What should I know about caring for dry skin?

Dry skin is defined as flaking or scaling of the skin when there is no evidence of dermatitis (inflammation). It appears most often on the shins, hands, and sides of the abdomen, and can be associated with itching. Dry skin is more common during the winter months, when humidity is low, and improves in the summer time. Some people also have a genetic (inherited) tendency to develop dry skin. In addition, elderly people tend to have more trouble with dry skin because of the natural changes in skin that occur as we get older.

Treatment is important because excessively dry skin can lead to dermatitis or eczema. Dry skin may be prevented or treated by:

• Taking lukewarm baths or showers as opposed to using hot water.
• Limiting baths/showers to 5 to 10 minutes.
• Applying a moisturizer right after drying off from a shower or washing your hands.
• Using a moisturizing body soap and hand soap.
• Using heavier creams or ointments during the winter months and lighter lotions in the summer.

If the above treatments do not improve the condition of the dry skin, it is possible that the flaking is a sign of underlying dermatitis (which is also called eczema). There are different types of dermatitis that may cause dry, itchy, flaking skin. They include:

• Seborrheic dermatitis: A red, scaly, mildly itchy rash on the scalp, eyebrows, and sides of the nose in areas that contain many oil glands.
• Allergic contact dermatitis: A rash that results when the skin comes in contact with a substance that causes an allergic reaction, such as poison ivy. Allergic contact dermatitis of the hands often causes scaling, redness, and vesicles (blisters filled with fluid) on the palms or fingers.
• Atopic dermatitis:Long-lasting type of dermatitis usually starting in childhood that tends to run in families. It also may cause excessively dry, itchy skin on the face and body.
• Athlete's foot: Dry flaking skin on the soles and/or sides of the feet and between toes, caused by a fungus.

What should I know about facial skin care for mature skin?

Photoaging refers to the damage that is done to the skin from prolonged exposure to UV radiation over a person's lifetime. Examples of skin changes associated with photoaging include:

• Roughness.
• Wrinkling.
• Irregular pigmentation (coloration).
• Inelasticity.
• Enlarged sebaceous (oil) glands).
• Precancerous and cancerous lesions.

Sunscreens and sun protection are important to prevent further progression of photoaging. Smoking has also been shown to speed up aging of skin, so smoking cessation is important for good skin health. In addition, a well-balanced diet allows the skin to get the nutrition it needs to help repair ongoing damage from the sun and other environmental elements.

Many topical (applied to the skin) non-prescription and prescription products are currently available for anti-aging purposes, including:

• Retinoids: Retinoids are prescription (tretinoin, tazarotene) and nonprescription (adapalene) medications first developed to treat acne. They improve skin texture and color when used over an extended period of time. They exfoliate the skin (removes a dead layer of skin cells), help even pigmentation, and minimize fine lines. Many people can benefit from using retinoids at bedtime. Side effects of retinoids include dryness, skin peeling, and redness. You may be able to minimize these side effects by using the cream every other night and then gradually increasing the frequency to every night, as tolerated. Retinoids can also makes the skin more sensitive to ultraviolet rays from the sun; therefore, the use of a broad-spectrum sunscreen each morning is recommended.
• Alpha hydroxy acids (AHAs): Alpha hydroxy acids (glycolic, lactic, tartaric, and citric acids) are found as ingredients of numerous skin products. In the United States alone, there are approximately 185 manufacturers of products containing AHAs. Creams and lotions with AHA may help with fine lines, irregular pigmentation, age spots, and may help decrease enlarged pores. Side effects of AHAs include mild irritation and sun sensitivity. For that reason, sunscreen should also be used every morning.
• Beta hydroxy acid (salicylic acid): Salicylic acid has been studied for its effect on photoaged skin. It exfoliates skin, and can improve skin texture and color. It penetrates oil-laden hair follicle openings and, as a result, also helps improve acne. There are many over-the-counter products available that contain salicylic acid.

What should I know about facial skin care for acne-prone skin?

• If you are prone to acne, choose a cleanser specially formulated for acne. These products often contain salicylic acid or benzoyl peroxide, which help to clear acne.
• Clean your face gently, as trauma to the acne breakouts may worsen acne or cause scarring.
• Avoid harsh mechanical scrubbing of skin and picking lesions.
• If you need to use a moisturizer, use light, non-comedogenic moisturizers, which do not cause acne.
• Women should use an oil-free non-comedogenic foundation, as heavy makeup or other cosmetic products may block pores and worsen acne.

What should I know about protecting skin from the sun?

Protecting your skin from the sun is important because the sun emits ultraviolet radiation (UVR). Over time, UVR exposure causes many changes in the skin, including wrinkles, discoloration, age spots, benign (non-cancerous) growths, and pre-cancerous and cancerous growths. In fact, most skin cancers are related to sun exposure.UVR consists of two main subtypes: UVB and UVA. UVB rays are responsible for sunburns and tanning. UVA rays are believed to be responsible for photoaging (the damage that occurs to the skin from many years of exposure to the sun). Both types have been linked to cancer.Most sunscreen products prevent sunburns by blocking UVB rays. Newer sunscreen products are also successful in blocking UVA rays. For that reason, sun protection recommendations emphasize certain behaviors, as well as the use of sunscreens. The recommendations include:

• Avoiding midday sun (between 10 a.m. and 3 p.m.).
• Wearing wide-brimmed hats, long-sleeved shirts, and pants.
• Using a generous amount of sunscreen and reapplying it frequently (every 2 to 3 hours).
• Using sunscreens that have a sun protection factor (SPF) greater than 30, and have UVA and UVB coverage.
• Avoiding tanning beds (tanning beds are now considered a carcinogen, capable of causing cancer).