Chances are, you have a complaint or two about your skin – whether it’s age spots on your cheeks or varicose veins on your calves. But you don’t have to grimace and bear it. Here’s expert advice on how to handle these and other top skin conditions…
All women want to put their best skin forward, but it’s hard when you’re coping with acne, varicose veins, age spots, moles and more.
Yet having healthy, naturally glowing skin from head to toe isn’t out of reach.
We asked top dermatologists about the 10 most common skin problems women face.
Find out what causes them and the best ways that you and your dermatologist can fix these trouble spots.
How it happens: You thought you left breakouts behind when you graduated high school, but now acne is popping up all over.
It’s a common problem, affecting about 20% of people, says New York City dermatologist Howard Sobel, MD.
Adult acne on your face, back and other embarrassing places is brought on by several factors:
- Bacteria called P.acnes, which cause redness and inflammation
- Sticky skin cells that clog up pores
- Excessive oil production
- Too much of the hormone androgen in your body
- Compression from pressing the phone against your chin, for example, or wearing tight clothes (often the culprit behind tush acne)
Skin solution: Banish blemishes with a multi-step approach, says Leslie Baumann, a Miami Beach dermatologist and author of The Skin Type Solution (Bantam):
1. In the morning, use a facial wash with salicylic acid to unclog pores, followed by benzoyl peroxide topical (over-the-counter solutions are 2.5%-10%) to fight bacteria. If you have moderate to severe or resistant acne, use a prescription topical (or, in some cases, oral) antibiotic.
2. At night, use the same salicylic acid face wash or a gentle cleanser if the twice-daily dose is too drying. Follow that with a pea-size amount of a prescription retinoid, such as Differin or Tazorac, applied over the affected area to exfoliate dead skin cells and prevent clogged pores.
For mild to moderate acne, a new step-saving option is available: Epiduo Gel, which combines two prescription medications (benzoyl peroxide and adapalene, the generic version of Differin), needs to be applied only once a day.
Oral contraceptives and prescription anti-androgen medications, such as spironolactone (Aldactone), can help control hormone-fueled acne, says dermatologist Ava Shamban, owner of the Laser Institute For Dermatology and European Skin Care in Los Angeles.
What about body acne or “bacne?” It’s caused by the same bacteria as facial acne, “but can be aggravated by sweat during exercise,” Sobel says.
To prevent acne in hard-to-reach places, use a body wash with benzoyl peroxide or salicylic acid daily, along with a back brush or loofah to exfoliate dead skin cells, he advises.
2. Age or liver spots
How they happen: Those annoying flat brown blotches have nothing to do with your age or liver. They’re really sun spots caused by ultraviolet damage.
“Melanocytes – the cells that produce melanin, which gives skin its color – get damaged over time and produce more and uneven [pigment],” Sobel says.
The result? Spots that crop up on sun-exposed parts of your body.
Skin solution: Try a one-two punch: one product to lighten the skin and another to exfoliate (which helps the ingredients sink in).
Hydroquinone, such as prescription Tri-Luma, is a topical bleaching cream that inhibits melanin production, so age spots fade.
“But skin can get used to hydroquinone, so I have my patients take a holiday,” Baumann says. Her patients start on a series of one to two tubes of Tri-Luma and then switch to Retin-A. Retinoids like Retin-A act as an exfoliant by speeding cell turnover.
Other good skin-sloughing options include chemical peels and microdermabrasion, which uses tiny rough grains to buff the skin.
For stubborn, dark age spots, try intense pulsed light (IPL) laser treatments to lighten them. You’ll need 3-4 sessions with an experienced dermatologist.
After treatments, use sunscreen religiously; it’s the best way to prevent age spots in the first place.
How they happen:Can you still see the scars from a childhood bike accident that gouged your knees? Here’s why: Scars are the result of damage to the skin’s collagen and elastin, Sobel says. The trauma can be caused by surgery, injury, even severe acne.
Skin solution: If the scars are old, you’ll have to just live with them. But you can diminish them when they’re new – less than a year old, Baumann says.
Scars that are thin, flat, white and tissue paper-like can sometimes be treated with a Fraxel laser, which pokes small holes in the skin.
“When it heals, the skin pulls together and is tighter,” Baumann explains.
Steroid injections can soften and improve the appearance of new, thin keloid scars, which are raised, bumpy and flesh-colored; older ones may have to be surgically removed.
Red scars can be treated with a vascular laser, which targets blood vessels, to tone down the color.
And the pockmarks left by a bad bout of acne? Try Fraxel lasers and injectible fillers, such as Restylane, which stimulate collagen production to help fill in depressed areas. In some cases, they can be surgically removed by a plastic surgeon.
How they happen: Birthmarks are an overgrowth of pigment cells, although some fade and disappear over time. Most are harmless and don’t require treatment, although you may wish to remove them.
But if your birthmark is dark brown, it’ll need to be evaluated by a dermatologist, Baumann says. Those can turn into melanoma, a dangerous and potentially deadly form of skin cancer.
Skin solution: A variety of lasers can target and remove the pigment. For example, a vascular laser, such as the V-Beam, can get rid of purplish port-wine stains, she says.
A plastic surgeon can remove dark, brown birthmarks by shaving them off with a blade or cutting them off surgically using a local anesthesia. There’s a risk of scarring when birthmarks are excised.
Want a less drastic approach? Try camouflaging cream, such as Dermablend Corrective Cosmetics, which has waterproof formulations.
5.Spider and varicose veins
How they happen:Veins have valves that prevent blood from flowing backward. When the valves weaken, they allow blood to flow backward and pool, causing the bulges.
Varicose veins are often blue, appear twisted and stick out from the skin’s surface. Spider veins are often red or blue, small and look like branches right under the skin. Both tend to crop up in the legs; spider veins sometimes appear on the face.
They’re caused by heredity, sun damage, hormonal changes (such as during pregnancy) or adult rosacea [see below], Sobel says.
Skin solution: A pulse dye laser can zap away facial spider veins, which are dilated blood vessels. The treatment requires about three visits to a dermatologist’s office, spaced a month apart. It will cause redness for a few days.
Sclerotherapy is the gold standard for treating varicose veins. After assessing the vein through an ultrasound, a physician injects an agent, such as glycerin, into the varicose vein.
“This causes the vein to immediately shrink and dissolve over a period of weeks,” Sobel says. A series of three injections are needed. You’ll also have to wear support stockings for a week after each treatment.
Any way to prevent varicose veins in the first place?
“Regular exercise, such as walking or running, improves leg strength and circulation,” Sobel says.
Also, keep off the extra pounds, don’t cross your legs while sitting and don’t stand in one place for long periods.
6. White spots
How they happen: Blame the sun here, too, for those uncolored spots that crop up on your legs, arms and hands.
“White spots are a sign of sun damage that has killed the cells that produce color [melanocytes],” Baumann explains.
White spots may also signal a more serious skin disorder called vitiligo, which is marked by white patches that slowly grow larger. With vitiligo, experts believe the body produces antibodies that attack and kill pigment cells, causing the gradual sapping of color.
Skin solution:See your dermatologist immediately for a skin assessment to determine if you have vitiligo.
There’s no cure for the disorder, but treatments can restore some of the pigmentation. Topical or oral psoralen, for example, reacts with UV light to darken the skin, Sobel explains.
Another option: Protopic, an anti-inflammatory ointment that suppresses the immune response, preventing antibodies from attacking pigment cells. It needs to applied twice daily.
While you can’t make white spots disappear, you can conceal their appearance with a camouflaging cream (such as by Dermablend Corrective Cosmetics) to even out your skin tone.
7. Stretch marks
How they happen: Rapid weight gain – for example, during pregnancy – or weight loss stretches the skin to the point of breaking, just like a rubber band that loses its elasticity. The result? Pinkish, reddish or purplish grooves that appear on breasts, hips, stomach and rear.
Skin solution: “Stretch marks are best treated when they’re fresh and still red,” Shamban says.
Moisturizing makes the skin more pliable and helps reduce the appearance of stretch marks. Prescription retinoid cream, such as Retin-A, is effective too.
“Retin-A helps speed up cell turnover and [stimulates] collagen to help repair the damage,” Baumann says.
A more expensive option: Fraxel laser treatments, which create small dots of damage along the affected area, stimulating collagen and elastin production to help fill in stretch marks.
How it happens: The cause of this annoying skin condition isn’t known, but it can show itself in several ways: facial flushing (including redness on the cheeks and nose), acne-like bumps, small, dilated blood vessels near the skin’s surface, and swollen bumps along the nose and eyes.
“There’s no cure for rosacea, but you can get it under control and prevent it from getting worse,” Baumann says.
Skin solutions: Use cleansers and moisturizers with anti-inflammatory properties (such as Aveeno Ultra Calming Daily Moisturizer and Eucerin Redness Relief Daily Perfecting Lotion) to help quell redness.
And here’s an excuse to drink coffee: Caffeine helps to close dilated blood vessels that bring on flushing.
Also steer clear of rosacea triggers: Avoid the sun (and always apply sun block), hot and cold temperatures, spicy foods and alcoholic drinks.
For moderate to severe cases of rosacea, try daily topical treatments, such as microbe-fighting Finacia and Metrogel, or oral antibiotics to reduce inflammation and pimple-like bumps, Sobel says.
IPL laser treatments can zap visible blood vessels and facial redness in one to five sessions, depending on the condition’s severity, Baumann says.
9. Ingrown hairs
How they happen: The culprit is shaving and waxing. Shaving cuts hairs to a sharp point. When it starts to grow in, the hair shaft pierces the skin surrounding the follicle, Baumann explains. In other cases, it curls and grows back into the skin rather than breaking through it.
As with acne, bacteria can infect it, causing soreness, redness and pus.
Skin solutions:Put down the tweezers.
“You don’t want to go digging around – you can get scars,” Baumann says. Instead, slough off the top layer of skin to free trapped hair. Here’s how:
- First, wet a washcloth in hot water, wring it out and apply the warm compress to the ingrown hair. This softens the skin so the hair can work its way through it.
- If that doesn’t work, gently exfoliate the area with a soft loofah while showering or apply a chemical exfoliator, such as alpha hydroxy acid or salicylic acid, twice a day, Shamban suggests.
- If the area is inflamed and has pus, dab on benzoyl peroxide to kill the bacteria, just as you would with a pimple.
In the future, nix the razor and get laser hair removal treatments, such as with the Alexandrite laser, which removes unwanted hair in about two to three sessions and is less likely to cause ingrown hairs.
However, not everyone is a candidate for laser hair removal, so consult with a qualified doctor before you do it.
How they happen: Moles occur when skin grows in a cluster, rather than spreading out. They tend to be more common in people with light skin. Although most moles aren’t dangerous, some can develop into melanoma, a deadly form of skin cancer.
Alert your dermatologist if a mole is asymmetrical (half of the mole is unlike the other half); has an uneven or scalloped border; is two-tone (such as tan and black); is larger than the size of a pencil eraser; or has changed in size, shape or color.
Skin solution:Not all moles are precursors to skin cancer and may not need to be removed.
Get yearly mole checks by a dermatologist (twice a year if you have a personal or family history of skin cancer).
“But if you notice any mole that suddenly grows, changes color or bleeds, make an appointment right away,” Baumann says. “Those changes could indicate melanoma.”
If skin cancer is suspected, a dermatologist may shave off or cut out the mole (using a local anesthetic) to get a tissue sample. A biopsy helps determine if it’s cancerous or harmless.