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The Derm Blog

Smarter Skin Care

Liver spots have nothing to do with your liver. They are actually “sun” spots and are the result of sun damage to melanocytes, the pigment making cells in your skin. Although patients often think these brown spots occur only on the back of the hands, they can be found anywhere there is sun damage such as the face, chest, back, and scalp.

Sun spots are a sign of aging; it takes years of sun damage to develop them and they are associated with being old. As such, patients often ask me what they can do to get rid of them.

There are many ways to treat sun spots including freezing them with a cryospray, zapping them with a laser, applying a chemical peel, and treating with bleaching creams. Treating them with lasers, peels, or freezing can be painful and can lead to more pigmentation from damage done by the treatment. Bleaching creams can work, but many of the products currently available are not potent enough to lighten these spots satisfactorily.

A recent study published in the Journal of Drugs and Dermatology examined the effectiveness of a new treatment that combines a bleaching agent with a retinoid to treat these brown spots. Retinoids are used to treat a variety of skin conditions from acne to wri

Botox Might Help Shrink Pores, Reduce Excess OilNovember 16

Botox® (botulinum toxin A) is a popular and effective treatment for wrinkles. Now using Botox might have another benefit, reducing large pores on the skin.

Having pores that are too big on the nose and forehead is a common complaint from men in clinic. Men have a higher density of sebaceous glands than women and sometimes have excessively oily skin with wide, deep pores. Excess oiliness and big pores can be difficult to treat. Surgical treatments such as lasers, microdermabrasion, and chemical peels can be used to improve the appearance, but results are often not satisfactory. Topical retinoids such as Retin-A® and Tazorac® can also effective in some people, but require applying the medication daily.

A cosmetic physican in Chicago has published a study using Botox to treat oily skin complexion and large pores. He found that 17 of 20 patients who received Botox in the skin reported a reduction in the oiliness and the pore size in the treated areas.

Botox works by blocking the release of a neurotransmitter, acetylcholine. Acetylcholine controls sweating, which is why Botox works so well to treat excess perspiration (hyperhidrosis), and can effect production of sebum. Botox injected into the skin then can block excess sebum production le

New Powerful Skin Antioxidant From FernsNovember 12

Every new skin care product and berry juice touts its antioxidant properties and ability to keep you young and wrinkle free.

In theory, eating foods high in antioxidants like blueberries or acai berries, or applying topical antioxidants like vitamin C should soak up free radicals. However, in reality, consumed antioxidants do not concentrate in the skin (no matter how much Mona Vie you drink) and topically applied antioxidants degrade too quickly to have any effect (despite what they tell you in the infomercial).

To make matters worse, most antioxidants applied to the skin don’t penetrate the dead, outer skin and so cannot have any effect on the living skin below (sort of like trying to clean a window that is dirty on the outside by applying cleaner on the inside). That may change soon.

A group of physicians at Duke University is working to find a way to apply potent topical antioxidants which are stable, penetrate the skin, and have measurable damage-protecting abilities. Through years of research, they found that popular antioxidants such as vitamin C and vitamin E do not live up to their claims, and have little if any actual antioxida

Why Do Quarterbacks Get Acne?November 10

It was a real dilemma. A patient of mine came to see me last week for acne. He is the star quarterback for one of the local high schools and is having a great season. At the same time that his passing-yards-per-game increased, so have the number of pimples on his face. Interestingly, his acne is confined to his chin and jaw.

So here is this handsome kid who is the new star on campus with big red pimples all over his chin. Could his acne be related to football?

It is. Acne is common in teenagers, over 80% have some acne during these years. While we have dispelled some of the myths, like eating greasy foods makes acne worse, there are things in a teenager’s life that can exacerbate the problem: in this case, football equipment.

There is a skin condition called acne mechanica that occurs in areas where the skin is occluded. This often happens under athletic equipment. It is common in high school athletes, especially hockey and football players. When solid or nonbreathable materials, such as pads or straps, rest on the skin, it occludes the pores. Heat and friction under the material makes the problem worse.

It can be improved by applying a breathable fabric such as cotton between the equipment and

Hormone Replacement Therapy Doesn’t Make You YoungerNovember 5

For post-menopausal women, decreasing estrogen levels might contribute to skin aging. Common skin changes associated with being post-menopausal include atrophy (thinning of the skin), wrinkling, dryness, laxity, sallow complexion, and poor wound healing. There are estrogen receptors in the skin and it is thought that the decrease in estrogen that accompanies menopause leads to a loss of estrogen activity and to these undesirable skin changes.

It is commonly believed that estrogen replacement in addition to relieving hot flashes, also gives the skin a younger, healthier, pre-menopausal appearance. However, studies thus far have been conflicting and there is little research to support these claims. A recent study examined if treating post-menopausal women with hormone replacement therapy would improve their skin.

The researchers took post-menopausal women who had crows feet, jowls, and dry skin and gave some women hormone replacement and some women a placebo. Nearly 500 women were enrolled in the study that lasted about a year.

Unfortunately, they found that there was no differences in skin wrinkling or complexion in women who took hormone replacement as compared to those who took the placebo.

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