Spring Time Skin Prep
by Tsippora Shainhouse MD, FAAD, DAAP.
Spring is here and it will soon be warm enough to let some of your skin come out of hiding. From smoothing out dry, flaky, or bumpy skin to evening out skin tone and, finally, to stocking up on skin-saving sunscreens, this guide will help you manage some of these skin woes just in time.
1. DRY, FLAKY SKIN: Cold, dry, winter weather and months of forced, electric heat suck moisture out of your skin, leaving it parched, flaky, and itchy. Spring showers will start to add humidity to the air and help hydrate your skin. Prep skin by exfoliating dead, dry layers and sealing in moisture.
MANAGEMENT: Use a moisturizing bar soap or creamy body wash in the shower. Keep bath and shower water warm, but not hot, to avoid rinsing off your natural skin oils. Once a week, try a sugar scrub with natural oils to remove dead, dry layers. Pat dry with your towel, and apply a moisturizer within 3 minutes of getting out, in order to lock in the water. Ingredients like hyaluronic acid and urea will help draw water to the skin surface, while dimethicones, oils, and petrolatums will help seal in the moisture.
2. KERATOSIS PILARIS: These are the hard, non-painful, non-itchy bumps on your upper arms. They occur because of a genetic tendency for the hair follicles to become clogged up with extra skin/keratin. It usually starts in childhood and gets less severe with age. Some women develop it during pregnancy. It can be managed so that it feels smoother, but there are no definitive treatments.
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MANAGEMENT: Use a moisturizing soap in the shower. Use an exfoliating moisturizer with hydroxyl acids, such as salicylic acid, glycolic acid, or ammonium lactate. If this isn’t enough, ask your dermatologist about topical retinoids
3. STRETCH MARKS: Purple stretch marks can develop when the skin on the breasts and abdomen (as well as thighs and arms) is stretched quickly due to rapid weight gain caused by normal puberty, pregnancy, body-building/rapid muscle bulking, internal (cortisol, estrogen) or external hormones (hormone replacement therapy, birth control), over-eating, drug-induced (marijuana) or medication-induced weight gain. Stretch marks occur when collagen and elastin in the dermis layer of the skin breaks. The appearance does not improve when you lose the weight, because the elastic fibers are already broken. It’s easy to hide them under layers of heavy clothing during the cold winter months, but come spring and summer, our clothing choices can leave less to the imagination.
MANAGEMENT: It is difficult to treat, but the purple-pink discoloration will fade with time. Lasers that target red color (pulsed dye lasers, KTP lasers) can be used to fade them quicker. Fractional resurfacing lasers and micro-needling can be used to help the depressed appearance by creating microscopic wounds within the dermis to encourage new collagen growth and dermal repair. Topical retinoid creams can help as well, and are safe to start using after delivery. While it is unlikely that the medication will become internalized, if you are currently or are planning to breastfeed, discuss topical retinoids with your doctor and decide if you should wait until afterwards.
4. BODY HAIR: After months of being slightly less vigilant about getting rid of underarm, bikini, and leg hair, warmer weather means: spring clothes, bare legs, and bathing suits.
MANAGEMENT: Shaving is fine. It cuts every hair at the same length, so all of the hairs will grow back at the same time and will have the same blunt end, making re-growth seem thick. Shave in the shower, so that skin has a chance to be wet and hairs can soften. Use a multi-blade razor for a closer shave.
If you choose to wax, be sure that the salon is clean, does not re-use their wax, and that they use a clean stick every time they dip it into the wax.
Hair removal laser is an effective method for removing hair. Technically, it is not permanent, but it will permanently reduce hair growth by at least 50 to 70% after a set number of treatments. It usually requires up to 5 treatments to notice an up to 70% reduction in hair growth, but can require at least 10 treatments. Avoid going in the sun for the first days after a laser treatment, to avoid hyperpigmentation.
5. DARK SPOTS: Brown sun spots (aka lentigines), hyperpigmented scars, and hormone-induced melasma can all get darker when exposed to sun. The best plan is to treat the discoloration before summer hits, and wear sun protection every day to prevent it from worsening or recurring.
MANAGEMENT: Fading creams, when used regularly over months, can help lighten dark patches. Look for ingredients like: vitamin C, kojic acid, birch bark, licorice root, and prescription-strength hydroquinone. Topical retinoids work well with these lighteners, as they bring fresh, new skin cells to the surface. Lasers use light energy to break up pigment, and can demonstrate significant lightening within a week. Sometimes a single IPL or Nd:YAG treatment is sufficient. Be sure to wear a wide-brimmed hat and broad-spectum sunscreen whenever you are outdoors, to prevent further darkening or recurrence.
6. SUN PROTECTION: Ultraviolet (UV) rays are present every day and have the potential to cause skin damage including sunburns and skin aging, even when it is cold or cloudy. UV rays reflect off of ice and snow, sand and water, and can pass through clouds and untreated window glass. With more skin exposed during the warmer months, it is even more important to make sun protection part of your daily routine.
MANAGEMENT: The best offense is a great defense. Start with sun protective clothing, especially if you will be spending significant time outdoors. Look for shirts with longer sleeves and higher necklines and consider wearing longer pants or skirts. Find a wide-brimmed hat that stays in place without obstructing your peripheral vision, as well as a pair of UV-blocking, dark-lensed sunglasses. Finally, find a broad-spectrum sunscreen with an SPF of 30+ and apply a generous layer about 20 minutes before heading outdoors, so that it has time to soak in and dry. Because the UVA-blocking ingredients begin to breakdown after 2 hours, and natural zinc oxide and titanium dioxide can wipe off onto clothing, re-apply sunscreen every 2-3 hours if you will be staying outside.
Dr Shainhouse is a board-certified dermatologist and pediatrician, practicing in Los Angeles, California. She trains medical students and residents, educates patients, and is a medical advisor to health, fitness, beauty and professional magazines, websites and news outlets. #stayskinsafe.