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The 411 on Acne: Dr. Goldfaden breaks down everything that we need to know about treatment

If you suffer from Acne or are trying to eliminate those stubborn scars from years ago, you’ll want to read this. In the past decade there have been many treatment options developed for acne prone skin. With the popularity and availability of over the counter skin care products, the consumer has become more savvy about how products perform and what to use in order to treat and or prevent acne. We sat down with Dr. Goldfaden to get the 411 on the best and most effective acne treatments on the marketplace.

With the advancements of lasers, many turn to these to help to treat acne and eliminate scarring. There are many different types of lasers and while there is not a tremendous amount of research to suggest they really work against acne, they can help some people. Due to the possible side effects I would sooner suggest trying another treatment first before taking the last road.

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How do you approach treatment of acne? 

When a patient is dealing with Acne, it is always important to do a 360 degree evaluation. This means investigating all the possible things that could be causing the acne. The patients age, diet, exercise routine and overall health. I am more likely to treat acne prone skin with natural yet effective products before prescribing an antibiotic. If there is an infection present then an antibiotic will be suggested. Exfoliation is the main suggestion for fighting acne prone skin. Exfoliation not only clears up existing oil and bacteria, it also removes dead and dry skin cells and inhibits future breakouts. Throughout years of research one ingredient I have found to be beneficial when applied topically is Organic Red Tea extract or Rooibos. Red Tea extract is soothing and fights inflammation, irritation and redness. I will usually prescribe an exfoliation scrub in conjunction with a red tea based serum to Acne sufferers for dead skin and bacteria removal and healing properties.

What about antibiotic treatment and effectiveness, long term use, resistance, ability to tackle the root cause?

Accutane is the most clinically effective drug to fight acne but very strong and has many side effects. Long term use of any antibiotic is not recommended and the natural approach is always the first choice of treatment. Over usage of any antibiotic can result in a resistance, but when used properly and if all avenues have been exhausted prior, this can be a very beneficial and successful approach to combat stubborn acne.

What are your views on of accutane and dosing? Has your view changed over the years?

Accutane will be prescribed as a last option. I have never been a fan of Accutane as it has many unwanted side effects. However it remains the most effective drug for Acne. Natural topical treatments are always recommended first before an antibiotic.

How have lasers impacted treatment?

There are many types of lasers available now, however they can be expensive and can cause unwanted side effects such as pain, burning, peeling, redness and dark spots as well as no results. I recommend older and more mature adults to look at this option as a last resort rather than sending younger men and women to laser treatments simply based on the variety of alternative and successful options that do exist.

Any recent advances that are exciting to you?

Accutane still remains the popular choice for prescription. Lasers and OTC skincare products have become more and more popular in recent years which allows all of our research to become more mainstream and accessible to the general public which is so great.

Can you talk to us about AHA/BHA acids as treatments?

Alpha hydroxy acid-based facial exfoliators are an excellent choice for people with oily skin. In general, beta hydroxy acid is a more effective treatment for acne prone skin. Beta-hydroxy acid (also called salicylic acid), is a synthetic derivative that comes from the same source as aspirin.  Both AHAs and BHA work by combining with the structural lipids in your stratum corneum and dissolving them so that the dead skin cells break away. Since the introduction of OTC skincare products such as the popular wipes and our Fresh A Peel lactic acid wash, peels can be done safely at home with no side effects.

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How does Vitamin A interact with spot prone skin?

Vitamin A or retinoids help repair sun damage, fine lines and wrinkles, overall skin tone,  cell turnover, Acne and overall skin repair. Vitamin A stimulates skin cell renewal by increasing the rate of cell division 1-3. Retinoids or Retinol products can help to unclog pores thus inhibit dead skin cells to clog pores and cause future breakouts. Vitamin A can also help to inhibit acne scars from forming.

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Overall Nail Health

Beautifully manicured hands are all the rage right now and the options are limitless but make sure you aren’t damaging the health of your nails. Over manicuring is quite common and something to try and avoid. Filing everyday or too often removes essential nail growth tissue which can cause nail thinning and cracking. Nails are attached to the finger by tiny tissue structures. Over manicuring, filing or cutting can be damaging to these structures and cause nails to either grow too fast, too slow or in odd uneven shapes. Filing nails into unnatural shapes(very pointy or very square) can also cause damage. So, what should you ask the nail technician to do? Ask her not to over file the nail and no extreme shapes and then ask her to push back the cuticles instead of cutting them. Over cutting the cuticle can be damaging as well. The cuticle is there to protect your nail bed so removing it too often can allow germs to get in, inviting infection. Over tending to the cuticles is also extremely drying. If you are having your cuticles cut during every manicure, consider cutting that in half. Using a cuticle oil or Vitamin E oil on the cuticle daily will ward off excessive dryness as well.

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How dangerous is shellac or the ‘gel mani’?

There is a lot of controversy around these polishes that are adhered by drying under a ultraviolet light and then removed with acetone. There are two major concerns when it comes to this type of nail service. The first is the potential risk for skin cancer on the tops of the hands. Although their has been a study that concluded one would probably have to have 250 years worth of drying under a UV light to see actual cancer, the UV damage is a real threat. Even if it is only once a month that your hands are being exposed they can still become damaged and show signs of sun damage quickly.  Not only will they feel and look dry, they may develop sun spots/dark spots as well. Rule of thumb, wear and SPF on the tops of the hands when you know you’re going to get a manicure. Opt for a 50 SPF or higher. After the manicure make sure to apply lots of hand cream to replenish oil and hydration back into the hands. Hands to Heart is the perfect way to fight off dark spots and dryness from the UV light.
Screen Shot 2014-11-10 at 2.17.21 PMThe second concern is the removal process of shellac. At some salons you soak your nails in a little bowl of acetone(yuck!) and at others they apply a tiny piece of acetone soaked cotton to the tips and wrap them with foil for a few minutes.  Either route seems pretty damaging. Acetone is a chemical and can be very damaging to soft tissue. After the polish is loosened by the acetone the technician will remove the polish. This should be a very easy process that includes use of a metal scraper.  If there is actual scrapping that you can feel she is doing it incorrectly. the issue with this removal precess is that while scrapping the polish off, she is also removing healthy nail cells and thinning out the surface. A few shellac manicures will not ruin your nails but over time they can damage the integrity of the nail causing thinning and breakage. As with anything-moderation is key.

Regular manicures can also be damaging to nails and overall health due to some nasty ingredients found in certain polish. Here are a few ingredients to stay clear of. Formaldehyde which is used to embalm bodies Dibutyl Phthalate (DBP) which has been liked to reproductive issues and banned in Europe and Toulene: part of the makeup of gasoline. However there are a number of ‘clean’ or 3-free and 5-free nail polishes that can take the place of toxic polish.  Some of our favorites are Zoya, RGB, Ten Over and Sparitual(vegan).

Nails are also an indicator of overall health. Below are signs to watch out for, if you are experiencing any of these see a dermatologist.

Very pale nails: anemia, liver disease, malnutrition

White nails: hepatitis or liver issues

Yellow nails: fungal infection

Bluish nails: lack of oxygen, lunch issues

Ripped nails: early sign of psoriasis or inflammatory arthritis

Cracking/splitting nails: fungal infection

Dark lines or spots under the nail bed: could be melanoma but don’t mistake this for a bruise if there was trauma to the nail.

Regardless of what type of polish or manicure you choose to have it is always a good idea to rest nails in between services. Take off all the polish and let them breathe!

 

 

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Understanding Sunscreen: Dr. G breaks down what we need to know

 

Lauren/Lisa: What is SPF and what does it mean?

Dr. Goldfaden: The protection is all factored on the time spent in the sun. SPF, “Sun Protection Factor” primarily measures UVB protection. Sun Screen products above SPF 50 do not offer an increase in sun protection (this is the current FDA regulations). When one wears an SPF 30 for example, you could stay out in direct sunlight for 30 times longer before UVA/UVB damage occurs than a person with no sunscreen. This is how SPF factor’s are designated. The key to proper sun protection is the reapplication throughout the day. There is NO one miracle sun screen that covers and protects you completely throughout the day.

Lauren/Lisa: What is the difference between UVA and UVB rays?

Dr. Goldfaden: UVA makes up

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about 90% of the UV radiation that reaches the earth on a daily basis – visible light that we see. UVB makes up the remaining 10% and is strongest during the peek hours of the day (11-3pm) when the sun is at its strongest. Although both cause skin damage and have been shown to lead to cancer, UVB rays penetrate deep into the dermis layers and causes the actual sun burn, redness and damage to the deep layers within the skin.

Lauren/Lisa: What is the difference between Chemical and Physical Sunscreen? Is one more preferable than the other?

Dr. Goldfaden: It’s important to understand the difference between Physical and Chemical SPF levels: Physical sunscreens protect your skin from the sun by deflecting or blocking the sun’s rays. Chemical sunscreens work by absorbing the sun’s rays. Some chemical filters can scatter sun rays, but still mostly just absorb them. Physcial sunscreens have been approved from the FDA and show no issues at all. Chemical sunscreens are also safe depending on the type of ingredient – some chemical filters generate free radicals which can cause skin damage, irritation, and aging. For optimal protection, a sunscreen that offers both physical and chemical protection (and the chemical ingredient has been approved) are the safest.

Lauren/Lisa: How often should you reapply SPF throughout the day?

Dr. Goldfaden: Reapplication every hour when in direct sunlight and up to three times daily (AM/Mid—day/Afternoon) when going in and out of indoor/outdoor areas. As a general rule of thumb: if you are going to be outside for 20 minutes or more, SPF is recommended and I always recommend an SPF of at least a 30 in any case.

Lauren/Lisa: There are so many different SPF levels on the market. What are the rules? What is the highest level that we should be applying on our skin?

Dr. Goldfaden: The FDA has put in strict enforcements and regulatory measures to ensure that all SPF products follow a mandate the use of certain sun blocking agents, that have been FDA approved, are being used in products that claim SPF factors. Furthermore, the FDA outlines the template that companies must use in disclaiming the products safety and SPF legalizations on the secondary packaging. This ensures that all companies are following the same guidelines, restrictions and safety for our marketplace and consumers. The most notable and recent change is the use of SPF levels greater that 50. You won’t see sunscreens on the market in a year from now claiming SPF levels of 100. There is no substantiation that shows further sun blocking treatment benefits from a 50 to 100.

Product Spotlight, Sun Visor: Dr. Goldfaden’s fast absorbing, oil-free, PABA-free and fragrance-free SPF 30 sunscreen protects your skin from harmful UVA/UVB rays. This unique product offers dual-action protection by delivering high-level UV filters to help prevent sun damage, fine lines, and dark spots. Skin renewing organic red tea works to rejuvenate skin and provide antioxidant benefits. This advanced, revolutionary, ultralight translucent oil-free, fragrance-free and even smear-free formula is a must for all skin types.

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