There are some lucky people who don’t get poison ivy or oak. If you’re like me, you do. Here are some poison plant pointers:

Ivy block cream prevents poison ivy or oak, but only if it is applied 15 minutes before exposure. It doesn’t work after you’ve been exposed.

The intensely itchy, sometimes frighteningly-bubbly rash is an allergic reaction to oil, urishiol, found on poison ivy, oak and sumac plants.

You can wash off the oil with soap and water. Do not use laundry detergent, alcohol, or expensive poison ivy soap — any ordinary bar of soap will wash off the oil. However, the oil is quickly absorbed into your skin, like olive oil into nice piece of Italian bread, so time is of the essence. Once the oil is absorbed in your skin, you cannot get it out no matter what you use.

• You can wash off 50% of the oil within 10 minutes
• You can wash off 10% of the oil within in 30 minutes
• After 1 hour, no amount of washing will make any difference. Nothing will prevent the soon to be rash.

Whatever you do, don’t touch your groin in the first hour or so. You could end up in the hospital; I’ve seen it.

After one hour, you cannot spread poison ivy to someone else. Scratching or breaking the water blisters does not spread the poison ivy or the rash.

The rash lasts for 2 weeks, sometimes less if it is not severe. No cream or treatment, however expensive, can shorten the duration. The rash must run its course.

Once your arms and face turn into wet tapioca pudding, use a drying astringent like Domboro soaks to dry it out.

Once the blistering dries up, apply a topical steroid like hydrocortisone 1% cream or anti-itching lotions like topical Calamine or Benadryl. Cool baths with collodial oatmeal will also help. Super hot showers will relieve the itching, but only temporarily, and in the end, only makes it worse.

If you have a severe case of poison ivy, defined by your mother doesn’t recognize you or you are unable to sit, stand, or lie down, then see a dermatologist for prescription drugs to help.

Photo: Jim Frazier (flickr)

Post by Dr. Benabio, copyright The Derm Blog 2009.

Last week one of my patients complained that she gets facials every month for her wrinkles, but that she still has prominent wrinkles around her eyes and mouth. “What,” she asked, “is she doing wrong?”

Facials are the third most popular treatment in spas after nails and massage. They come in many flavors like: mineral masks, steam treatments, microdermabrasions, LED light treatments, blu-light, and even oxygen facials.

Facials can be beneficial; they extract clogged pores, exfoliate dull, scaly skin, and give you a deep, invigorating cleansing, leaving your face smooth and silky. But facials cannot treat wrinkles, broken blood vessles, or brown spots.

Facials are done by aestheticians who are not licensed to practice medicine. Aestheticians cannot administer treatments that penetrate the skin or have  biologic effects (by definition, this would be considered medicine and must be administered by a licensed practitioner such as a physician or registered nurse).  Deeper problems such as wrinkles require invasive treatments which cross the line from cosmetics to medicine.

Facial massages or electrostimulations, which are supposed to tone your skin, don’t. Toning or building muscle requires intense and repeated activity. Just like building biceps, firming musles on your face would require working out. The problem is that wrinkles on your face are caused by contracting muscles — crow’s feet are caused by contracting muscles around your eyes; frown lines are caused by furrowing your brow; lip lines are caused by contracting the muscles around your mouth. Any treatment then that firms facial muscles would only make wrinkles worse.

Other treatments such as oxygen facials and mineral treatments have no evidence to support them, (unless you count “Madonna said so” as evidence). Save your money and have your daughter apply a mud mask the next time you go to the beach.

Photo: Arkansas Shutterbug (flickr)

It is a medical breakthrough. No, not a cure for cancer, but for the short lashed. The FDA has approved a prescription medication that makes your eyelashes grow.

We have known for years that prostaglandin medications used to treat glaucoma have an interesting side effect –they make patients’ eyelashes grow. Now a prescription drug is available that is specifically for treatment of hypotrichosis of the eyelashes, (which means sparse lashes).

Eyelashes are hair, just like the hairs on your head and legs. Not all hairs are created equal though; eyelashes are designed to grow a certain (short) length, then stop. The number and thickness of your lashes is determined by your genetics.

Latisse (bimatoprost opthamlic solution 0.03%) is a prescription drug made by Allergan, the makers of Botox. It’s a prostaglandin, an active biologic compound named after the prostate gland, the first place they were found. Latisse has been shown to increase the number, thickness, and darkness of lashes.

Latisse can be applied to the upper eyelashes only and should not be applied directly into the eye. It takes about eight weeks to notice results, and it can take 16 weeks to see the full effects of the drug. Unfortunately, you have to continue using Latisse to maintain the results; if you stop using it, then your eyelashes will go back to the way they were before you started treating them.

Side effects of using Latisse include disoloration of your eyelid. Fortunately this appears to be reversible; the color fades when affected people stop using it. Latisse can also cause darkening of the iris in your eye. Your eye color is genetically determined, but medications can change the color. Latisse might cause increased brown pigmentation of your iris. This side effect, unlike the darkening of your eyelid however, is permanent.

Latisse costs about $120 dollars a month and, of course, is not covered by health insurance. It is apparently already popular among the celebrity crowd: reports say Jenny McCarthy has been using it.  The question is how long will it be before someone starts applying it to their eyebrows? I could be the poster boy.

Photo: Nicholas Kenrick (flickr)

Put your foot into a tub of water and let hundreds of fish nibble on the dead skin on your feet. Who thought this was a good idea?

Rough scaly feet is one of those little problems in life for which no one seems to have a good solution. The skin on the bottom of your feet has the thickest outer layer anywhere on your body. It is designed to protect you from the endless trauma of walking. Without that extra thick layer of skin, every little stone that you stepped on would tear right through. The friction from wearing your new Jimmy Choo Zip Gladiator Sandals would cause painful, water-filled blisters on the balls of your feet.

Constant friction from shoes and repeated wetting and drying of your feet lead to excess skin growth — your skin is compensating to keep your feet protected. The result is often thick, scaly, rough skin. Repeated drying out of the skin from wearing sandals can lead to impressivly thick, cracked skin on the heels. Thick yellow rough skin is not only unattractive (no matter how pretty the strappy shoes are), it is uncomfortable. Rough skin catches on your socks and sheets and can give your partner an unintentional exfoliation while lying in bed.

There are no shortage of tools to try to remedy this problem. Ancient civilizations used pumice stones to smooth skin. (Interestingly the shoes they wore look like today’s hot summer sandals, and ancient Romans apparently knew that pretty sandals don’t compensate for ugly feet.)

After thousands of years of using pumice stones, the PedEgg was invented in 2007. The PedEgg is basically a cheese grater mounted on a plastic egg. The blades are designed such that it is difficult to cut yourself, but not impossible, despite their claim that it won’t tear a balloon.

Now there is the fish pedicure. Salons starve these little fish, then put your feet into a bath of tepid water and allow the toothless fish to nibble away at whatever little flakes of dead skin they can get at. Apparently the tingling sensation is rather pleasant. The problem is, there is no way to sterilize fish. (Well, not without cooking them anyway, and cooked fish are not very good at eating). Many states have already banned the practice, and it is unlikely to be available anywhere here in the US. So for now you will have to make do with your PedEgg (you know you have one). Just be sure you sterilize it before you grate any Grana Padano cheese with it. Please.

Photo: Deckchua

“Those lips that Love’s own hand did make”

Shakespeare is referring to lips that the goddess of Love crafted with her own hands. Lips have always been an important feature in beauty, across time and cultures. Smooth, full lips can be attractive suggest youth and sensuality. Because we look at lips when people talk, they are a prominent feature on the face. Here are 5 tips to have beautiful lips.

Lip plumpers

Young women don’t have wrinkles, but they sometimes like to have fuller lips. Lip plumpers are an ingenious cosmetic trick to give you fuller lips. The skin on your lips is thin and the lips have an impressive blood supply. Lip plumpers are hot pepper or other irritants that penetrate this thin skin and cause dilation of the blood vessels. When the blood vessels dilate, the lips fill with blood like balloons, giving you an instant fuller look. They have the added bonus of giving your kissing partner a tingling sensation that he will certainly feel long after you stopped kissing him.

Exfoliate

A second cosmetic concern for lips is that they can be flaky or scaly. This can happen from excess dryness (chapped lips) as well as from sun damage. Use a fine scrub or mild exfoliator to buff your lips to a smooth pink. This should be done in moderation though, as it is easy to over exfoliate lips and develop irritation that will be neither attractive nor good for kissing.

Moisturize and Protect

Once you have exfoliated your lips, it is important to moisturize them. Because the skin is thin and because your lips are subject to constant wetting, they dry out easily.  Use a lip balm regularly throughout the day to keep moisture locked in and prevent dryness. Always choose a lip balm that has a sunscreen. The thin skin on lips accumulates sun damage over the years leading to hard scaly spots (called actinic chelitis) and even skin cancer such as squamous cell carcinoma.

Stop smoking

This seems like a no-brainer, but it is important to mention here. Smoking is bad for lips for two reasons. First, smoking causes wrinkles and lips are prone to developing fine vertical lines that give lips a crepe paper look and make it nearly impossible to get a nice smooth line of lipstick. The actual act of smoking can itself worsen these wrinkles as the vertical lines form from puckering your lips on the cigarette. Some people take this as far as to never drink out of straws for the same reason; I don’t think that is necessary though (unless you are working on a super thick shake from In-and-Out Burger which is nearly impossible to suck up).

Fillers and Botox

Lastly, cosmetic procedures can be done to improve problem lips. Specially fine line fillers can be used to smooth the vertical wrinkles around the lips as well as to fill the lips themselves for a poutier look if desired. Botox in small doses can also be used to relax the fine lines around the lips and can smooth out wrinkles here for months at a time. Although many MediSpa’s advertise for lip fillers, not everyone does this well. Lips that have been treated with Botox or fillers should be barely noticeable, not like two hot dogs without buns. Ask to see photos of before and after treatments to be sure that your physician can provide results that look like “Love’s own hands” created.

Photo: Ibrahim Iujaz (flickr)

Maybe it’s the economy. Or maybe it’s too many late nights watching back episodes of CSI on your DVR. Either way, you notice that there are dark circles under your eyes that didn’t seem to be there before. What causes these dark circles under the eyes, and what can you do to treat them?

After wrinkles, dark circles are probably the second most common complaint that I hear in clinic from patients about their faces. There are two main reasons for dark circles:

1. Blood or blood vessels that appear prominent in this area.
2. Excess pigment is being produced from the pigment cells (melanocytes).

The skin under your eyes is the thinnest skin on your whole body (the thickest is on your upper back). As a result, blood vessels can be seen right through the skin in this delicate area. The deep maroon color of blood appears blue when seen through the skin. Many people who have dark circles have them simply because they inherited thin skin in this area, and the blood vessels are easily seen.

Aging and sun exposure causes thinning of the skin which makes this problem more obvious over time. Allergies can cause congestion of the blood under the eyes, making dark circles appear. Slow blood flow can also lead to leaking of the blood out of the vessels, leading to a brownish discoloration from the iron in the blood (called hemosiderin). Things that cause worsening of the blood flow, such as smoking, can also make dark circles worsen. Poor sleep and eating foods high in sodium can also lead to puffiness of the eyes, making the dark circles appear worse.

There are many things that can cause an excess of pigment production as well. For example, atopic dermatitis or eczema often leads to chronic redness and itching around the eyes. This chronic inflammation turns on the melanocytes leading to darkening of the skin in the affected areas. Sun exposure also turns on pigment producing cells. Getting too much sun can lead to darkening of the skin under the eyes, like a tan, which can be slow or difficult to fade, especially in women of Latin American, Mediterranean, and Asian descent.

The best way to treat dark circles is to treat the underlying problem. If you have allergies, then see your physician about allergy medications and nasal sprays to help reduce congestion. If you have itching or redness, then you might need a topical steroid to control the inflammation and prevent darkening of the skin. Most importantly, you should protect yourself from the sun and wear sunscreen everyday, especially in months when the sun’s rays are strongest. No matter what the underlying problem is, darkening of the skin from the sun will only make it worse.

Many creams that promise to clear up dark circles fail to deliver on their promises. Consider seeing a makeup specialist at your local department store or salon instead; they can recommend products that reflect light or lighten the area to improve your appearance. In most cases, your money is better spent there than on “miracle” eye creams.

Photo: Wakima, Flickr.com

While muscular arteries carry your blood away from your heart, it is the thin walled veins that bring the blood back to the lungs and heart. Because there is no muscle in veins, the muscles of your legs and feet are what squeeze the blood back up to your heart. One way valves in the veins help keep the blood moving up by preventing it from flowing backwards, down into your legs.

When the veins are damaged, as can happen from excess pooling of blood, from diabetes, and from genetic factors, then the valves fail and the blood begins to pool in the vessels. The result is dilated baggy veins that pouch out from the skin. Over time smaller veins grow to try to redirect the blood flow. These tiny vessels are the spider veins that develop.

Sclerotherapy works by causing the treated veins to scar down, sealing them tight and preventing the blood from filling them again. This is done by inserting a tiny needle into the vein and injecting a substance that causes damage to the blood vessel walls. The two most commonly used substances are hypertonic saline and detergents.

Hypertonic saline is super salty water. The high salt damages the red blood cells in the veins causing a clot to form. Once a clot fills the whole vein, the blood cannot flow back into it. The vein eventually atrophies and disappears. The advantage of hypertonic saline is that it is readily available and often works. The disadvantage is that it can be painful, and if the saline is injected into the tissue outside of the vein, then tissue damage can occur, leading to an ulcer.

Detergents are, just as it sounds, soaps. Injecting detergents into the veins also causes a clot to form and damages the vessel walls. Again, this leads to a sealing of the vessel and eventually the vein disappears. There are several detergents available for physicians to use including sotradecol, which is FDA approved, and polidocanol, which is not FDA approved at this time, but is often preferred because it is effective and less painful than other detergents. These detergents also have a low likelihood of causing a serious allergic reaction which can occur when these substances are injected right into your bloodstream.

Ironically, the larger blue veins (3 mm or less in diameter) are often easier to treat than the smaller ones. Sclerotherapy of larger blue veins usually leads to good results in just a few days. Larger veins can, however, lead to brown pigmentation of the skin. This pigment is from the iron in the red blood cells that were trapped in the vein. The brown color can take 6 months to 2 years to fade. The smaller, red spider veins are less likely to cause this brown discoloration when treated. However, they can be more difficult to treat. It often takes several treatments and can take months to see improvements. They can also regrow more easily. The more times these small red veins have been treated, the less likely that they will go away completely with therapy.

Veins higher on the leg and thigh can also be easier to treat than those lower on the leg or foot. Varicose veins on the inside ankle are notriously difficult to treat and are the most likely to lead to an ulcer of the skin after treatment with sclerotherapy.

Women will spend thousands of dollars on surgeries, laser treatments, Botox, fillers, even night creams, all to make their faces look younger. But sometimes their hands give away their true age.

Although your face is your most important feature in determining your age, your hands are a not distant second. Hands covered in brown spots, fine lines, paper thin skin, and hollowed out spaces might belie your wrinkle free face and pouty lips.

Aging hands are caused by the same fact0rs as an aging face. It is part genetics and part age, but mostly, it is due to a lifetime of sun exposure. Hands are particularly vulnerable to ultraviolet light damage because they are almost always exposed and because we rarely protect them. Unless the days of white gloves return, it will be necessary to take extra precautions with your hands, especially when the warm weather returns and you take off your mittens.

Any sunscreen that you use for your face or body will also work for your hands. I recommend a broad spectrum sunscreen with an SPF of 30. There are sunscreens specially formulated for hands such as Neutrogena’s Age Shield Hand Cream.

Hands that are already showing the effects of sun and age can be treated much like your face. Retinoids are the mainstay for treating aging skin. Retinoids such as Renova have been shown to increase collagen production, help smooth fine lines and wrinkles, and lighten brown spots. They can be used once a day at bedtime just like a night cream. Night time is the best time because it is less likely that you will wash off the cream overnight whereas during the day, frequent hand washing can mean that creams don’t have time to work.

Brown spots can also be treated with a light spray of liquid nitrogen. This damages the pigment producing cells of the skin and can fade brown spots to blend in with your natural skin color. Brown spots can also be treated with lasers such as the Nd:YAG laser or IPL light treatments. Lastly a limited chemical peel can be done with acids such as tricholoracetic acid. These peels can lighten brown spots as well as help smooth wrinkles when done over the whole hand.

Wrinkles and fine lines can also be treated with fraxtionated lasers such as Fraxel. These lasers destroy pinpoint spots on the skin leading to improved collagen growth and smoothing of pigment without burning the skin extensively. Atrophy or hollowness on the back of the hands can be quickly improved by injecting fillers. Treatment with Sculptra or Radiesse can plump up the back of the hands giving them an instantly younger look.

Finally keeping your hands well moisturized is the cheapest and most important treatment against aging skin. Dry, cracked hands appear dull and older. Simply applying a good hand moisturizer periodically during the day will give your hands a healthy glow and younger appearance.

Despite its association with passion, love, and vibrancy the color red is not what most people want to see on their faces when they look in the mirror. Redness on your face develops from inflammation and from dilated tiny blood vessels right at the surface of your skin. Sometimes the redness can be sudden, whereas other times it can develop slowly over many years. Here are five things your should know about facial redness and what to do about it.

1. The most common cause of facial redness is rosacea. Rosacea is a chronic inflammatory condition that leads to red, sensitive skin and sometime to pimples on the nose and cheeks similar to acne. People with rosacea often have sensitive skin that stings when exposed to sun or cold and turns bright red when they eat hot or spicy foods. If you have rosacea, then try products that contain anti-inflammatory and anti-redness ingredients such as feverfew (found in Aveeno facial products) or licorice (found in Eucerin facial products).

2. Over-exfoliating or scrubbing your skin can lead to redness. This is common among young women with acne. Remember that acne is from bacteria trapped in clogged pores. Scrubbing with apricot scrubs or using alcohol based toners will not help erase your acne, but it certainly will worsen the inflammation. Often this makes a bad situation worse. Unless you have very oily, sebaceous skin, remember that scrubbing is best done in moderation and in the middle of winter when your skin is already is dry and sensitive, scrubs might not be needed at all.

3. Excess sun exposure over years can lead to redness. The ultraviolet radiation from the sun triggers blood vessels to grow like weeds across your face. If you look closely at some people’s skin, you can see that diffuse redness is actually millions of tiny threadlike vessels right at the surface. This condition can be treated by using a laser that targets blood vessels. The laser can literally explode the tiny vessels, destroying them along with their unwanted redness. The downside is that you will often have obvious bruising for a few days; however, when the bruising heals, the redness is often significantly reduced and sometimes is erased altogether.

4. Allergic contact dermatitis can also cause redness on your face. Common causes of allergy include chemical sunscreens, preservatives in cosmetics, hair dyes, and fragrances. Skin allergies occur when your immune system reacts to a particular allergen. It is the same reaction as poison ivy or poison oak and can lead to redness, scaling, and itching. If you have a rash around your eyes, a rash that is itchy, or a chronic redness and scaling on your face, then see your physician. He or she can do patch testing to determine if you have a skin allergy and can give you a list of products to avoid.

5. Rarely is redness on the face the result of an underlying medical condition. Women with lupus, an autoimmune disease that can affect many organs, sometimes develop a bright red rash on their cheeks and nose, often called a butterfly rash because from a distance it looks like a butterfly on their face. The rash is triggered by sun exposure but can occur any time of the year. If you have the sudden development of this type of facial redness, then you should see a physician. A few blood tests can diagnose the condition and sometimes treatment is needed to keep the immune system from flaring.

Photo:  Brent and Marilynn, Flickr.com

Sun spots are a sign of aging; it takes years of sun damage to develop them and they are associated with being old. As such, patients often ask me what they can do to get rid of them.

There are many ways to treat sun spots including freezing them with a cryospray, zapping them with a laser, applying a chemical peel, and treating with bleaching creams. Treating them with lasers, peels, or freezing can be painful and can lead to more pigmentation from damage done by the treatment. Bleaching creams can work, but many of the products currently available are not potent enough to lighten these spots satisfactorily.

A recent study published in the Journal of Drugs and Dermatology examined the effectiveness of a new treatment that combines a bleaching agent with a retinoid to treat these brown spots. Retinoids are used to treat a variety of skin conditions from acne to wrinkles. They are effective antiaging agents and smooth out pigment irregularities. They found that applying Solage® (which contains mequinol, a bleach, and tretinoin, a retinoid) lightened brown spots after two months of use. They also found that the treated spots did not return after stopping the treatment.

Because sun spots are the result of damage from ultraviolet light, it is necessary to wear sunscreen and avoid sun exposure in the treated areas or the brown spots will eventually come back (not to mention, you would develop new ones).

Post written by Jeffrey Benabio, MD. You might also like:

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Hormone Replacement Therapy Does not Make You Younger

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Photo: Sukanto Debnath