Skin Care Down and Dirty

                 Patients and friends always ask me how to improve their skin. Depending on the individual there may be an assortment of specific recommendations. But overall there are a few simple things that can improve nearly everyone’s skin tone, reduce pore size, and remove small blemishes and fine lines.

Cleanse your skin every day. By in large the skin is not “dirty”. We now know that bacteria normally live with us, on our skin, in our intestine and all around us. Having a healthy bacterial balance is actually good for us! So when I say cleanse your skin, I’m not referring to sterilization. You do not need anything with the term “anti-bacterial” in your daily routine. Cleansing is meant to remove superficial dead skin, make up, dust, dirt, sweat and oil that build up over the day. These things can clog pours and lead to blemishes. They can also add to the appearance of fine lines and wrinkles, which can make your appearance sallow and washed out. (see below for my wrinkle talk)

Finding the right cleanser for you may take several tries. I recommend something mild without fragrance or exfoliating ingredients unless you know your skin can tolerate those things.

 Tone your skin. Topical retinoids are the mainstays of medical skin toning. Retinoids are the key to younger looking skin.   Tretinoin is the most potent and available by prescription only. Some products that can be purchased over the counter and contain reduced levels of retinol, which is a derivative of retinoic acid. Retinoids work by increasing collagen in the skin, which reduces fine lines and wrinkles and opening clogged pores, which improves blemishes. Retinoids can also improve pigment irregularity like sun spots, hyper-pigmentation and melasma giving users a healthy balanced appearance to their skin.

Apply retinol to clean skin 15 minutes after washing your face. Apply a pea-sized amount to the cheeks, chin, nose and forehead. Avoid your eyelids and lips.

The most common complaint about topical retinoids is skin irritation and dryness.   These side effects are typically short-lived, lasting 2-3 weeks after first starting therapy. Topical retinoids should be used daily to maintain glowing and healthy appearing skin.

Moisturize your skin. Moisturizers are all over the marketplace and every day it seems there is something new from a top manufacturer.   The real truth of the matter is that a moisturizer should have as few ingredients as possible to avoid skin reaction and paradoxical drying of the skin. Good moisturizers should sooth, not sting. Apply twice a day, once following skin toner and once in the morning prior to applying sunscreen and makeup.


Protect your skin. We all talk about the importance of sun protection, but we know now that the sun doesn’t just cause wrinkles and brown spots but it is the leading cause of skin cancer too. Applying a non-comedogenic sunscreen, SPF 35 or greater, to the face neck and chest every morning will do more for your skin quality than anything else, and you will achieve the added benefit of reducing your risk of skin cancer. (Less chance of having to see me!)



The above regimen, when used for 4-6 weeks consistently will improve your skin’s appearance. This can have anti-aging effects; make your skin glow and your self-image glow as well.

There are many, many, many skin care regimens available from manufacturers and retail outlets. Any or all of them can work for you. The above list is composed of what I believe are the highlights of any skin care regimen and should be a fairly simple, sustainable and cost effective routine.  Come to the office any time!  We offer sales and samples of some great products that the staff and I all use and are reasonably priced.  If you have other skin conditions such as acne, psoriasis, significant hyper-pigmentation, or new or changing skin lesions have these evaluated by a clinician prior to starting skin care.

             Oh and a word about wrinkles.

Wrinkles are normal.  Aging is normalEveryone has wrinkles.  Try not to hate your face by dwelling on the folds that give you character!  Skin care as described above is aimed at improving and protecting your skin and getting the added benefit of feeling radiant and healthy!    If certain wrinkles are bringing you down, I’m happy to talk about those with you and develop an individual plan of care.  But always remember to love yourself and love your age!


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