You guys asked so many great skincare and skin health questions on my social media channels, so I wanted to share some of my responses right here!

Q: I suffer from Melasma and wonder if you recommend any supplements in addition to taking the normal precautions for Melasma?

Dr. Bowe: This is such an important topic and I’m so glad you asked. I have a series of three posts all about Melasma, my in-office strategies, and the products I typically recommend to my patients right on my website! Here are links that I think you will find helpful (my answer to your question is in Melasma 102)!! https://drwhitneybowe.com/melasma-101-understanding-this-condition/, https://drwhitneybowe.com/melasma-102-game-plan/, https://drwhitneybowe.com/melasma-103-q-a-with-dr-whitney-bowe/.

Q: Do you recommend Botox?

Dr. Bowe: Hi! I just did an interview all about Botox with my good friend, Julia Dfazic of Lemon Stripes! Here is a link: https://lemonstripes.com/lifestyle/botox/

Q: What skincare products to use to minimize acne scars from cystic acne?

Dr. Bowe: Excellent question – I have a post on my website all about cystic acne! Here is a link I think you will find helpful: https://drwhitneybowe.com/acne-q-a-focus-on-cystic-acne/.

Q: I love the dewy fresh glow for spring. How can I do that?

Dr. Bowe: ANSWER: I love it too! I was recently on Good Morning America demonstrating the HydraFacial, which I have found is really effective in achieving a healthy, radiant glow. Here are a few links on that: https://drwhitneybowe.com/dr-bowes-guide-to-the-facial-thats-been-making-a-splash-for-healthy-beautiful-skin-the-hydrafacial/ and https://drwhitneybowe.com/the-hydrafacial-a-healthy-beautiful-glow-this-spring/. Also, for a more comprehensive approach to your skin’s health, check out this post: https://drwhitneybowe.com/forget-8-glasses-of-water-a-day-why-drinking-even-a-bathtub-full-of-water-wont-give-you-the-dewy-healthy-skin-you-want/. I share a lot of information about nourishing your skin from the inside out on my website, my social media, and in my book, The Beauty of Dirty Skin. For a lasting healthy glow, I believe what you put into your body is just as important as the topical products you use on your skin!!

Q: What do you recommend for men’s razor bumps and rash?

Dr. Bowe: I recommend that my patients shave at the end of their shower or after getting out of the shower so that your skin has a chance to warm up. I also recommend using a very gentle exfoliant before shaving. You don’t want to aggravate and irritate your skin and hair follicles, but a gentle exfoliant can be very helpful, pre-shave. After you shave, I recommend a moisturizing lotion with antibacterial ingredients. If my patients have very sensitive skin, I often suggest staying away from heavily scented products, as they can be very irritating. I also always keep a fresh aloe plant in my house for all types of skin irritation. Smoothing fresh aloe over angry skin is my go-to at home remedy.

Q: Are there any over the counter facial exfoliating products gentle enough for Melasma?

Dr. Bowe: One option to consider is my Oatmeal Coconut-Oil Power Mask/scrub for sensitive skin. I include this recipe in my book, The Beauty of Dirty Skin. The oatmeal gently removes the dead cells on the surface to reveal your glowing skin underneath. You will need 1 tablespoon coconut oil (melt it down first), 3 tablespoons rolled oats and warm water. I typically advise my patients to leave it on for 15 minutes (and to gently exfoliate by rubbing in the mask in circular motions during application) and then rinse with cool water and pat dry. Or, you can simply use a baby washcloth for a gentle, mechanical exfoliation. In terms of an OTC option, I like this product by La Roche-Posay: https://www.dermstore.com/product_UltraFine+Scrub_27304.htm

Q: We are always told to reapply sunscreen after 2 hours. Does that mean 2 hours after application or 2 hours after sun exposure? I often put on sunscreen inside before I put on my bathing suit, but don’t immediately go outside. Same thing with my facial sunscreen.

Dr. Bowe: I look at the studies and the science before giving my recommendations. The standard rule of thumb at this time is to apply your sunscreen 15-30 minutes before heading outside and reapplying every 2 hours (more frequently if you have just gone swimming or if you are sweating excessively from exercise). Here is a study which is on point: https://www.ncbi.nlm.nih.gov/pubmed/11712033. With the FDA’s new proposed regulations and discussion of sunscreen safety (I will be sharing a lot more on this on my website), I often opt for UPF swimsuits, rashguards, and clothing for myself and for my daughter. We find they are a game changer in terms of enjoying our time at the beach or pool and minimizing the surface area we have to continuously cover with sunscreen!

Q: Is there a more cost effective alternate to CE Ferulic?

Dr. Bowe: CE Ferulic is one of my all-time favorite serums. While it is at a higher price point, it is just one of those products that I feel is worth the investment because it is effective and delivers results (admittedly, the scent is not my favorite aspect of the serum). For more cost effective options, my patients often love the No 7 serums. I share a lot of information about them on my Dr. Whitney’s Picks page: https://drwhitneybowe.com/dr-whitneys-picks/.

Q: Do you recommend a series of chemical peels or microneedling?

Dr. Bowe: My patients love in-office chemical peels. For dull, dry skin, I opt for a glycolic acid peel. For oily/acne prone skin, I focus on a salicylic acid peel. Both options will help boost your healthy glow (and if you are planning to wear makeup for an event, your makeup applicationwill be so much more smooth and beautiful). For an at home option, check out this “babyfacial” from Drunk Elephant. And, here is my post all about microneedling, which my patients love and we have wonderful results: https://drwhitneybowe.com/microneedling/. In terms of which one would best suit your needs? It will depend on your personal skincare goals and budget! I love both options!

There are a few questions I haven’t hit upon yet, so I will circle back to those very soon!

Dr. Whitney

Question 1: How do I get rid of cystic acne?

ANSWER: Cystic acne is usually a result of hormones, stress and diet. The cysts are deep, and often tender or even painful, and they tend to stick around for what feels like FOREVER! If you try to pop them, nothing comes out because they’re not connected to the surface. You usually end up making things worse. When the cysts resolve, they leave marks that can sometimes last for weeks or even months.

Ok, enough doom and gloom. What can we do to treat or prevent cystic acne? Although the typical acne creams with retinoids and benzoyl peroxide can’t hurt, they don’t do much in cases of cystic acne. To treat cystic acne, it’s best to use a multimodal approach. First, diet and stress are key factors in this kind of acne. More on how to make some dietary and lifestyle changes that will help prevent cystic acne below. Second, many of my patients with cystic acne benefit from prescription hormonal medications such as birth control pills or a medication called spironolactone. If you’re going the birth control route, you should make sure your pill contains BOTH estrogen and progesterone. Progesterone only forms of contraception (the “mini-pill,” implantable devices and even some IUDs can make cystic acne MUCH worse). Spironolactone has literally been a game changer in my practice. It’s a pill you take every day that blocks the effects of male hormones on the skin, and can dramatically clear up adult female acne. But I like to keep the doses low and to do that, I need to make sure my patients are following the right diet and reducing their stress levels as much as possible. That’s one of the reasons I wrote The Beauty of Dirty Skin (link below). It’s easy to write a prescription, but diet and stress management is complicated! You can write chapters on those topics… so I did! Last, I like to tackle cystic acne using minimally invasive procedures in my office like cortisone injections, chemical peels and light-based therapies.

Question 2: Is there anything other than Retin A, cortisone injections to treat cystic acne? What preventative steps can be taken in terms of diet and lifestyle?

ANSWER: Cortisone injections can be amazing if you can get in to see a derm, but that’s easier said than done for most people! When it comes to diet, it’s essential to avoid skim milk, as this has been shown in a number of studies to trigger acne. But also beware of milk proteins that might sneak their way into your diet: whey and casein can play a major role in acne for some people, and they are commonly found in protein powders and “healthy” bars that are high in protein. High cortisol levels can also make cystic acne lesions explode all over your chin. It’s essential to start making lifestyle changes that drop those cortisol levels and keep them in a healthy range. One tip for doing that is incorporate regular exercise. Regular exercise reduces stress levels very effectively and helps you sleep better (which in turn further reduces your stress hormone levels in your blood).

Question 3: Are regular treatments like peels or lasers something that should be considered to minimize future cystic acne breakouts and/or reduce residual scarring?

ANSWER: Absolutely! My patients who can afford to get regular peels and light-based therapies see a huge difference in their skin FAST. Salicylic acid chemical peels combined with Theraclear (also called Acleara) light treatments are incredibly effective and work FAST. In my practice, I use a number of lasers and devices to improve acne scarring and minimize pore size, including Fraxel, Endymed Intensif and Microneedling. However, these treatments can be costly and those costs can add up.  Even without these therapies, if you use the right skincare products and make certain lifestyle changes (detailed in my book – The Beauty of Dirty Skin), you can achieve beautiful, radiant skin on any budget!

xoxo,

Dr. Whitney

@DrWhitneyBowe

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