Friday, April 3, 2009

Basic Operating Instructions: Taking Care of Your Skin

Different people and different skin types need to do different things
for their skin. We have an old expression in dermatology that still
rings true: “If it’s dry, wet it; if it’s wet, dry it.” In recent decades,
another truism has been added: “If it’s fair, shield it; if it’s dark,
you’re probably very fortunate.” That’s because your melanin pro-
tects you from skin cancers, wrinkling, and keeps you looking
If your skin is fair, if you burn easily, or if you have a personal or
family history of skin cancer, you should protect yourself from the
sun by wearing hats and caps, using sunscreens, and avoiding
going to tanning parlors. If your skin is dark, you may have other
reasons to protect it from the sun (see Chapter 12 where I talk
about the dark spots that occur in dark skin). People with dark
complexioned or Asian skin may have other reasons to be very
sensitive and prone to irritation and possibly less tolerant of many
of the topical medications that are used to treat acne.
The ultimate operating instruction: Whether you have dry, regular,
or oily skin, a big acne breakout or smooth sailing on the pimple
front, there’s something that’ll keep your face looking its best and
most attractive to the rest of the world and is guaranteed to help
you make friends and influence people. I suggest that you simply
exercise your muscles of facial expression — and smile!
Washing your face
Rocket science? Maybe not. But as a dermatologist, I have a few
reasons for walking you through a little face-washing tutorial. First,
I often begin my instructions for applying medications in later
chapters with phrases like “Wash your skin . . .” or “To a clean, dry
face, apply . . .” so, it seemed to make sense that I fill you in on the
details. The second reason for this bit of Face Washing 101 is even
simpler — many people screw it up. But don’t worry: I’m here to
help. And, if you’re like many folks, my face-washing routine can
simplify your mornings and evenings and save you some cash.
These days, society as a whole is really into soap — the cleaner the
better! As little kids, we’re told to scrub, scrub, scrub with plenty of
soap and water. As teenagers, we use more soap — to fight acne and
oily skin. As adults, we tend to follow the same routines even though
our skin has changed. And the range of different types of soaps
available is mind boggling — super-fatted, deodorant, rejuvenating,
oatmeal, avocado, citrus, aloe vera, sandalwood, wintergreen, pep-
permint, patchouli, and vitamin E to name a few.
Many types of cleansers are also available. Some exfoliate as they
clean, and the medicated ones generally contain benzoyl peroxide
or salicylic acid in various concentrations. Overcleansing with
these products can be irritating. More often than not, these items
will only dry out and irritate your skin, particularly if you’re already
applying a topical anti-acne medication (see Chapters 7 and 9).
Washing excessively — more than twice a day — with any soap
(regular soaps, acne soaps, antibacterial soaps, soaps with abra-
sives, or even gentle soaps) has little positive impact on your acne.
In fact, if you have acne, your skin may be red and inflamed, and
frequent washing only makes it redder.
Washing your face with a mild soap just twice a day is the best tactic,
regardless of your skin type or acne activity. I recommend the follow-
ing soaps and cleansers, depending on your skin type. These tried-
and-true recommendations may not sound as exciting as a Provencal
honey-lavender soap with grape seeds, but they flat out work:
 Oily skin: Ivory soap
 Dry skin: Dove soap
 Extra-sensitive skin or allergic reaction to soaps: Nonsoap
cleanser such as Cetaphil, Aquanil, or Neutrogena Extra
Gentle Cleanser
At the risk of sounding like a parent — with the whole “wash
behind your ears” thing — now that you have your soap, here’s
how to use it:
1. Get the soap wet, using lukewarm water.
2. Using your fingertips or a soft washcloth, apply the soap
to your skin and rub it gently into your skin using a cir-
cular motion. Don’t use loofah sponges, brushes, or sand-
paper please.
3. Splash your face with lukewarm water until the soap is
completely gone. Expect to rinse your face for just a few
seconds — perhaps as long as it would take to sing “Happy
4. Pat — don’t rub — your skin until it’s dry. Use a soft
cotton towel.
And that’s it!

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