We do cardio for our heart and keep our brain limber with mental puzzles, but it’s essential to take steps to care for our largest organ as well. HealthScene Ohio spoke with Dr. Christina Cernik with Summa Physicians, Inc. about all things skincare, from acne prevention to sun damage.
HealthScene Ohio: At what age should you consider using an anti-aging product?
Christina Cernik: Anti-aging products may be considered at any time during adulthood. Prescription anti-aging medications, such as tretinoin, improve fine lines and wrinkles more and more over time, so starting this medication during your 20s or 30s will give you more improvement at age 50 compared to starting it later in life. However, this medication should not be used if you are trying to get pregnant, are pregnant or are breastfeeding. That being said, it is important to remember that aging is a normal part of life; hence, signs of aging are not medically necessary to treat. Also, it is important to realize that certain lifestyle choices will make you age faster. These include smoking cigarettes, using tanning beds, sunbathing and using illicit drugs.
HSO: Can your lips get addicted to lip balm?
CC: Lips do not get addicted to lip balm. However, overuse of topical steroids (hydrocortisone or stronger prescription-strength topical steroids) can lead to a steroid withdrawal syndrome. In most cases, over-the-counter topical hydrocortisone cream should be used no more than twice a day for a maximum of one week. If you are treating a skin condition on your face or lips and it does not clear up in that amount of time, it is time to be evaluated by a physician.
It is also important to be aware that many lip balms contain ingredients that cause allergic contact dermatitis in some people. If you are using lip balm and develop redness, pain, stinging or burning on your lips, you may be allergic to something in the balm. If you are using several different lip balms and develop this problem, it can be difficult to pinpoint which one is the culprit. Petrolatum-based lip balm (Vaseline) contains minimal ingredients, lacks common irritants and allergens (fragrance, dyes, preservatives) and is typically a good choice for people with sensitive skin or lips.
HSO: For acne-prone skin, what makes the most difference: face wash, toner or cream?
CC: Acne is best treated by a physician with prescription medications. Over-the-counter medications such as benzoyl peroxide sometimes improve mild acne, but acne is most effectively treated with prescription medications. A “one size fits all” approach cannot be applied to patients with acne: Some people have cystic lesions, others have whiteheads and blackheads; some people are oily, while others struggle with dry, sensitive skin. A dermatologist can formulate an individualized treatment plan for each patient based on what type of acne and skin the patient has. It is also important to keep in mind that acne causes scarring in some people, so the earlier acne is treated by a physician, the less likely the patient is to have permanent scarring.
HSO: How often should you reapply sunscreen, and what factors affect the time it takes to wear off?
CC: Sunscreen should be reapplied every 90 to 120 minutes. Regardless of SPF or water resistant labeling, much of sunscreen applied initially is rubbed, sweated or swam off within 90-120 minutes.
HSO: What ingredients should you look for in lotions that are most effective? What ingredients should be avoided?
CC: The heaviest and most effective moisturizers come in the form of an ointment, such as petroleum jelly. The next best formulation is a thick cream that comes in a jar. Lotions are thinner and may work well for people without dry skin, but for people with dry skin or eczema, a lotion-formulated moisturizer may not be heavy enough. The most effective time to apply a moisturizer is within a couple of minutes of drying off after bathing. If you wait too long to apply a moisturizer, much of the moisture in your skin will have already evaporated by the time you apply it, and it does not work as well.
Ceramides are molecules in normal skin that keep the skin from drying out. Many over-the-counter moisturizers contain ceramides, which work well for people with dry skin or eczema. Examples are Cerave cream and Cetaphil Restoraderm cream; some of these have generic brand equivalents. Ingredients that may be irritants or allergens for some people include fragrances, dyes, herbal ingredients, and preservatives, and are best avoided in people with a history of sensitive skin or eczema.
HSO: When you’re outside for long periods of time, does the type of material you wear affect how well UV rays can penetrate clothing or is the advent of UV-reflective clothing just a gimmick?
CC: Studies have shown that sun-protective clothing with a UPF (Ultraviolet Protection Factor) does have sun-protective benefit, although wet clothing appears to lose some of its UPF. UPF-labeled clothing can be purchased, or already existing clothing can be laundered with tinosorb-containing material (Sunguard). Clothing without UPF labeling can also offer significant protection. Clothing that is loose-fitting previously washed and densely woven offers more protection than tight-fitting, loosely woven clothing. Wide-brimmed hats (at least 4-centimeter brim) are advised.
HSO: What type of moles, such as raised or flat, might cause concern?
CC: Melanoma is a cancerous mole, and unfortunately, it can be deadly. In 2015, approximately 10,000 people died from melanoma. Sometimes melanoma develops within a mole that a person has had for years, and the person will notice the mole seems to be changing in some way. Melanoma may also present as a brand new mole that the patient did not have before. Any new or changing mole should be promptly evaluated by a physician.
It is important for everyone to be aware of the “ABCs of Melanoma.” A stands for asymmetry in shape, B for irregular borders and, perhaps most importantly, C stands for two things: color and changing. Moles should be evaluated if they are more than one color, changing colors or a color different from the rest of one’s moles, which is termed the “ugly duckling” sign. Ugly ducklings are typically darker (dark brown or black) or pinker/redder than the rest of one’s moles. It is also important to be aware that change in a mole is not normal.
If a mole is found to be changing in size, shape or color, or if a mole starts to itch, hurt or bleed, or is not healing, it needs to be evaluated by a physician right away. Finally, though melanoma is usually a multi-colored mole or a mole that is darker than the rest, sometimes it is colorless and appears pink. People may mistake it for a pimple that will not heal. Any new pink skin lesion that does not resolve or heal within one month should be evaluated by a physician.
Images accompanying the ABCs of melanoma may be found on the American Academy of Dermatology’s website.
HSO: Is a moisturizer with sunscreen or makeup with sunscreen enough protection for our faces?
CC: Using a daily moisturizer with SPF 30 or higher year-round is a good idea, but if you are planning on spending time outdoors, a broad spectrum sunscreen, SPF 30 or higher, should also be applied and then reapplied every 90-120 minutes.
HSO: What are some common mistakes people make when treating a sunburn? What’s the most effective way to treat a sunburn?
CC: Once you have a sunburn, the damage is done. As with any other type of burn, you should drink plenty of fluids to stay hydrated. It is also helpful to keep the affected area covered with an emollient such as petroleum jelly to promote healing. If necessary, pain control may be achieved with aspirin, acetaminophen or nonsteroidal anti-inflammatory drugs. Prevention is the best approach. Sunscreen, sun-protective clothing, seeking shade and avoiding midday sun (9 a.m. to 3-4 p.m.) are recommended.
HSO: Why do age spots appear as we get older, and is it possible to prevent them?
CC: Lentigo is the medical term for an age spot, or “liver spot.” Lentigines are a result of cumulative sun damage over a person’s lifetime. Tanning bed use accelerates the development of age spots. Steps to prevent age spots include avoidance of tanning bed use and excessive sun exposure, as well as the regular use of sunscreen and/or sun-protective clothing while outdoors. Following these recommendations will keep your skin healthier and looking younger longer.
Sarah Sole is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
About the Expert
Dr. Christina Cernik specializes in dermatology at Summa Physicians, Inc. in Akron. She attended Northeast Ohio Medical University and did her residency at Roger Williams Medical Center. She chose to specialize in dermatology because she enjoys the variety it brings her and watching her patients improve with treatment. Her philosophy for patient care is that each patient should be treated how one would want a family member treated, with attentiveness and kindness.
