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There are now a number of laboratory studies that associate certain UV filters in chemical-based sunscreens - specifically oxybenzone and octinoxate – with the bleaching of coral reefs. While the lab setting may have limitations, there is agreement amongst most experts that more studies are needed. Many states are now considering legislation to ban the sale and use of chemical sunscreens that contain the incriminated ingredients. What should one do in the meantime for protection from the sun? Fortunately, there are many effective mineral-based sunscreens on the market - containing zinc oxide and/or titanium dioxide. Also remember to seek shade, wear protective clothing, and limit sun exposure between 10am and 3pm. Additional information on sunscreens and sun protection is available at www.aad.org/

Painful, swollen, red, or purple skin lesions on the toes and feet have been reported in some patients with COVID-19 infections. This eruption appears similar to a condition typically seen in cold weather, known as chilblains. The good news is that this eruption is usually seen in younger patients with mild forms of the disease, and seems to portend a good prognosis. Other types of skin eruptions have been reported in COVID-19 patients, but their relationship to the disease is currently unclear. The American Academy of Dermatology has established an international registry to develop a better understanding of skin eruptions in COVID patients.

Now that frequent hand washing has become the new norm, many patients are complaining about dry, red, burning skin. This condition, irritation dermatitis, is treated with regular applications of moisturizers such as Aveeno Eczema Therapy Balm, Vanicreme, and Cerave Cream among others. More severe cases require a prescription topical steroid cream or ointment.

On the subject of hands, the long-standing custom of hand shaking may become a thing of the past even after the pandemic ends. Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious disease recently stated, “I don’t think we should ever shake hands ever again, to be honest with you,” he added later. “Not only would it be good to prevent coronavirus disease; it probably would decrease instances of influenza dramatically in this country.”

Our office remains open for urgent dermatologic conditions, and we also offer telemedicine appointments. If you have any questions or would like to schedule an appointment, please call 310-274-9954 or email us: damg@derm90210.com

Cosmeceuticals are over-the-counter skincare products that contain biologically active ingredients. Underscoring their popularity, there’s been double-digit annual growth of new products entering the marketplace over the past decade and it’s been estimated that the global market value of the cosmeceutical industry will be $73 billion by 2023! Cosmeceuticals typically contain lower concentrations of active ingredients than prescription products and are classified as cosmetics by the FDA. Consequently, they do not have to undergo the same level of scrutiny with regard to safety and efficacy before entering the marketplace. With so many options available, how does one select the right products? A recent review article in the International Journal of Dermatology evaluates data for some of the most commonly used active ingredients in cosmeceuticals and came to the following conclusions:Retinols have strong evidence for improving lines/wrinkles, pigmentation, elasticity, firmness, brightness, and overall photodamage. The product should contain at least 0.25% retinol to be effective.Vitamin C (ascorbic acid) has strong clinical evidence for improving discoloration/pigmentation and for fighting ultraviolet-induced skin damage. Topical vitamin C is unstable and not all products are the same. It should be packaged in opaque airtight containers.Glycolic Acid has strong clinical evidence to treat acne, fine lines, roughness, and pigmentationHyaluronic Acid has clinical support for improving skin hydration, elasticity, firmness, wrinkles, and roughness.Collagen doesn’t have evidence to support its effectiveness topically. Collagen is a large molecule and is unlikely to penetrate the top layer of skin.Keep in mind that formulations and stability can vary from product to product. Also, many claims are based on lab studies that don’t necessarily correlate with actual clinical results. Please schedule an appointment with your dermatologist if you have questions about your skin care products and routine.

A newly released study by the FDA confirmed evidence of a recent smaller pilot study that certain chemical sunscreens can be detected in the blood following topical application. The specific ingredients evaluated include UV filters that screen out the sun's harmful rays: avobenzone, oxybenzone, octocrylene, homosalate, octisalate, and octinoxate. It did, however, find elevated levels of the chemicals for days and even weeks following application. It’s worth pointing out that the sunscreen products were applied to 75% of body surface area over 4 days. They were applied once on day 1 and four times during the remaining 3 days at 2-hour intervals. This study didn’t look for or find evidence of deleterious health issues. While research is needed before it can be determined if the absorption of sunscreen ingredients has any effect on a person’s health, these ingredients have been used for several decades without any reported internal side effects in humans.So what should you do now if you want to protect yourself or your kids from the sun? Mineral based sunscreens with at least SPF 30 containing zinc oxide and/or titanium dioxide are safe and effective. Some of the newer formulations are aesthetically pleasing leaving minimal to no white film compared to earlier versions. Sun protective clothing and UV protected sunglasses are also very helpful. Minimize sun exposure between 10 am and 2 pm especially in spring and summer when UV radiation is at its peak. Skin cancer is the most common cancer in the United States and can significantly impact quality of life. Unprotected exposure to the sun’s harmful ultraviolet rays is a major risk factor for skin cancer and everyone should protect their skin by limiting exposure to the sun. If you have questions about sunscreens and sun protection measures please talk to your dermatologist.

Concern about the safety of product ingredients has led to significant growth in the sale of natural skincare products. A recent editorial titled, “Natural Does Not Mean Safe—The Dirt on Clean Beauty Products” (JAMA Dermatol. 2019;155(12):1344-1345.) points out that science refutes many assertions by those who promote natural skincare/clean beauty products.The FDA has failed to define clean and natural, leaving these labels open to interpretation by non dermatologist retailers, bloggers, and celebrities who have set out to define clean beauty for themselves. According to the article, hundreds of compounds have been arbitrarily demonized without scientific backing by the clean beauty movement. A couple examples include petrolatum, an excellent and economical moisturizer for severely dry skin, and parabens, which are some of the least allergenic preservatives available and were named 2019 nonallergen of the year by the American Contact Dermatitis Society. By contrast, many so-called natural products contain high concentrations of botanical extracts that are a leading cause of irritant or allergic contact dermatitis and photosensitization (sun sensitivity).The Environmental Working Group’s (EWG), a powerful force driving the clean beauty dialogue, scores thousands of products based on the putative toxicity of their ingredients, but their method for assessing risk doesn’t seem to be backed by data and their claims are not always uniformly agreed on by a broad consensus of experts. The bottom line is that natural is a marketing term that does not necessarily mean safer or more effective. If you have questions regarding the safety of your skincare products please speak to your dermatologist during your next office visit.

Flu season is here and our office patient evaluation questionnaire includes questions about vaccination history, specifically flu and shingles. We’ve found that many patients don’t receive their recommended vaccines. The development of vaccines has been one of the major advances in modern medicine for protection against certain serious diseases, preventing spread of these diseases, and saving lives.According to the Centers for Disease Control and Prevention (CDC), Vaccines are recommended for children, teens, and adults based on different factors like age, health conditions, lifestyle, jobs, and travel. CDC and other medical experts update vaccine recommendations every year based on the latest research and science.Vaccination is a critical step in protecting those that are most vulnerable to illness – infants and young children, the elderly, and those with chronic conditions and weakened immune systems. Vaccination is important because it not only protects the person who gets the vaccine, but also helps to keep diseases from spreading to others, like family members, neighbors, classmates, and other members of your communities.Like any medication, vaccines can cause side effects. In most cases, side effects are mild (e.g., soreness where the shot was given) but go away within a few days. Severe, long-lasting side effects from vaccines are rare.For additional information about vaccines check the CDC website, www.cdc.gov, and discuss vaccines with your primary physician.

Itching, that annoying, sometimes persistent problem can actually be a very complicated symptom. When accompanied by a rash, the problem is usually a bit easier to diagnose but itching without a rash can be more difficult.Dry skin, especially in fall and winter, is generally the most common cause of itching, followed by a number of medications.Some underlying diseases such as thyroid, kidney or liver disease, anemia, diabetes, cancer, certain nerve conditions, and some mental health conditions can be an underlying cause of itching.Your dermatologist can evaluate you to determine the cause of your itching and offer suggestions for relief.

In our September newsletter, we discussed the importance of the skin barrier’s acid mantle protective layer and how excessive and or harsh cleansing agents may be. This can cause dry, flaky, sensitive skin and may aggravate various underlying skin conditions.On the other hand, an occasional light chemical peel might be a good supplement to your regular skin care regimen. This involves the application of a chemical solution to remove top skin layers leading to growth of new, smoother, and younger looking skin.Removing only the outer layers of skin, this exfoliation can help uneven pigmentation, dryness, acne and fine wrinkling. These procedures take only 15 minutes, and the downtime is minimal. We offer various kinds of light peels including Beta Lift, VIPeels and mild strength TCA peels. Talk to your doctor about the right peel for you.