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Lotions, Ointments, and Creams, oh my!

(Part 3 of 3)

“Is It Possible to Reverse Sun Damage? by Ali Venosa, Nov 3, 2019. Ah ha, now we’re getting somewhere since my face looks like a mottled patch of connected brown spots in desperate need of repair.

“…The number one ingredient you should look for is retinol, according to Dr. Bank.

“It’s the gold standard,” he says. “Other than women who are pregnant, pretty much anyone can use …retinol. Retinol, a derivative of vitamin A, works by encouraging cell turnover and increasing collagen production, both of which help set damaged skin cells on a healthier course. Available both over-the-counter and in prescription strengths, retinol works to combat nearly all of the signs of sun damage. It can help color, tone and texture,” says Dr. Bank. “It can even out pigmentation and help fade brown spots. It can make the skin smoother and softer, and even diminish fine lines and wrinkles.”

According to, Oct 22, 2019, “…Retinoids—the most used and most studied anti-aging compounds—

may reduce fine lines and wrinkles. It also fades actinic keratosis spots… even pigmentation….

“…They also stimulate the production of new blood vessels in the skin, which improves skin color. Additional benefits include fading age spots and softening rough patches of skin. However, it takes three to six months of regular use before improvements in wrinkles are apparent—and the best results take six to 12 months.

“Because retinoids can cause skin dryness and irritation, doctors often recommend using them only every other day at first and then gradually working up to nightly applications. Wear a sunscreen during the day, because retinoids increase the skin's sensitivity to sunlight. These drugs must be used continually to maintain their benefits.” Wrinkles don’t bother me for some reason. It’s expected, but the actinic keratosis and brown spots do. “Retinoids minimize the appearance of wrinkles, bolster skin's thickness and elasticity, slow the breakdown of collagen, and lighten brown spots caused by sun exposure.” I like the sound of this―lighten brown spots.

"…Dermatologist Patricia Farris, MD, says, "they're a favorite because there's so much science behind them.

“Retinoids first came to market in the early 1970s as an acne-fighting drug. Since then, they have also been used to treat… wrinkles and blotchiness caused by sun exposure, and aged skin.

“Retinoids work by prompting surface skin cells to turn over and die rapidly, making way for new cell growth underneath. They hamper the breakdown of collagen and thicken the deeper layer of skin where wrinkles get their start, Jacob says.

“It's not true, Farris says, that retinoids thin the skin. They typically cause peeling and redness in the first few weeks of use -- but they actually thicken the skin.

“For brown spots that give the skin an uneven tone, retinoids slough them off and curb the production of melanin, a darker pigment.” Woo-hoo!

“Retinoids for aging skin―dermatologists like to prescribe tretinoin and retinoic acid (Retin-A, Renova, Refissa) that is "100 times" as potent as the retinol-containing products sold without prescription, Jacob says. " Tretinoin works better because it has a stronger capability of preventing the breakdown of collagen," she says. "I prescribe it to my patients because, if they're here, they've already tried the over-the-counter varieties."

“Retinol, found in over-the-counter products, changes to retinoic acid when put on your skin.

“For a new patient, I might start with a retinol and build up slowly to prescription strength," Farris says. "Sometimes, retinol is a better choice for a new patient.

“Makers of the over-the-counter creams and gels don't have to say how much retinol their products contain, and in the short term, the products might not be as effective as tretinoin. But they do smooth out the skin and minimize the effects of sun damage, Farris says. Generally, it takes about 3 to 6 months of daily use to notice a difference. With prescription retinoids, a patient might notice smoother, more even-toned skin in as early as 6 to 8 weeks.

Retinaldehyde, another form of retinoid that you can get without a prescription, is highly effective in rejuvenating older skin, Jacob says.

Creams, lotions, ointments

“All three are ultimately a combination of water and oil in different ratios. Those ratios determine how moisturizing they are, how well they prevent the body’s own moisture from evaporating from the skin, and how light or heavy they feel.

“Lotions contain more water than creams. Lotion is best for people with normal to oily skin and those who live in warm, humid climates. An example is Aveeno Daily Moisturizing

“Creams are thicker than lotions because they contain more oil — typically, they are composed of about half oil and half water. They also contain heavier ingredients, such as lanolin and shea butter. Creams absorb into the skin less rapidly than lotions. Most creams come in a jar or a squeeze tube versus a pump bottle. CeraVe Moisturizing Cream is an example.

“Ointments are thicker still, and greasier. An occlusive such as mineral oil or petrolatum (petroleum jelly) is the main ingredient. Medicated products such as topical antibiotics often come in ointment form because ointments stay on the skin longer. Aquaphor Healing Ointment is an example.

“Studies show that coconut oil can boost the moisture content of dry skin. It may also improve the function of the skin, helping prevent excessive water loss and protecting you from external factors, such as infectious agents, chemicals, and allergens,”

“Daily shower is more about habit and societal norms than health. Perhaps that’s why the frequency of bathing or showering varies so much from country to country.

“Besides considering it healthier, people may choose to shower daily for a number of reasons, including:

· concerns about body odor

· help waking up

· a morning routine that may include working out.

“Each of these has merit, especially considering that personal or work relationships can be jeopardized by complaints about body odor or personal hygiene. But what is considered acceptable in this regard varies from culture to culture. And some (perhaps a lot) of what we do when it comes to cleaning habits is influenced heavily by marketing. Ever notice that directions on shampoo bottles often say "lather, rinse, repeat"? There is no compelling reason to wash your hair twice with each shower, but it does sell more shampoo if everyone follows these directions.

“When it comes to concerns about health, however, it’s not at all clear that a daily shower accomplishes much. In fact, a daily shower may even be bad for your health.

“What are the health impacts of showering (or bathing) every day?

Normal, healthy skin maintains a layer of oil and a balance of "good" bacteria and other microorganisms. Washing and scrubbing removes these, especially if the water is hot. As a result:

· Skin may become dry, irritated, or itchy.

· Dry, cracked skin may allow bacteria and allergens to breach the barrier skin…allowing skin infections and allergic reactions to occur.

Antibacterial soaps can actually kill off normal bacteria. This upsets the balance of microorganisms on the skin and encourages the emergence of hardier, less friendly organisms that are more resistant to antibiotics.

“Our immune systems need a certain amount of stimulation by normal microorganisms, dirt, and other environmental exposures in order to create protective antibodies and "immune memory." This is one reason why some pediatricians and dermatologists recommend against daily baths for kids. Frequent baths or showers throughout a lifetime may reduce the ability of the immune system to do its job.

“And there could be other reasons to lose your enthusiasm for the daily shower: the water with which we clean ourselves may contain salts, heavy metals, chlorine, fluoride, pesticides, and other chemicals. It’s possible these may cause problems, too.

“The case for showering less:

· Overcleaning your body is probably not a compelling health issue. …You could be making your skin drier than it would be with less frequent showering.

· …Daily showers do not improve your health, could cause skin problems or other health issues — and, importantly, they waste a lot of water.

· …The oils, perfumes, and other additives in shampoos, conditioners, and soaps may cause problems of their own, such as allergic reactions (not to mention their cost).”

I personally exfoliate about twice a week after which I liberally apply coconut oil. It’s not greasy and is absorbed within minutes. Later in the day, I apply a skin cream. Why do all this? Because my legs, arms and chest look and feel dry and are rough to the touch, but my face has all the brown spots. I plan to ask my dermatologist if I should consider a retinoid.

What started out as a minor annoyance a year ago with dry skin is becoming a full-blown war. I’m hoping the coconut oil and cream route will make a difference. Too early to tell.

And the journey continues…


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