Solutions to Your Skin Problems

Lois W. Stern *

* This article was excerpted from Madeleine Arena's chapter: in Tick Tock, Stop the Clock ~ Getting Pretty on Your Lunch Hour

There is a Solution for Most Every Skin Problem
You Just Need to Find It

In her chapter four of Tick Tock, Stop the Clock ~ Getting Pretty on Your Lunch Hour, Madeleine Arena presents some typical real life skin problems and how to best resolve them. Although all names and their stories are pure fiction, their stories are oh so true to life!

Ella’s Story

I am an extremely active person. I spend a lot of time outdoors, gardening, playing tennis and, I must admit, basking in the sun. I always liked the way I looked with a tan and achieved a beautiful tan easily. In my younger days my skin was great, so I never thought much about the long-term effect of my lifestyle. But when I was mistaken for a senior citizen, I knew it was time for action. I experimented with a variety of over-the-counter products, but nothing seemed to help. Finally, I consulted with a leading cosmetic dermatologist to help revitalize my appearance.

Ella’s Skin Problems
  • Dry, mature and sun damaged skin
  • Thin, flaking skin
  • Dark spots on face, chest, arms or hands
  • Wrinkles around eyes, mouth and forehead

Here is the skin care treatment plan that helped Ella reverse her sun damage, improve her skin texture and even her skin tone to restore some of her youthful glow.

Problem #1 Skin discoloration on her face, neck and chest

Treatment plan for this problem
Ella’s dermatologist prescribed nightly application of Retin-A and prescription strength hydroquinone. The Retin-A acted to exfoliate her skin and stimulate new collagen. (Retin-A helps treat wrinkles by increasing cell renewal and preventing the breakdown in collagen - key contributors to skin aging.) The hydroquinone worked to lighten her dark pigmentation spots. To help Ella tolerate the dryness and flaking that resulted from the combination of these products, her dermatologist also recommended that she apply anti-oxidants and a hydrating moisturizer with good water binding ingredients, including both ceramides and hyaluronic acid following morning and evening cleansings.

Problem #2
Fine lines and wrinkles

Treatment plan for this problem
Ella’s dermatologist explained that the single most important step in treating fine lines and wrinkles is the consistent use of sunscreen, but that the combination of Retin-A and prescription strength hydroquinone will make the skin more sensitive to sun. He stressed the critical importance of wearing sunscreen every day, recommending a micronized zinc oxide sunscreen SPF-30 to provide a high level of broad-spectrum protection from the sun. He added a product rich in peptides to Ella’s daily regime, to stimulate collagen and elastin production.

Problem #3
Dry skin

Treatment plan for this problem
In addition to the antioxidant moisturizer rich in water binding agents (i.e. ceramides, and hyaluroic acid) already included as part of Ella’s daytime protocol, her dermatologist recommended the use of some hydrating ingredients such as Borage seed oil, lactic acid or Linoleic acid.

The combination of products prescribed above also helped prepare Ella’s skin for the IPL (Intense Pulsed Light) treatments that followed. Six IPL treatments helped to greatly diminish her deep pigmentation problems, along with her fine lines and wrinkles. She is considering undergoing an alternating series of in-office microdermabrasion treatments and glycolic acid peels, also suggested by her dermatologist.

Grace’s Story

Every day when I look in my magnifying make-up mirror, I cringe at what I see: enlarged pores, blackheads, wrinkles, and brown spots. While my skin has become less oily, it seems that I have traded some of my blemishes for wrinkles. I have tried what seems like every product on the market with no success. My pores are still enlarged, I am shiny by 10:00 AM and I still have breakouts. I thought my skin would get better as I aged, but that didn’t happen. I have even begun to see wrinkles and brown spots added to the mix. I guess the only positive thing I can say for my skin is that it is not sensitive.

Luckily, I sought out a cosmetic dermatologist to help me deal with my skin problems, who worked along with a fantastic esthetician. Together they explained that although there were no quick fixes, they could help me considerably if I would consistently follow a skin care routine that they would create for me. With their support, I was eager to begin.

Grace’s Skin Problems
  • oily skin
  • enlarged pores
  • blackheads
  • breakouts
  • age related fine lines
  • uneven skin tone

Problem #1
Blemishes and dark spots:

Treatment plan for this problem
Since her skin was not sensitive, Grace’s dermatologist urged her to go for it - the powerful prescription medications and medical procedures that would really make a difference in helping her accomplish her skin care goals. She was directed to use a cleanser containing a combination of glycolic and salicylic acids twice a day, explaining that the synergistic combination of ingredients would help rid her skin of bacteria that could cause breakouts. She also was advised to apply a nightly dose of Retin-A to not only help alleviate her troublesome breakouts, but also to treat Grace’s early wrinkles by exfoliating her skin and stimulating new collagen. In addition, the doctor ordered a prescription strength hydroquinone serum to lighten her dark spots.

Problem # 2
Oily Skin and Wrinkles

Treatment plan for this problem
To help Grace deal with her excess oil that troubled her throughout the day, her dermatologist gave her a sample of oil absorbing tissue blotters to try. He prescribed an oil free anti-oxidant serum that contained vitamins, peptides, green tea and Resveratrol (a substance found in the skins of red grapes), to help treat her wrinkles and anti-aging concerns. He also stressed the importance of using an oil free sunscreen with an SPF-30, explaining that this step is the most effective way to prevent premature aging as well as future pigmentation problems. He cautioned her that the combination of Retin-A and prescription strength hydroquinone would make her skin more sun sensitive, so she had to be diligent in her use of sunscreen. He further recommended that she use mineral make-up with an SPF-20 in place of a liquid foundation to give her an oil free advantage, excellent coverage for blemishes and dark spots, and sun protection.

The home care routine that was designed for Grace was part of an overall treatment plan that also included monthly deep cleansing facials and chemicals peels that alternated between glycolic and salicylic acids. Her dermatologist recommended these peels every other week for the first three months, then once a month for the next six months. Chemicals peels were scheduled two weeks after the deep cleansing facials. At the end of this six month period, they would evaluate Grace’s progress and modify her skin care regime as necessary.

Sally’s Story

I never know from one day to the next how my skin will look. My skin is so reactive, but I am never quite sure what it is reacting to. The clock is ticking and I can see it on my face. I am between a rock and a hard place. I need moisture and anti-aging products, but when I use them my face stings and burns. So if I don’t moisturize, I wrinkle; and if I do, I react. In addition, my skin is so flaky that my make-up cakes into the wrinkles and makes my face and eyelids look like I have baked a cake on them. As if all these issues weren’t enough, the perpetual redness of my cheeks and neck make me look like I am in a constant state of embarrassment.

Sally’s Skin Problems
  • dry, flaky skin, dull looking skin
  • sensitive, itchy
  • makeup cakes into wrinkles
  • reacts poorly to skin care products
  • red, flushed color to cheeks and neck
  • puffy eyelids

At the end of her patience, Sally made an appointment with a dermatologist well known for her ability to treat women with sensitive skin. The doctor explained that a damaged skin barrier (the outer layer of her skin), caused her problem. Sally learned that when you cannot keep important elements like moisture inside the barrier, and you cannot keep problematic things such as irritants, allergen and bacteria outside the barrier, a cycle of inflammation begins. Inflammation leads to itching and a continued deterioration of the barrier. Hence, the skin cannot retain water, and dehydration occurs, which causes more inflammation, itching and dryness.

Problem # 1
Dryness, Crepiness and Wrinkles

Treatment plan for this problem
The main objectives of Sally’s plan were to alleviate skin dryness and minimize both her wrinkles and the stinging and redness caused by skin sensitivities. A gentle hydrating cream cleanser designed for sensitive skin types was recommended for twice daily use.

In the evening after cleansing, Sally was advised to apply an anti-oxidant night cream and to look for products that contained moisturizing ingredients such as Borage seed oil, Ceramides, Pro-Vitamin B-5 or olive oil and anti-oxidant ingredients such as Idebenone, Coenzyme Q-10 and Grape Seed extract. After cleansing in the morning, she was to apply a moisturizer with an SPF-30 or more, but was cautioned to pay close attention to how her skin responded to the moisturizer with sunscreen.

Problem #2
Redness and Stinging

Treatment Plan for this problem
Sally’s dermatologist recommended that she see an allergist, who could perform a patch test to further identify her specific triggers. However her dermatologist gave her a list of some of the most common sensitizing ingredients and advised Sally as a first step, to avoid those items temporarily and see if that helped reduce her skin sensitivity. The dermatologist explained that once the cycle has begun, all products used must soothe and desensitize. (She also advised Sally that while the redness might be annoying, her primary issues were dryness, crepiness and wrinkles.)

Sally’s plan incorporated products rich in anti-inflammatory and antioxidant ingredients to help rebuild the barrier and treat wrinkles. She was advised to use a gentle hydrating cream cleanser, as it also would effectively deep cleanse her skin without irritation. Her dermatologist recommended that in the morning she was to apply an anti-inflammatory serum after cleansing, and follow with a moisturizer and sunscreen with micronized Zinc Oxide (minimum of SPF-30), as it might be better suited to her sensitive skin.

In the evening after cleansing, she was instructed to apply an anti-inflammatory/anti-oxidant night cream as well. The doctor recommended products that contained anti-inflammatory ingredients such as Aloe Vera, Green Tea, Licorice, Evening Primrose oil and Zinc, and wrinkle treatment ingredients such as peptides for collagen and elastin production, Coenzyme Q-10 and Grape Seed extract.

Want to learn the basic Do's and Dont's of good skin care habits? Click on Skin Care

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© 2011, 2013 by Lois W. Stern

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Lois W. Stern is the published author of two award winning books: Sex, Lies and Cosmetic Surgery and Tick Tock, Stop the Clock ~ Getting Pretty on Your Lunch Hour as well as numerous magazine articles. Her Professional Edition DVD is a popular aid to office staff while interacting with their patients.

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