Saturday, June 19, 2010

Treating Your Skin Type Right

A smart skin-care routine can take years off your face. But how do you know what's best for your complexion? Five top dermatologists weigh in with advice on treating your skin type…

You don’t treat cashmere the way you do cotton. And you wouldn't handle silk like denim. Same goes for your skin.

When it comes to care, each skin type – dry, normal, oily or acne-prone – requires its own regimen.

“Over time, a careful and consistent routine with products for specific skin types can improve the overall health and appearance of your skin,” says Sonia Badreshia-Bansal, M.D., a clinical instructor of dermatology at the University of California, San Francisco.

So what’s the best Rx for your face?

First, identify your skin type from the descriptions below. Then follow our simple, dermatologist-recommended tips for what to do and avoid. The result? A gorgeous, glowing complexion.

Skin type: Oily
“Oily skin appears greasy, and may have a film on it during the day and large pores,” says Neil Sadick, M.D., clinical professor of dermatology at Weill Cornell Medical College in New York.

“It’s also prone to breakouts and sebaceous hyperplasia, which are little bumps caused by excess oil secretion,” he says.

How to treat it: Control grease with cleansers that contain alpha-hydroxy or salicylic acids. (The latter helps if you’re also acne-prone.)

These decrease secretions and absorb some of the oil on your skin.

Also, try a foaming cleanser, which contains surfactant, a wetting agent that gets rid of excess oil and dirt easily, says Badreshia-Bansal.

And avoid toners and astringents, because they dehydrate your skin.

It’s a common mistake that women with oily skin make, says Paul M. Friedman, M.D., clinical assistant professor at the University of Texas Medical School and co-author of Beautiful Skin Revealed: The Ultimate Guide to Better Skin (Sandow Media).

“This just causes skin to produce more oil,” he says.

Another mistake: Not moisturizing your oily skin.

What matters is the type of product, Friedman explains. Avoid rich, heavy creams or those that don’t let your skin breathe. Choose a light lotion labeled "noncomedogenic," so it won’t clog pores.

If you have wrinkles or age spots, oily skin can benefit from anti-aging ingredients like alpha-hydroxy acids or retinols.

“These are a little drying, so they’ll actually be helpful,” Sadick says.

Skin type: Dry
Dry, thirsty skin is flaky, itchy, tight, dull in appearance and rough. Seriously parched skin may also be red, inflamed and cracked. If you have eczema, the dryness tends to be worse in the T-zone (forehead and nose areas).

How to treat it: Avoid soap, which can dry out your skin, as well as cleansers with potentially irritating ingredients like salicylic acid and benzoyl peroxide.

“Instead, use a gentle cleanser that’s also moisturizing, such as those from Dove, Neutrogena or Cetaphil,” Friedman says.

Is your complexion extremely dry? Wash it only at night, when skin tends to be dirtiest, and splash on lukewarm water, not hot, which can strip skin of moisture. In the morning, just rinse your face with cool water.

“This will help maintain the skin’s natural oils,” Badreshia-Bansal says.

Slather on a creamy moisturizer that contains dimethicone (a form of silicone) or grapeseed oil, suggests Badreshia-Bansal. Dermatologist favorites include Eucerin Everyday Protection Face Lotion and Cetaphil Moisturizing Cream.

Apply it when your face is damp to trap water in the skin’s surface. Reapply midday if your skin feels tight.

For wrinkles or uneven skin tone, apply retinols every other night, not nightly, and follow up with a moisturizing cream, Badreshia-Bansal advises.

At night, soak a washcloth in cold soy milk and apply it to dry skin for 10-20 minutes.

“Soy has strong anti-inflammatory capabilities, so it can be very soothing,” Sadick explains.

To help moisturizers penetrate your skin better, scrub away flakes with a gentle exfoliator only once a week. Avoid those made with pits or seeds (because they can scar your skin) or a harsh loofah. Buy one with beads instead.

Skip this step if your skin is severely dry.

“Exfoliants can cause more inflammation, cracking and/or fissuring,” Sadick says.

Skin type: Combination
As the name implies, combination is a blend of both dry and oily skin. Typically, the cheeks are dry while the forehead, nose and chin are oily.

How to treat it: Look for non-comedogenic products or those labeled “for combination skin.”

You can use the same products for both dry and oily spots, but in different amounts. For example, put more moisturizer on your dry cheeks and less on your forehead, Sadick advises.

Plus, exfoliate oily areas, Badreshia-Bansal suggests. If those zones are acne-prone, apply zit-zappers only on those spots – such products can irritate dry areas.

Skin type: Normal
Every woman covets this no-fuss balanced skin type.

“Normal skin has good translucency and luminosity,” Sadick says. “It doesn’t have the film you’d see on oily skin or the flaking, fissuring or redness of dry skin.”

How to treat it: Take your pick of moisturizers. Lotions have more water in them so they’re lighter, creams are the heaviest, and serums are somewhere in between.

You can also put on moisturizers that fight wrinkles, age spots or uneven skin tone. Apply them right after washing your face and before drying it completely so the products’ active ingredients can penetrate more deeply into damp skin, Badreshia-Bansal says.

Also, scrub with a gentle exfoliator a few times a week to remove the dead top layer of skin cells that give your complexion a dull appearance.

Skin type: Acne-prone
About 40-50 million Americans have some form of acne, according to the American Academy of Dermatology (AAD). If you’re one of them, you're plagued with whiteheads, blackheads, pimples and cysts, all of which result when “hair follicles become clogged with oil and dead skin cells,” Friedman explains.

How to treat it: Be gentle. Overzealous washing, scrubbing and product application won’t remove acne and can make it worse.

“Gently cleanse your skin to remove excess oil and dead cells,” Friedman says. Do this twice daily with products that contain acne-fighting ingredients, like salicylic acid and benzoyl peroxide. Friedman suggests Neutrogena Oil-Free Acne Wash, Clean & Clear Continuous Control Acne Wash or Proactiv products.

Also, apply post-cleansing treatment products with retinols or glycolic and salicylic acids.

“[These] remove the top-most skin cells to reveal newer ones below,” Friedman says. Retinols help fight acne as well as fine lines and wrinkles.

Whether you’re shopping for a moisturizer, treatment product, sunscreen or makeup, look for those labeled "oil free" and "noncomedogenic." Typically, gel or serum formulations fall under this category and are good for acne-prone skin.

“They more easily absorb excess oil and won’t feel heavy or thick,” Badreshia-Bansal says.

And avoid products with cocoa butter and coconut oil (heavy ingredients that may clog pores) or cinnamon, which can irritate skin and aggravate acne.

If over-the-counter options don’t zap zits, see a dermatologist for stronger treatments, like “retinoids, antibiotics, oral contraceptives, chemical peels and microdermabrasion,” Friedman says.

He also recommends lasers, which have been found to reduce acne lesions and scars in multiple studies.

Skin type: Sensitive
This delicate skin type is easily irritated and itches, burns, stings and/or feels tight when certain products or cosmetics are applied.

“As a result, you have to be extremely careful about what you use on your face,” Badreshia-Bansal says. “Though anyone can have sensitive skin, it’s most common in light-skinned women who sunburn easily and those over age 30.”

How to treat it: Cleanse just once a day – at night when skin is dirtiest. Just splash your face with cool water in the morning.

Wash with a gentle, creamy cleanser and avoid exfoliators with fragrances, alcohol, menthol and soap, which can cause stinging and irritation. Instead, look for skin-care products with calming ingredients, such as green tea, polyphenols, chamomile and aloe.

“As a general rule, the fewer ingredients in a product, the better,” Badreshia-Bansal says.

If you’re using active ingredients such as retinols, thoroughly dry skin before applying the products. They tend to penetrate more deeply into damp skin, which can be irritating.

And always test a new product by placing a small amount on your wrist or behind your ear for a few days. No reaction in 72 hours? It’s probably safe.

You’ll also need to avoid sunscreens with chemicals that are absorbed into your skin. Instead, choose physical sunscreens, which protect by sitting on top of the skin’s surface. Good options include titanium dioxide and zinc oxide, Badreshia-Bansal says.

Skin type: Rosacea prone
About 14 million people in the U.S. have rosacea, a type of sensitive skin, according to the AAD. Most of them are 30-50 years old.

Symptoms include redness, flushing, pimples, swelling and visible blood vessels on the forehead, cheeks, nose and/or chin. There’s no cure for rosacea, and it can worsen if it’s not treated.

How to treat it: Avoid known rosacea triggers, such as sun, alcohol, spicy foods, caffeine, citric acid, stress, and extreme hot and cold temperatures, says Jenny J. Kim, M.D., associate professor of dermatology at the University of California, Los Angeles, David Geffen School of Medicine in Los Angeles.

Rubbing skin with an exfoliator, washcloth or puff can irritate and worsen rosacea. Instead, lather up with a mild, soap-free cleanser and lukewarm water.

Avoid using too many products at once.

“The old adage ‘less is more’ applies to patients with sensitive skin,” Kim says. More products mean more chance of irritation.

See a dermatologist for topical prescription medications, such as metronidazole and azeleic acid, commonly used to treat rosacea, and in-office treatments like laser therapy, which can help clear up broken blood vessels, redness and flushing.

Skin type: Sun-damaged skin
Skin that has spent too much time in the sun tends to be dehydrated and dry. It also has dark spots, uneven tone and a dull, rough appearance.

How to treat it: Regularly hydrate skin with a rich moisturizer.

Give skin a glow and erase some of that sun damage by exfoliating regularly. This removes the top layer of dead skin cells, says Katie Rodan, M.D., associate clinical professor of dermatology at Stanford University and author of Write Your Skin a Prescription for Change (Pairadocs Publishing).

Scrub with a physical exfoliator (with beads) or use a chemical one that has alpha hydroxy acids, beta hydroxy acids and retinoids, which loosen the bonds that keep dead cells on skin.

Ward off further damage by wearing a broad-spectrum sunblock with an SPF of at least 30 and avoiding UV rays by wearing a hat and sunglasses, covering up with clothing and staying in the shade.

For a day at the beach, slather on an ounce of sunscreen from head to toe and reapply every two hours or immediately after swimming or sweating.

“If you stop sunbathing and [start] using sunscreen now you’ll still make a big difference in your skin,” Rodan says.

And apply a moisturizer with a high-potency antioxidant every morning.

“This protects your already fragile, sun-damaged skin against free radicals that can break down collagen and lead to the development of skin cancer,” Sadick says.

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