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Common Complexion Questions

Aug 17, 2007
As we get older our skin changes, and with those changes we wonder, What's happening to my skin? As adults, we believe we shouldn't be experiencing the torments of acne as we did as a teenager, or we notice brown spots that suddenly appear out of nowhere. We also worry about those days gone by when we used baby oil as tanning lotion. Here are the most common questions adults are asking their dermatologists.


Why am I experiencing acne now that I'm older?
Acne usually occurs on the face, neck, back, chest and shoulders. Adult acne is caused by a combination of several factors: hormones leading to excess oil secretion, faulty closing of the hair duct, and infection.

Acne develops when a sebaceous gland, which is connected to a pore and contains a fine hair, becomes blocked with sebum, an oily substance made by the sebaceous glands that normally empties onto the skin's surface through the opening of the pore. If a pore becomes clogged and prevents the sebum from reaching the surface of the skin, bacteria that normally lives on the skin begins to grow in the pore. These bacteria produce chemicals and enzymes and attract white blood cells that cause inflammation. When the wall of the clogged pore breaks down sebum, dead skin cells and bacteria seep into the nearby skin, leading to pimples.
Here is a list of other situations that may cause a breakout:

1. Women: two to seven days before their menstrual period begins
2. Friction caused by leaning on or rubbing the skin
3. Pressure from bike helmets, backpacks, or tight collars
4. Environmental irritants, such as pollution and high humidity
5. Squeezing or picking at blemishes
6. Hard scrubbing of the skin

How can I treat my acne?

Although there are many remedies you can purchase at the local drugstore, consult your dermatologist first to determine what type of acne you have. He may then prescribe a medication specifically to meet your needs. The biggest breakthrough in acne treatment has been the development of topical retinoic acid, a form of vitamin A. Other acne products consist of the following ingredients:

1. Azelaic acid cream
2. Alpha-hydroxy acids (including glycolic acid, lactic acid, and gluconic acid)
3. Benzoyl peroxide
4. Topical antibiotics (gels, lotions, and solutions)
5. Antibiotic pills
6. Birth control (for women)
7. Accutane or Sotret for severe acne (women who choose this treatment must be on some type of birth control)

Aside from medications, keep in mind that a healthy lifestyle can also prevent breakouts, such as: getting plenty of sleep, drinking a lot of water, and eating a balanced, healthy diet.

Also consider cleaning items in your home that may be contain germs, such as: the phone, dirty towels, pillowcases and sheets

Skin Types

What type of skin do I have? There are six categories of skin types:
1. Dry
2. Somewhat dry
3. Normal
4. Somewhat oily
5. Oily
6. Combination.

Skin type, which is determined by the amount of oil secretion, is hereditary. The different areas in the skin that produce oil and the amounts of oil produced are based on genetics.

Some women classify themselves as having sensitive skin. Overexposure to the elements or overuse of products can lead to skin allergies or sensitivities. To avoid this, try to minimize the number of products you use and try to find products designated for sensitive skin whenever possible.


What are these brown spots on my skin?
Hyperpigmentation comes in many forms, including freckles, melasma, liver spots, sun spots, acne scars or wounds. Hyperpigmentation results from too much abnormal melanin (dark brown to black pigment occuring in the hair, skin and iris of the eyes) within the superficial skin cells. The main causes of increased melanin production are acute sunburn and chronic sun exposure. The second most common cause is hormonal change as a result of pregnancy, oral contraceptives or hormone replacement therapy. Another cause of hyperpigmentation is post-inflammatory hyperpigmentation that occurs after a wound or blemish heals.


How many times a day should I wash my face?
Cleansing is essential for your skins long-term health, however, cleansing can strip your skins protective oils that act as natural barriers to the elements. Washing your face any more than twice daily can lead to dry, irritated skin. When cleaning your face, use tepid water and a gentle cleanser if you have sensitive skin. If you have oily skin, do not be tempted to wash your face when it gets oily throughout the day. Try using oil blotting papers instead.
Here's a clear way to cleanse your face:

1. Choose a cleanser that is formulated for your skin type;
2. wash your hands before you cleanse your face; 3. splash your face with warm water (hot water will stimulate and expand facial blood vessels, which can give you a flushed appearance);
4. work the cleanser into a lather, then gently massage it into your skin in a circular motion with your fingertips do not forget your hairline and neck;
5. remove the cleanser by splashing your neck and face with warm water;
6. blot your face with a clean towel (don not rub your face, it could cause irritation);
7. dampen a cotton ball in toner or Witch Hazel;
8. skim over your neck and face to remove any trace of cleanser you might have missed; and
9. apply your favorite moisturizer.

Skin Cancer

What causes skin cancer?
There are three main types of skin cancer:
1. Basal cell carcinoma
2. Squamous cell carcinoma
3. Melanoma

Basal cell and squamous cell cancers make up 95% of all skin cancers and are highly curable when treated early. Melanoma, made up of abnormal skin pigment cells, called melanocytes, is a serious form of skin cancer and causes 75% of all skin cancer deaths. Left untreated, it can spread to other organs and is difficult to control.

Ultraviolet (UV) radiation from the sun is the number one cause of skin cancer, and UV light from tanning beds is just as harmful. Exposure to sunlight during the winter months puts you at the same risk as exposure during the summertime.

Excessive and unprotected sun exposure causes basal cell and squamous cell skin cancer, while episodes of severe sunburns, usually before age 18, can later cause melanoma. Other less common causes are repeated X-ray exposure, scars from burns or disease and occupational exposure to certain chemicals.
About the Author
Dr. Lycka is one of North America's foremost authorities on cosmetic and reconstructive surgery. You can find out more at http://www.barrylyckamd.com and http://www.restoringyouthonline.com. He is founder of The Ethical Cosmetic Surgery Association (http://www.ecsaonline.com).
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