Past Advice
705 users have voted.
Tip #
Emergency pimple treatment!

Have you ever been traveling or in a situation when you develop a zit or blemish and have absolutely nothing available to treat it? Well, I have! If I’m at home I have a cabinet of emergency skin supplies to deal with it (I will share these emergency items with you in future posts!). But when I’m traveling, I’m limited by what supplies I can bring because I never check baggage anymore and my space is limited. So in an emergency pimple attack, use toothpaste! It really works at drying up a pimple in an emergency situation. ☺

We dermatologists do not totally understand why it works, but it does seem to do the job. Now, ideally dermatologists would like to prevent pimples and acne, not treat them once they are there. So, I do not recommend this as routine acne treatment. You cannot prevent pimples with toothpaste. And toothpaste is quite drying and irritating to the skin, which is why I recommend only keeping the toothpaste on for an hour or two the first time you try this trick. If you have dark skin, too much irritation from toothpaste can cause increased pigmentation, so again don’t leave it on too long if you haven’t ever tried this. You can always reapply it if necessary. You can put it on at night before you go to bed and sleep with it too, but if you are one of those women who easily develops dark spots on your skin after a pimple is gone, the toothpaste can accentuate this so I wouldn’t recommend keeping it on that long. Put it on in the morning when you wake up and while you drink your coffee or tea or eat breakfast. But don’t forget to wash it off, obviously, before you put on your sunscreen, and make-up. ☺
702 users have voted.
Tip #
Free treatment to prevent wrinkles!

For the next 1-2 weeks, I am going to give you quick useful tips that you can use throughout your life, whether you are a teenager or someone older. After that, I will get back to some more substantive tips including acne scarring, treatment of increased facial pigmentation and other topics that many of you have inquired about.

During my surgical fellowship training, my fellowship director, Dr. Roy Grekin, used to play this game with me. He would ask me, “What side does this woman sleep on?” This “test” taught me several things, including the importance of being a detailed observer of even the most subtle facial features; how the deeper anatomy of muscles, fat and bone structure affect the way the skin drapes over these structures and ultimately effects the way skin ages; and how habits also affect the way the skin ages over time. I eventually got to be pretty good at this test and continue to use it as I evaluate women’s skin today. Which brings me to today’s tip. This tip is the least expensive but may be the most difficult thing you can do to avoid deep facial lines as you age. What is it? Sleep on your back!

Over years of sleeping on your side, vertical and diagonal lines develop on the side of your face that you sleep on. These lines are usually most noticeable on the area between your nose and your cheek. Sleeping on your side can also deepen the nasolabial fold and cause lines anywhere on your cheek depending on your deeper facial anatomy and where your skin creases over those deeper structures while you sleep. They start out very subtly in young women and may be faint in the morning and disappear within hours, but by middle age these wrinkles start to be pronounced and permanent. You can often get rid of them with a facelift or soften them with filler. But this can be expensive…so why not just avoid these lines all together! Sleeping on your side is a very difficult habit to break, but if you can, it’s a free way to prevent wrinkles as you age!!!
702 users have voted.
Tip #
What can I do about my oily skin?

Oil production by the skin is part of having healthy skin. There are many skin disorders where oil is under-produced, leaving the skin dry and more susceptible to irritants and allergens causing inflamed and itchy skin. But when the skin produces too much oil, it can leave the skin shiny and even greasy feeling. On the bright side, people with more oily skin tend to have fewer fine lines and fine wrinkles, but this is little consolation to most women suffering from oily skin! In the meantime women with oily skin often feel it is unattractive and their make-up smears easily. So what to do?!!

There are the obvious blotting pads which often have a little bit of powder to help not only soak up the oil but also help minimize shininess of the skin. But besides these blotting pads, there are other products that you can use. You should consider, in this order, benzoyl peroxide, salicylic acid and glycolic acid products. I specifically recommend pads or washes. Use these products only on the oily areas of your skin such as your forehead, nose and chin….or wherever those areas are for you.

If you like using a wash, use the medicated wash on the oily areas and a gentle wash (see Tip #17 under Past Advice) on the other areas of your skin. But if you prefer the pads (which is easier than using two different types of facial cleanser), make sure you also use a gentle cleanser so you don’t start to irritate your skin. Using your hands to wash your face instead of a wash cloth or buff puff also keeps your face from being irritated. I recommend starting with low % benzoyl peroxide (2-5%) pads and working up as tolerated if you’ve never tried anything.

If you have really oily skin, consider a sulfur mask. But use it slowly and cautiously. Start out only using it for a few minutes at night before bed and only 1-2 times a week in the beginning and slowly work up if needed and obviously, if you tolerate it. It’s better to be patient than to end up with peeling skin. But these masks definitely dry you out, so make sure to use a light oil-free moisturizer in anticipation of the coming dryness.

If you have tried these without benefit there are things your dermatologist can offer…

Topical retinoids such as adapalene, tretinoin and tazarotene (depending on your skin) are also very helpful and good for acne but require a prescription in the US. They should be used only in the areas of oily skin and use them every other night in the beginning. You will also need to use a gentle moisturizer and light oil-free moisturizer to avoid any added irritation to your skin.

But if you are fed up with topical treatments for one reason or another, there is an oral medication called aldactone, or Spironolactone, which actually slows down your oil production! It is also awesome for some types of adult female acne, especially those deeper underground, tender cysts along the jawline! It’s very safe if you are healthy but not an option for some people with certain disorders such as kidney disease, or for women who are nursing, pregnant or may become pregnant. I will check my patient’s potassium levels to be safe. Spironolactone can occasionally cause temporary menstrual irregularities but if you are on oral contraceptive pills that won’t be a problem.
706 users have voted.
Tip #
What can I do about my bumpy upper arms (keratosis pilaris)?

Keratosis Pilaris (KP) is a very common condition where the skin—most commonly on the upper arms—feels bumpy. You can also get KP on the thighs, buttocks and on the lower cheeks. Sometimes people will grow out of it in adulthood. This is especially true on the face, where most children do eventually outgrow it. It is usually asymptomatic and improves, in most, in humid environments, in the summer and with sun exposure. It is felt to be primarily genetic and is more commonly seen in people with dry skin, atopic dermatitis and eczema.

Sometimes KP has a white bumpy look consisting of pinhead sized individual scattered bumps and sometimes it looks like pink pinhead size individual bumps or spots. The white type is more responsive to treatment although, in general, it is very difficult to treat. So, before I discuss treatment, I want to give you realistic expectations on what treatment can do. It can improve the look and feel of KP but it will not cure KP or take it away entirely. Unfortunately, when you stop treatment, the KP will return.

Now onto treatments. For starters, you need to use very gentle soaps and lotions and constantly moisturize but do not over-wash. You can refer to my Past Advice on my website ( under Tips #17 and #9 for what moisturizers and lotions I recommend. If you are not able to see a dermatologist and want to start with OTC treatments, I would start with CeraVe SA renewing lotion with 3% salicylic acid and Eucerin Intensive Foot Repair with urea and lactic acid. These can be pretty irritating so I recommend alternating using them in the evening using them only once or twice a week each in the beginning (use one on Monday and Friday and on Wednesday use the other and then switch the next week.) If you are not irritated after using them for 3 weeks, I would increase to using them every other night.

It’s likely that you will experience some irritation at some point so you will need a topical steroid to counteract the irritation (redness, burning and dryness). In the US, you will have to settle for hydrocortisone 1% ointment since anything stronger would require a prescription. But if you have access to a medium strength steroid such as triamcinolone 0.1% ointment, that would be better. Use the steroid instead of the medicated lotion at night for a couple of days so you can treat the irritation and take a break from the medicated lotion which is causing the irritation.

If you have tried OTC treatment, your doctor can prescribe a topical retinoid and medium potency steroid. This does work but the irritation can limit your ability to use the retinoid. I typically start out by prescribing Differin lotion 2 times a week and increasing treatment by one day every 2-3 weeks until irritation starts. Once irritation develops, I have the patient start using triamcinolone 0.1 ointment or Topicort 0.05% cream (although I prefer ointments in this case) for a couple of days and then restarting the Differin lotion on a less frequent basis once the irritation has resolved. If you are tolerating Differin and the KP is not resolved I will step up treatment to Tazorac 0.05% cream once or at most twice weekly again combating irritation with medium potency steroids. Breaks from the retinoids (Differin and Tazorac) are good and often needed. Irritation is very likely but consult your dermatologist on the best application schedule for you!

You can use some of these treatments in children but I don’t recommend it since they are very irritating and KP is a benign condition. Also, most kids don’t even know they have it and so you just draw attention to it if you start treating or fussing over it. I recommend treating it only when the child or adolescent starts to become self conscious about it, and it’s always best to start treatment in “long sleeve weather” if you live in an area that allows for that since you can hide any irritation you are trying to work through getting to know how to use your new lotions/creams!
678 users have voted.
Tip #
Cleansers I recommend

I thought it would be important to discuss cleansers today in light of my recent posts on over-the-counter acne treatment. For those of you who are using OTC acne treatment other than washes or are fortunate enough not to have acne but have sensitive or dry skin or struggle with dermatitis or eczema, today’s advice should be very helpful.

If you like a bar soap, I recommend Cetaphil Gentle Cleansing Bar soap. I keep it in my shower to wash my body. You can certainly use it to wash your face as well. It’s great for anyone using OTC acne treatments unless you are already using and liking an acne wash. If you are already using Dove or Olay products and like them, don’t change anything…these are gentle and good products as well, but beware of the fragrances if you have very sensitive skin.

If you prefer a liquid wash or like to keep a second cleanser to wash your face every night, I recommend CeraVe Hydrating Cleanser or Cetaphil Gentle Skin Cleanser. These cleansers do not strip the body of its own natural protective oils while very gently cleaning. They do not really foam…but that doesn’t mean they aren’t cleaning!!! They are my favorite facial washes to recommend and I personally use them both!

One last tip—if you are extremely dry like me, but insist on washing your face more than once a day, you should try using one of the liquid cleansers on a soft cotton pad without water—yes, without water. This is the way I clean my face when it’s not time for a shower.