August is Psoriasis Awareness Month

          What is psoriasis? Psoriasis is a chronic, inflammatory disease of the immune system with predominantly skin and joint manifestations. It usually occurs on the scalp, elbows, knees, hands and feet, but may also affect the fingernails and toenails and even inside the mouth. Psoriasis affects approximately 2% of the U.S. population and occurs in two peaks: 20-30 and 50-60 years old; however it can affect all age groups.

What does psoriasis look like? There are several clinical subtypes, including: plaque, inverse/flexural, guttate, erythrodermic and pustular psoriasis. Plaque psoriasis is the most prevalent subtype, with about 80% of patients exhibiting this clinical picture which includes red patches, papules, and plaques that are covered by silvery scales and are sometimes itchy.

How is psoriasis diagnosed and treated? Plaque psoriasis, the most common subtype, is usually diagnosed clinically. Patients with localized plaque psoriasis can be treated topically with high potency steroids in combination with a Vitamin D analog (i.e. calcipotriene). In patients with moderate to severe disease, systemic therapy should be initiated, in addition to topical treatment. Systemic therapy includes, phototherapy, oral medications such as methrotrexate and cyclosporine, and biologic agents such as Humira and Stelera.

It’s important to remember that psoriasis is a lifelong disease that can affect all aspects of a patient’s quality of life. As many as 50% of these patients will experience symptoms of depression, and many others will feel socially stigmatized. As clinicians, it’s important that we address both the physical and emotional consequences of this sometimes debilitating disease.

The Truth about Vitamin D

 Most people know that being out in the sun can provide them with a certain amount of Vitamin D, the vitamin necessary for building and maintaining strong and healthy bones. However, relying on natural sunlight and tanning beds for Vitamin D comes with a hefty price tag. These methods of tanning expose us to the harmful effects of ultraviolet (UV) radiation, which we know can lead to skin cancer and premature aging of the skin.

 

Getting vitamin D from a healthy and balanced diet, offers a healthier and much safer alternative. Consider foods such as spinach, almonds, tofu, avocado, oily fish (salmon & tuna) and broccoli, to name a few. Also consider taking multivitamins containing Vitamin E.

        
And if you’re still a bit skeptical about the harmful effects of UV radiation, consider the following facts compiled by the American Academy of Dermatology (AAD):

1 UV rays can cause premature aging of the skin and skin cancer. There is significant scientific evidence to support the fact that UV radiation from the sun and tanning devices is a known carcinogen (cancer-causing agent).

2 The number of diagnosed cases of skin cancer continues to increase. One in five Americans will develop skin cancer during his or her lifetime.

3 Dietary sources of vitamin D do not prematurely age the skin or increase the risk of developing skin cancer. Dietary sources such as the ones mentioned above, and vitamin supplements are safe methods for receiving your daily dose of Vitamin D.

4 People need vitamin D to absorb calcium and phosphorus, which are essential for bone health. Vitamin D increases the body’s ability to absorb calcium and phosphorus, two minerals that are essential for healthy bones. Getting enough calcium and vitamin D is fundamental to prevent osteoporosis in men and women who are 50 years of age and older.

5 Vitamin D from food and dietary supplements offers the same benefits as vitamin D obtained from UV light, without the danger of skin cancer. The body cannot use Vitamin D until the liver and the kidneys process it. The usable form of vitamin D created by this process is the same, regardless of how it enters the body. So why not facilitate this process in the healthiest way possible?

Lastly, how much Vitamin D should you be getting? Based on current scientific evidence, the Recommended Dietary Allowance (RDA) for vitamin D is:

• 400 IU (International Units) for infants/children 0-1yr

• 600 IU for children, teenagers and adults 1-70yr

• 800 IU for adults 71+ yr

Neutrogena: Worst Sunscreen?

           With so many sunscreens on the market, how do you know which ones to choose and which ones to avoid? Well according to a recent article released by The Environmental Working Group (EWG), Neutrogena is the worst brand for sun protection due to toxicity and false advertising. With regard to toxicity, many Neutrogena sunscreens contain harmful chemicals such as oxybenzone and retinyl palmitate. With its use in sunscreen as a broad-spectrum UVB and short-wave UVA protector, oxybenzone acts as an endocrine disruptor, interfering with the hormone system and potentially causing developmental disorders and birth defects. By acting like estrogen, it is associated with endometriosis in women and alters sperm production in males.

Retinyl palmitate, a form of vitamin A, is another harmful ingredient found in as much as 33% of Neutrogena sunscreens. While vitamin A, or Retinol, is used in many skin products to slow the signs of aging, its use as an ingredient in sunscreen is controversial due to its effects when exposed to sunlight. While evidence is not definitive, a US government study found that it “may speed the development of skin tumors and lesions when applied to the skin in the presence of sunlight.”

Neutrogena’s advertised SPF levels of over 70 have been debunked by the US FDA. An abundance of research shows that SPF levels max out at about 50, so don’t let sun care brands convince you into paying more for a higher SPF!

Please remember that any sunscreen is better than no sunscreen. That being said, we recommend the following sunscreens that are safe and effective:

Theraderm

Sunfogettable
SolBar

Milia versus Whiteheads

We notice these tiny whitish bumps that spring up around our eyes and cheeks, but when we try to extract them, nothing comes out! Chances are you have a condition known as milia. Milia are small, pearly white to yellowish cysts composed of a protein called keratin. Located just beneath the skin’s surface, these tiny firm bumps can be caused by pore-clogging moisturizers (such as those containing petroleum and mineral oil) and/or genetics. You may be asking, “Can I remove these on my own?”Unfortunately, the answer is no. Because milia do not have an opening at the surface of the skin, as found with blackheads, they can’t be easily squeezed out. Removal requires that a dermatologist or aesthetician use a lancet or cautery to create an opening in the skin in order to extract the keratin. No acne spot treatment in the world will be able to remove these cysts, which can remain on your skin for years (with the same size and shape), sometimes disappearing on their own. We recommend that you do not try extracting these cysts yourself; otherwise you run the risk of scarring, skin damage and infection.

Can milia be prevented?

Yes. Once removed, you can prevent milia from returning by using a topical retinol/retinoid (rx) cream daily. These creams have exfoliating properties that turn over dead cells, keeping your skin smooth and your pores clear. You can also try a series of chemical peels with our aesthetician, which help shed off dead skin cells as well. Next month we have a chemical peel event in our Cape Coral location. Sign up today and experience what chemical peels can do for your skin!

 

5 Ways to Prevent Eye Wrinkles

1. Sunscreen. We cannot stress the importance of applying sunscreen enough. You may be thinking, “I don’t have the time,” or “it’s messy and ruins my make-up,” but fret not. Florida Skin Center offers Sunforgettable mineral sunscreen by Colorscience, in powder form! Sold in both SPF 30 and 50, this sunscreen is easily applied with the provided brush so it won’t ruin your make-up.

2. Rubbing your eyes. Whether we’re tired, scrubbing off make-up, or simply rubbing our itchy eyes, we unknowingly create winkles. The skin around our eyes is particularly delicate. So wash this area gently, and take an antihistamine (Zyrtec or Claritin) if you’re experiencing itchiness due to allergies.

3. Sunglasses. Not only are they stylish, but they also prevent us from squinting and creating crow’s feet, frown lines, and forehead lines.

4. Retin-A. Also known as Tretinoin, Retin-A is a prescription vitamin A derivative that speeds up cell turnover, thus exfoliating the skin. This exfoliation softens the appearance of fine lines and wrinkles… yay! And since the area around our eyes is delicate, we recommend starting with a low strength Retin-A, twice a week. Speak with your provider at Florida Skin Center to see if this prescription medication is suitable for you.

5. Botox. There’s a lot of stigma attributed to Botox, and rightfully so. The media loves to focus on “bad botches,” where patients’ faces have that frozen, wind-blown appearance. When performed by a licensed and trained medical provider, Botox is safe and can look very natural. It works by temporarily relaxing the muscles surrounding the eyes, thereby preventing you from squinting which causes crow’s feet. Botox typically lasts 3-4 months.

These 5 tips, combined with a skin regimen formulated by your providers here at Florida Skin Center, can help decrease the appearance of wrinkles around the eyes. Start now if you haven’t already!