sunny days, because you do not use enough of it to
give you sufficient UV protection,” explained Dr. Shainhouse. “You
should use about a teaspoon of sunscreen to cover your face ears neck and upper
chest.” The SPF in your makeup is great for going in and out of stores
while running errands, but if you’re spending time outdoors, grab the
sunscreen.
What
skincare products do I really need?
There are a lot of skin and
anti-aging products, and it can feel overwhelming to try to pick one. They’re
also incredibly expensive. Don’t hesitate to ask your dermatologist about the
best products for your skin. It’s not a silly question, and it could end up
saving you big bucks.
“So often patients are
using way too many products that can irritate their skin without benefit,”
Dermatologist Heather Rogers, MD told me. Save yourself some time and just ask.
Does
higher SPF mean better protection?
I have fair skin, so I’m
always looking for higher SPF sunscreens. SPF 100? Yes please! I’ll be
protected all day! However, that doesn’t really account for what SPF actually
means.
“An SPF of 50 means you
can stay in the sun 50 times longer than you could without it before burning.
But it does not take in account that sunscreen starts to break down as soon as
it is applied to the skin,” explained Dr. Rogers. “No matter the SPF,
you use still need to reapply every two to three hours when outside enjoying
the sun.”
What’s
the difference between UVA and UVB rays?
Many sunscreens feature the
fact that they protect against both UVA and UVB rays, but what does that really
mean? “SPF only describes protection from UVB rays, the sunburn rays that
also damage your skin’s DNA. But the sun also has UVA rays that penetrate the
skin more deeply causing wrinkles, brown spots, and DNA damage,” said Dr.
Rogers. “Instead of looking for a product with the highest SPF, look for a
product with an SPF of 30 that is labeled with UVA and UVB protection or broad
spectrum. Hunt until you find one that you like enough to reapply.”
Some of the broad spectrum
sunscreens are effective, but people avoid them because they end up giving you
a completely white face. “The best, broadest protection comes from zinc
oxide,” said Dr. Rogers. “It used to make you look like a clown but
now there are many great products from creams to sprays and powders. I use a 15
percent zinc-based sunscreen every day on my face.”
Is
it okay to pop a pimple?
We’ve all been there. You’re
getting ready for a night out with friends, and there it is. That giant pimple
is just begging to be popped, right? According to the dermatologists, it’s
important to resist that temptation.
“The truth is, even
though it feels really good to pop it, a lot can go wrong when we start
picking,” warned Dr. Rogers. “We often pick too much recreating a
bigger wound for our body to heal. And when we squeeze it we can push some of
the pus deeper into the skin causing more inflammation.”
Do
I really need eye cream?
As a frequent smiler and
laugher, I have a lot of fine lines around my eyes. I’d like to find the right
cream to help prevent more, but it can be a little confusing, especially when I
don’t even know if eye cream is the way to go.
“Eye creams are typically
more expensive than face creams with fewer anti-aging ingredients because eye
skin is sensitive. Most people can simply use their face cream around their
eyes,” said Dr. Rogers. “Eye creams are helpful for people with oily
skin who do not use a heavy moisturizer, for a specific eye problem like dark
circles or puffiness where a target treatment could help — but don’t expect
miracles.”
Will
a base tan prevent a sunburn?
As summer approaches, it’s
natural to want a little color before donning that new bikini. And hey, you
need a little tan so you won’t burn, right?
“No, no, no! There is no
such thing as a healthy tan,” Dr. Rogers told me. “Tanning is the
skin’s response to injury from the radiation of the sun. Your skin cell tans
only after the damage to your DNA has begun, as an attempt to protect itself
from further injury.”
How
can I prevent acne?
Most of us wait until after
we’ve developed acne to visit the dermatologist, but it’s a better idea to talk
before it’s an issue at all. One place to start, is your diet.
“Your skin is what you
eat. Beware [of] dietary impacts on your skin. High glycemic index foods like
pastas, candy, and sugary foods make it hard for the body’s immune system to
attack the bacteria that causes acne,” New York Dermatologist Dr. Bobby
Buka told me. “A surprising culprit is one that may help your cholesterol
but not your skin — skim milk. The process of making milk less fatty removes
some of the healthy components like fatty acids, which play a critical role in
appearance of younger-looking skin.”
What
should I avoid?
Some of the skincare steps
that we take to keep our skin youthful and glowing can actually damage it
overtime. Always check with your dermatologist about which practices are
beneficial and which ones do more harm than good.
“Overwashing your face
does not make you super clean; it is a super myth. Acne is not associated with
facial cleanliness,” explained Dr. Buka. “We all have bacteria on the
surface of our skin. It’s the overgrowth of this bacteria that causes acne. In
fact, overwashing destroys essential defensive oils that fight acne.”
What
are the best products for acne-prone skin?
If your skin tends to break
out with even the slightest change, talk with your dermatologist about
strategies to prevent these breakouts.
“I always advise our
patients to check their cosmetics, sunscreens, moisturizers, etc., and use only
products labelled with terms such as ‘noncomedogenic,’ ‘non-acnegenic,’ ‘does
not clog pores,’ or ‘won’t cause breakouts,'” David Lortscher, MD,
dermatologist and founder of Curology, told me. “The label
‘noncomedogenic’ indicates that the manufacturer considers the product to be
designed for people with oily or acne prone skin and is less likely to cause
acne. It is not a guarantee, but can be a useful guideline.”
When
can I expect improvement from my acne treatment?
When you have acne, you want
it gone yesterday. It can be hard to wait and see, with every new treatment.
However, always make sure to ask your doctor how long the benefits of a new
treatment usually take. Knowing that help is on the way can allow you to feel a
little more hopeful and patient.
“We can’t judge how a
patient is responding to acne treatment until at least six to eight weeks have
passed, although most patients see improvement beginning around three to four
weeks,” Dr. Lortscher said. “We always remind our patients that
patience is key.”
Is
it okay to use lemon juice on my skin?

It’s always best to check any
natural or DIY skin treatments with your dermatologist before diving in. We
often assume that because something is natural it’s safe, but that is not the
case, especially when it comes to your skin.
One of the more common at-home
treatments is lemon juice, and it can actually be dangerous. “Lemon juice
as a home remedy for acne can backfire, so we do not recommend it, but it is
tempting to try this as a remedy for acne and dark spots, as it’s readily
available, inexpensive, and you can find it touted online as an easy fix,”
said Dr. Lortscher. “However, using lemon juice on your skin can cause
significant dryness, redness, and irritation. Lemon juice may have an exfoliating
effect on the most superficial corneocytes (dead skin cells) of the epidermis,
but there are better ways to exfoliate.”
Dr. Lortscher recommends
avoiding lemon juice on the skin, because the compounds in the lemon can react
with sunlight, causing a rash and sunburn. So if you do try it, don’t go
outside!
Is
it okay to use baking soda on my skin?
Another DIY acne treatment is
baking soda, but just like lemon juice, it’s just not worth it. “Some
people try baking soda as a cost-effective scrub or mask — not the best idea!
Scrubbing your face with a paste of baking soda would be very harsh and disturb
your skin’s natural barrier, or acid mantle,” explained Dr. Lortscher.
“A very dilute baking soda mixture as a cleanser for acne, while not something
we recommend, would likely not cause harm for most people, but it’s just not
worth risking, as your skin may react to this assault by becoming red, raw and
sensitive. In susceptible people, this irritation can lead to acne
breakout.”
What
should I be doing to look my best?
At the end of the day, we’re
all just trying to look and feel our best, so it’s not a bad idea to ask your
dermatologist how to do that. Take advantage of her knowledge and ask away!
“Likely due to greater
awareness and acceptance, I am seeing more and more people in their late
twenties and thirties coming in concerned about newly formed fine lines on
their faces,” Dr. Jeremy Brauer, a New York City based dermatologist, told
me. “They are often focused on treating that one line or concern, and I
spend a good deal of time explaining the anatomy of the aging face and the need
for a full-face, combination approach.”
You and your dermatologist can
work together to come up with the right skincare regimen for you. “Most
importantly, I always emphasize the appropriate use of broad spectrum, UVA/UVB
protective sunscreen,” said Dr. Brauer. “Treatment of the aging face
really depends on the individual, their skin, and their goals, and it is not
about chasing one wrinkle at a time.”
SOURCE:
THE LIST
Kayode Ojo
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.