Anti-Aging in the Digital Era: Part I

/in , , /by

By Elena Allbritton, MD, FAAD

Aging is a universal biological process, but how we age has changed dramatically in the modern world. From AI-powered skincare apps to laser resurfacing technology that was unimaginable two decades ago, patients today have more tools at their disposal than ever before. At the same time, new digital-era stressors like screen time, blue light exposure, and poor sleep hygiene are accelerating certain aspects of skin aging. This guide offers an evidence-based overview of what we know, what works, and how to build a comprehensive anti-aging strategy.

Understanding Skin Aging: The Science Behind the Process

Skin aging occurs through two overlapping mechanisms: intrinsic (chronological) aging and extrinsic aging driven by environmental exposures. Intrinsic aging is genetically programmed and involves the gradual decline of collagen and slower cellular turnover. Extrinsic aging accounts for most of the visible facial aging and is primarily driven by ultraviolet (UV) radiation, known as photoaging.

A landmark study published in the Clinics in Dermatology (2012) estimated that UV exposure accounts for up to 80% of visible facial aging signs. Additional culprits include air pollution, infrared radiation, and high-energy visible (HEV) light commonly emitted by digital screens (Nakamura et al., 2015, Journal of Investigative Dermatology).

At the cellular level, aging skin is characterized by shortened telomeres and mitochondrial dysfunction.

Understanding these mechanisms helps explain why multi-modal anti-aging strategies tend to outperform any single-ingredient or single-treatment approach.

Evidence-Based Skincare Ingredients for Anti-Aging

The cosmeceutical market is flooded with products promising dramatic results, but only a handful of active ingredients have robust clinical evidence supporting their efficacy. Here is what science says about the most important ones.

Retinoids (Vitamin A Derivatives)

Topical retinoids remain the gold standard in evidence-based anti-aging skincare. Tretinoin (retinoic acid), a prescription-strength retinoid, has been shown to stimulate collagen synthesis and reduce the appearance of fine lines and rough texture. Retinoids are known to cause transient mild irritation, including redness and dryness. Over-the-counter retinol offers a lower-potency alternative with a more tolerable side effect profile for some individuals.

Antioxidants: Vitamin C, Niacinamide, and Resveratrol

Topical antioxidants neutralize reactive oxygen species (ROS) generated by UV radiation, pollution, and HEV lights, making them particularly relevant in the digital era. L-ascorbic acid (Vitamin C) at concentrations of 10-20% has been shown to boost collagen synthesis and provide photoprotection when applied beneath sunscreen (Pinnell at al., 2001 Dermatology Surgery). Niacinamide (Vitamin B3) addresses multiple aging endpoints, including barrier function and hyperpigmentation, with a well-documented tolerability profile. Resveratrol and other plant-derived polyphenols show promising preclinical data for activating sirtuin pathways linked to cellular longevity.

Peptides and Growth Factors

Signal peptides such as palmitoyl pentapeptide-4 (Matrixyl) are a viable complement to retinoid-based regimens, particularly for patients who cannot tolerate retinoids. Growth factor formulations derived from human fibroblast-conditioned media or plant stem cells are also gaining traction, though regulatory inconsistencies mean that independent clinical validation varies significantly by product.

Sunscreen: The Non-Negotiable Foundation

No anti-aging regimen is complete without daily broad-spectrum SPF 30+ sunscreen. Mineral sunscreens (zinc oxide, titanium oxide) have additional relevance against HEV/visible light, which can be important for patients prone to melasma.

In-Office Procedures: What Technology Offers

For patients seeking more significant or faster results than topical agents can provide, a range of evidence-backed in-office treatments are available. The appropriate treatment or combination of treatments depends on an individual’s skin type, concerns, downtime tolerance, and budget.

Neuromodulators (Botulinum Toxin)

Botulinum toxin type A (commercially available as Botox, Dysport, and Xeomin) remains one of the most studied and widely administered aesthetic interventions. Meta-analyses consistently support their safety and efficacy when administered by trained physicians/providers.

Dermal Fillers

Hyaluronic acid (HA) fillers address volume loss, a primary driver of the hollow, aged appearance that develops in the mid-face, temples, and perioral area. HA is a naturally occurring glycosaminoglycan, well-tolerated and reversible with hyaluronidase. Biostimulatory fillers such as poly-L-lactic acid (Sculptra) and calcium hydroxyapatite (Radiesse) offer a different mechanism for gradual, longer-lasting volumization.

Laser and Energy-Based Devices

Laser resurfacing – both ablative (CO2, Er:YAG) and non-ablative (Fraxel, Nd:YAG, Clear and Brilliant, IPL) – target the epidermis and dermis to stimulate collagen remodeling, improve texture, reduce dyspigmentation, and address vascular lesions. Fractional photothermolysis enables faster healing compared to fully ablative lasers, which can require 2+ weeks of recovery. Energy-based devices, including radiofrequency (Thermage, Morpheus8, Infini/Genius RF) and focused ultrasound (Ultherapy, Sofwave), stimulate collagen and elastic production and are particularly effective for early skin laxity and tissue “lifting.” A growing body of literature supports combination protocols in a single treatment session.

Chemical Peels and Microneedling

Chemical peels using trichloroacetic acid (TCA), glycolic acid, or phenol stimulate rejuvenation. Medium-depth TCA peels (20-35%) improve photodamage, fine lines, and keratoses. Microneedling with radiofrequency (RF microneedling) is a versatile treatment for textural irregularities, enlarged pores, and mild laxity, particularly in patients with darker skin phototypes, where the risk of post-inflammatory hyperpigmentation with lasers is higher.

Aging well isn’t about chasing a single solution—it’s about combining proven skincare, sun protection, and thoughtfully selected treatments to support your skin over time. With so many options available, a personalized, evidence-based approach remains key to achieving natural, long-lasting results. In Part Two, we’ll explore how lifestyle optimization—including sleep, nutrition, stress management, and daily habits—plays a powerful role in how your skin ages from the inside out.

How Stress and Sleep Disruption Show Up on Your Skin

/in , , /by

As the holiday season comes to a close and the new year begins, life can feel more hectic than ever, and your skin is often the first casualty. Scientific research has repeatedly confirmed what many of us feel intuitively: stress and poor sleep directly impact your skin’s appearance, function, and ability to heal. Let’s break down how stress and sleep disruption show up on your skin, and what you can do to ameliorate these effects.

Stress Weakens the Skin Barrier and Triggers Inflammation

The skin barrier is your body’s frontline defense, keeping moisture in and irritants out. But the skin is not just a passive barrier; it has an active role in your body’s response to stress. The skin both responds to and produces stress-related molecules that influence inflammation. When under stress, your body activates the hypothalamic-pituitary-adrenal (HPA) axis, raising cortisol levels, our primary stress hormone. Chronic elevation in cortisol levels has been shown to reduce the production of key lipids in the skin, slow cellular turnover, and increase inflammation, all of which can lead to:

  • Dryness and flaking
  • Increased sensitivity
  • Burning or stinging
  • Exacerbations of conditions such as acne, eczema, psoriasis, and rosacea

Stress Worsens Breakouts

As we have reviewed, stress amplifies inflammatory pathways in the skin, which can cause new breakouts to appear. Furthermore, the higher cortisol levels caused by stress increase production of sebum, or oil, clogging pores and exacerbating acne.

Stress Accelerates Visible Aging

Continued exposure to high levels of cortisol induces the breakdown of collagen and elastin in the skin associated with the biologic hallmarks of aging. Chronic stress can also lead to a reduction of hyaluronic acid production, resulting in dehydration and thinning of the skin. This can present as more noticeable fine lines, loss of firmness, and a dull, uneven skin tone.

Loss of Sleep Leads to Increased Inflammation and Impaired Skin Repair

While you sleep, your skin enters “recovery mode” and engages in regeneration and repair, guided by your circadian rhythm. At night, your skin increases cell turnover, DNA repair, and moisture balance. Sleep loss may influence skin regeneration through changes in circadian-regulated processes and hormonal shifts. When sleep is disrupted, this can lead to the accumulation of DNA damage, reduction in barrier oils, decreased skin hydration, and increased inflammation. Poor sleepers (less than five hours of sleep per night) have been found to have greater water loss through the skin, indicating an effect on barrier function. Alternatively, good sleepers (7-9 hours of sleep per night) have been found to recover from skin damage 30% better than poor sleepers.

How to Protect Your Skin from Stress & Sleep Disruption

Manage Stress Through Small, Realistic Steps

Expecting someone to completely remove stress from their life is neither practical nor achievable, but there are a few obtainable additions to your schedule that can help combat everyday stress:

  • 10-minute walks
  • Breathing exercises
  • Mindfulness or meditation
  • Limiting screen exposure before bed

Prioritize Consistent Sleep

Sleeping 7-9 hours per night allows your skin the recovery time it needs. Maintaining a consistent sleep schedule by going to bed and waking up at a similar time every day can benefit your circadian rhythm. You can improve your sleep pattern with these simple tips:

  • Avoid screens 60-90 minutes before bed.
  • Create a “Wind-Down” Routine, such as reading, stretching, or journaling.
  • Avoid caffeine 8 hours prior to bedtime.
  • Support sleep during the day with regular exercise.

Build a Stress-Friendly Skincare Routine

When stress is already impacting the skin, skincare should support recovery rather than contribute to the strain. These tips can help maintain a stress-free routine:

  • Use a gentle, fragrance-free cleanser. Fragrant products may contain chemicals that can trigger inflammation and alter your skin’s pH.
  • Support your skin barrier with a ceramide-rich moisturizer to increase skin hydration. A strong skin barrier helps reduce inflammation, sensitivity, and premature aging.
  • Avoid frequent product switching to allow your skin to adapt.
  • Daily use of a broad-spectrum SPF 30+ mineral sunscreen helps guard against external stressors and slow the development of visible aging.

Final Thoughts

Your skin is a mirror of your overall well-being. When stress rises, and sleep falls, your complexion feels and shows the effects. But with the right strategies, you can protect your skin and maintain its healthy glow. If the stress in your life is starting to show, consult with a dermatologist to restore your skin to its happiest, healthiest self.

 

 

 

 

 

 

 

References

  1. Altemus M, Rao B, Dhabhar FS, Ding W, Granstein RD. Stress-induced changes in skin barrier function in healthy women. Journal of Investigative Dermatology. 2001;117(2):309-317. doi:10.1046/j.1523-1747.2001.01373.x
  2. Arck PC, Slominski A, Theoharides TC, Peters EMJ, Paus R. Neuroimmunology of stress: Skin takes center stage. Journal of Investigative Dermatology. 2006;126(8):1697-1704. doi:10.1038/sj.jid.5700104
  3. Duarte M, Pedrosa SS, Khusial PR, Madureira AR. Exploring the interplay between stress mediators and skin microbiota in shaping age-related hallmarks: A Review. Mechanisms of Ageing and Development. 2024;220:111956. doi:10.1016/j.mad.2024.111956
  4. Oyetakin-White P, Suggs A, Koo B, et al. Does poor sleep quality affect skin ageing? Clinical and Experimental Dermatology. 2014;40(1):17-22. doi:10.1111/ced.12455
  5. Xerfan EM, Andersen ML, Facina AS, Tufik S, Tomimori J. Sleep loss and the skin: Possible effects of this stressful state on cutaneous regeneration during nocturnal dermatological treatment and related pathways. Dermatologic Therapy. 2021;35(2). doi:10.1111/dth.15226

The Scary Truth About Halloween: Rashes, Breakouts & How to Avoid Them

/in , , /by

With Halloween just around the corner, most of us are busy focusing on the fun of finding the perfect costume, planning spooky parties, and, of course, indulging in way too much candy, but the real fright might come after the trick or treating is over. From heavy costume makeup and sugar overload to adhesive-packed accessories and costume fabrics, Halloween festivities can wreak havoc on your skin. Breakouts, irritation, and skin reactions are just a few of the spooky surprises your skin might face. But don’t let the fear deter you from Halloween fun. With a few tips, you can keep your skin happy and healthy through the spooky season.

Here’s how to enjoy your Halloween festivities without letting your skin suffer the scary consequences:

Preventing Acne

The scariest thing about Halloween can be waking up with a breakout the next day. Costume makeup can be comedogenic, meaning it clogs your pores, leading to breakouts. The ingredients in these spooky makeups can be harsh on the skin as well, causing irritation and further putting your skin at risk. Here are some tips to help you rock your Halloween costume without the next-day consequences:

1. Choose Skin Friendly Costume Makeup

Not all costume makeup is created equal. Many products contain heavy oils or harsh chemicals that can clog pores, cause irritation, and trigger breakouts. Look at the ingredients in your makeup to help combat this spooky consequence. Opt for non-comedogenic, fragrance-free, and hypoallergenic makeup options. Additionally, choosing water-based makeup can help prevent breakouts from clogged pores, especially if your skin tends to be more oily.

2. Prep Your Skin

Preparing your skin prior to applying makeup can make a big difference. Start with a clean and moisturized face as your base. Application of a primer can create a barrier between your skin and potentially harmful makeup. This will also allow your makeup to go on more smoothly and last longer throughout the night!

3. Splurge for New Makeup

Although it can be tempting, do not use last year’s leftover Halloween makeup. Makeup that has been sitting open, hiding in the dark corners of your cabinet, has been in prime conditions for bacterial growth. Toss the old stuff and get new, clean makeup to help prevent breakouts.

4. Don’t Skip Your Nighttime Cleanse

Don’t forget to wash off the night before heading to bed! Using an oil-based cleanser can be beneficial in removing waterproof makeup and excess oil on the skin. Don’t forget to moisturize afterward to soothe and hydrate your skin.

5. Limit Sugar Intake

Foods and candies high in sugar can cause increased inflammation and oil production, contributing to skin breakouts. Fight these effects by enjoying your Halloween treats in moderation. Balance this consumption with plenty of water and skin-friendly foods rich in antioxidants, like berries, leafy greens, and nuts. Your dentist might thank you as well!

Preventing Contact Dermatitis

The only thing scarier than ghosts and goblins? Waking up after Halloween with an angry, itchy rash. This frightful reaction is often caused by Contact Dermatitis, a type of skin rash that occurs when your skin comes into contact with an allergen or irritant. There are two main types of contact dermatitis:

  • Allergic Contact Dermatitis: an immunologic reaction that is triggered by an allergen. These substances include metals, plants, medicines, cosmetics, and preservatives.
  • Irritant Contact Dermatitis: caused by a harsh substance that causes direct damage to the skin’s protective barrier. These irritants include acids, alkalis, solvents, and detergents.

Symptoms typically include a red, itchy rash with dry or scaly patches, and sometimes even blisters or bumps. This reaction is typically evident within several hours of contact with an irritant. Such a reaction caused by an allergen usually appears within 24-48 hours of exposure, but may develop as soon as 8 to 12 hours after contact or may be delayed as long as 4 to 7 days

Many Halloween products, such as costume makeup, face paint, masks, and accessories, can contain dyes, fragrances, and preservatives, leading to such reactions.

Here’s how to avoid a Halloween skin scare:

1. Utilize Patch Testing

After purchasing your new costume makeup or paint, perform a patch test by applying a small amount on a small area of the skin, such as your inner forearm, at least 24-48 hours before use (we recommend the inner aspect of your forearm). This area can then be monitored to see if there is a reaction to this new product. If you notice any irritation, redness, itching, or swelling, this new product is one to avoid.

2. Beware of Accessories

Fake eyelashes, prosthetics, fake nails, and glitter can help you complete the look of your dreams, but the adhesives used to keep them in place can be irritating to the skin. Opt for medical-grade or latex-free adhesives. Make sure to be gentle when removing these products and do not rip them off; rather, use a proper adhesive remover or warm compress to dissolve the glue safely. Nickel, a common allergen, is found in a large amount of costume jewelry. Be aware of this common metal and seek out accessories that are nickel-free.

3. Avoid Latex if You’re Sensitive

Many masks and prosthetics contain natural rubber latex, which is a common allergen for many. If you are sensitive, select a latex-free alternative to prevent a reaction.

4. Choose Costume Fabrics Wisely

Whether you are donning all black or your costume entails bright colors, many fabrics utilized for costumes contain heavy dyes that can irritate the skin. Additionally, many of these costume fabrics are composed of rough, synthetic materials that can further cause inflammation. Combat these effects by washing any new costume fabrics to remove any residue before wearing. Consider wearing a layer of clothing under your costume to provide a barrier to these irritating fabrics.

5. Clean Your Hands Often

Whether you are touching up your Halloween makeup or reaching into the candy bowl, our hands come into contact with a lot of potential sources of irritation. Anything your hands come into contact with can unknowingly be spread to the face and cause a reaction. Irritation of the eyelids is commonly caused by these contaminants transferred from your hands. Make sure to wash or sanitize your hands throughout the night to avoid spreading allergens to your face.

 

Halloween is all about having fun, dressing up, and eating way too many sweets, but your skin shouldn’t have to pay the price. With a few mindful choices and a good nighttime skin care routine, you can enjoy all the spooky fun without waking up to a skin nightmare. And if you do have any skin care frights, reach out to your local dermatologist to help restore your skin to its original glow.

Resources

  1. Commissioner, O. of the. (2022, November). Novelty Makeup. U.S. Food and Drug Administration. https://www.fda.gov/cosmetics/cosmetic-products/novelty-makeup
  2. Marks, J. G., & Miller, J. J. (n.d.). Eczematous Rashes. In Lookingbill and Marks’ Principles of Dermatology (6th ed.).
  3. Zirwas, M. J. (n.d.). Review of Contact dermatitis to cosmetics. Clinical Reviews in Allergy & Immunology. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30421329/.

Back-to-School Skin Concerns: Sports Edition

/in , /by

By Koji Ota, MD

 

Fall is an exciting time when kids return to school to begin a new academic year, and for many, this also kicks off the fall sports season! Let’s discuss some of the most common skin concerns that affect young athletes and what to look out for.

Sun Protection

Proper sun protection remains important even as the summer ends and the weather cools. This is especially true if your child participates in outdoor sports, where they are exposed to ultraviolet (UV) radiation for hours at a time, which can cause sunburns and increase the risk of skin cancer. Make sure to apply a sunscreen that has broad-spectrum coverage and an SPF of 30 or higher, and reapply every 2 hours when going outside.

Folliculitis and Acne

Bacterial folliculitis, or infection of hair follicles, is common among athletes.  This is due to various risk factors such as increased sweating and friction, or rubbing against various equipment like protective gear. These factors can also worsen pre-existing acne, which is not primarily an infection, but can look similar to folliculitis. It is important to shower soon after sports and to clean equipment and dirty clothing properly. Using cleansers or wipes that contain anti-acne ingredients, such as benzoyl peroxide or salicylic acid, can be helpful in controlling acne as well.

While most breakouts are mild, a bacterial skin infection can sometimes become serious and require treatment. If your breakouts are recurrent or worsening, see a dermatologist who can help you develop a proper skin care routine for the sports season.

Fungal Infections

Tinea, commonly referred to as ringworm, is a skin infection caused by a group of fungi called dermatophytes that commonly affects athletes. They cause itchy, round, scaly plaques with a central clearing. They are spread through skin-to-skin contact, as well as contact with contaminated surfaces. These infections can appear anywhere on the body.

Most mild cases can be treated with topical antifungals. However, in certain areas of the body, such as the scalp, a course of oral antifungal medication prescribed by a doctor may be necessary.

Prevention involves keeping your skin clean and dry. It’s recommended to shower after playing sports and to wear dry, clean, non-constrictive clothing. The fungi that cause ringworm thrive in moist environments, such as damp shoes or socks.

Viral Infections

Warts are caused by human papillomavirus infections that can appear as rough, firm bumps. They are also caused by skin-to-skin contact or contact with a contaminated surface, such as showers and swimming pools. Wearing footwear when walking in public areas can significantly reduce the risk of transmission. There are many treatment options for viral infections, ranging from over-the-counter salicylic acid products to in-office treatments that include freezing with liquid nitrogen, prescription topical medications, and specialized injections.

Herpes simplex virus, which commonly causes cold sores on or near the lips, is also transmitted through skin-to-skin contact and results in grouped blisters that may experience burning or stinging pain. This is more commonly seen in high-contact sports, such as wrestling. Taking an oral antiviral medication such as valacyclovir can reduce disease duration when taken early.

 

These are only some of the most common skin issues that can occur in the setting of school sports. For any questions or concerns, make an appointment with your board-certified dermatologist for an appropriate diagnosis and treatment.

 

 

 

 

 

References

  1. Pujalte GGA, Costa LMC, Clapp AD, Presutti RJ, Sluzevich JC. More Than Skin Deep: Dermatologic Conditions in Athletes. Sports Health. 2023 Jan-Feb;15(1):74-85. doi: 10.1177/19417381211065026. Epub 2022 Jan 17. PMID: 35034516; PMCID: PMC9808835.
  2. Back to School Skin Health – Combatting Common Classroom Skin Concerns [internet]. US Dermatology Partners. 2019 September [cited 2025 September 7]. Available from: https://www.usdermatologypartners.com/blog/back-to-school-skin-health-combating-common-classroom-skin-concerns/

Summertime and the Bugs are Biting, Part II

/in , /by

By Dr. Scott Norton

This is the second half of our summer bug series. In Part 1, we explored outdoor biters and stingers like mosquitoes, bees, fire ants, and ticks. If you’ve already been scratching from those, get ready — in this post, Part 2 we will look at the pests that live closer to home (or in our homes): the ones in our hair, our beds, and sometimes just in our imagination.

 

Part 2: Head Lice, Bed Bugs, Scabies & More

Head Lice: Tiny Bugs in the Hair
Head lice are small insects that live only on people (not pets). They’re common in kids aged 6 to 10 and spread among healthy children mostly through head-to-head contact.

Female lice lay eggs (nits) on hair shafts near the scalp. The eggs hatch in about 10 days. Both newly hatched baby lice and adult lice feed on human blood.

Lice bites cause itching and are especially common behind the ears and neck. But many things that look like nits are harmless things, like dandruff or lint. It’s important to find a live louse before starting treatment.

Special shampoos are available over the counter to treat lice. Permethrin and malathion can treat head lice. If those shampoos don’t work, stronger treatments like ivermectin may be needed.

The CDC and the American Academy of Pediatrics no longer support “No Nit” school policies, because lice aren’t dangerous and don’t justify keeping kids home.

Bed Bugs: Tiny Insects, Giant Problems
Bed bugs don’t transmit disease, but they cause extremely itchy bites and psychological distress. They hide in cracks of bed frames, seams of mattresses, furniture, picture frames, walls, and loose wallpaper. At night, they emerge for a blood meal.

First-time bites may go unnoticed, but repeat bites often cause itchy red bumps in clusters. Dermatologists can help with the itching, but getting rid of bed bugs requires a pest control professional.

Scabies: The Itchy Skin Mite
Scabies is caused by a tiny, tick-like mite that lives only on humans and is spread through skin-to-skin contact. Females burrow into the skin to lay eggs. After a week, the eggs hatch, and the baby mites crawl away to burrow elsewhere.

Scabies spreads through skin-to-skin contact, so if someone has scabies, it typically spreads to most or all of their household contacts. If scabies occurs in a group setting, such as daycare centers or nursing homes, it can be difficult to control. And it causes a great deal of anxiety among everyone involved. Although people rarely get scabies from sharing clothes or bedding, we still treat potentially contaminated fabric items with hot water washings and heated dryings.

Scabies symptoms appear weeks after first exposure. They are often intensely itchy at night and can cause itchy red bumps or tiny blisters. Dermatologists generally confirm a diagnosis of scabies by examining skin scrapings using a microscope. Most other doctors make the diagnosis based on a patient’s symptoms.

Scabies treatment usually includes permethrin cream (which is applied over nearly every body surface) and sometimes oral medicine. Even after a person’s mites are gone, the itching can persist for weeks. Everyone in close contact should be treated, and their bedding should be washed in hot water.

Spider Bites: Often Blamed, Rarely Guilty
There are thousands of spider species, but only a few can hurt humans. Many people wrongly blame spider bites for skin sores.

Key point: Brown recluse spiders do not live in the DC area. In places like Arkansas, Missouri, and Oklahoma – yes. But not here. Painful skin sores in our area are usually due to bacterial infections, especially Staphylococcus aureus. If you observe a spider biting you, try to capture it in a plastic bag or take clear photos to help with identification.

Concern for Infestation
Everyone gets itchy skin. Most people scratch some part of their skin many times each day. Sometimes a person finds that all of their skin is itchy and may perceive crawling sensations … even when no bugs or other creatures are present. This is a very complicated and frustrating situation. The patient may believe that some sort of bug has infiltrated their body.

Many patients in this situation collect bags of lint or skin flakes, believing they contain bugs. Although there may be no evidence of infestation, the sensations and distress are real. This concern may become all-consuming and cause additional problems at home, interactions with others at home and beyond, and constant fear of being singled out. Doctors must investigate the possibility of a true infestation and must also look for other medical causes. Sometimes the problem is not a bug, but how their skin or nervous system processes ordinary, unremarkable skin sensations.

Final Thoughts
From head to toe, indoors and out, bugs can cause irritation and illness. But most of the problems they cause can be prevented or treated. If you’re not sure what’s biting you, or your skin just isn’t right, don’t scratch your head – go see your dermatologist.

 

 

 

 

 

 

 

Reference:

Norton SA. Ectoparasite infestations and arthropod injuries, in Harrison’s Principles of Internal Medicine (21st ed.) Holland S et al (eds). New York: McGraw-Hill, 2025.

Summertime, and the Bugs Are Biting – Part 1

/in , /by

By Dr. Scott Norton

Earlier this month,  I saw  George Gershwin’s opera, Porgie and Bess. It was a wonderful performance, and I’ve been humming the opening aria, Summertime, for the past few weeks. Everyone knows the tune for Summertime, whose lyrics were written by George’s younger brother, Ira Gershwin, and their collaborator, DuBose Heyward. Since Summertime is my current earworm, the tune is on my mind as I write this blog post on summertime’s annoying critters. So, how about these lyrics?

Summertime,
And the livin’ is easy.
Bugs are bitin’ and the skeeters are high
Oh, your daddy’s itchy
and your mama is scratchin’
So, hush, little baby, don’t you cry!

One of these mornin’s,
you’re gonna get bitten.
Yes, you’ll scratch your skin
and you’ll wonder why.
But ’til that mornin,
there’s nothing can harm you,
With daddy and mammy standing by.
So hush, little baby, baby don’t you cry

The biting creatures of summertime are usually small, but they cause a lot of misery. They feed on blood, usually from animals other than humans, but let’s face it, people are also excellent sources of a blood meal. Bug bites and bug behaviors can cause itchy bumps, all kinds of rashes, and allergic reactions. Sometimes when we scratch, we unintentionally introduce common bacteria like staph (Staphylococcus aureus) into our skin, and that can lead to secondary infections, such as impetigo. And yes, some of these bugs spread disease — Lyme disease and West Nile Virus, for example.

In this essay, the word “bug” is used loosely. Scientists (and science-oriented readers) will correctly point out that many commonly found biting creatures are, in fact, not true bugs, but rather other types of irritating pests. When bugs bite, they’re usually trying to feed; when bugs sting, they’re usually trying to defend or protect themselves or their communities (like a beehive or an ant hill). But bites may hurt, itch, swell, or trigger allergic reactions. If your reaction to the bite is severe or simply uncomfortable, you may want to see your health provider. Keep in mind that it’s often difficult to determine what actually bit you, unless you actually catch the bug in the act (or take a sharply focused photograph) and get it identified.

In our area, the most common biting creatures are mosquitoes, horseflies, midges (or no-see-ums), and other biting flies; stinging insects such as bees, wasps, hornets, fire ants; and ticks, tiny creatures more closely related to spiders than to insects. These are our topics for this essay.

Part 1: Mosquitoes, Bees, Fire Ants & Ticks

Mosquito Bites: Itchy and Annoying
Female mosquitoes bite because they need blood meals to reproduce. (Male mosquitoes are vegetarians who feed on nectar and sap.) When mosquitoes bite, they inject saliva into your skin to keep your blood from clotting. Your body’s reactions to the insect’s saliva cause typical insect bite reactions, which appear as red, itchy bumps that can last a few days. Cortisone creams and anti-itch products help.

Some mosquitoes transmit viruses and cause diseases. In our area, West Nile Virus has been around for years, but several other mosquito-borne diseases are emerging threats in southern states. Zika, Chikungunya, dengue, and even malaria are among the worrisome emerging threats in southern states. By the way, house flies don’t bite, but they can spread germs. Keep them off your food.

Bee and Wasp Stings: Ouch!
Bees, wasps, hornets, and yellow jackets sting to protect themselves. Most stings cause redness, swelling, and pain. The stinger from a true bee stays in your skin and keeps pumping venom, so remove it quickly.

To reduce the itchiness and other signs of inflammation, treat insect bites with:

  • Ice or cold compresses
  • Antihistamines (oral)
  • Cortisone creams

Some people are allergic to bites and may go into anaphylactic shock. They need emergency care and should carry an epinephrine injector like an EpiPen.

Fire Ants: Small but Dangerous
Fire ants are mostly in the South, but they’re spreading. They can both bite and sting. When disturbed (say, if you accidentally stepped on the ant hill that they call home) they quickly swarm over you. Their stings cause red bumps, pus-filled blisters, and sometimes allergic reactions.

Treatment:

  • Ice or cold compresses
  • Antihistamines (oral)
  • Cortisone creams

Severe reactions require epinephrine and medical help.

Tick Bites: More Than Just a Bite
Ticks are blood feeders that attach to skin painlessly. They stay on for 1–3 days to get their meal, so it’s been important for them to evolve into biters that you might not notice.

All ticks can transmit some types of diseases. In our area, Lyme disease is the most common. A tick grows in size as it feeds – like a balloon being blown up.

Remove a tick with fine tweezers, grabbing it close to the skin. Avoid using heat or chemicals. Wash the area afterward and save the tick in a clear plastic bag to show your doctor. When bitten by a deer tick in a high-risk area (like the DMV), your doctor may prescribe a single dose of doxycycline, an antibiotic that can kill the first waves of the Lyme disease bacteria that enter your body.

Learn how to prevent tick bites here.

Getting Help for Bug Bites

Dermatologists are often experts in recognizing and treating insect bites and stings. If you’ve been bitten and are concerned, see your family doctor or your dermatologist. And if your symptoms are severe — like a life-threatening allergic reaction (known as anaphylaxis) to a bee sting — call 911 or go to the nearest emergency room.

If you see a doctor because of a bite, the doctor usually asks a lot of questions: When did the bites occur? Where were you when you were bitten? What were you doing? Were you gardening, camping, hiking, or playing sports in grassy fields? Have you travelled somewhere recently? Were you around pets, farm animals, or wildlife? These clues help us piece together what kind of creature might be causing the trouble.

In Part II, we’ll discuss some bugs that stick around year-round, like head lice, bed bugs, and scabies. We’ll finish with some myth-busting about spider bites and a peculiar issue known as “total body infestation.”

Stay tuned for Part 2 next month…

 

 

 

 

Reference:

Norton SA. Ectoparasite infestations and arthropod injuries, in Harrison’s Principles of Internal Medicine (21st ed.) Holland S et al (eds). New York: McGraw-Hill, 2025.

Hormonal Acne as an Adult

/in , , /by

By Kyleen Davis, FNP

Let’s get one thing straight—acne isn’t just a teenage thing. Even though Hollywood would have us believe that breakouts magically disappear with high school, many women continue to deal with acne well into adulthood. And let’s be honest, it’s frustrating. It can feel like your skin is going backwards.

The culprit? Often, it’s hormones.

Hormonal acne is super common, especially for women, and it’s usually tied to shifts in hormones related to things like your menstrual cycle, perimenopause, or menopause. These changes can ramp up oil production and inflammation, leading to—you guessed it—breakouts.

You’ve probably tried the usual go-to treatments like benzoyl peroxide or retinoids. And yes, they can work! But if your acne isn’t budging, there are newer, evidence-backed options worth considering.

Let’s walk through them:

Spironolactone

Spironolactone wasn’t originally made for acne—it’s actually a blood pressure medication. But it turns out it has anti-androgen properties, which means it helps block certain hormones that trigger acne.

Many women have seen big improvements (we’re talking 50% to 100% better).1 Side effects are usually mild—think dizziness, headaches, or changes in your period. Most young, healthy women don’t need frequent blood work monitoring on this medication, but if you’re older or have other health concerns, your provider may want to monitor your potassium and kidney function. It’s not safe during pregnancy and isn’t used in men.

Chemical Peels

Chemical peels aren’t just for glowing skin—they can actually help clear up acne. They exfoliate dead skin cells, unclog pores, calm inflammation, and even regulate oil production.

We offer an Acne Salicylic Wash Peel that specifically targets breakouts, reducing redness, swelling, and excess oil.

Niacinamide

You might’ve seen this ingredient pop up in serums and moisturizers—and for good reason. Niacinamide (a form of vitamin B3) helps reduce oil production, calms inflammation, strengthens the skin barrier, and even fights off free radicals that can worsen acne.

It’s gentle, effective, and works for most skin types.

Clascoterone: A Topical Anti-Androgen

This one’s relatively new and exciting. Clascoterone (brand name Winlevi) is a cream that works like a topical version of spironolactone—it blocks hormone receptors in your skin, helping to reduce oil and inflammation.

The best part? It’s topical, so you skip the systemic side effects of oral medications. It’s safe for both women and men, even teens 12 and up. The downside? It’s still pretty new, so cost and insurance coverage might be a hurdle for some.

Combined Oral Contraceptives

Certain birth control pills can also double as an acne treatment, especially if your breakouts seem to follow your menstrual cycle. They help regulate hormones that contribute to acne, and some even come with added benefits for women dealing with cycle irregularities.

Some types seem to work better for acne than others. Pills containing drospirenone or other low-androgenic progestins often show the best results.2

Light & Laser Therapy: A Non-Invasive Option

If you’d prefer to stay away from pills and creams, light therapy might be a good fit.

Red light therapy reduces inflammation, speeds up healing, and even helps fade post-acne marks. Blue light therapy, on the other hand, targets acne-causing bacteria directly and is a great option if you’re coming off antibiotics or want a non-drug approach.

We offer in-office blue light treatments, and while at-home devices are out there, they tend to be less powerful.

Quick breakdown:

Red Light:

  • Soothes inflammation
  • Boosts collagen
  • Helps with overall skin healing

Blue Light

  • Zaps acne-causing bacteria
  • Can help with precancerous skin issues too
  • Promotes smoother, clearer skin over time
What’s Next? New and Emerging Options

Researchers are working on even more targeted hormonal treatments, like selective androgen receptor modulators (SARMs). The field is moving toward more personalized approaches, combining both topical and systemic therapies to get the best results.

The Bottom Line

Dealing with hormonal acne as an adult isn’t just common—it’s totally normal. And thankfully, treatment options are getting better and more tailored every year.

If you’re feeling stuck with your current routine, let’s talk. There are plenty of new solutions out there, and we’re here to help you find what works best for your skin. Book a consultation and let’s get you on the path to clearer, more confident skin.

 

 

 

 

 

Resources

  1. American Academy of Dermatology. (2025). Stubborn acne? Hormonal therapy may help.https://www.aad.org/public/diseases/acne/derm-treat/hormonal-therapy.
  2. Arrington, E. A., Patel, N. S., Gerancher, K., & Feldman, S. R. (2012). Combined oral contraceptives for the treatment of acne: A practical guide.Cutis, 90(2), 83–90.https://cdn.mdedge.com/files/s3fs-public/Document/September-2017/090020083.pdf
  3. Casey, F. E. (2023, January 11).Contraception and its impact on acne. Contemporary OB/GYN. https://www.contemporaryobgyn.net/view/contraception-acne
  4. Charny, J., Choi, J. & James, W. (2017). Spironolactone for the treatment of acne in women, a retrospective study of 110 patients. International Journal of Women’s Dermatology, 13, 3(2), 111-115.
  5. Cleveland Clinic. (2024, September 19).Red light therapy: Benefits, side effects & uses.https://my.clevelandclinic.org/health/articles/22114-red-light-therapy
  6. Fioravanti, G., & Casale, S. (2021). Social media and body dissatisfaction in young adults: An experimental investigation of the effects of different image content and influencing constructs.Body Image, 38, 1–11.https://doi.org/10.1080/14656566.2021.1918100
  7. Hebebrand, M., & Del Rosso, J. Q. (2025, January 28).What’s new in the medicine chest: Acne vulgaris.Dermatology Times. https://www.dermatologytimes.com/view/what-s-new-in-the-medicine-cabinet-acne-vulgaris
  8. Hebert, A., Thiboutot, D., Stein Gold, L., Cartwright, M., Gerloni, M., Fragasso, E., & Mazzetti, A. (2020). Efficacy and safety of topical clascoterone cream, 1%, for treatment in patients with facial acne: Two phase 3 randomized clinical trials.JAMA Dermatology, 156(6), 621–630.https://doi.org/10.1001/jamadermatol.2020.0465
  9. Lortscher, D., Admani, S., Satur, N., Eichenfield, L. Hormonal contraceptives and acne: a retrospective analysis of 2147 patients. Journal of Drugs in Dermatology, 15(6), 670-674.
  10. Macy, E., McCormick, T. A., Adams, J. L., Crawford, W. W., Nguyen, M. T., Hoang, L., Eng, V., Davis, A. C., & McGlynn, E. A. (2022). Association between removal of a warning against cephalosporin use in patients with penicillin allergy and antibiotic prescribing.JAMA, 327(3), 239–247.https://doi.org/10.1001/jama.2021.24751
  11. Miller, K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J. H., & Jemal, A. (2019). Discrepancy between perceived diet quality and actual diet quality among US adult cancer survivors.JAMA Oncology, 5(6), 845–847.https://doi.org/10.1001/jamaoncol.2019.0601
  12. Paller, A. S., Mendes-Bastos, P., Siegfried, E. C., Raymundo, A. F., Yang, H., Hu, X., Calimlim, B. M., Platt, M., Zheng, Y., Teixeira, H., Liu, J., & Eyerich, K. (2024). Upadacitinib in adolescents with moderate to severe atopic dermatitis: Analysis of 3 phase 3 randomized clinical trials through 76 weeks.JAMA Dermatology, 160(12), 1304–1313.https://doi.org/10.1001/jamadermatol.2024.3696

Measles: What it is and How to Prevent it

/in , /by

With cases in the United States on the rise, many are seeking more information about the measles virus and how it could impact them. Measles is a viral respiratory illness that can cause serious complications. Worldwide, measles causes 1 million deaths per year in children under 5 years old. In 2024, there were a total of 285 cases in the United States. As of March 25, 2025, there have been 378 reported cases: two in Prince George’s County and one in Howard County.3,5 Ninety-five percent of those infected were unvaccinated. To date, there have been 2 deaths associated with measles in the United States in 2025.3 With the uptick of cases seen this year, it is important to be aware of how we can mitigate the infection.

How Measles is Spread 

The measles virus is highly contagious and spreads either through direct contact or via airborne particles that are spread when an infected individual sneezes, coughs, or talks. The measles virus can remain infectious in the air for up to 2 hours after the infected person leaves the area, whether or not the patient was masked. Patients with measles should remain in airborne precautions for 4 days after the onset of their rash.

What does Measles look like?

Measles often begins with a prodrome, or early symptoms, that precede the rash and begin an average of 10-12 days after exposure. The characteristic prodrome consists of fever, malaise, and the 3 C’s: cough, coryza (runny or stuffy nose), and conjunctivitis. During this period, you may also begin to notice white spots inside the mouth, called Koplik’s spots, that are highly indicative of a measles infection. This prodrome typically lasts about 2 to 4 days. Following about 14 days after exposure, a non–itchy rash consisting of red spots develops. This rash typically appears first on the head, most often behind the ears, then progresses to involve the rest of the body, spreading from the head to the toes, and often sparing the palms of the hands and the soles of the feet. This rash typically subsides after about 1 week of fever resolution. Infected individuals are contagious for approximately 4 days before the onset of the rash and 4 days after the rash appears.

Measles infection can lead to various complications, including ear infections, diarrhea, or pneumonia, with pneumonia the most common cause of measles-related death. Rarely, measles can lead to encephalitis, or inflammation of the brain, occurring in about ~0.1% of children. This can lead to permanent brain damage, and may become potentially fatal in 10-20% of patients. Of the reported cases of measles, ~30% of individuals experience one or more complications.2

Women exposed to measles during pregnancy have an increased risk of complications, including increased risk of premature labor, miscarriage, and low birthweight.

Preventing the Spread of Measles

The only way to prevent measles infection is through vaccination. There is no antiviral medication. The MMR vaccine, which vaccinates against Measles, Mumps, and Rubella, is recommended at ages 12-15 months and 4-6 years old. One dose of the MMR vaccine is 93% effective against measles infection, with prevention increasing to 97% with the second dose.

Prior to the implementation of the MMR vaccine, there were approximately 3-4 million measles cases in the United States each year, accounting for 400-500 deaths. Following the introduction of the vaccine, the yearly cases dropped significantly, with only 37 yearly cases reported by 2004.1

When 95% of the community is vaccinated against measles, we reach herd immunity, a phenomenon in which a sufficient portion of the population becomes immune to a disease, thereby reducing its spread and providing indirect protection to individuals who are not immune.

Currently in the United States, we are below the threshold required for herd immunity with 92.7% of kindergarten-aged children being vaccinated, increasing the risk of infection for those without immunity.3

As the MMR is a live, attenuated vaccine, it may be contraindicated in certain immunocompromised populations, making the need for herd immunity even more important for those who cannot receive the vaccine but are at risk.

International travel has been a leading cause of measles infection in the United States. The CDC recommends getting the vaccine at least 2 weeks before departure, with one dose recommended for infants aged 6-11 months and 2 for those 12 months and over.

What to do if you have Measles

If you think you or your child may be infected with measles, call your primary care provider or urgent care facility and tell them you suspect measles. Do not proceed without calling ahead. You may be directed to a facility with an airborne infection isolation room (AIIR); the facility will provide you with specific instructions, including entering through a separate entrance to prevent the risk of spreading to other patients and healthcare workers. The patient and accompanying family members should wear a mask or should be “tented” if masking is not tolerated.

As cases of measles continue to rise in the United States, with new confirmed cases in Maryland, it is essential we work to counteract its spread through vaccination. If you are unable to find your vaccination records or have specific questions about vaccination recommendations, talk to your primary care physician.

 

 

 

 

 

Resources

  1. Gastanaduy P, Haber P, Rota P, Patel M. Chapter 13: Measles. Centers for Disease Control and Prevention. April 24, 2024. Accessed March 13, 2025. https://www.cdc.gov/pinkbook/hcp/table-of-contents/chapter-13-measles.html.
  2. James WD, Elston DM, Treat J, Rosenbach M, Neuhaus IM, Andrews GC. Measles. In: Andrews’ Diseases of The Skin: Clinical Dermatology. Elsevier; 2025.
  3. Measles cases and outbreaks. Centers for Disease Control and Prevention. March 7, 2025. Accessed March 12, 2025. https://www.cdc.gov/measles/data-research/index.html#cdc_data_surveillance_section_1-measles-cases-in-2024.
  4. Marks JG, Miller JJ, Lookingbill DP. Measles. In: Lookingbill and Marks’ Principles of Dermatology. Saunders Elsevier; 2019.
  5. Maryland Department of Health Center for Immunization. Maryland.gov Enterprise Agency Template. Accessed March 25, 2025. https://health.maryland.gov/phpa/OIDEOR/IMMUN/Pages/Measles.aspx.
  6. History and current status. American Academy of Dermatology. Accessed March 25, 2025. https://www.aad.org/member/clinical-quality/clinical-care/emerging-diseases/measles/history-current-status.

How to Take Care of Your Lips

/in , , /by

By Joan Pohutsky DNP, NP-BC

Valentine’s Day is just around the corner- are your lips ready? This part of your face can be easily overlooked, yet they are one of the most sensitive areas of the face prone to dehydration, damage, and irritation. Dry, chapped, and cracked lips can leave you feeling less than confident, especially when you’re looking to flaunt your best pout.

But what makes them so vulnerable, and how do you properly care for your lips? With a few simple steps, you can ensure that your lips are soft, supple, and ready to shine for Valentine’s Day (and beyond).

Why Are Our Lips So Vulnerable?

Dry, chapped, red, sore, cracked lips, also known as cheilitis, can be exacerbated by:

Anatomical factors: Skin on the lips is thinner than the rest of the face and lacks sebaceous glands, which produce natural oils. This can quickly lead to epidermal barrier dysfunction.

Environmental factors: Extreme weather conditions, such as cold, windy, dry, or very sunny climates.

Allergies and Irritants: Sensitivities to lip products, food, toothpaste, and certain medications.

Stress: Psychological and emotional stress can lead to repetitive mechanical trauma, like lip licking or constant rubbing.

Other conditions: Actinic cheilitis, caused by sun damage, can lead to skin cancer if not treated. It can also, less commonly, be a result of nutritional deficiencies such as B12 or iron.

Treatment: Caring For Your Lips

Treating the underlying cause is important, as is following general guidelines including:

  1. Hydration

Drinking water is important for your overall health, but drinking more water alone will not improve cracked, dry lips. Look for products with the following:

Hyaluronic Acid, Honey, Ceramides, Vitamin E, Oils, Oils, Dimethicone, Petrolatum, or Shea Butter

Using a humidifier and regularly applying lip balm with active ingredients can help lock in moisture externally and provide protection.

  1. Gentle Exfoliation

Exfoliating your lips helps to remove dead skin cells, improving smoothness and preventing lips from looking rough and flaky. However, the thin and delicate skin on the lips makes gentle methods of exfoliation crucial so as not to impair your skin barrier – once or twice a week is usually enough. If your lips are particularly chapped, skip exfoliation until they heal! Exfoliating cracked lips can worsen irritation. Look for gentle lip scrubs that contain sugar, honey, or olive oils, then gently massage the scrub into your lips with small circular motions and rinse with lukewarm water.

  1. Avoid Trauma: Harsh Products and Lip Licking

The lips are a common location for contact dermatitis, a rash that manifests as inflammation, redness, itching, and discomfort. Contact dermatitis develops due to skin sensitivities or allergic reactions to certain ingredients in products used on or around the lips. Common culprits include:

Toothpaste and other products such as mouthwash, denture cleaner, and dental floss can contain fluoride, sodium lauryl sulfate (SLS), and flavoring.

Citrus, Cinnamon, and other acidic foods

Metal in orthodontic devices and dental restoration

Medicines like neomycin and bacitracin

Fragrances and preservatives

It may feel like licking your lips is a quick fix for dryness, but it actually can worsen the problem. Enzymes in saliva can irritate the delicate skin on the lips and evaporate quickly, leaving your lips even drier than before. Instead of licking, use a soothing lip balm whenever your lips feel dry.

Choose a product free of potential irritants, especially those containing eucalyptus, camphor, flavoring, fragrance, lanolin, menthol, oxybenzone, phenol, propyl gallate, and salicylic acid.  Artificial fragrances, dyes, and alcohols can further dry out and irritate your lips.

Also, avoid long-wear and matte lip formulas if your lips are already feeling dry or cracked. These products often contain drying ingredients that exacerbate lip irritation. If you must wear a long-lasting lipstick, layer it over a nourishing lip balm to create a moisture barrier.

  1. Daily Sun Protection

Just like anywhere else on your body, your lips are vulnerable to the sun’s harmful ultraviolet (UV) rays. Exposure to UV light can cause sunburn, premature aging, thinning of the lips, and increase the risk of skin cancer including basal cell carcinoma, squamous cell carcinoma, and melanoma.

Protect your lips by using a mineral lip balm with SPF 30 or higher. Look for products with broad-spectrum coverage to protect against both UVA and UVB rays, containing zinc oxide or titanium oxide. Reapply regularly throughout the day, especially if you’re spending time outdoors, in the water, or perspiring, and consider sun-protective clothing like wide-brimmed hats.

  1. Diet and Lifestyle

Deficiencies in certain vitamins and minerals can lead to lip inflammation, which can be prevented by a balanced diet rich in essential nutrients such as:

Vitamin A, B Vitamins, Vitamin C, Vitamin E, Iron, Zinc, Magnesium

Additionally, alcohol consumption should be limited due to its diuretic effects contributing to chapped, discolored lips. Don’t smoke, as it can break down collagen and elastin, decreasing volume and thus causing vertical wrinkles, or “smoker’s lines.”

Summary

Be sure your lips are part of your skincare routine by maintaining healthy habits like hydration and sun protection. Make an appointment to see us if you have any new or changing lesions on your lips or would like to discuss restoring your lips’ appearance with safe and effective procedures that yield natural-looking results.

 

Happy Valentine’s Day—here’s to love and healthy, happy lips!

 

 

 

Sources

American Academy of Dermatology. (n.d.). How to heal dry, chapped lips. American Academy of Dermatology. Retrieved December 30, 2024, from https://www.aad.org/public/everyday-care/skin-care-basics/dry/heal-dry-chapped-lips

Devgan, L., & Singh, P. (2023) Clinical assessment of a topical ceramide and hyaluronic acid based lip treatment in perceived lip aesthetics. ResearchGate. Retrieved from https://www.researchgate.net/profile/Lara-Devgan/publication/381229429_Dr_Devgan_Platinum_Lip_Plump-_Clinical_assessment_of_a_topical_ceramide_and_hyaluronic_acid_based_lip_treatment_in_perceived_lip_aesthetics/links/6662a48bb769e769191d78e7/Dr-Devgan-Platinum-Lip-Plump-Clinical-assessment-of-a-topical-ceramide-and-hyaluronic-acid-based-lip-treatment-in-perceived-lip-aesthetics.pdf

Fonseca, Allene MDa,b; Jacob, Sharon E. MDc,d,e; Sindle, Allison MDf,*. Art of prevention: Practical interventions in lip-licking dermatitis. International Journal of Women’s Dermatology 6(5):p 377-380, December 2020. | DOI: 10.1016/j.ijwd.2020.06.001

Lugović-Mihić, L., Špiljak, B., Blagec, T., Delaš Aždajić, M., Franceschi, N., Gašić, A., & Parać, E. (2023). Factors Participating in the Occurrence of Inflammation of the Lips (Cheilitis) and Perioral Skin. Cosmetics, 10(1), 9. https://doi.org/10.3390/cosmetics10010009

Park K. Role of micronutrients in skin health and function. Biomol Ther (Seoul). 2015 May;23(3):207-17. doi: 10.4062/biomolther.2015.003. Epub 2015 May 1. PMID: 25995818; PMCID: PMC4428712.

Shang J, Feng X, Chen Y, Gu Z, Liu Y. Human lip vermilion: Physiology and age-related changes. J Cosmet Dermatol. 2024; 23: 2676-2680. doi:10.1111/jocd.16317

Tips for Nail Health

/in , /by

We decorate them, paint them, and use them daily, but how do we keep our nails healthy? Brittle or fragile nails affect up to 20% of the population. This can be due to age, environmental factors, pregnancy, repeated trauma, medications, and much more! Fragile nails can lead to breakage, splitting, flaking, and chipping. In this blog post I’ll be discussing some Dos and Don’ts of nail care to ensure you keep your nails healthy and strong.

How do our nails grow?

Our nails are composed of multiple layers of tightly packed protein, called keratin, which grows from the nail matrix, an area at the base of the nail below the cuticle. Fingernails grow about 2-3mm per month, with our toenails growing about 1-2mm per month. The rate of their growth is dependent on many factors including age, gender, season, dominant hand, and medications to name a few. Did you know your nails tend to have accelerated growth during the summer months? Keep reading for some tips to keep your nails healthy and strong.

5 Dos of Promoting Healthy Nails

  1. Keep the nails short: Trimming the nails regularly decreases the risk of trauma to the nail. It is best to cut your nails almost straight across to help protect against ingrown nails. Use a nail file to round the corners to prevent them from snagging onto things and breaking. Tip: If your nails become thick and difficult to cut, soak them in warm water for a few minutes or trim them after getting out of the shower.
  2. Keep the nails clean and dry: Ensuring you keep your hands, feet, and nails dry can prevent splitting of the nails.  Keeping them clean helps prevent bacteria from accumulating underneath the nails. Tip: Wear rubber gloves when doing wet work.
  3. Keep the nails moisturized: This helps nails remain flexible and protects against splitting or damage. Soaps and household cleansers can dehydrate the hands and nails, so wearing protective gloves while performing household tasks and applying moisturizers are beneficial.
  4. Wear properly fitted footwear: Wearing the correct size footwear helps prevent injury to the toenails due to trauma from the front of the shoe. Alternating which shoes are worn can reduce repeated injury.
  5. Take a break between nail polish uses: Acetone-containing nail polish removers can dehydrate the nail plate. Allowing 1-2 weeks between manicures allows the nails time to recover. Use this break to rehydrate your nails with moisturizers. Despite the effect nail polish remover can have, don’t pick nail polish off as this can damage the nail.

5 Don’ts of Promoting Nail Health

  1. Do not cut your cuticles: The cuticle acts as a protective barrier to the nail matrix; it is inadvisable to cut the cuticle as it allows a route for bacteria to enter.
  2. Do not bite your fingernails: Nail biting is harmful; it can introduce bacteria, increasing the risk of infection. Additionally, biting nails may be harmful and damaging to your teeth.
  3. Do not use harsh chemicals on the nails: Harsh chemicals can damage nails, making them more prone to breakage. TIP: Choose an acetone-free polish remover to avoid further drying of the nail.
  4. Do not use the nails as a tool: Whether opening a can or scraping something off, using your nails to perform activities intended for tools can cause trauma and damage.
  5. Do not remove hangnails or ingrown nails: When removing a hangnail or ingrown nail improperly, you run the risk of causing further damage. Tearing off a hangnail or unearthing an ingrown nail can injure normal skin and introduce bacteria. Hangnails should be gently clipped with a clean scissor or nail clipper, while the removal of an ingrown nail should be managed by a dermatologist or podiatrist.

When to consult a Dermatologist

The condition of your nails can provide clues about your overall health. Changes in nail appearance or health may signal an underlying illness. If you notice any of the following, make an appointment with us for further evaluation:

  1. Change in color of the nail: Whether the nail begins to appear white, yellow, green, or black, this could be an indication of an underlying pathology, including infection, anemia, lack of circulation, or even skin cancer.
  2. Changes in the shape of the nail, including thinning or thickening: Alterations in the thickness or shape of the nails can be due to many conditions such as psoriasis, abnormal thyroid function, circulation or respiratory problems, signs of inadequate nutrition, and gastrointestinal disease, among others.
  3. Indentations, grooves, or any other changes to the nail surface: You may experience transverse lines, longitudinal ridging, pitting, or small dents of the nails. These can be associated with psoriasis, atopic dermatitis, alopecia, lichen planus, or a prior systemic illness or stress.
  4. Separation of the nail from the surrounding skin: If the nail begins to lift and separate from the surrounding skin, this could be attributed to underlying mechanisms such as infection, tumors, psoriasis, or injury to the nail.
  5. Pain or swelling surrounding the nail: Developing redness, tenderness, and swelling around the nail can indicate there is an infection in the area that needs to be addressed.
  6. Failure of the nail to grow: Lack of nail growth can be due to various etiologies including injury, nutritional deficiencies, psoriasis, lichen planus, or advanced age.

Taking care of your nails is more than just aesthetics, it’s an important part of your overall health. By adopting habits like proper trimming, regular moisturizing, and avoiding harsh chemicals, you can keep your nails in top condition. With the right care and attention, you can maintain nails that are not only healthy and functional but also a source of confidence and style.

 

 

 

References:

  1. Bolognia JL, Cerroni L, Schaffer JV. Biology of Nails. In: Dermatology. 4th ed. Elsevier Science Health Science; 2017.
  2. Chessa MA, Iorizzo M, Richert B, et al. Pathogenesis, clinical signs and treatment recommendations in Brittle Nails: A Review. Dermatology and Therapy. 2019;10(1):15-27. doi:10.1007/s13555-019-00338-x
  3. Draelos ZD. Understanding and Treating Brittle Nails. Cosmetic Dermatology. 2009;22(12).
  4. Garbers LE, Miola AC, Dias PC, Miot LD, Miot HA, Schmitt JV. Efficacy of 2.5 mg oral biotin versus 5% topical minoxidil in increasing nail growth rate. Experimental Dermatology. 2021;30(9):1322-1323. doi:10.1111/exd.14316
  5. How to trim your nails. American Academy of Dermatology. Accessed December 11, 2024.https://www.aad.org/public/everyday-care/nail-care-secrets/basics/how-to-trim-nails#:~:text=To%20properly%20trim%20your%20nails%2C%20dermatologists%20recommend%20the%20following%20tips,few%20minutes%20to%20soften%20them.
  6. Tips for healthy nails. American Academy of Dermatology. Accessed November 25, 2024. https://www.aad.org/public/everyday-care/nail-care-secrets/basics/healthy-nail-tips