Psoriasis 101 Information on Skin Disease

Top Five Psoriasis Myths

1. Myth: Psoriasis is contagious.

Fact: Psoriasis is not contagious. It is a life-long, immune mediated skin disease.

2. Myth: Psoriasis is caused by poor hygiene.

Fact: There is no link between hygiene and psoriasis. Psoriasis is a disease that no amount of washing or scrubbing can remove the scaly areas, or ensure they don’t come back.

3. Myth: Psoriasis is just an annoying skin rash.

Fact: Once thought to be a skin condition, research has shown that psoriasis is actually a disease of the immune system that causes abnormal growth in skin cells.

4. Myth: Psoriasis can be cured.

Fact: Psoriasis is a chronic disease for which there is currently no cure. Once symptoms appear, patients have psoriasis for life.

5. Myth: Psoriasis only affects patients physically.

Fact: There is a significant emotional impact experienced by psoriasis sufferers including feelings of helplessness, hopelessness, anger, frustration and even depression.

Several factors are thought to aggravate psoriasis. These include stress and excessive alcohol consumption. Individuals with psoriasis may also suffer from depression and loss of self-esteem. As such, quality of life is an important factor in evaluating the severity of the disease. There are many treatments available but because of its chronic recurrent nature psoriasis is a challenge to treat.

Plaque Psoriasis

About 80% of people living with psoriasis have plaque psoriasis, which also is called “psoriasis vulgaris.” “Vulgaris” means “common.”

How to recognize Plaque Psoriasis:

1. Raised and thickened patches of reddish skin, called “plaques,” which are covered by silvery-white scales.

2. Plaques most often appear on the elbows, knees, scalp, chest, and lower back. However, they can appear anywhere on the body, including the genitals.

3. Plaques vary in size and can appear as distinct patches or join together to cover a large area.

In the early stages, the psoriasis may be unnoticeable. The skin may itch and/or a burning sensation may be present.

Plaque psoriasis usually first appears as small red bumps. Bumps gradually enlarge, and scales form. While the top scales flake off easily and often, scales below the surface stick together. The small red bumps develop into plaques (reddish areas of raised and thickened skin).

Now that you know a bit more about psoriasis, we urge you to find out more about this!

About the author: Psoriasis is an inflammatory skin condition and CAN be cured! We urge you to find out more about Psoriasis at http://Psoriasis.eask.info

Psoriasis by Camry James

Natural Acne Treatments Vs Leading Pharmaceuticals

In June 2009, the pharmaceutical giant Roche Holding AG, pulled its Accutane acne medicine from the U.S. market after juries awarded at least $33 million in damages to users who blamed the drug for bowel disease.

According to Bloomberg.com, “Roche notified the U.S. Food and Drug Administration today that it was withdrawing Accutane after a “reevaluation” of its product lines showed it faced serious challenges from generic competitors, company officials said in a statement.”

This is just another in a long list of recent health concerns over pharmaceutical skincare treatments and the serious health risks they may pose.

As the natural skincare movement gains popularity, many consumers are discovering their old over the counter acne treatments can have potentially harmful chemicals that would be best to avoid. In response to these concerns, many have made the switch to all-natural acne skincare treatments. While some are convinced that natural remedies can’t be strong enough to fight stubborn acne. If you are convinced a more powerful acne medication is the best option, read on to find out what approach is right for you to become acne free.

Product	Contains Chemicals	Birth Defects	Depression Psychosis	Skin Irritation	Restrictions on Sun Exposure	Gastro-intestine Disorders
Vivoderm 100% Natural Anti-Acne Mask	NO	NO	NO	NO	NO	NO
Retin-A	YES	NO	NO	YES	YES	NO
Tetracycline	YES	YES	NO	NO	YES	YES
Benzoyl Peroxide	YES	NO	NO	YES	NO	NO
Differin	YES	NO	NO	YES	YES	NO
Skinoren*	YES	NO	NO	YES	YES	NO
Roaccutane	YES	YES	YES	YES	YES	YES

Effective Natural Acne Treatments and Ingredients

There are various home treatments and natural ingredients that have been proven to be effective in treating mild to moderate cases of acne. Some of these may include:

· Massage essential oils into your skin at night such as Tea Tree Oil, Bergamot Oil, Clove Oil, Lavender Oil, and Rosewood Oil. Wash your face clean in the morning with pure soap and water.

· Acne starts within the body, not just at the surface of the skin. Therefore, it is important to drink plenty of water to help detoxify your body and help clear acne.

· You can exfoliate and clear pores with an oatmeal mask once or twice a week. Cook oatmeal and while it is still warm, apply to your face, allow oatmeal to dry and then wash away.

There are many varieties of at home solutions, some of which are effective, and some not. Those with more serious cases of acne however, such as cystic acne, usually turn to stronger over the counter acne treatments.

Over the Counter Acne Treatments

Over the counter acne products tend to be more powerful in fighting acne because each product works differently to target causes of acne. Certain products function by killing Prionibacterium acnes (P.acnes), the bacteria that creates inflammation. Other medications reduce sebum output and renew skin. Other products function by using combinations of these things. Acne medication treatments work in different ways depending on their active ingredient. Here are some common active ingredients that acne products contain.

*Benzoyl Peroxide works to eliminate P. acnes and reduces excess oil and dead skin cells. It is available in different strengths that come in products in certain percentages.

*Salicylic Acid prevents pores from clogging by slowing the process of skin cell shed within hair follicles. It also helps fight whiteheads and blackheads.

*Alcohol and acetone are found in astringents and cleansing washes. They clear your skin of dirt and oil.

These medications might be more powerful in treating acne but they often come with more side effects such as dryness, sensitivity to sun, stinging or irritation, redness or peeling.

There are many natural options that are now available that give you the opportunity to fight acne with powerful results but without the unnatural chemicals that may cause unwanted side effects. The top natural acne treatments have been proven to be as strong as leading pharmaceuticals, yet a perfect compromise between gentle home remedies that don’t show results and powerful but irritating over the counter products.

When it comes to the next generation of acne treatments, the most promising products are natural blends to specific herbal constituents–like Rosemary, Marshmallow, Aloe Vera, Lavender, Fennel, Angelica, and Green Tea – that evade irritating side effects. Vivoderm Laboratories offers a natural acne mask that reduces sebum output, controls inflammation, unclogs pores, and moisturizes skin. It also serves as an acne scar treatment as it regenerates skin affected by redness and scars. Many herbs also contain natural antiseptic properties to attack acne-causing bacteria. This anti-acne treatment removes dead skin cells and repairs blemishes without drying out the skin.

The bottom line is to always be aware of chemicals you expose yourself to and make the choice that is best for you. If chemicals are in any way a concern for you - opt for a natural solution that treats the root causes of acne, not just the symptoms and become acne free – naturally.

A Scientific Look at Moisturizers (pt.1)

Moisturizers are widely used products that are important in many dermatologic and cosmetic skin therapies. They contain varying combinations of emollients, occlusives, and humectants to achieve their beneficial effects, and there is an overwhelming number of formulations available. To develop a rational approach for prescribing moisturizers, commercially available products can be categorized on the basis of application site.

There is a vast array of moisturizers available on the market today and consumer demand for these products is growing. These products range from value brands that provide basic moisturization to luxury therapeutics with claims of anti-aging benefits. A recent US study found that moisturizers are the third most commonly recommended OTC topical skin product (13.4%) behind hydrocortisone (27.6%) and anti-infectives (23.4%).

What Are Moisturizers?

The term moisturizer is a marketing term with little or no scientific meaning. Consumers see moisturizers as actively increasing the water content of the skin. Dermatologists see moisturizers as bland oleaginous substances that are applied to the skin by rubbing. The term “moisturizer” does not necessarily imply that moisture or water is being added to the skin. Moisturizers are a key component of basic skin care especially when there is alteration of the epidermal barrier and reduced water content in the epidermis.
They are used to restore the barrier function of the epidermis, to cover tiny fissures in the skin, provide a soothing protective film, and increase the water-content of the epidermis. They may, thus, slow evaporation of the skin’s moisture, thereby maintaining hydration and improving the appearance and tactile properties of dry and aging skin. Newer products claim to have other properties such as anti-aging, skin-firming, anticellulite, and sun-protectant effects.

How Do Moisturizers Work?

For many years, epidermal water content has been known to be crucial for skin plasticity and the prevention of “dry skin”. Traditionally, moisturization was believed to inhibit transepidermal water loss (TEWL) by occlusion. Water originates in the deeper epidermal layers and moves upward to hydrate cells in the stratum corneum (SC), eventually being lost to evaporation.

The SC architecture is the most important factor in water flux and retention in the skin, and in overall level of moisturization. The four key processes for the formation and functioning of the SC are the corneocyte process, SC lipid process, natural moisturizing factor (NMF) process, and desquamation process. Corneocytes are the physical barrier of the SC and, when hydrated, contribute to elasticity. The lipid bilayers of the SC function as a moisture barrier and although they prevent the entry of many chemicals, they are the means of entry for most topically applied substances. The NMF is found within corneocytes and is a mix of hygroscopic molecules that, by helping maintain hydration in the corneocyte, keep the SC hydrated. Half of the NMF is amino acids derived from the protein filaggrin in keratinocytes, and the other half is salts, including lactates, urea, and electrolytes. Production of NMF is directly related to external humidity. In desquamation, corneodesmosomes are degraded by water-dependent hydrolytic agents. When there is low moisture in the SC, these enzymes do not work efficiently. Corneocytes accumulate on the skin surface producing the signs of dry skin, e.g., when the moisture content is less than 10%, and when there is loss of continuity of the SC.

The moisturizing treatment involves repairing the skin barrier, retaining/increasing water content, reducing TEWL, restoring the lipid barriers’ ability to attract, hold and redistribute water, and maintaining skin integrity and appearance. Moisturizers perform these functions by acting as humectants, emollients, and occlusives. Moisturizers containing collagen and other proteins, i.e., keratin and elastin, claim to rejuvenate the skin by replenishing its essential proteins but whether or not they have any effect on skin hydration is questionable. Moisturizers also act to reduce skin friction and increase skin hydration by providing water directly to the skin from their water phase and by increasing occlusion, as measured as a decrease in TEWL. Loden suggests that skin care products not only form an inert, epicutaneous layer, but that they also penetrate and influence the structure and function of the skin.

Moisturizers have little effect on the mechanical properties (i.e., distensibility, hysteresis, and elasticity) of the skin but do increase skin hydration significantly, as shown by an increased skin capacitance.10 When moisturizers are used to improve skin plasticity it is suggested that lipid-rich formulations be used.

Emollients

Emollients, which are mainly lipids and oils, hydrate and improve the appearance of the skin by contributing to skin softness, enhanced flexibility, and smoothness. The “skin slip” or lubricity of some moisturizers, contributes to consumer satisfaction and product preference. Consumers desire smooth skin following moisturizer application. Emollients serve to fill the cracks between clusters of desquamating corneocytes and are not usually occlusive unless applied heavily.

Long chain saturated fatty acids and fatty alcohols are commonly used in topical pharmaceuticals and cosmetic formulations. They exert their benefits through effects on the skin barrier, partially through improved repair, and on permeability. Examples include stearic, linoleic, linolenic, oleic, and lauric, which can be found in palm oil, coconut oil, and wool fat. A sterol-enriched fraction from canola oil reduced clinical signs of sodium lauryl sulphate (SLS)-induced irritation. Other lipids (e.g., fish oil, petrolatum, shea butter, and sunflower seed oil) had no effect on the degree of irritation. Loden and Andersson suggested that canola oil assisted the skin in supplying the damaged barrier with adequate lipids. Essential fatty acids (i.e., linoleic and alpha-linoleic acids) influence skin physiology and pathology via their effects on skin barrier functions, eicosanoid production, membrane fluidity, and cell signaling.

Next article will focus on emollients, occlusives, and humectants and what an ideal moisturizer should be….

J. N. Kraft, BSc (Hons)1 and C. W. Lynde, MD, FRCPC2
1Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
2University Health Network (Western Division) and Department of Dermatology, University of Toronto, Toronto, Ontario, Canada

Removing Blackheads and Comedones

Eliminate blackheads and whiteheads

Blackheads are tiny, dark spots caused by a small plug in the opening of a follicle (pore) on the skin. Blackheads are also called open comedomes. A blackhead is a type of acne vulgaris. It is caused by excess oils that have accumulated in the sebaceous gland ’s duct. Blackheads are typically caused by excessive oil and makeup, which can facilitate the multiplication of the bacterium propionibacterium acnes, the predominant anaerobe of the normal skin flora. The substance found in these bumps mostly consists of keratin and modified sebum (an oily secretion of the sebaceous gland ), which darkens (resembling dirt) as it oxidizes.

If you suffer from blackheads or whiteheads and need to know which products are best. Look for non-comedogenic products - they are less likely to cause blackheads (called open comedones) or whiteheads (closed comedones). Most brands of make-up are non-comedogenic, which means they won’t clog your pores. If your skin is prone to acne or
especially sensitive, try to find products that are non-comedogenic, oil-free (water-based), hypoallergenic (unlikely to cause an allergic reaction) and fragrance free. It may be helpful to remove make-up before exercise, as the products can travel across the face through sweat and clog your pores. However, since no product is non-comedogenic for everybody, it’s a good idea to first test any new product on a small area of your own skin.

Blackheads are the slightly different sibling of pimples, and like pimples, squeezing them can be damaging. Composed of the same oil, or sebum, that contributes to the production of pimples, blackheads result from a building up of this oil in pores. The difference in appearance than that of a pimple is the result of the blackhead’s exposure to the air.
The oxidation (or darkening)  of the the oil causes the trademark black color of these blemishes.

While blackheads are more easily obscured by makeup, they can seem less offensive to the sufferer, and as a result, less damaging to squeeze. But squeezing is not good for blackheads. It can leave a permanent scar on skin and also leaves your skin open to infection. Comedones (blackheads and whiteheads) are caused by the densely packed skin cells. Comedones, commonly appear on the face and shoulders, but they may also develop on the trunk, arms, legs,
and buttocks. They are most common in teenagers but can occur at any age, even in infants.

Treatment for whiteheads and blackheads depends on the severity of the condition. Treatment may include lotions or gels placed on blemishes or sometimes entire areas of skin, such as the chest or back (topical medications). Oral medications, such as antibiotics, may be prescribed.

Causes of Blackheads

Blackheads are caused when excess skin oil, sebum and congesting toxins are expelled through your skin from the blood and lymph fluid that supplies your skin with nutrients. These congesting toxins combined with skin oil and sebum clogs your pores causing blackheads, whiteheads, and full blown acne. Dirt also plays a big role in developing skin blackheads. The dirt stored on the face or other parts of body help the bacteria to develop.

Symptoms of Blackheads

Blackheads and whiteheads are a combination of oils, sebum and cellular fragments that form firm to hard plugs within hair follicles. Blackheads are open to the skin’s surface and become darkened at the surface by exposure to oxygen (oxidation). They are called open comedones (or comedo, singular). Whiteheads are closed from the skin’s surface by
cellular debris at the follicle opening. Because they are closed from oxygen they do not oxidize or turn brown. They form a light or yellow-white lump and are called milia (or milium, singular). When bacteria is added to these plugs, the condition can lead to acne.

Treatment of of Blackheads

Mild cases of acne can be self-treated with over-the-counter topicals (applied to the skin) creams typically with benzoyl peroxide. Zinc Oxide is also a safe natural alternative to reduce infections. There are also a variety of different medications that your family physician might prescribe that come as creams, ointments, and pills. Some of the stronger medications for acne are not to be used if you are pregnant, so make sure you tell your doctor if this is a possibility. Most acne medications work by reducing the next “crop” of acne, so don’t get discouraged if the treatment does not work right away.

Home Remedy for Blackheads
1. In 3-4 cup boiled water, add 2 tsp of soda bicarbonate. Steam a towel with this. Thereafter, place the towel gently on your face. Do it for about 5-6 times. Make a paste by mixing 1 tsp curd and 1 tsp rice flour.  Apply the paste on the affected area. After some time, wash your face with cold water.

2. Take about 1 tsp of juice extracted from fresh coriander leaves and add ½ tsp of turmeric powder in it. Apply this mixture while going to bed. Wash your face the next morning with cold water.

3. Take a pinch of soft portion of glycerin soap and mix with a pinch of table salt. Apply this mixture on the blackheads. Do it for about a week and see the magical results.

4. Salicylic acid, glycolic acid, benzyl peroxide, etc. can be counter-productive to softening and dissolving blackheads and whiteheads as they can dehydrate dry, normal and combination skin

5. Make a paste by mixing 1 tsp limejuice and 1 tsp of finely powdered cinnamon. Apply it on the affected area before going to bed. Wash it off in the morning.

When looking over other strategies on how to remove blackheads, you want to make sure that you are not using your fingernails to squeeze. Your fingernails could be loaded with all kinds of bacteria, which could cause infections. If you do decide to squeeze, make sure you are properly cleaning and sterilizing your hands or using a tissue, to reduce the risk of infection.

Exercise caution. Squeezing a blackhead too much or too soon may lead to the rupturing of a blood vessel. Even though this is a rare occurrence, it can still happen. If you find this happening to you, do not continue to squeeze the blackhead because you may make it worse.

Harmful Skincare Ingredients in Pregnancy

By Van Le | Many pregnant women radiate that natural special “glow”, however, hormonal changes can also influence new reactions to certain chemicals. Knowing what, and more importantly, what not to put into your body during those nine months can affect the well-being of you and your baby. What to put on your body is no different. Since some skincare products can seep into the bloodstream, pregnant women should avoid the following ingredients.

Retinoids

Due to the ability to accelerate cell growth and renewal, retinoids (a type of Vitamin A) are commonly found in many anti-aging products. While Vitamin A is vital for growth and development of the fetus, excessive amounts can lead to birth defects. A study conducted in 1995 suggests that women who consume more than the recommended amount of Vitamin A in the first two months of their pregnancy doubled the risk of having a child with birth defects, according to the March of Dimes website. Topical application of retinoids has not been proven to be harmful, but as a precaution, many doctors and the National Institute of Health advise pregnant patients to stay away from skincare products containing this ingredient.

Salicylic Acid

Acne can wreak havoc anytime, but can be especially frustrating during pregnancy. Salicylic acid is a powerful and common remedy to help sooth inflammations and reduce redness caused by acne pimples, however, it can be harmful for the developing fetus. Medical experts have yet to pinpoint the exact amount of salicylic acid to deem as harmful, but believe that it can lead to respiratory problems for both the mother and baby.

Oxybenzone and Avobenzone

Just because you’re pregnant does not mean you can’t have some fun in the sun. As always, sun protection is pivotal, especially during hours of 10am and 4pm, when the sun’s UVA and UVB rays are most harmful. During the 1970s the Food and Drug Administration approved oxybenzone and avobenzone as safe UVA absorbers, however, a study done at Mt. Sinai School of Medicine in New York states that oxybenzone may cause lower birth weight in baby girls and has also been linked to cell damage and allergies. Avobenzone is capable of absorbing UVA lights, making it effective in sunscreen products, however, it can be absorbed into the skin, therefore, some healthcare professionals encourage expecting mothers to stay away from products containing oxybenzone and avobenzone. A safe sunscreen alternative is zinc oxide, which is made of organic ingredients that siton top of the skin as a protective barrier. Physical sun protection such as clothing as hats are also effective and highly recommended by doctors.

An expecting mother may not have total control over her cravings or hormones, but can dictate which products and ingredients go in and on her body. Most pregnant women abstain from products that have been proven as dangerous and unsafe, such as alcohol and cigarettes. A commitment to stay away from potentially harmful ingredients can also have long-lasting positive effects for both the mother and unborn child.

Van Le is a staff writer for the CSU paper the Daily Titan and writing intern for Vivoderm Laboratories in Los Angeles, California. She is currently pursuing a Journalism degree at California State University, Fullerton.

For the latest findings on natural skincare link to http://naturalantiagingproducts.net

The Dangers of Parabens in Cosmetic Products

By: Van Le |  The cosmetic industry brings in billions of dollar annually, and every day, thousands of consumers meticulously search for the perfect shade of foundation, concealer, or powder to match our skin.  We analyze the front of the product, looking closely at the color, packaging, and eye-catching designs, but rarely look at the back of the products.  The few times that we turn the product over to look at the back labels, we often only read the directions for use and our eyes almost never make it down to the ingredients list.  Recent trends have pushed consumer awareness of potentially harmful cosmetic ingredients, specifically parabens.

Parabens are widely used as preservatives in cosmetic products, and they prevent the growth of microorganism such as mold and fungus.  They are esters of p-hydroxybenzoic acid and commonly labeled in beauty products as methylparaben, propylparaben, and butylparabens.  Parabens have been widely used in makeup without regulation since the Food and Drugs Administration (FDA) does not have the authority to approve cosmetic products, however, there have been recent studies that suggest parabens may be linked to breast cancer.

The FDA notes that the Cosmetic Ingredient Review, an industry-sponsored organizations that looks at the safety of cosmetic products, states that methyparaben, propylparaben, and butylparabin are all safe to when used alone up to 0.4%.  Companies that use parabens often use a combination of several parabens in their products, however, industry experts still insist that they are safe.  Companies often use parabens because they are cheap and extend the product’s shelf-life.

The Breast Cancer Fund is an organization dedicated to eliminating environmental factors that can lead to the disease, and according to its website, conducted a study in which high amounts of parabens have been extracted from biopsy samples of breast cancer tumors.  The website also states that  “parabens have also been found in almost all urine samples examined from a demographically diverse sample of U.S. adults,” suggesting that our skin absorbs the parabens.

As a result, organizations such as the Breast Cancer Fund are spearheading campaigns to increase consumer awareness and urge companies to eliminate parabens from their products.  “Think Before You Pink” is a campaign that reveals names of companies who claim to support the fight against breast cancer, but actually use ingredients that are linked to the disease in their products.

Since there is currently not enough scientific proof to show that parabens are harmful to the body, the FDA cannot ban its use, however, many consumers are taking the precautionary route by choosing products that contain natural ingredients.  The argument over the safety of products containing parabens continues. Although physical beauty is only skin deep, cosmetic products containing parabens can seep beyond the skin and harm our bodies.

Van Le is a staff writer for the CSU Daily Titan and writing intern for Vivoderm Laboratories in Los Angeles, California. She is currently pursuing a Journalism degree at California State University, Fullerton.

For the latest findings on natural skincare, you can also link to http://zincmoisturizer.com

Skincare Dollars and Sense

Many consumers are frustrated by skin care products that don’t do what they claim to. Worse still is investing in an expensive yet ineffective cream or treatment only to discover the cheapest drug-store brand would work just as well. In a world of hyper-consumerism, false advertising and a plethora of products from which to choose, how do you choose the good from the bad?

There are some great products on the market that can genuinely improve your skin’s appearance and help your skin look smoother, more radiant, and youthful. But, there are literally thousands of products to choose from and unless you spend hours a day researching beauty products, it’s difficult to find the one of the few that actually produces real results and eliminates years of aging from your face and body.

Not only should a quality skin product help reduce bags under, and fine lines around, the eyes, but it should even out coloration inconsistencies caused by age spots and other unwanted pigment concentrations.

In a marketing-rich world of super models and glamorous actors, many will understandably spend any amount of money to make themselves look better or younger. Cosmetic surgery and skin care is a multi-billion dollar industry.

As the law of supply and demand proves, the higher the demand for youth and beauity, the more manufacturers will rush to provide the solution. Many times this rush results in the creation of an inferior product with little to no research and development to back it.

All of the money goes into the marketing of the product. On the surface everything looks great. The bottles and jars that the creams come in look appealing. The magazine advertisements are glossy, complete with a youthful looking model or a well known celebrity who doesn’t even really use the products.

You can’t really blame these companies. When you are spending a fortune paying for marketing, whether it be on the product containers, magazine, radio, and TV ads, royalties paid to celebrities and models, you have to charge a lot of money for your products or you’re going to lose money.

On the other hand, this doesn’t mean you and I have to fall for these types of marketing schemes. After all, these companies aren’t going to encounter any shortage of people who will open their wallets and purses to purchase their products anytime soon. The reality is most people simply won’t take any time to research products and understand what ingredients work and what ingredients are actually bad for your skin!

Retinoids and Dry Skin

Dry skin recommendations and supplements that can help your skin

RETINOIDS
The group of medicines known as retinoids are derived from Vitamin A. Creams containing the retinoids retinol and retinaldehyde can be obtained over the counter at pharmacies and supermarkets. Other topical retinoids containing tretinoin or isotretinoin require a doctor’s prescription. Adapalene is a related prescription medicine.  Topical retinoids can be applied to any area but are most often used on the face, the neck and the back of hands.

When you first start using the retinoid, apply your night cream first then re-apply the retinoid. Do this every third night for two weeks. Then apply moisturizer followed by retinoid every other night. If no redness occurs after two weeks you can adjust your regimen and apply the retinoid after cleansing but before your night cream. Then apply the night cream after the retinoid. Do this, using the retinoid every other day, for one week.

If you experience redness or flaking, begin using the retinoid every night. In about twenty-four weeks you will notices fewer wrinkles and smoother skin as well as preventing future wrinkles. Since retinoids speed up the rare at which skin cells divide, some flaking is normal. This flaking is not additional dryness, but rather dead skin cells sloughing off. You can use a facial scrub once or twice a week before an important event to remove these fakes, allowing your skin to look radiant. Stronger products are more irritating than those with a lower percentage of retinoids, so you can switch products depending on your needs.

Dermabrasion 101

Dermabrasion is one of three commonly used office-based surgical skin resurfacing and rejuvenation procedures. The technique takes its origin from ancient Egypt in 1500 B.C. where healers used a form of sandpaper to even out scars. Today the technique has seen over 3500 years of evolution.

Dermabrasion mechanically removes the most superficial layers of the skin and allows your skins normal healing properties to rejuvenate the skin itself. It is designed to reduce or remove moderate wrinkles, fine lines, skin blemishes, and uneven skin surfaces. In addition to wrinkle treatment, the technique has been used to treat acne scars, hide or camouflage surgical or traumatic scars and in select cases to remove precancerous lesions.

Microdermabrasion is not the same treatment as dermabrasion and will not be discussed further than this paragraph. Microdermabrasion is a much more superficial and thus a less dramatic rejuvenation procedure with little to no recovery period. Being a more mild procedure than dermabrasion, multiple treatments of micordermabrasion are often required and may never achieve the same degree of rejuvenation as traditional dermabrasion. Microdermabrasion uses a device that sprays a fine beam of aluminum oxide microcrystals to superficially peel the skin surface while simultaneously removing the tissue debris. As microdermabrasion is not as invasive a procedure, non-medical personnel offer this treatment through many spas and clinics.

Skin rejuvenation can also be performed with lasers or chemical peels. These modalities will not be discussed in this article.

CAUTIONS
Patients with darker skin complexions (Fitzpatrick skin types III to VI) may experience permanent skin discoloration or blotchiness with dermabrasion procedures. Patients of African, Asian and Hispanic descent should specifically be cautioned about skin discoloration.

PRE-TREATMENT CARE

Patients with a history of oral herpes infections should be placed on oral acyclovir prior to this treatment to avoid a herpes flare or extension of the condition following dermabrasion.
THE PROCEDURE
Dermabrasion is performed in an out-patient (often office) setting under local anesthesia. Full-face dermabrasion is performed under conscious sedation or general anesthesia, often with the assistance of an anesthetist. A small motorized hand piece rotates a wire brush or diamond fraise at speeds of 15,000 to 30,000 rpm. Skilled manipulation of the rotating brush or fraise removes the upper layers of skin in the areas requiring treatment. This results in a raw, open, partial thickness (through skin) wound that heals by epithelialization of the surface of the skin in a relatively short period of time. Initially the small pinpoint bleeding of the raw wound may be alarming but will subside rapidly with appropriate wound care.

THE RECOVERY
The recovery following dermabrasion skin resurfacing is approximately 2-3 weeks. Early post-operative pain is controlled with prescription medications for the first few days. Most patients require only over-the-counter medications or are comfortable without pain medication within days of the procedure. The skin may weep for the first 10-12 days but eventually stops as the surface layers of the skin are restored. Redness of the treated area is a normal part of recovery and disappears within 3-4 weeks of the procedure. Complete sun avoidance on the treated area must be observed until the redness in the skin has disappeared. Remember good sun protection should still be observed well after the healing period, as it was likely the sun damage to your skin that has driven you to seek this form of treatment in the first place.

Make-up can be used to cover the early skin discoloration once the skin has healed. Please ask your physician or surgeon for directions on when make-up can be used safely.
COMPLICATIONS

A discussion of potential complications is essential with every discussion about a surgical procedure. It is important to know that although complications from surgery are possible they are not common. Some possible complications associated with a dermabrasion are listed into both early and late complications:

EARLY
* Excessive surface bleeding
* Redness (fades with time)
* Infection (viral)
* Skin sensitivity

LATE
* Hyperpigmentation
* Hypopigmentation
* Milia
* Asymmetry (between sides)
* Residual wrinkles
* Scarring

For a more detailed discussion on expected results, recovery, and specific complications, please see your individual surgeon.

COST
Dermabrasion procedures are not covered under most insurance plans and the final cost for such procedures will be at the discretion of the plastic surgeon performing the procedure. Most surgeons quote costs based on the number of aesthetic areas being treated. The average cost of this procedure, is $1000 and higher.

DISCLAIMER
This website does not cover all of the medical knowledge related to dermabrasion nor does it deal with all possible risks and complications of skin resurfacing procedures. Although it is designed to provide the patient with greater depth of information in some areas, it is not intended to substitute for the in depth discussion between patient and surgeon that must occur prior to any surgical or treatment procedure. For a more detailed discussion on expected results, recovery, and specific complications, please see your plastic surgeon or dermatologist.

Author: Dr. Bryce J Cowan BSc MSc MD PhD FRCS(C)
Plastic, Reconstructive, Mohs & Aesthetic Surgeon

Side Effects and Conditions Caused By Isotretinoin

Minor discomforts such as dry mouth or nose, dry eyes, dry skin, or itching usually go away as the body adjusts to the drug and do not require medical attention unless they continue or are bothersome.

Other side effects should be brought to a physician’s attention. These include:
•    burning, redness, or itching of the eyes
•    nosebleeds
•    signs of inflammation of the lips, such as peeling, burning, redness or pain

Bowel inflammation is not a common side effect, but it may occur. If any of the following signs of bowel inflammation occur, stop taking isotretinoin immediately and check with a physician:
•    pain in the abdomen
•    bleeding from the rectum
•    severe diarrhea

Conditions Caused By Benzoyl Peroxide and Tretinoin

The most common side effects of antiacne drugs applied to the skin are slight redness, dryness, peeling, and stinging, and a warm feeling to the skin. These problems usually go away as the body adjusts to the drug and do not require medical treatment.
Other side effects should be brought to a physician’s attention. Check with a physician as soon as possible if any of the following side effects occur:

•    blistering, crusting, or swelling of the skin
•    severe burning or redness of the skin>
•    darkening or lightening of the skin (This effect will eventually go away after treatment with an antiacne drug ends.)
•    skin rash

Other side effects are possible with any type of antiacne drug. Anyone who has unusual symptoms while using antiacne drugs should get in touch with his or her physician.
Interactions

Patients using antiacne drugs on their skin should tell their physicians if they are using any other prescription or nonprescription (over-the-counter) medicine that they apply to the skin in the same area as the antiacne drug.

Isotretinoin may interact with other medicines. When this happens, the effects of one or both drugs may change or the risk of side effects may be greater. Anyone who takes isotretinoin should let the physician know about all other medicines being used and should ask whether the possible interactions can interfere with drug therapy.

Among the drugs that may interact with isotretinoin are listed below:
•    Etretinate (Tegison), used to treat severe psoriasis. Using this medicine with isotretinoin increases side effects.
•    Tretinoin (Retin-A, Renova). Using this medicine with isotretinoin increases side effects.
•    Vitamin A or any medicine containing vitamin A. Using any vitamin A preparations with isotretinoin increases side effects. Do not take vitamin supplements containing vitamin A while taking isotretinoin.
•    Tetracyclines (used to treat infections). Using these medicines with isotretinoin increases the chance of swelling of the brain. Make sure the physician knows if tetracycline is being used to treat acne or another infection.

Parental Concerns

Acne comes at a difficult time, the adolescent years. While mild acne can be treated with over-the-counter medications, more severe acne needs medical attention. Experts advise against a wait-and-see attitude. Treatment options can help control acne and avoid scarring.

Isotretinoin can cause serious birth defects, including mental retardation and physical deformities. This medicine should not be used during pregnancy. Sexually active adolescent females who are able to bear children should not use isotretinoin unless they have very severe acne that has not cleared up with the use of other antiacne drugs. In addition, acne treatments that can dry the skin should be used with caution by people with skin of color.

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