How to Moisturize Properly (and Save Money)

Should I use different moisturizers for different body parts?

Yes. You wouldn’t use shampoo to wash your hands, so don’t use the same moisturizer on your face that you use on your feet.

  • For dry, cracked feet, use a moisturizer that contains a mild acid, such as lactic acid which softens thick, scaly skin. My patients like AmLactin Cream.

What is the best way to moisturize?

  • Shower or bathe in comfortably warm, not hot water.
  • Use a mild cleanser such as Dove instead of soap. I can’t tell you how often patients’ dry skin is caused by some “natural” or “organic” soap. Unless these soaps are specifically designated as moisturizing, they are often too drying for your skin in the winter.
  • Pat dry with a towel, leaving your skin damp.
  • Apply cream to your damp skin, locking in moisture. Doing this everyday will significantly relieve your dry, itchy skin in just a week’s time.

What is the best way to moisturize during an economic recession?

OK. So maybe we aren’t in a recession just yet, but skin care products can be prohibitively expensive. If you are moisturizing properly, then you could easily use 5 ounces each week. That means you could use up one Aveeno Skin Relief Moisturizing Cream every two weeks!

Simple petroleum jelly (Vaseline Ointment) — it might be old-school, but it works.

Use a thin coat right after the shower. You can blot excess with your towel. Some patients like to use it only at bedtime since it can mark your clothing.

New Research Discovers Cream that Minimizes Scars

We are all scarred. Scars are a natural part of healing. They occur when there is damage to the dermis, the deeper layer of the skin. The wider and deeper the original injury, the more significant the scar will be.

Scars vary by the location of the injury and by your genetics. Some people, especially those with dark skin, are prone to develop thick, raised scars called hypertrophic scars or keloids. Keloids are more common on the upper chest, upper back, neck, and ears. Other people develop flat, white scars. In fact, even stretch marks are a type of scar.

Once a scar has developed there is little or nothing you can do to change it. Over the counter creams cannot change the appearance of a scar (no mom, not even topical vitamin E). However, your physician can sometimes surgically revise a scar or can inject it with steroid to flatten it.

A new study to be published in the Journal of Experimental Medicine has shown that the development of scars can be minimized by blocking osteopontin. Osteopontin is a protein implicated in chronic inflammatory conditions and in various types of cancer.

Research by Professor Paul Martin and colleagues at the University of Bristol shows that osteopontin (OPN) is one of the genes that triggers scarring and that applying a gel, which suppresses OPN to the wound, can accelerate healing and reduces scarring. It does this in part by increasing the regeneration of blood vessels around the wound and speeding up tissue reconstruction.

Once again, we see that chronic inflammation is the basis for disease, in this case scarring. Prescription drugs that block osteopontin are probably years away, but they might be worth the wait.

Photo of a keloid from the American Association of Family Practice Physicians.

Garlic Treaments for Skin Problems


Garlic is a member of the onion family and has been used for medicinal purposes since the times of the pharaohs of Egypt. There are a few studies linking garlic to skin care.

In one study, ajoene, a component of garlic, produced a clinical response in patients with basal cell carcinoma skin cancer. It was shown to induce apoptosis (death) of cancer cells in 17 of 21 patients with basal cell skin cancers. This is interesting research, but unfortunately does not make garlic a viable treatment for skin cancer yet; in these patients the skin cancers became smaller, but were not cured.

Basal cell carcinoma should be treated with destructive surgery such as electrodessication and curettage (ED&C), simple surgical excision, or a Mohs procedure. In some instances it can be treated with prescription anti-cancer creams. Diagnosis and treatment of any skin cancer should be discussed with your physician.

Garlic has also been used as a short term treatment for athletes foot (tinea pedis). In one study, application of ajoene cream resulted in cure in 27 of 34 patients after 7 days of treatment with no recurrences after 3 months.

Although, if fungus ridden feet are keeping you from dating, I am not sure that a garlic cream is your best option.

Want to Be Successful? First Be Beautiful.

Life is better if you are beautiful. Totally unfair but somewhat true. A recent article in The Economist explored the economics (fittingly) of this timeless truism.

[W]hen all other things are taken into account, ugly people earn less than average incomes, while beautiful people earn more than the average. The ugliness “penalty” for men was -9% while the beauty premium was +5%. For women, perhaps surprisingly considering popular prejudices about the sexes, the effect was less: the ugliness penalty was -6% while the beauty premium was +4%.

There might be some biologic basis to our attraction for attractive people:

[Certain] aspects of beauty … are indicators of health. Skin and hair condition, in particular, are sensitive to illness, malnutrition and so on (or, perhaps it would be better to say that people’s perceptions are exquisitely tuned to detect perfection and flaws in such things).

Is it any wonder that cosmetics is a $250 billion dollar industry?

Photo of Tom Brady and Gisele Bundchen from

Skin Care Myths: Drinking More Water Will Hydrate Your Skin

This is a popular one, perpetuated by fitness and fashion magazines.

Only one study ever linked drinking water with skin hydration. That study used expensive mineral water, not plain bottled or tap water, and the study didn’t have a control group.small-glass-of-water.JPG

No study has ever shown regular water has any impact on your skin and no controlled study has ever shown that any type of drinking water has an effect on your skin.

From a physiologic perspective, drinking water could only have a negligible impact on your skin’s hydration. In fact, patients who have too much water in their tissues (edema) do not have healthy skin. For example, patients with venus insufficiency who have swollen, fluid filled legs have skin that is often dry, itchy, and scaly.

The amount of water in your skin after a 5 minute shower is magnitudes higher than you could achieve by trying to hydrate it from the inside out. The key is to apply a cream or ointment when your skin is still wet to seal in the moisture.

Then drink as little or as much water as you like.

Bacteria Secretes Sticky Glue, Causing Acne

sticky gum

Propionibacterium acnes (P.acnes) is the bacteria found in acne. A new study in the Journal of the American Academy of Dermatology has shed some light on how it wreaks its damage.

P. acnes lives in a biofilm, an aggregation of bacterial organisms and sticky extracellular substance, that allows it to stick to the wall of the hair follicle. This sticky substance also causes the skin cells to stick together, limiting their ability to shed. These stuck-together skin cells (keratinocytes) then block the hair follicle, forming a keratin plug and trapping the natural oils (sebum) below the surface. When the pressure from this trapped oil builds up, a pimple is born. The acne bacteria then live happily encased in their protective biofilm, trapped in the follicle.

This is why combination therapy is most effective against acne; if you don’t break up the keratin plug on the skin’s surface, then antibacterial medications cannot penetrate and won’t work.

Proactiv® works by employing a mild acid to break up the plugged pores and an antibacterial to kill the P. acnes. Prescription acne therapy works similarly. I often prescribe a retinoid, like Retin-A, to break-up the keratin plugs and an antibiotic, like benzoyl peroxide or clindamycin, to kill the bacteria.

Unfortunately, even with the appropriate combination therapy, it still takes up to 12 weeks to clear up your acne. On the up side, if you follow this regimen daily, you really will see results.

Burkhart, CG and Burkart, CN. Expanding the microcomedone theory and acne therapeutics: Propionibacterium acnes biofilm produces biological glue that holds corneocytes together to form plug. J Am Acad Dermatol 2007;57:22-4

Photo credit: FCC, xcaliber