Nashville Dermatologist -- Skin Care 101, Part One

One of the THE most common questions I get from patients is, "What skincare products should I use?" I get it -- it is completely, 100% overwhelming trying to figure out what we should and shouldn't be using on our skin. For starters, the shelves in the drugstore are full of different brands. And that's just the drugstore! Then there are the department store counters, the specialty skincare stores, and now the online vendors. How in the world do you choose?

In a series of posts, I am going to break down skincare. This series is going to take awhile, so hang in there -- but know that everyone will be able to learn something useful from this series.

The first, absolute, number one thing you need to figure out first is your skin. This can actually be fairly complex. You need to start paying attention -- is your skin oily? dry? a combination? Are you prone to developing acne? Do you have rosacea, even in a mild form? Is your skin really sensitive? Is your skin easily irritated? Do you have any history of eczema? 

And secondly, what are your problem areas? Do you have a lot of sun damage and brown spots/uneven pigmentation that you are trying to correct? Are you concerned about fine lines and wrinkles? Are you concerned about skin laxity? Is loose skin around the eye an area of concern for you? Are you concerned about pore size? Blackheads? Are you losing volume or plumpness to your skin? Do you have hormone-induced changes to your skin such as hyperpigmentation?

Once you have a sense of the answers to these questions, you can start to pick the right products. Because ultimately, there are a lot of amazing skincare products out there, but if you aren't picking products that are targeting your skin type and your problem areas, you will not be getting the results that you want and you MAY even be making your skin worse in the process.

For example, I have sensitive, acne-prone skin, which is a tough combination. There is a popular prescription retinoid (retin-a type product) that is designed for anti-aging and is also designed to be moisturizing, which I thought might be great for me since my skin is so sensitive. However, when I tried it on my face, I got CYSTIC ACNE. It was simply much too moisturizing for my acne-prone skin. It is still a great product -- but just not for me. 

And that is the crux of choosing skincare -- choosing the right products for you.

Nashville Dermatologist -- Picking a Sunscreen, Part One

So last week we talked about common-sense ways to protect your skin from the sun and we learned that sunscreen is preferably your last line of defense against sun damage.

BUT . . . we all go outside and we all need sunscreen, so let's talk about how to pick the best one for you.

Before we go on, we need to mention that this blog is intended for educational purposes only and cannot nor should not replace the recommendations of your own personal physician. There are many factors that affect which sunscreen you choose, and we are going to try to simplify that process for you.

First things first, sunscreen is meant to protect you from the sun's damaging rays. How does it do that? Well, sunscreen utilizes either chemical blockers (which absorb the damaging rays) OR physical blockers (which reflect the damaging rays), OR a combination of both. These days, most effective sunscreens use a combination.

Chemical blockers that are commonly used include avobenzone, octinoxate, oxybenzone, octisalate, octocrylene, homosalate, and mexoryl.

Zinc dioxide and titanium dioxide are the two physical blockers that are used. Because zinc and titanium do not rub in and instead leave a white, chalky paste sitting on the surface of your skin, often these particles are "micronized" or basically are made super, super tiny so that they do not leave a chalky coating on your skin.

So how do you know whether you want a physical sunscreen, a chemical sunscreen, or both -- and when you are reading the label of ingredients, how do you know if your chosen sunscreen is effective?

There are two things you really need to know regarding the efficacy of your sunscreen -- first is the SPF, or sun protection factor, and second is the spectrum (is it "broad spectrum" or not).

SPF is the numerical rating that describes the relative strength of the sunscreen at blocking UVB rays. Dermatologists generally agree that you want to choose an SPF 30 or higher. SPF DOES NOT imply the duration that a sunscreen will last, but rather the amount of UVB rays that it will block. So choosing a higher SPF DOES NOT mean that you can reapply less frequently. Above SPF 50, the increase in sun protection is small, however for people who have a history of melanoma or are particularly prone to burning, an SPF higher than 50 is often a good choice. At Traceside, our family members are wearing an SPF 70 at the beach.

The SPECTRUM of the sunscreen indicates whether it covers both UVA and UVB rays. As we discussed above, the SPF tells you how well the sunscreen blocks UVB. But what about UVA? The sunscreeen also needs a UVA blocker. The physical blockers will both block UVA. The chemical sunscreen Mexoryl also blocks UVA.

So, in summary, when you are reading the label on a sunscreen you want to choose a sunscreen with:

1. SPF 30 or higher

2. Broad-spectrum (UVA and UVB) coverage

3. to achieve that, you need to either have picked:

* a completely physical sunscreen (zinc and titanium only)

* a chemical sunscreen that contains Mexoryl

* or a chemical sunscreen that ALSO has at least one of the physical blockers

Stay tuned! On our next post we will cover choosing the actual brand and special considerations for people with specific concerns (aka an allergy, sensitive skin, acne-prone skin, etc.).