I’m so excited to share this incredibly relevant and high yield conversation with Dr. Peter Lio. If you are wondering if you should avoid gluten in your diet and/or skincare, pondering which petroleum alternatives are best for dry skin, or how ingredients like honey and oatmeal affect skin health and our skin microbiome, this is a must read!

[More about Dr. Lio: he is a Clinical Assistant Professor of Dermatology & Pediatrics at Northwestern University Feinberg School of Medicine. He received his medical degree from Harvard Medical School, completed his internship in Pediatrics at Boston Children’s Hospital, and his Dermatology training at Harvard. While at Harvard, he received formal training in acupuncture. He is a world renowned expert in eczema and alternative medicine. He is also the co-editor of what I think will become a bible for dermatologists who are interested in a holistic and comprehensive approach to the skin, Integrative Dermatology: Practical Applications in Acne and Rosacea. I’ve already pre-ordered my copy and can’t wait to get it in my hands!]

Q & A: 

Dr. Bowe: Many people are trying to avoid gluten in their diets as well as their skincare. We often see “gluten free” on food labels as well as skincare labels.  What is your take on whether people should avoid gluten in foods/how do you know if you should avoid it?

Dr. Lio: Gluten has been soundly vilified in the past few years, but I’m not sure it’s totally deserving of all of the hate. Clearly for people that have celiac disease it is essential to totally avoid it; outside of this select group, things get a little more confusing. My feeling is that some people really do have a sensitivity to gluten that doesn’t necessarily show up on testing, and for others it may be that simple carbohydrates and refined sugars in foods are causing their issues, but that they are so closely associated with gluten in a modern diet that people really do improve by throwing out the baby with the bathwater, so to speak. I do think that diets that avoid gluten (and grains in general) tend to be healthier since they usually focus more on greens and vegetables–it is hard to argue with that! However, as a fan of baking breads and a lover of pizza, I’d like to think that gluten-containing foods can be healthy and well-tolerated for many, especially when prepared in a wholesome way and eaten in moderation.

Dr. Bowe: How important do you think it is to avoid gluten in skincare for most people/how do you know if you should avoid it?

Dr. Lio: In skincare, I think it is even more confusing. Perhaps even for those with celiac disease, my sense is that as a large protein there is probably little or no absorption of gluten through the skin, so I’m not sure making a “gluten-free” claim has much real meaning outside of “sounding” healthier. To be honest, though, the vast majority of skin care products that I am aware of have never had gluten in the first place, so it’s a little disingenuous, sort of like advertising “gluten free apples.”

Dr. Bowe: Oatmeal has been shown to be very beneficial for dry, itchy, eczema prone skin.  Can a moisturizer containing oatmeal be used in someone who believes they are sensitive to gluten?

Dr. Lio: I think the answer is yes for most patients. While there are patients with true allergy to oat and they must totally avoid oatmeal-containing products, it turns out that pure oats do not contain gluten at all, but during harvesting and transportation, sometimes gluten can be introduced. Because of this, many companies have switched to using certified gluten-free oats for skin products, and I think this is a good thing since oatmeal can be helpful in a variety of products, especially as you say, for dry and itch skin.

Dr. Bowe: We’re well aware that natural is NOT always better, and not all natural ingredients are inherently safe for the skin. However, from what I have read and experience with my patients, honey has been reported to have a number of benefits and appears to be very safe for use on skin. What are your thoughts about the use of honey in skincare and in your diet when it comes to skin benefits?

Dr. Lio:

Honey in skincare:

Honey is pretty amazing stuff! There is reasonably good evidence for using honey in wound healing and burn treatment, and even some evidence for treating acne and rosacea. It has some powerful antibacterial properties and is very soothing for the skin. However, all honeys are not the same. Certain honeys such as Manuka and Kanuka have robust literature on their healing properties, and Manuka even has a special rating called a UMF (Unique Manuka Factor) that helps quantify its quality. As you might imagine, the higher UMF honeys (greater than 20, for example) can be prohibitively expensive. Additionally, honey is tough to work with: it’s sticky and thick, making it difficult to leave on the skin during the day or even overnight, so that can be limiting as well.

Honey in diet:

I think that having some honey in the diet can be healthy. Honey has a lower glycemic index than sugar, but still contains sugars. I have seen evidence that honey is likely better than agave nectar as a sugar alternative, especially because of its other health benefits. However, it is something to use sparingly, I think, since sugary foods seem to fuel inflammation for a lot of my patients.

Dr. Bowe: Honey, especially manuka honey, is known for its antibacterial properties.  Now that we know how critical a healthy, diverse skin microbiome is, how do you reconcile use of an antibacterial ingredient in a disease where bacterial diversity and health is so critical?

Dr. Lio: I think this is the kind of question that we are really struggling with right now. It seems that our over-simplified understanding of “bacteria” as a monolithic pathogen has led to using sledge-hammers like antibiotics for lots of conditions without really taking the complexity of the microbiome into consideration. My sense is that in disease there is imbalance. Sometimes, even shaking things up in a very inelegant way can allow for the balance to return. Many are now too young to remember this, but when we were growing up, we had an old Cathode Ray Tube television. Sometimes the picture would blink and flash… and we’d give it a firm whack on the side and voila–it would work again! This to me is an analogy of why relatively crude approaches seem to help sometimes, especially when we take into account more natural products that have subtleties that we cannot always fully appreciate.

Dr. Bowe: While I don’t love coconut oil for acne prone areas such as the face, chest and back, I do find that it can be very hydrating and calming in my patients who are not acne prone, but do suffer from very dry skin.  Coconut oil is also known for its antibacterial properties.  How do you address concerns that ingredient like coconut oil might be damaging our microbiome, or decrease diversity of our microbiome?

Dr. Lio: I would say that, as we discussed with honey, natural antimicrobials tend to be much more subtle and nuanced than medical-grade antiseptics, disinfectants, and antibiotics. Coconut oil does seem to be antimicrobial (perhaps due to the monolaurin), but also has supportive elements that can strengthen the skin barrier and, in turn, the microbiome, such as medium-chain fatty acids. I think we have a lot more to learn about this, but it does seem to be gentle enough to use in both dry, irritated skin but also on healthy skin, and that suggests that it is not knocking things out of balance for most people. In atopic dermatitis we often see staphylococcus aureus bacteria start to dominate and, accordingly, diversity of the microbiome suffers. Application of coconut oil in this scenario led to a 95% decrease in staphylococcus aureus, suggesting that diversity was restored.* But we really do need more research here.

*Ref: Verallo-Rowell VM, Dillague KM, Syah-Tjundawan BS. Novel antibacterial and emollient effects of coconut and virgin olive oils in adult atopic dermatitis. Dermatitis. 2008 Nov 1;19(6):308-15.

Dr. Bowe: Skin hydration is so important in people who suffer from eczema.  What are your favorite ingredients to look for in moisturizers, especially if someone is looking for petroleum-free ingredients. One of my favorites is sunflower seed oil.  Curious what you think about that ingredient or any others you like to recommend for your patients who suffer from eczema?

Dr. Lio: I am a big fan of sunflower seed oil as well—there is evidence that it calms inflammation, helps heal the skin barrier, and even stimulates the production of natural ceramide fats in the skin, all of which are fantastic for patients with eczema.

We mentioned coconut oil above for its ability to decrease staph bacteria in eczema, but it turns out that it is an excellent moisturizer as well, and outperformed a petroleum product (mineral oil) in a head-to-head study.*

I’ve been very interested in a plant called Cardiospermum halicacabum which has some very interesting anti-inflammatory properties** and I have worked with a small company to get a very natural moisturizer that features this ingredient as well.

*Ref: Agero AL, Verallo-Rowell VM. A randomized double-blind controlled trial comparing extra virgin coconut oil with mineral oil as a moisturizer for mild to moderate xerosis. Dermatitis. 2004 Sep 1;15(3):109-16.

**Ref: Fai D, Fai C, Di Vito M, Martini C, Zilio G, De Togni H. Cardiospermum halicacabum in atopic dermatitis: clinical evidence based on phytotherapic approach. Dermatologic Therapy. 2020 Nov 10:e14519.

 Dr. Bowe: Are any salts, minerals or vitamins especially helpful when applied topically?

 Dr. Lio: Topical vitamin B12 seems to help with eczema. I actually developed a version of this after reading a very compelling study* but not being able to find a commercial version available, and that has been helpful for some of my patients. We call it “Pink Magic” because the B12 powder is dark crimson and when mixed with the shea butter base, it makes a lovely pink color!

Zinc oxide, best known as the base of many diaper pastes, is incredibly gentle and soothing for damaged or open skin. It is probably underutilized because it is so thick and pasty, but I often use it as part of cooling wraps for patients with open areas of skin, and this wrap (known as the Unna Boot) has tremendous healing properties.

*Ref: Stücker M, Pieck C, Stoerb C, Niedner R, Hartung J, Altmeyer P. Topical vitamin B12—a new therapeutic approach in atopic dermatitis—evaluation of efficacy and tolerability in a randomized placebo‐controlled multicentre clinical trial. British Journal of Dermatology. 2004 May;150(5):977-83.

Dr. Bowe: Any salts (electrolyes), minerals or vitamins you suggest getting in your diet to improve skin hydration or skin health?

Dr. Lio: I am an avid proponent of vitamin D supplementation for all my patients with atopic dermatitis. There is a little bit of controversy around this, but I truly think that there is a group for whom it makes a big difference. The problem is, I can’t predict who will be in that group! So I think it’s reasonable (especially here in cold, gray Chicago) to have folks supplement with vitamin D—I certainly do so myself.

It’s not quite a vitamin, but probiotics also have a fascinating body of evidence in atopic dermatitis. Like vitamin D, I think there really are some patients who do better on them, although we are in the early days of understanding which strains, the dosage, the frequency, etc. Right now, I like a probiotic mix that contains Lactobacillus paracasei and Lactobacillus fermentum as these have the some of the best evidence in atopic dermatitis.*

*Ref: Wang IJ, Wang JY. Children with atopic dermatitis show clinical improvement after Lactobacillus exposure. Clinical & Experimental Allergy. 2015 Apr;45(4):779-87.

Dr. Bowe: What nutritional advice do you give patients suffering from very dry skin who wish to hydrate from the inside out?

Dr. Lio: There is an interesting literature about an amino acid supplement L-histidine (not to be confused with “histamine”). I do recommend this for some patients as it seems to be able to help restore the skin barrier and seems very safe and inexpensive. The dose for adults is 4 grams per day, and it is widely available in health food stores as a powder.

Dr. Bowe: Fragrance, especially natural fragrances like essential oils, is such a confusing topic. What do you tell patients when it comes to fragrance in skincare: what to look for vs what to avoid?

Dr. Lio: Here I am pretty firm: I prefer no fragrances whatsoever for my sensitive skin patients and especially for those with eczema/atopic dermatitis. The reason is that even potentially helpful natural fragrances, especially in these more sensitive folks, can become allergens over time, sensitizing them to these products. Ideally, we want products that have been designed for and tested in atopic dermatitis patients.  We want as few ingredients as possible, and there is a long list of things we specifically want to avoid. A great resource can be found at The National Eczema Association website.

Disclosure: I’m a board member and a Scientific Advisory Committee member, but I only donate to the NEA I do not make any money from them. They are a non-profit organization dedicated to improving the lives of patients with eczema.

Dr. Bowe: Vit E: are there skin benefits to using it topically?  What about via supplementation?

Dr. Lio: To my knowledge, there is no good data about topical vitamin E in eczema, but there was a neat study showing that 400 IU of vitamin E daily improved eczema symptoms and signs better than a placebo at 4 months.* This is a very reasonable supplement to add for those with eczema, I think.

*Ref: Jaffary F, Faghihi G, Mokhtarian A, Hosseini SM. Effects of oral vitamin E on treatment of atopic dermatitis: A randomized controlled trial. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2015 Nov;20(11):1053.

Dr. Bowe: Some prebiotics, like inulin, are made of sugars linked together?  We know sugar is not good in your diet, but could sugar on the skin be a good thing for your microbiome? 

Dr. Lio: Yes, I think that the concept of prebiotics and synbiotics (prebiotics + probiotics) are very compelling topically applied to the skin. In fact, I’m currently an investigator for a new topical probiotic spray that seems very promising. I think that sugars on the skin have a very different effect than those in the diet since they can directly feed the bacteria there and are likely not absorbed into the body. This question has actually come up because of “sugar scrubs”: I had a patient with diabetes who wanted to try them, but was concerned. So long as there are not actual cuts or abrasions, the sugar is not absorbed and it is safe.

I hope you found this discussion as eye opening as I did!  For more of Peter Lio’s tips and expertise, be sure to follow him on:

Facebook

https://www.facebook.com/ChicagoEczema

And on Twitter too: @ChiEczema

Hope you enjoyed this exciting and truly informative Q & A.

Dr. Whitney

 

Why Alcohol in your Hand Sanitizers is NOT the Same as Alcohol in your Toner

As a doctor and a scientist, I know that alcohol can be a lifesaving ingredient in certain scenarios, but it can do harm in others.  Alcohol use in skincare products requires some serious thought. Here’s what you need to know when it comes to alcohol in your skincare products.

For your face: 

Not all alcohols are created equal.  Alcohols fall into 2 main categories: drying alcohols, and hydrating alcohols.  When it comes to products you use on your face, you want to avoid drying alcohols, but welcome the use of hydrating alcohols.

Drying alcohols are often listed on labels as SD alcohol, denatured alcohol, ethyl alcohol or isopropyl alcohol.  These are lightweight, volatile alcohols, meaning they evaporate quickly off the surface of the skin.  The problem is, these types of alcohols do major damage to the natural lipids and fatty acids on the surface of your skin, so they damage your skin barrier.  For people with oily skin, they can give you a sensation of feeling like you’re degreasing the skin and drying out the oil, but the long term damaging effects far outweigh that temporary sensation.  In fact, over time, your skin will actually pump out more oils to compensate for the stripping and drying effects these alcohols have.  So, long story short, these types of alcohols should be avoided by people of ALL skin types when it comes to their facial skin.

Hydrating alcohols, or fatty alcohols, are actually excellent ingredients when it comes to facial skincare!  Examples include cetyl, stearyl and cetearyl alcohol.  These alcohols are emollients, meaning they keep skin hydrated and supple—yes, the exact opposite of what you might expect when you see the word “alcohol” on the label!

For your hands:

Hand sanitizers that contain 60% ethyl alcohol and  70% isopropanol are incredibly effective germ killers, meaning they can kill many disease causing bacteria and viruses within seconds.  These are the kinds of alcohols I warned you to avoid in your facial skincare, but when faced with a virus like COVID-19, the benefits currently outweigh the risks when using them in your hand sanitizers. Just be sure to only use them when you don’t have access to running soap and water, and moisturize as often as possible to restore those lipids and encourage the regrowth of healthy bacteria (your microbiome).

Dr. Whitney

We don’t need a twelve step routine to keep our skin healthy! In fact, I am a big believer in a lean approach to skincare – giving our skin only what it needs and what it wants. Everything I use has a purpose and works in synergy with my skin’s natural balance and with the other products I’m using.

Here are 3 of my must-have categories of products for my morning skincare routine:

1. GENTLE CLEANSER: My first step in the morning is cleansing with a gentle cleanser.

Your skin should feel hydrated and nourished after you cleanse, not tight and squeaky clean. I always use warm – not hot – water to cleanse and I pat dry with a clean baby wash cloth.

Here are 4 of my favorite cleansers (at different price points):

Naturopathica Manuka Honey Cleansing Balm

Farmacy Clean Bee

La Roche Posay Toleriane Gentle Facial Cleanser

Simple Kind to Skin Unscented Micellar Cleansing Water

2. VITAMIN C SERUM: I apply my Vitamin C Serum immediately after cleansing.

Vitamin C acts as a powerful antioxidant, boosts collagen production, and brightens dark spots.  Vit C helps to reduce visible signs of aging by combating the free radical damage arising from sun exposure, heat exposure, and other environmental stressors (like pollution). I often explain that free radicals are like tiny missiles, and they destroy everything in their path. They are highly reactive forms of oxygen whose effects can damage cell membranes and other structures in the body, including DNA and collagen. When you are exposed to a lot of free radicals, it means you are suffering from oxidative stress, and too much oxidative stress can lead to premature aging, skin cancer, and chronic skin conditions like acne. Vitamin C is a free radical scavenger, thereby protecting your skin!

Here are links to four Vitamin C serums I’m loving right now (at different price points):

Summer Fridays CC Me Serum

Marie Veronique Vitamin C + E + Ferulic Serum

Mad Hippie Vitamin C Serum

Naturopathica Vitamin C15 Wrinkle Repair Serum

 

3. MOISTURIZER: I love to lock in all that goodness and hydration with a moisturizer.

I either layer a moisturizer under sunscreen, or look for sunscreens that also act as moisturizers. I will share my favorite sunscreens as a separate post, but here are some of my current favorites in the moisturizer category:

GLOWBIOTICS Probiotic HydraGlow Cream Oil (note: a little goes a long way…blend a few drops with foundation or sunscreen)

First Aid Beauty Ultra Repair Cream Intense Hydration (this is great if you have extremely dry skin – otherwise, I would opt to use it at night instead of in the morning).

Tatcha: The Dewy Skin Cream

[*As I mentioned earlier, I will be sharing my favorite sunscreens separately, but I do wear sunscreen every day, rain or shine!]

I’m sharing more about my skincare routine and on my Instagram posts and stories, so be sure to check them out!

Dr. Whitney

You guys know I’m always reading the most cutting edge scientific studies that give me insight into living your healthiest life, and when your body is healthy, your skin is healthy!

The most exciting new science that has caught my attention surrounds a new way to approach food: The Circadian Rhythm Diet. Skin health, and our overall health, is not just about WHAT we eat — of equal importance is WHEN we eat.   Timing our meals first gained momentum with intermittent fasting, but the Circadian Rhythm Diet takes the science to a whole new level, and at its core is our exposure to BLUE LIGHT.

Humans have evolved to be highly sensitive to the 24-hour solar cycle.  We all have an internal clock that controls almost every biological system in our bodies, from our sleep-wake cycles to our mood, to our immune strength, our metabolism and our cellular health- yes, even our skin’s health.  The most important thing that sets our circadian rhythm, or sets our internal clock, is our exposure to NATURAL SUNLIGHT.

In the past, we rose with the sun, ate during daylight hours, and then rested and fasted when the sun set.  In fact, when our eyes perceive blue light, it tells our brain to shut down production of our sleep hormone, melatonin. It sets our internal clock to WAKE UP!  We need the sun’s bright blue light in the morning to become alert and active, and we need dark, or at least the absence of blue light, to jump-start our brain’s, and consequently our skin’s, sleep mode and recovery.

Now, we find ourselves totally MESSING with our internal clock as a result of using screens late that emit stimulating blue light rays. We’re tricking our brains into thinking it’s still daytime, and we delay our production of melatonin, impair our sleep, and mess up our health.  What else are you doing while you check emails or watch Netflix at night?  You snack.  Most of us eat a late dinner, oftentimes after sunset, and we snack until we finally pass out, way after our ancestors did when they followed natural light patterns in the sky.

When intermittent fasting became popular, people started to recognize that it’s not just WHAT we eat, but WHEN we eat is just as important when to comes to health. Now, we can take that one step further with Circadian Rhythm Diet.

Mounting evidence says that if you want to optimize your weight, your metabolism, your overall health, and of course, your skin health, you should try syncing up your mealtimes with the natural cycles of light.

Calories seem to be metabolized BETTER in the morning, and eating after dark jolts the brain into thinking it’s daytime and can disrupt the healthy circadian rhythm that is so critical for our health, including our skin health. As we know, beauty sleep is real! Sleep is a necessary phase of profound regeneration for the skin. While we rest, our skin cells are renewing, regenerating, and restoring themselves – and so is our entire body. Our immune system needs this quiet time to stay in peak condition.

If you want to try to take your health and wellness to the next level, give this a try:

  • Eat while it’s light, and limit what you eat during hours when it is dark.
  • Eat a heavier breakfast, a medium sized lunch, and a lighter dinner.
  • The earlier your dinner, the better. Try not to wait too long after the sun sets to eat.
  • After dinner, try to limit the amount you eat.

Craving info on relevant studies? Check out these links:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3756673/

http://www.xinhuanet.com/english/2019-10/05/c_138448870.htm

https://www.technologynetworks.com/cell-science/news/meal-timing-can-make-or-break-your-cells-circadian-rhythm-318644

Dr. Whitney

 

 

 

Winter is the perfect time to get cozy and make some easy, nourishing DIY skincare and fruit infused water recipes!

Here are some of my favorites:

Green Tea and Honey Power Mask

The green tea is soothing, removes impurities and reduces inflammation, while the honey is bacterial and soothing!

You need:

  • 2 bags of green tea
  • warm water
  • 3 tablespoons of Manuka honey

To make: Cut open 2 green tea bags and empty contents into mixing bowl. Add a few drops of water and mix with fork just to dampen. Then, mix in 3 tablespoons of honey (I use a fork to mix, which seems to work better than a spoon). Apply mask to face.

Triple Coconut Sugar Cookie Body Scrub

This triple coconut sugar cookie scrub is inspired by one of my favorite holiday cookie recipes. It’s so easy to make and is absolutely delicious for your skin.

You need:

  • ¼ cup coconut sugar
  • ¼ cup shredded coconut
  • ½ cup melted coconut oil

Mix these three ingredients and you have a nourishing exfoliating scrub for rough patches like your elbows or dry, cracked heels. The coconut oil is so hydrating and the sugar crystals are an excellent natural exfoliant for your body.

Guys, I do not use this on my face. Coconut oil can actually clog pores and aggravate acne, and sugar crystals are too abrasive for the delicate skin on your face. But, these ingredients work beautifully as a body scrub!

Happy holidays!!

Dr. Whitney

 

This morning, Ginger Zee and I shared a Facebook live focusing on melasma.

As Ginger and I discussed during our Facebook live, melasma, also called the “pregnancy mask” can be incredibly frustrating and emotional.

We received so many wonderful questions that I wanted to address them with comprehensive resources so you guys have this information at your fingertips!

To begin, I share all the basics about melasma, including what this condition is and what causes it, in my post, Melasma 101.

Next, I share my Melasma Game Plan in Melasma 102.  Specifically, I discuss sun exposure, heat exposure, and diet when it comes to keeping this condition under control! These are many of the points we discussed during the FB live.

And, in Melasma 103, I answer many of the questions I receive in the office and on social media about in-office procedures that can help, at home peels that can help, products I often recommend to my patients, and more! Many of these products are the ones that I discussed during our FB live and I include links.

The additional products I mentioned during the live are:

Naturopathica Vitamin C15 Wrinkle Repair Serum

Supergoop! Unseen Broad Spectrum SPF 40 

Glowbiotics Tinted Mineral Sunscreen with Iron Oxide

For more information like this, be sure to follow me on social media! My handle is @drwhitneybowe.

Have a wonderful day and keep your questions coming!

Dr. Whitney

More and more companies are marketing their products as “paraben-free.”  What’s the fuss and should you be concerned about parabens when choosing your favorite skincare options?

What are parabens?

Parabens are a group of preservatives used in cosmetics to help keep those products from becoming contaminated with microbial growth (like harmful bacteria or yeast).  They extend the shelf life of a product.  If you make a DIY recipe and don’t use it right away, it could easily become contaminated with “bad bugs,” the kind that can cause infections.  That’s because you’re not adding preservatives to those concoctions.  Almost all of the water-based products you see on the shelf in a store, or order online, contain preservatives to keep them free of growth that would be very unpleasant to discover in your skincare products, and could even harm you.  Parabens are actually one of the least irritating preservatives found in skin care today.  They were named the “non-allergen” of the year in 2019 by the American Contact Dermatitis Society (ACDS)!  This is because parabens are unlikely to cause a skin allergy or irritation, compared to all the preservatives on the market today.

So, why are so many products claiming to be “paraben-free?”  And why do I recommend avoiding parabens in skincare? 

Here’s the scoop:

A study done back in 2004 detected parabens in samples of breast tissue from breast cancer patients.  Parabens were actually found within the cancerous tissue samples collected.  Some types of parabens are known to mimic estrogen, so the concern is that they may be disrupting hormones and possibly increasing the risk of cancer.  There are also some studies that raise concerns about exposure to parabens and male reproductive health. Basically, parabens bind to certain estrogen receptors, and turning on estrogen signals can theoretically contribute to a whole host of issues for men, women and children.  Butylparabens and propylparabens are the most likely to bind to estrogen receptors.  In fact, the EU has banned the use of these 2 preservatives in diaper creams, and reduced their allowed concentrations in a myriad of other cosmetic and personal care products.

We know that parabens are indeed absorbed by the body, mostly through our use of cosmetic or personal care products such as makeup, lotions, hair products and perfumes.  However, we  don’t fully know whether they pose any long-term health risks.  Concerns exist, but no clear link has been demonstrated.  The FDA believes that, so long as they are used in low concentrations, they are probably not doing any harm.  Even well known and respected skincare brands, like Cerave, continue to formulate using parabens in many of their most popular products.

Where I stand:

In the case of parabens, I don’t believe in innocent until proven guilty.  In my opinion, parabens are guilty until proven safe.  I want to see evidence proving that parabens are not causing any significant hormonal disruption before I feel confident recommending paraben-containing products to my patients!  Also, parabens aren’t the only chemicals linked to hormone disruption – there are others used in skincare, household products and in food, so these exposures can add up. I have too many patients struggling with fertility issues, and battling breast cancer.  Given that there are other preservative options available with safety data, I am not ready to take that risk.

Dr. Whitney

I love fall. I go apple picking with my daughter (a family tradition since I was a kid), we sip on hot apple cider, pick pumpkins, and bake at home . . . it’s one of my favorite times.

So many of my patients love it too, but I notice an upswing in sensitive skin and eczema discussions during our appointments in fall. WHY?

In a nutshell:

  • The cooler, dry air of fall steals the moisture from our skin. When we add indoor heat, we notice that our skin feels dry, itchy, and more easily irritated.
  • Without healthy hydration, we also notice more pronounced fine lines and if you are prone to eczema, you may notice a flare.
  • As the weather gets cooler, we also crave those hot showers and baths. Very hot water strips our skin barrier of its healthy bacteria (microbiome) and natural oils. This contributes to irritated, sensitive skin and eczema.

 

So, what can you do to help replenish your skin’s healthy moisture?

  • Use a cool mist humidifier at night!
  • Dial down exfoliation – stop stripping your skin’s healthy oils and protective barrier. Most people with sensitive skin can only exfoliate twice a week, and I prefer using creams or serums with chemical exfoliants such as lactic acid and glycolic acid over using harsh scrubs. Dry skin is more prone to irritation.
  • Reach for rich, hydrating day and night creams to help replenish and lock in the moisture your skin is losing throughout the day due to the cold, dry weather. Look for ingredients like hyaluronic acid and ceramides, which help to lock in moisture.

Dr. Whitney

 

Dr. Whitney Bowe joins Good Morning America on Melanoma Monday to share information on how to keep your skin safe and healthy this summer!

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

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