How to Treat Keratosis Pilaris or “Chicken Skin”

Homemade OvenFried Chicken Raw

If you’ve got tiny, dry bumps on your thighs, then you likely have keratosis pilaris (KP). KP is a common, harmless, genetic skin condition caused by a buildup of the protein keratin that plugs up the hair follicle, resulting in an acne-like bump that can be either white or red in color. Since it resembles goosebumps, KP is often referred to, albeit ungraciously, as “chicken skin.”

Keratosis pilaris most commonly occurs on the backs of the upper arms and on the thighs, and less commonly on the face, neck, and buttocks. Although adults can develop KP, it’s most common in children and adolescents who as they age, typically outgrow it.

Although it’s benign, KP can be unsightly and embarrassing, leading many sufferers to hide their skin and avoid wearing sleeveless shirts and shorts.

How do you treat keratosis pilaris? Although you can’t be cured of KP, there are several things you can do to reduce the bumps and improve your skin’s overall appearance:

1. Moisturize daily. Moisturizing daily, particularly after showering or bathing when the skin is still damp, is one of the most effective and inexpensive ways to treat KP. Moisturizing is especially important during cold weather months when KP often worsens.

2. Look for products containing lactic acid, glycolic acid, or urea. Many over-the-counter lotions and creams contain these ingredients that help exfoliate dead skin, making skin feel smoother and softer. With prolonged use, they can help remove bumps and improve the appearance of your skin. Always use gentle moisturizing body washes that both cleanse and moisturize the skin.

4. Consult your dermatologist. If you haven’t had any improvement with OTC products, then talk with your dermatologist about other options. Prescription retinoids can help KP, and in some severe cases, laser treatments can be used.

Photo credit: FCC, snowpea&bokchoy

How to Keep Skin Hydrated During Winter Travel

On a recent flight, a woman sitting across me whipped out a cosmetic bag bursting with facial products. She squeezed, rubbed, and spritzed her face all the way from San Diego to Minneapolis. Was she doing the right thing? Maybe. Though her seat mate probably wasn’t too happy.

There’s no doubt that air travel dries out your skin. At 40,000 feet, there is extremely low humidity in the air which evaporates all the moisture off your skin.

Here are 5 tips for keeping your skin looking and feeling healthy during winter travel:

1. Moisturize, moisturize, moisturize. Before you leave your house, apply a facial moisturizer. (Here’s a post on 6 tips for choosing the proper facial moisturizer.) Also, keep one in your bag so you can reapply as needed.

2. Hand moisturizer. If you’re smart, you’ll be washing your hands a lot and applying gel hand sanitizers to ward off colds. Unfortunately, you’ll also be suffering from dry skin, nails, and cuticles. Always keep a travel size hand moisturizer in your bag so you can reapply after every hand wash, gel application, or anytime you feel dry.

3. Don’t forget your lips. Because the skin on your lips is so thin and delicate, moisture evaporates off of them more quickly, leading to dry, chapped lips. Pamper your lips with a soothing lip balm, preferably with SPF 15 or 30, and reapply frequently. If you’re prone to licking your lips, avoid flavored balms.

4. Skip the peanuts and pretzels. Eating salty foods will draw moisture away from the skin and cause swelling and bloating. Bring your own healthy, low-salt or no-salt snacks instead.

5. Beware the booze. Tempted by the free wine coupon? Alcohol dehydrates you and your skin. If you do imbibe, then have 2 glasses of water for each alcoholic drink.

Photo credit: FCC, Irargerich

Can I Use My Body Moisturizer On My Face?

Lotion

I’m always encouraging patients to save money on skincare products and to keep products to a minimum. When it comes to moisturizer, however, more is better. You should have one for your body and one for your face. Here’s why:

Body moisturizers are generally heavier and greasier because they’re designed to cover large areas of skin that are less sensitive than your face. Applying body moisturizers to your face can lead to irritation, clogged pores, and acne.

Facial moisturizers, in contrast, are designed to be lighter, less greasy, and non-comedogenic (non-pore clogging). They’re best for people with sensitive or acne-prone skin and good for just about anyone else.

You don’t have to spend lots of money for a designer facial moisturizer. Most over-the-counter ones work just fine.

Next time, I’ll share 6 tips for choosing a facial moisturizer.

Photo credit: FCC, Inglis

Is Your Hand Sanitizer Causing Hand Dermatitis?

Hand Sanitiser Cloud

They’re everywhere: airports, schools, hospitals, movie theaters, and on many people’s key chains and backpacks: hand sanitizers.

A recent article in Cosmetic Dermatology titled “Rethinking Hand Sanitizers” looks at the benefits and drawbacks of hand sanitizers.

Alcohol-based hand sanitizers when used properly do help prevent the spread of disease.  They’ve been endorsed by the World Health Organization and have played an important role in reducing the impact influenza and other infections.

Unfortunately, hand sanitizers are also a major cause of hand dermatitis which can lead to severe dryness, burning, redness, and cracked, bleeding skin.

So, should you stop using hand sanitizers? Not yet. They’re still less drying than soap-and-water hand washing. Instead, try this: Use hand sanitizers when necessary. And moisturize frequently.

If you develop a raging case of hand dermatitis, then follow these steps:

1. Stop using hand sanitizers, unless absolutely necessary.

2. Treat your hands to thick moisturizing creams, such as Neutrogena Hand Cream, and apply repeatedly throughout the day.

3. At night, apply a thick moisturizing cream or a healing ointment such as Aquaphor to your hands and wear cotton gloves to trap moisture in the skin.

4. It may take up to 2-3 weeks for your hands to heal at which point you can start to safely use your hand sanitizer again. But don’t stop the moisturizing, unless you want to keep repeating steps 1-3.

Here’s a video that shows you how to properly use hand sanitizer.

Photo credit: FCC, bratha

Can I Get Rid of Ridges In My Fingernails?

ridge walk

Ridge walking is exciting. Ridges in your nails are not.

Vertical ridges in your fingernails generally are not a health concern, but they can be unsightly. And many patients ask me, ” Can I get rid of ridges in my fingernails?” The truth is, once you have fingernail ridges, you’ll likely always have them.

Fingernail ridges are caused primarily by aging, something you can’t stop. But you can reduce the appearance of fingernail ridges by following these three steps:

1. Moisturize your nails. Use restorative moisturizing hand creams daily, and gently rub the cream into your nails and nail beds.

2. Consider taking 1500 mcg of Biotin once a day, which is widely available at drug stores.

3. Reduce your use of nail polish remover, which dries out nails and can contribute to the development of nail ridges. Look for non-acetone nail polish removers, and use no more than once a week.

Photo credit: FCC, colchu

Fall Is Here, Time To Change Skincare Products In Your Vanity

What I Wore: The Editor

Fall is finally here. It’s time to change the clothes in your wardrobe to knee-length pencil skirts, motorcycle leather jackets, and animal print handbags, says Vogue. It’s also time to change your skincare products, says @dermdoc.

Most of us associate changing seasons with changing wardrobes, but it’s also the time to evaluate your skincare routine. Humid, warm air will change to dry, cool air like greens to reds on maple trees. Your skin is a living organ and actively responds to these environmental changes.

  • Dry air means your skin will produce more oils to protect itself.
  • Cool air means that previously flushed skin will pale.
  • Less sun means that thick skin will shrink.
  • Less ultraviolet B light means that tanned skin will fade to allow for maximum vitamin D production.

When you start packing away your shorts and spaghetti strap dresses, remember that your skin needs you to pack away some of your summer products.

  • Dryer, thinner skin is more sensitive; consider exfoliating less frequently. Some scrubs or at-home microdermabrasions should be reduced to once every few days or week.
  • Some retinoids like Retin-A or Renova, can be reduced from every day to every other day to minimize irritation in fall and winter.
  • Listen to your skin. Is it increasingly red and stinging as the weather changes? You might have to stop some peels or toners completely until springtime.
  • Consider switching soapy facial washes to soothing or creamy facial cleansers.
  • Change from a lotion moisturizer to a cream moisturizer. If you haven’t moisturized every day, then you should start now.
  • Use a facial moisturizer, particularly if you’re prone to acne or have excessively dry facial skin.
  • Depending on how far north you live and on your skin tone, you might be able to cut back on sunscreen for winter. Although complete sun protection is the best way minimize all damage to your skin, wearing sunscreen year-round may not be necessary. If you’re not sure, talk to your dermatologist.
  • Remember that even in winter, at high altitudes and where the ground is covered with snow, ultraviolet light can be strong, more like summertime sun. So you always need sunblock when skiing or snowboarding.

Photo credit: FCC, Jessica Quirk

Weak, Split, Torn, Brittle, Frustrating Fingernails

Ever have a beautiful woman walk up to you, thrust her fingernails in your face and say, “Why do my nails keep splitting like this??” I have.

One of the rare hazards of being a dermatologist is being accosted with skin, hair, or nail questions at social settings. Broken, split, weak, or brittle nails are common, so I get this question a lot.

Nails are an appendage of skin and are made up of protein. Nails need moisture to stay healthy and pliable. They dehydrate much like your skin dehydrates. Dry nails are brittle: instead of flexing, they fracture and split from the tips backward. Once a nail is split, it is difficult to stop the split from spreading. Nail splitting occurs more frequently in winter when your skin and nails are  dry.

Nail polish can help protect your nails; however, nail polish remover worsens dryness. Therefore, the more frequently you paint and remove polish, the more your nails dry out. If you paint your nails, then touch up chips rather than remove the polish frequently. Keep the polish on for as long as you can before removing.

What else can you do to strengthen weak nails?

Apply to your nails a moisturizer with urea, like Eucerin Hand Creme. This puts moisture back in the nails and keeps them pliable.

Avoid excess washing. Soap and water dry your skin as well as your nails. (I can write you a doctor’s note that says you are not allowed to wash the dishes. If you must, then wear gloves).

Remember that once a nail is split, it cannot be repaired. The key is to keep the base of the nail healthy so when it grows out to the tip, it stays strong and intact. Fingernails grow 3 mm each month, so a 2-3 mm split will take a month to grow out.

There are lots of products that promise to strengthen or harden nails. Most of them are a waste of money, for example,  gelatin tabs. Gelatin tablets are animal collagen derived from bone. The collagen is broken down into protein by your digestive system. As such, taking gelatin tabs is no better than eating a piece of chicken or any other protein. Eat plenty of protein as part of a complete diet, but don’t bother with supplements.

Don’t waste money on calcium or other “mega-nail” vitamins. There is no calcium in nails and loading up on vitamins will not make nails grow faster or stronger.

There is some evidence that taking biotin, a B-complex vitamin, at 2.5 mg each day can help weak nails by improving protein synthesis. Remember though, if you start taking biotin today, it will be June before you see improvement because you can only improve nail that hasn’t yet grown.

Just like trimming dead ends can help your hair, trimming split ends can help your nails. Try to clip off the split part, but avoid being too aggressive because you can spread the split farther. With a little effort and a lot of patience your nails will be hard as nails.

Oh, and next time, a least buy me a drink.

Photo: KW Sanders (flickr)