Likewise Blog

In addition to doing your own exams and having an annual full body exam, there are simple things you can do to reduce your risk of melanoma.

• MStop outdoor and indoor tanning. Research shows indoor tanning increases a person’s melanoma risk by 75%. Getting a base tan prior to a vacation does not protect you, it only increases the chance you’ll develop skin cancer.
• MUse sunscreen every day. Look for an SPF of at least 30 as well as Zinc (no less than 6%) on the ingredient list. Apply 20 minutes before outdoor activity and reapply every 2 hours that you are outdoors and more often if you are sweating heavily or swimming. Even on cloudy, rainy, or snowy days you need to wear sunscreen if
  you are exposed to the sun.
• MLimit your outdoor activity to early morning and later afternoon. UV radiation is most intense during the hours of 10 AM and 4 PM. Plan outdoor activities to minimize exposure.

One person dies every minute from a melanoma. While a component of this cancer is genetic, there are still many steps you can take to reduce your chances of having it. This May, take time to educate yourself and the ones you love about preventing melanoma and have your annual full body exam if you haven’t already.

As rates of other cancers seem to be on the decline, the rates of malignant melanoma are on the rise. It is now the most common cancer among people 25-29 years old. A majority of new melanomas are being diagnosed in white males over the age of 50. May is national skin cancer awareness month, so it is a great time to establish a routine of self-examination and get in to see your dermatologist for an annual full body exam.

Anyone can get melanoma. Finding it early is the key to surviving this aggressive, potentially fatal cancer.  People who are
at the highest risk are Caucasians with fair skin (always sunburn) with red or blonde hair and blue or green eyes. The risk is also greater for people with a first degree relative (parent, sibling, or child) with melanoma and those who have a large number of moles (50 or more).    Regularly checking your own moles helps, you know what they normally look like, and therefore will alert you to any new or changing ones.

An easy mnemonic to help you remember what to look for is ABCDE:

• MA is for Asymmetry:  look for moles where the shape of one half is different from the other.
• MB is for Border:  look for moles with irregular, scalloped, or jagged borders.
• MC is for Color:  look for moles with multiple colors or variation in color-especially shades of black, brown, blue, red, or white.
• MD is for Diameter: melanomas are usually larger than 6 millimeters (the size of a pencil eraser) but they can be smaller too.
• ME is for Evolution/Evolving:  moles that are undergoing ANY kind of change, especially as outlined above, need to be evaluated by a medical professional.

Another good rule of thumb to follow is the “ugly duckling” sign. If you spot a mole that just doesn’t look like anything else you currently have or have seen before, then it needs to be checked.

Sometimes, melanomas can be painful, itch or bleed. Often times, however, they are asymptomatic. Many people also think that a melanoma has to be raised, but that is wrong. They can be flat and not even felt on the skins surface. This is the reason that you must LOOK at all of your moles, even in places that you don’t regularly see in the mirror (back, calves, and bottoms of feet).  It is also possible to develop melanoma of the nail bed. This type of melanoma is more common in darker skinned people
(Hispanics and African Americans) and usually appears as a darkly pigmented streak down the nail.

Truth in the Skincare Aisle – Dark Circles

When discussing dark circles – we need to begin with the actual cause of the condition.  Many people think they have “dark circles” when they are actually dealing with “dark shadows.” Let’s discuss both:

1. M Dark Circles: This condition is actually not that common. If you pull the lower eyelid skin taunt – and you see discoloration – then you most likely suffer from true dark circles. Usually this is caused by a thinning of the skin which is part of the aging process. Thinning of the skin exposes the bluish red blood vessels which causes discoloration. IPL “intense pulse light” treatments use heat to vapor vessels and may improve under eye dark circles.

2. M Dark Shadows:  This condition is what most of us deal with. Pull your lower eyelid skin taunt – if the color disappears – then you are dealing with true “dark shadows.” This appears as part of the aging process which we discussed in part one. The support structure of muscles and ligaments under the eye begins to collapse and the surrounding area becomes puffy. The collapsed structure casts a “shadow” on skin making it appear as if it is a dark circle.  You can treat this condition with hyaluronic acid, as discussed in part one.

Of course, many people are interested in treating their dark circles or shadows in ways that don’t involve serious treatments of injections.  I’d like to share some cosmetic solutions that are also simple and easy:

1. M Apply andaily eye treatment. This contains Haloxyl which controls both eye puffiness and reduces the effects of dark circles.

2. M Use a peach colored concealer to counteract the red or bluish cast.  A beige concealer will create more a grey effect than a natural skin tone.

3. M Apply concealer after you put on your foundation. This will help you use the right amount of concealer as well as keep the foundation brush from wiping off the concealer.

Always remember to start your daily skincare regimen with a broad spectrum, SPF 50 moisturizing sunscreen to prevent further aging from the sun and skin cancer.

These few techniques will help your eyes looking fresh and you looking your best.

Truth in the Skincare Aisle – “ Eye Bags”

Over time, we have discovered that often it is not the fullness under the eye (what often is referred to as bags) that is a distraction to the normal curvature of the face. It is actually the depression directly under the fullness that attracts our attention thus drawing our eyes to the fullness. Our thoughts have changed over time and many of us feel it is the loss of deep tissue of the lower lid that causes the depression, which is more of a problem than the out-pouching of fat.  We have started using hyaluronic acid fillers to lift this depression leveling the plane between the depression and the “bag”.  This leaves the lower lid looking full rather than sallow. You typically see the lower lids of teens and kids full with convex curvature rather than concave curvature which is the look we are all trying to achieve by using fillers.

Swelling of the lower lid is another reason for “bags”.  This can be hereditary but most often is associated with allergies and sinus issues. Sleeping with the head propped up at least 50 degrees can minimize this type of swelling. When we lay flat fluid tends to collect in our eyelids but when we sit up the fluid drains down away from the lids. Talking antihistamines can also help with this type of swelling. Massaging the lower eyelid, moving the skin toward the temples, will encourage the fluid to drain into the lymphatic and minimize the appearance of bags. Temporary improvement may also be achieved with cool soaks on the affected area.

Another cause of “bags” is eating salty foods that retain water. Modifying your diet by eliminating salty foods will reduce water retention and the appearance of bags. This simple adjustment of your diet can help prevent swelling in the eyelid area as well as improve healthy living.

Apply an ointment or skincare moisturizer. While it may seem unorthodox, Preparation H is another temporary fix. You need to be careful not to get the cream in your eye.  Also, eyelid skin is very sensitive and could be easily irritated by creams not specifically created for lower lid skin – so use this temporary remedy with caution.

Next we’ll discuss causes and remedies for dark circles under your eyes.

Your diet, stress level, medications, hormones, even your own skincare regimen and moisturizer selection can affect your skin; however, the biggest changes to your skin are seasonal. In fact, you may see your skin type move from the middle of one spectrum to an entirely different category. From the vibrant blooms of spring and summer to the golden leaves of autumn to the pure white brilliance of winter, your skin changes through the seasons. And like each new season, your body requires a unique approach to skincare.

 As a dermatologist, I find the way the seasons affect the skin fascinating.  Most of my patients are surprised to find that as the seasons change – so do the characteristics of their skin. So what does this mean for our skincare?  Well let’s discuss it by skin type.

Dry Skin

Summer heat and humidity can actually be good for those with dry skin.  Some people may find their forehead flakes less and their cheeks don’t feel so tight.  I recommend, each morning, to use a gentle cleanser and moisturize with zinc based SPF 50 Broad spectrum Moisturizer.  If you find your t-zone is getting a little oily – you can use a Normal to Oily moisturizer on your t-zone and a Normal to Dry Moisturizer on your cheeks.  At night, use a gentle cleanser, a Vitamin A Derivative (Retinol) Anti-Aging Treatment followed by a Moisturizer.

Normal Skin

For those with Normal Skin- the summer heat and humidity can bring on the Oil.  They may find that they start to have sheen on their forehead or cheeks and might need to blot a little throughout the day.  Use a specialized Oily Treatment on the t-zone or oily areas and then Normal To Oily moisturizer on the rest of your face.  Again – please make sure you wash with a gentle exfoliator each morning and that your Moisturizer is Broad Spectrum SPF 50 and Zinc based.  At night, use a gentle cleanser and a Vitamin A Derivative (Retinol) Anti-Aging Treatment.  You may not need a moisturizer with the Anti-Aging treatment – see how your skin feels and apply a light layer where it may feel dry.

Oily Skin and Acne

Summer heat and humidity can make your skin more oily and prone to outbreaks of acne, especially around your T-zone. Using an Oily Skin Treatment on your face will help keep the acne at bay and control the excess oil production. Cleanse every morning with an Alpha and Beta Hydroxyl Acid Face Wash for gentle exfoliation and oil control.  Make sure your Oily Skin treatment has Broad Spectrum SPF 50 protection.  Again – I recommend a zinc based product; it helps calm acne and keeps the face from getting hot which can exacerbate outbreaks.

Summer Skin Care Warning: If you have rosacea, be careful. The sun worsens rosacea symptoms. The heat can exacerbate already irritated skin. To protect and calm rosacea in the summer, I recommend use of a Zinc based sunscreen moisturizer that contains Niacinamide and Azelaic Acid.  The zinc will help keep your face from heating up because it reflects rather than absorbs the suns rays.  In addition, niacinamde, zinc, and azelaic acid have a calming effect on the irritation of rosacea. All these ingredients can help keep your condition controlled.

Your face is your window to the world. Keep it healthy and beautiful by adapting your skincare routine for harsh heat and humidity.   Smart skincare will keep summer both safe and fun!

Children have the most beautiful skin; soft, smooth and wrinkle free.  As a mother, I’m passionate about my children’s skincare health. As a dermatologist, I see patients diagnosed with skin cancer every day.  In addition, all my patients are interested in how to prevent or reverse the aging process. So how does skin cancer and anti-aging relate to caring for children’s skin? In this article, we’re going to discuss three ways you can preserve your children’s beautiful skin for years to come.

First, and most important, skincare should start at birth, protecting our children from skin cancer.  We’re seeing young people diagnosed with skin cancer at alarming rates so we need to be vigilant about monitoring our children’s skincare and protecting them from sun exposure. In addition to the cancer itself, surgery leaves scars and other malformations that affect the face and skin.

For babies, 0 to 6 months, sunscreen moisturizer is not recommended.  Skincare is vital for children this young. Instead ofusingsunscreen moisturizer, use wide brimmed hats, light colored clothing, stroller and car window shading and physical covering such as SPF umbrellas whenever outside.  Avoid being in the sun between the hours of 11 and 1 when the sun’s rays are at their strongest. Between this time the sun can effect skincare even when inside! Keep babies this age protected from direct sunlight exposure through the windows.

Courtesy of Tom Clare

If you do apply a moisturizer on your infant, use a chemical free sun protectant moisturizer with SPF 50 and Broad Spectrum Protection.  This will protect them from both UVA and UVB Rays. I recommend using Zinc based sun protection skincare products.  Zinc is a non-chemical compound that actually reflects the sun’s rays.  In addition to protecting them from the sun, zinc keeps their faces from getting hot which can lead to or exacerbate other skin irritation. Your child’s comfort is important so perform the best skincare for them.

Second, start your child on a healthy skincare routine from an early age.  Just like we teach our children to brush their teeth morning and night, we also need to teach them to care for and protect their skin.  Begin with a morning routine that includes washing with a gentle cleanser and then apply SPF 50 Broad Spectrum Zinc based Moisturizer.  Just a small drop is plenty to both lightly moisturize and protect their face.  At night, cleanse again gently and apply a light moisturizer after they brush their teeth.  A light moisturizer morning and night helps keep the top layer of skin, the stratum corneum, healthy and strong; this is the skin layer that keeps out infections and protects us from the environment. By developing a daily routine, your children will become conditioned to protecting and caring for their skin.

Lastly, consider anti-aging for your child’s skincare. Why would we be worried about aging for our children’s skin?  The aging process begins the day we are born and sun exposure is the number one ager of skin. Aging occurs from Oxidation every day as our skin cells are exposed to the environment so skincare is in danger from day one. To protect from aging in later years, you must begin early.  Teaching your children to use a Daily Sun Protectant Moisturizer with Anti-Oxidants will protect them from the aging process of sun exposure and environmental oxidation.

Teach your children how to protect themselves from sun exposure and to implement healthy daily skincare habits.  These two things are the cornerstones to a lifetime of healthy and beautiful skin.

Several of my children are involved in sports.  Like many parents did when I was growing up, I spend hours on sunny athletic fields for games and tournaments.  As a dermatologist, it concerns me when there are athletes getting burned faces and parents neglecting their own skincare as well.  Please – always protect your face and body with a sunscreen moisturizer whether you are a participant or spectator at sporting events!! Skincare should be practiced at all times, even while rooting for your little athletes.

Athletes have a special skincare need that your average sunscreen moisturizer can’t perform. Athletes need a sunscreen moisturizer that is water resistant for optimal skincare; sweat and consistent sun exposure are a dangerous mix to athletic skincare.  Water Resistant means that your sun protection will not slide off your face as you begin to get hot and sweat or are swimming in the water.  Athletes need to use a sun protectant that states it is Water Resistant if they are going to practice good skincare.

According to the new FDA Guidelines for Sunscreens:

Water resistance claims. Water resistance claims on the front label of moisturizers must indicate whether the sunscreen remains effective for 40 minutes or 80 minutes while swimming or sweating, based on standard testing. Sunscreen moisturizers that are not water resistant must include a direction instructing consumers to use a water resistant sunscreen moisturizer if swimming or sweating.

So whether you are a runner, swimmer, or soccer player – make sure you use a Water Resistant sunscreen moisturizer to most effectively protect yourself while enjoying your sport.  Know whether you have 40 minutes or 80 minutes of skincare protection and re-apply accordingly.

I developed Likewise moisturizer with the athlete in mind.  Our moisturizers are SPF 50 and Water Resistant according to the new FDA Guidelines and protect for 40 minutes of sporting activity.  I wanted to make all my skincare products simple so that busy people can easily incorporate them into their lives. We recommend a pea sized drop of Likewise Moisturizer for morning use but if you are using it while sweating or in water you should apply more and reapply every few hours– you will not only be hydrated, but also protected from aging and skin cancer while you are active in the sun. I am currently formulating a Very Water Resistant Sport Moisturizer that will protect the athlete for 80 minutes on the field on in the water.  I will talk more about our upcoming products in future blogs.

Today’s “Truth in the Skincare Aisle” is that athletes need special skincare protection with a Water Resistant Sunscreen Moisturizer when they practice and when they play.  Make sure your family and yourself are properly protected and always have products in their gear bag and in the car for backup.  And remember the fans – they need protection too!!

I often get asked, “Is Likewise Skincare just for women?” My answer is always an emphatic NO. Your husband and your children need to be protecting themselves daily from the sun’s rays as well as you.  I developed the Likewise Anti-Aging Skincare Line with the entire family in mind.  I see men, women and children in my practice and today I want to talk about skincare for the whole family and how each member should apply moisturizer.

Regarding your children, it is never too early to start a skincare routine.  Just like brushing your teeth, your children will benefit from applying a zinc based moisturizer and sun protectant to guard against the aging process and skin cancer EVERY morning.  Like any good habit, the earlier you begin your moisturizer application– the more ingrained skincare becomes.

Children get so much sun exposure walking to the bus and being outside on the playground.  I know someone with children in Wisconsin whose elementary school has 3 recess breaks a day.  Children should have moisturizer applied to their skin just like adults (Babies six months and older can use sunscreen safely). I know with your children, it’s hard to imagine them aging and developing skin cancer, but the younger you can instill skincare protection, the better off they will be.  They will most likely thank you when they are 30!

Regarding teens and men, skincare is all about protecting skin from the environment daily.  Any man that wants healthy skin should develop a daily skincare regimen that includes a zinc based moisturizer, sun protectant and anti-oxidants to decrease his risk of skin cancer.  Many teen boys and girls are outside several hours a day with sports practice after school. Likewise Moisturizer is also Water Resistant which means it is designed to protect when you are swimming or on the field sweating.

We recommend a pea sized drop of Likewise Moisturizer for morning use but if you are using it while sweating or in water you should apply more moisturizer and reapply every few hours– you will not only be hydrated, but also protected from aging and skin cancer while you are active in the sun.

Today’s “Truth in the Skincare Aisle” is that it’s never too early and never too late to start protecting your family’s skin from aging and skin cancer.  A simple moisturizer application after brushing their teeth is all they need for healthy and protected skin.

(Today we have a guest blog – I asked Melanie Connellee, Chief Operating Officer of Likewise, how she manages a Busy Work and Family Schedule)

When Julie asked me to speak to the Likewise Community about Simple Living, I immediately thought about time and how we never seem to have enough. Just this weekend, we switched to Daylight Savings and “lost” an hour.  Even though this happens during the night – I felt like the next day I was already behind. I work full time, have a husband and two children and volunteer with several organizations that serve the homeless community.  I love to have friends for dinner, get outdoors and hike, exercise, play golf and enjoy my family.  Between the things I enjoy and my responsibilities of work, house, cooking, bill paying, walking the dog and caring for my family etc– life can get very overwhelming.

It used to be that when I got really busy – the way I coped was to get even busier! I would look at my schedule for the next day or week – and go into “hyper-drive.”  I’d decide that night to get more done – start a needed project, do the laundry, organize the dry-cleaning, clean a closet and plan meals for the next month. I thought by getting more done – I’d be more relaxed the next day and
week.  Usually, I was just really tired the next morning.

Another way I would cope with a heavy schedule was to multi-task and begin planning how I could get multiple errands done between work responsibilities and my children’s activities.  This meant marathon hours in the car – hating red lights, looking for parking places, standing in lines and ultimately feeling frustrated.

After some periods of being way too busy and feeling overwhelmed – I was talking with a friend.  We discussed how “fruitless” it seemed to try and do more.  That maybe the answer to getting more done was actually “slowing down.” I started a new technique – when life got really hectic and I could see my schedule crushing in on me – rather than go into hyper-drive- I would actually STOP and take a BREAK and take a BREATH.  I would purposely step out of the busyness and get quiet.  Sometimes I just sat in
the quiet, sometimes I would pick up a magazine that I never had time to read and flip through it in an unhurried way. Sometimes I would make a list.  If I had to do errands or take someone somewhere, I began to drive very slowly – not try and make the light and get anywhere fast.  Just go with the traffic flow and focus on being relaxed – enjoying the sun or rain outside or conversation with a family member. I would avoid multi-tasking like being on the phone while trying to pick up something at a store.

The result – I began to feel more focused, able to make smarter decisions, and ultimately plan better and get more done.  Sometimes by not addressing things so quickly, they would actually resolve themselves.  Meetings would get cancelled; other people would be able to help with a project, etc. It was amazing how a very simple step – taking a break and a breath – could have such a positive effect. 

They say that the simple things in life are the things we value the most. A cup of coffee with a friend, a good book, a walk with someone you love.  I now look forward to “taking a break and a breath”.  Just like using Likewise Skincare, it has become one of my tools for Simple and Healthy Living!

Skin Cancer is something I deal with every day in my office.  Today, I want to talk about this very serious disease and how you can protect yourself and your family with proper skincare and moisturizer and application.

Before we get into proper skincare and moisturizer application, let’s look at three very important facts from the American Academy of Dermatology Website on skin cancer:

• MBasal cell and squamous cell carcinomas are the two most common forms of skin cancer, but both are easily treated if detected early.A recent study found that basal cell carcinoma and squamous cell carcinoma are increasing in men and women under 40. In the study, basal cell carcinoma increased faster in young women than in young men.
• MCurrent estimates are that one in five Americans will develop skin cancer in their lifetime.
• MMelanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for adolescents and young adults 15-29 years old. Approximately 75 percent of skin cancer deaths are from melanoma.

 What these statistics and my own experience with my patient’s skincare tell me is that skin cancer occurrence is on the rise.  Unprotected sun exposure, poor moisturizer application and tanning bed use are known causes of skin cancer.  Skin cancer can be treated if detected early.  Now, my family and I love the sun as much as anyone.  We are very active in sports and enjoy being outside. So how do you give yourself “permission to go outside” and still deal with these sobering skin cancer facts. As a dermatologist and mother, this is the best advice I can give: Practice good skincare and apply moisturizer sunscreen!

First, every morning, have every member of your household (babies six months and older) put on a sun-protectant moisturizer that has SPF 30-SPF 50 and Broad Spectrum (preferably zinc) skincare protection.

WHETHER YOU ARE GOING TO BE IN AN OFFICE, DOING ERRANDS, PLAYING SPORTS, GOING TO SCHOOL OR JUST BEING IN YOUR HOUSE, you should be applying moisturizer. Just like you brush your teeth and protect yourself from cavities, this simple application of moisturizer will protect you and your family from both UVB rays that cause skin cancer and UVA
rays that cause aging. Using moisturizer is important to your skin’s health so apply moisturizer daily.

Also, avoid the direct sun outdoors between the hours of 11am and 1 pm when the sun’s rays are at its strongest. While a strong moisturizer with sunscreen protection is helpful, avoiding these inhibitors will greatly increase skincare protection.

Second, enforce good skincare by going to the dermatologist. Everyone should see a dermatologist every year for a skin check starting at age 25.  Skincare is not limited to the application of just moisturizer. Early detection is important to your health and critical to successful treatment if good skincare is going to be a part of your health.

Third, tanning beds are UV generating machines that are begging to destroy your skin. Most tanning bed users neglect to use moisturizer sunscreen before hopping into this giant microwave. By lying in a tanning bed, you are diminishing your skincare, exposing your skin to these powerful and dangerous rays.

“But Dr. Pena, I’ve been neglecting my skincare since I was sunbathing teen, why bother with sun protection now?”

THIS IS WHY: Cells which are not yet cancerous have not had enough damage done to them.  You can help save these cells from crossing from normal to malignant by conducting proper skincare. No matter what your age, by protecting your skin from sun exposure, you can prevent further cell deterioration which leads to skin cancer. 

You try to live healthy so why wouldn’t you protect yourself from the sun to take good care of your skin? Today’s Truth in the Skincare Aisle is that skin cancer can be prevented and managed with proper DAILY moisturizer application with sun protection, checkups with your doctor and avoiding tanning beds.