AVEENO ambassadors like me had an opportunity to ask celebrity dermatologist Dr. Jessica Wu and celebrity hairstylist Patrick Melville a few beauty questions. In this post is the Q and A with Dr. Jessica Wu. I’ll be following with another post with the session from hairstylist Patrick Melville.
Q and A with celebrity dermatologist Dr. Jessica Wu
Dr. Wu’s thoughts as a dermatologist about taking hormonal birth control pills for acne.
”Many of my patients have adult acne that has a hormonal component, meaning that they have an overabundance or male hormones (androgens). Often, hormonal acne flares up before your period, and it’s typically concentrated in the lower face: chin, jawline, and lower cheeks. For these patients, birth control pills (which contain estrogens, the ‘female’ hormones) can help balance the excess androgens.” Who is it effective for? Is it safe? “Birth control pills may have side effects including cause nausea, weight gain and breast tenderness. They may also increase your risk of developing blood clots and stroke, especially if you smoke or have high blood pressure. Your doctor may advise against taking birth control pills if you have a family history of breast cancer, since some types of breast cancer can be triggered to grow by estrogen. “ When to expect results and etc. “It typically takes at least a month, and sometimes up to 3-4 months, for the acne to respond to the birth control pills. I usually recommend trying all other treatments (the correct products, topical creams, facials, changing their diet) before starting any oral medication.”
How much is too much in skincare?
“Listen to your skin. If it gets red, itchy, flaky, and angry-looking, you may be over-using some product in your skincare routine.”
What signs should we look out for to determine if we’re using too many products or ones that are too strong?
“Try cutting back on your products, then adding them one at a time to figure out which one is causing the problem.”
The difference (or maybe lack thereof!) between recognizing and treating hyperpigmentation, dark spots, acne scarring, and sun damage.
“Hyperpigmentation simply means dark spots, which can be caused by acne scarring, sun damage, or hormone changes. You can typically use the same products to treat hyperpigmentation regardless of its cause.”
I wonder if I’m doing enough and what are the most important things I should be doing on a daily basis to prevent wrinkles, age spots and lines?
“Sunscreen! Ensure you are using AT LEAST an SPF 30 on your face each morning. Even if it’s not sunny out, those sun rays are still there!”
Suggestions for adult acne.
“Adult woman with acne tend to have drier skin than teens with acne, so traditional acne medications are often too drying and irritating, and make the situation worse. Your best bet is to use a gentle foaming cleanser (like Aveeno Ultra Calming Foaming cleanser) to remove makeup & surface oils, followed by a sulfur-based mask or treatment product (check out Clearasil Adult Treatment Cream, Bare Escentuals Blemish Therapy, or Murad Sulfur mask). Sulfur is antibacterial and anti-inflammatory, without being as drying as benzoyl peroxide. Since adult acne is often hormonal, it’s also a good idea to watch what you eat, especially when you’re PMS’ing: try to avoid dairy, refined carbs (bread, rice, potatoes, pasta) and sugar, which can trigger your hormones and make you break out. And, if you have irregular periods and facial hair growth along with your adult acne, be sure to see your doctor, since these can be a sign of Polycystic Ovarian Syndrome.”
Suggestions for if you have dry skin – this is what you should be putting on your face, if you have oily skin this is what you should be putting on your face. (Like do I need a toner, do I need a serum and if so what kind)
For dry skin (or if your normally normal-oily skin gets dryer in the winter) , try to avoid treatments and products that will strip your skin of its natural oils. Instead, wash with a mild, creamy cleanser, using your fingertips, and avoid alcohol-containing toner. Dab or spray it on if you feel like you need extra hydration before applying moisturizer. Better yet, skip the toner and go straight to the moisturizer. Look for richer cream formulas rather than lotions or gels. If you use a serum or medicated cream, apply that first, then your cream moisturizer to seal in hydration. If your skin is oily, look for a foaming cleanser to help break up oil. A skincare brush or washcloth can help remove oil and makeup. Follow with a toner; if you also have acne, choose one with salicylic or glycolic acid to help unclog pores. For anti-aging, look for antioxidant or retinol in gel or serum formulas (which are water-based) instead of a heavy moisturizing cream. If you have any dry patches (like your cheeks), apply a moisturizing lotion (not cream) to those areas only. Choose a moisturizer that’s oil-free, with ingredients like glycerin and hyaluronic acid to hold moisture in your skin, rather than oil-based creams.
What causes milia under your skin and what is it?
Milia are tiny, round white bumps that can appear anywhere on the face. They’re a type of cyst, made up of oil and dead skin cells. They can pop up for no apparent reason, but are often associated with using creams that are too heavy, especially rich eye cream. They usually go away on their own, but sometimes they grow until they’re drained. The cyst contents are very hard, not like a whitehead, so they’re hard to squeeze. Therefore , it’s best to see a dermatologist, who can use a special instrument to drain it hygienically and safely.
Best treatment for under eye puffiness:
It depends on what the puffiness is caused by. For example, if the puff comes and goes, or is worse in the morning, it may be due to water retention. In that case, avoid salty foods and foods with added salt after lunch and then sleep on an extra pillow. In the morning, hold cold teabags over your eyes for a minute or so, or use the Aveeno Anti-fatigue eye roller, both of which shrinks puffy tissues. Also, avoid hot water on your face. This should help reduce the fluid under your eyes. If your puffiness is associated with allergy symptoms (runny nose, itchy eyes), taking an antihistamine or using a neti pot may help. However, if it’s a hereditary fat pad, the best treatment is surgery.
What are those chicken bumps on my arms and what can I do about them?
The bumps on the backs of your arms are most likely a condition called “keratosis pilaris” which is caused by clogged hair follicles. This is a genetic condition that may improve with age. However, if it persists, you can minimize the bumps by exfoliating to help the dead skin cells slough off. I also recommend using a body wash containing salicylic acid to loosen the dead skin. In the morning, use a body lotion containing lactic acid (like Lac Hydrin or Am Lactin—both available at drugstores). At night, use a rich body butter to make the bumps smoother. For stubborn cases, I sometimes prescribe a retinoid like Retin A or Tazorac, and also do light in-office chemical peels.
I am most interested in how products work, or don’t work, together. For example, is it ok to mix Aveeno Skincare products with other serums masques, spf moisturizers, and so forth? Do these things interact badly?
Usually when my patients have a problem mixing their skincare products, it’s because they use products that cause too much irritation when used together: for example, using two different acne creams at the same time (like a benzoyl peroxide and a retinoid); or using a product with alphahydroxy acid and another with salicylic acid. Aveeno products are designed to be gentle and soothing, so you can generally mix and match them with your other skincare products. However, if you’re using a prescription product, check with your dermatologist first.
What is your opinion of having your hair tested and analyzed?
There are a few specific situations where hair testing can be helpful. For example, when someone has hair loss, hair can be plucked and tested for heavy metals like mercury that can cause hair thinning and neurologic symptoms. Sometimes we do scalp biopsies in the office to figure out the cause of hair loss, since certain inflammatory and autoimmune conditions like lupus and alopecia areata can affect the scalp and injure the hair follicles.
What are the best kinds of vitamins to take? Does you like Liquid or pill form?
Depends on the vitamins…for example, most of us could benefit from omega-3 fish oil, which has been shown to help dry skin, eczema rashes, & psoriasis. It’s also anti-inflammatory, so it can help calm acne breakouts. For fish oil, I prefer liquid form; there are fewer additives and starches, and more of it is absorbed by the body. Stronger Faster Healthier makes a chocolate-flavored fish oil that I take every day. For hair and nails, I recommend biotin. This comes in pills.
How does someone find out if they are lactose intolerant?
Usually it’s diagnosed when someone reports having stomach or intestinal problems when they drink milk or eat dairy products. Your doctor can also do tests in the office, like the hydrogen breath test. Some people have a milk allergy, and this can be diagnosed by an allergist who can do a skin test.
How come grown women get adult acne?
Many of my patients have adult acne that has a hormonal component, meaning that they have an overabundance or male hormones (androgens). Often, hormonal acne flares up before your period, and it’s typically concentrated in the lower face: chin, jawline, and lower cheeks. For these patients, birth control pills (which contain estrogens, the ‘female’ hormones) can help balance the excess androgens. Birth control pills may have side effects including cause nausea, weight gain, breast tenderness. They may also increase your risk of developing blood clots and stroke, especially if you smoke or have high blood pressure. Your doctor may advise against taking birth control pills if you have a family history of breast cancer, since some types of breast cancer can be triggered to grow by estrogen. It typically takes at least a month, and sometimes up to 3-4 months, for the acne to respond to the birth control pills. I usually recommend trying all other treatments (the correct products, topical creams, facials, changing their diet) before starting any oral medication.
Is there anything we can do to prevent or cover up age spots?
No fair blaming your age! Age spots are really sun spots…after all, ‘age spots’ are very uncommon on the breast or buttocks (unless you’re a nudist!). Sun spots are caused by UV rays, so the best prevention is to make sure you use a sunscreen that contains UVA protection. Look for ingredients like zinc, titanium dioxide, and mexoryl, which screen the pigment-producing rays. Some research also suggests that infrared rays that produce heat can also trigger sun spots, so I also warn my patients to stay cool with a spray bottle mister and stay in the shade, even if you’re wearing sunscreen. Over the counter products like Aveeno Positively Radiant, which contains total soy extract, have been shown to lighten spots, and stubborn spots can be lightened by prescription creams like Renova, as well as in-office peel and laser treatments. To cover spots, I recommend a stick concealer. These provide better coverage with less budging than liquid concealers. Or, try using the thicker foundation on the inside of the cap (or along the opening) of your tube or bottle of foundation. It’s thicker here, so you’ll get better coverage. Dab a bit on before you put on the rest of your makeup (if any), then dab a bit more on top of your foundation. Then powder it to set it.
I’d like to know what to do /how to handle “ear acne,” i.e. comedones on cartilage of the ear; as well as dry skin on the back of ears.. basically ear skin care!
The first step is to be as thorough cleaning your ears as you do your face. The skin on your ears is thick and has a high concentration of oil glands, so it tends to get clogged and form blackheads. If you have lots of blackheads, you can swab the earlobes and outer ear canal with a cotton swab dipped in acne toner. Careful not to drip into your ear. Facialists or dermatologists can also do extractions if you have large, compacted blackheads that won’t go away. Flaky skin on the back of the ears is often a sign of seborrheic dermatitis (a type of dandruff). This is caused by overgrowth of yeast that feeds on your skin and oils. Washing with a dandruff shampoo daily and using an anti-yeast cream (like Lotritimin) for a week or two usually calms the problem. Taking a probiotic (or eating yogurt) daily has also been shown to help this condition. If the flakiness spreads, oozes, or gets crusty, it’s best to see a doctor to make sure it’s not a Staph bacteria infection.
Thanks Dr. Jessica Wu for taking the time to answer AVEENO Ambassador’s skincare questions. I learned a lot.
