Dr. Rosenberger’s Top Tips and Picks

One of the perks of being a dermatologist is that I get to try every cream, lotion and potion that comes on the market and call it “work”.  Over the years, I have found some products that I really like.  Below is a run down of my favorites as well as some basic skin care tips.

SOAPS and WASHES

For Dry Skin I recommend using only a very mild soap such as Cetaphil Gentle Cleanser or Cetaphil Gentle Cleansing Bar especially for severely dry skin and areas of active rash.  For oily skin areas, I recommend Neutrogena Oil Free Acne Wash, Cetaphil wash for Normal to Oily Skin, Cetaphil Antibacterial Bar or OBAGI Foaming Gel.  Everyone should use a deodorant antibacterial soap, such as Cetaphil Antibacterial Bar, Lever 2000 antibacterial, Dial Antibacterial White Bar, once a week to the entire body and every day to the private areas (underarms, genitalia).  This helps prevent overgrowth of bacteria on the skin. 

 MOISTURIZERS

First, any open, cracked or raw areas should be coated three or four times a day with Aquaphor or Vaseline.  Avoid the use of antibiotic ointment unless the area appears infected.  Many have or will develop an allergy to the antibiotic ointment which complicates matters further.  A mild moisturizer such as Cetaphil cream after bathing works well if there are no open sore areas.   Overall, I recommend using creams that you scoop out of a jar as opposed to lotions that are pumped out of a bottle.  Lotions have been combined with more water and alcohol to allow them to easily come out of a bottle.  Cetaphil cream, the one in the big tub, not the pump, is the best moisturizer I have found for the price.  It is non-comodogenic and can be used on both the body and the face.  Apply the moisturizer immediately after patting dry from the bath/shower to lock in the moisture.  For excess dry flaky skin, avoid scrubs and other abrasive cleaners. A moisturizing chemical exfoliant and gentle massage with the fingertips in the shower work best and are least harmful. Products containing glycolic acid, lactic acid, and urea (all naturally found in our bodies), when applied topically can be great chemical exfoliants. Over the counter lotions containing these chemical exfoliants are AM Lactin and Carmol cream.  

SUNSCREEN AND SUN PROTECTION
SPF measures the length of time a product protects against skin reddening from UVB, compared to how long the skin takes to redden without protection. If it takes 20 minutes without protection to begin reddening, using an SPF 15 sunscreen theoretically prevents reddening 15 times longer - about 5 hours. (Actually, it may take up to 24 hours after sun exposure for redness to become visible.) To maintain the SPF, reapply sunscreen every two hours and right after swimming.
The Skin Cancer Foundation recommends SPFs of at least 15, which block 93 percent of UVB. While SPFs higher than 30 block only 4 percent more UVB, they are advisable for sun-sensitive individuals, skin cancer patients, and people at high risk of developing skin cancer. They also allow some margin for error if too little sunscreen is applied. Considering that the SPF is developed using a whole ounce to the entire body, most everyone does not apply enough sunscreen.
While SPF is the universal measurement of UVB protection, no comparable standard exists for UVA. Scientists worldwide are working to develop a standardized testing and certification method to measure UVA protection.
Broad-spectrum protection: The phrase indicates that a product shields against UVA as well as UVB. It does not guarantee protection against all UVA wavelengths, however. Most broad-spectrum sunscreens and sunblocks with an SPF of 30 or higher do a good job against UVB and short UVA rays; if they also contain avobenzone, zinc oxide, or titanium dioxide, they should be effective against the entire UVA spectrum.
Even with the ideal sunscreen, some UV rays can get through to your skin and cause damage. The Skin Cancer Foundation considers sunscreen one part of a comprehensive sun protection program, along with sun-protective clothing, sunglasses, shade, and sun avoidance from 10 A.M. to 4 P.M.

UVA (Ultraviolet -A) Long-wave solar rays of 320-400 nanometers (Billionths of a meter). Although less likely than UVB to cause sunburn, UVA penetrates the skin more deeply, and is considered the chief culprit behind wrinkling, leathering, and other aspects of "photoaging." The latest studies show that UVA not only exacerbates UVB's carcinogenic effects, but may directly induce some skin cancers, including melanomas.

For sunscreens, I recommend an SPF>30.  Make sure the bottle says that it protects against UVA and UVB, preferably 100% of UVA and UVB.  Remember that sunscreens generally wear off or the chemical breaks down in 2 hours.  So sunscreen needs to be reapplied throughout the day.  I particularly like sunscreens containing zinc oxide and titanium dioxide.  Zinc and titanium are physical barriers that work much better than the chemical sunscreens.  My favorite sunscreens include Coppertone Spectra3 and Neutrogena Sensitive Skin Sunblock for the body and Oil of Olay Daily Defense, OBAGI Healthy Skin Protection and OBAGI C SunGuard for the face.  A wide brimmed hat and protective clothing are also great.  I recommend the Coolibar website (www.coolibar.com) for protective clothing.  Look for the Skin Cancer Foundation Seal of Approval on Sun Protection Products (www.skincancer.org). For men especially, there are a number of new spray sunscreens that are very nice and work well to protect the scalp and ears.  My husband and I like Coppertone and Coppertone Sport Continuous Spray Sunscreen SPF 30.  New for 2006 is stabilized avobenzone.  Avobenzone is a good chemical UVA blocker; however, the chemical broke down extremely quickly.  The new form has longer lasting protection. This is being marketed most heavily by Neutrogena, who combines the stabilized Avobenzone with some chemical UVB blockers and calls it Helioplex.  This is a nice combination for those who do not like the mild opaque color of the physical blockers. Protect the eye area further by wearing sunglasses that block 100% of UVA and UVB.