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AAD Discusses the Benefits of Customized Skin Care

Posted: December 3, 2009

At the most recent meeting of the American Academy of Dermatology, dermatologists discussed how customized routines can help people's skin appear its best.

Finding the right skin care routine starts with understanding the unique needs of your skin type. For example, people with dry skin can benefit from applying moisturizer several times a day, whereas those with oily skin might need to apply a lightweight moisturizer only once a day. Customization is key, and dermatologists and skin care professionals can help people of all ages and skin types select products based on their individual skin care needs.

Speaking at the American Academy of Dermatology’s SKIN academy, Sonia Badreshia-Bansal, MD, FAAD, a dermatologist in private practice in Danville, California, discussed the importance of an individualized approach to good skin care and offered basic tips for the most common skin types.

“No matter what your skin type, using daily moisturizer and practicing year-round sun protection are vital to maintaining healthy, glowing skin,” said Dr. Badreshia-Bansal. “That’s because with adequate hydration and use of a broad-spectrum sunscreen, the skin has the advantage of protecting itself from free radicals and harmful ultraviolet radiation that cause skin damage, discoloration, premature wrinkles and even skin cancer. Over time, a careful and consistent skin care routine with products designed for specific skin types can gradually improve the overall health and appearance of the skin.”

Combination skin tips

For many people, their skin has areas that are dry and oily, which is classified as combination skin. With this skin type, the forehead, nose or chin might be oily, but the cheeks could be dry. For combination skin, Dr. Badreshia-Bansal recommends using a mild cleanser that minimizes sebum removal. In addition, a medium-weight lotion with broad-spectrum sunscreen containing many different sunscreen ingredients is beneficial.

“To improve skin texture, prevent fine lines and wrinkles, and help even skin color—especially to help lighten dark spots—an over-the-counter retinol cream or a prescription tretinoin cream can be used during the evening skin care regimen to maintain skin health and prevent future damage,” said Dr. Badreshia-Bansal. “However, when beginning use of tretinoin, the strength should be gradually increased due to its potential to irritate the skin, followed by vigilant use of a moisturizer to help offset any dryness or peeling.”

Dry skin tips

For dry skin, Dr. Badreshia-Bansal recommends washing the face twice a day with a gentle cleanser or creamy wash with mild detergent. She suggests applying a moisturizer with sunscreen once a day right after cleansing while the skin is still damp, as this can help seal in moisture.

“If the skin begins to feel tight, reapplying moisturizer mid-day will help to improve skin hydration,” said Dr. Badreshia-Bansal. “A sunscreen-containing moisturizer in a smoothing cream formulation that contains antioxidants, plus dimethicone, grapeseed oil or petrolatum, which prevent water loss from the skin, also is helpful.”

In some cases where the skin is very dry, Dr. Badreshia-Bansal noted that cleansing the face at night, when it is the dirtiest, may be the only time necessary to wash the face to prevent stripping the skin of its natural oils. If so, she advised rinsing the face with cool water in the morning to help maintain natural oils.

When exfoliating flaky skin, Dr. Badreshia-Bansal suggested that exfoliating once a week is sufficient. Since dry skin can be sensitive, gentle retinols should be applied sparingly to start, such as every other night, along with a moisturizing cream to help even skin tone, texture and color while continuing to hydrate the skin.

Oily/acne-prone skin tips

Oily or acne-prone skin, which is prevalent in teenagers and many adults, requires careful observation to ensure the skin responds favorably to products and the overall skin care routine. For example, some people with oily or acne-prone skin need to wash their face as much as two to three times a day. On the other hand, over-washing the skin also can lead to increased oil production, so a balance must be achieved based on an individual’s skin care needs. In general, using an oil-free, non-comedogenic foaming cleanser that contains salicylic acid or benzoyl peroxide is imperative to prevent breakouts.

Dr. Badreshia-Bansal said that contrary to popular belief, oily skin may still require a moisturizer. She suggested a moisturizer that is lightweight and non-comedogenic (does not block pores) that contains sunscreen, which has a dual function as a moisturizer and sun protector when applied every morning. Reapplying a sunscreen during the day is necessary to ensure continuous sun protection.

Exfoliating oily skin once or twice a week is sufficient, but Dr. Badreshia-Bansal cautioned that it is not necessary during acne breakouts, as the mechanical friction caused by exfoliation can make acne worse. She added that for skin that is prone to acne, avoiding products with cocoa butter, cinnamon and coconut oil will help prevent breakouts.

To help soften fine lines while reducing future breakouts, Dr. Badreshia-Bansal suggested using a retinol gel or serum nightly. “Your dermatologist can help recommend gentle and effective products that work together to improve the appearance of oily skin and help prevent acne,” said Dr. Badreshia-Bansal.

Sensitive skin tips

For sensitive skin, washing the face once a day should be enough to keep the skin clean. Dr. Badreshia-Bansal noted that exfoliation is not necessary and can worsen already sensitive skin.

“Avoiding products that contain fragrances, soap or alcohol will help patients with sensitive skin maintain skin health,” explained Dr. Badreshia-Bansal. “Calming ingredients, such as green tea polyphenols, chamomile, and aloe are beneficial and, as a general rule, the fewer ingredients in a product the better.”

In the morning, Dr. Badreshia-Bansal suggested applying a cream-based moisturizer to dry skin to help prevent or reduce irritation. Active ingredients found in skin care products penetrate more deeply into damp skin, which often can be beneficial in normal skin, but this can cause more irritation in individuals with sensitive skin. In addition, products containing acids, such as lipoic acid, glycolic acid and salicylic acid, may be irritating to sensitive skin. For that reason, caution must be taken with any skin care product containing these types of active ingredients.

To help prevent fine lines and wrinkles and help reduce irritation, Dr. Badreshia-Bansal recommends using a mild retinoid every night followed by a moisturizer to stimulate collagen production.

Skin of color tips

For people with skin of color, there are differences in skin anatomy, physiology and function that can influence how skin care products react with the skin. Even though skin of color is more resilient in many ways, it also is more sensitive to irritant reactions from harsh chemicals and active ingredients, such as glycolic acid, which can lead to exaggerated stinging and potential hyperpigmentation, or darkening of the skin.

Dr. Badreshia-Bansal noted that daily moisturizers are a must, since darker skin has a tendency to appear “ashy” when it is not well-hydrated. Creams and lotions applied after showering when the skin is slightly damp can help lock in moisture.

Because skin of color is more prone to discoloration and slow healing and scarring from trauma, Dr. Badreshia-Bansal stressed that sunscreen should be used vigilantly by people of color to prevent further sun damage and hyperpigmentation. She suggested that micronized zinc or titanium-based sunscreens will provide the most effective protection.

“People of color, especially those with darker skin tones, mistakenly believe that they don’t need to use sunscreen since they generally don’t sunburn,” said Dr. Badreshia-Bansal. “The fact is that sun damage still occurs in people of color, which can be very difficult to correct. More importantly, studies show that skin cancer is even more life-threatening when it develops in this population because people with skin of color often ignore the early warning signs – thinking they are not at risk.”

In addition, skin-lightening products can help lighten discolorations, such as a thin film of kojic acid or a cream containing hydroquinone. However, Dr. Badreshia-Bansal cautioned that patients should be careful not to over-irritate the skin with these products, which can worsen discoloration and acne, particularly in skin of color.

Regardless of skin type, Dr. Badreshia-Bansal finds that a few simple skin care tips can be beneficial in improving the overall appearance and health of the skin. “I recommend keeping the skin care routine very simple, being very gentle with your skin, and avoid irritating, over-washing and over-scrubbing the face,” said Dr. Badreshia-Bansal. “Finding moisturizers that contain sunscreen in a single combination product does the job of two products and are excellent for all skin types. The key is to find the skin care routine and appropriate products that work the best for your individual skin type, which is where your dermatologist or skin care professional can help get you started.”

For more information on improving the appearance of your skin, go to the “AgingSkinNet” section of www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.

Headquartered in Schaumburg, Illinois, the American Academy of Dermatology, founded in 1938, is one of the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, visit www.aad.org.