Dry skin is not as simple as lack of moisture. When dry skin occurs the intracellular matrix (the substances between skin cells that keep them intact) has become depleted or damaged, creating water loss. In order to prevent dry skin, the primary goal is to reduce the damage to, as well as preserve and enhance, the intracellular matrix.

To reduce damage to the skin’s matrix, never use drying skin-care products such as soaps, harsh cleansers, or products with irritating ingredients. These problematic products can disrupt the outer layer of the skin, destroying the intracellular matrix and eventually causing flakiness and roughness.

Constant exposure to arid environments, cold weather, as well as dry, low humidity air can destroy the skin’s matrix.

Sun damage plays a major role in why skin becomes dry any time of the year. Unprotected sun exposure creates a damaged outer layer of skin where skin cells adhere poorly to each other. The result is that the surface of new skin being formed is continually unhealthy and impaired. Sun damage also disrupts and destroys the skin’s intracellular matrix. Every day of the year,the skin is subject to sun damage. Keep in mind that the sun’s damaging rays come through office and car windows. Daily sun protection is vital to the health of skin.

Improving cell turnover is another important consideration in getting rid of dry skin and improving its appearance. Dry skin does not shed as it should and those built-up layers of dead skin cells can feel rough and cause skin to look flaky and dull. A well-formulated, pH-correct exfoliant such as an alpha hydroxy acid (glycolic or lactic acid) or beta hydroxy acid (salicylic acid) can handle this problem.

Genetically, aged skin is also a cause of dryness, because as the body’s levels of estrogen drop the skin becomes thinner and the fat deposits under the skin (part of the skin’s protective barrier) also become thinner or depleted altogether. Regrettably, there is little that can be done about this other than using various types of hormone replacement therapy (HRT) and plant-based hormone replacement (phytoestrogens) that can be consumed when eating or drinking soy-based foods.

By the way, while drinking eight glasses of water a day is great for your body, it doesn’t work to improve or reduce dry skin. If all it took to get rid of dry skin was drinking more water, then no one would have dry skin and moisturizers would stop being sold. The causes of and treatments for dry skin are far more complicated than just drinking water.

Here are some options to deal with dry skin:

   1. Daylight causes skin damage, which means it slowly becomes less able to hold moisture or feel smooth.

   2. Moisturizers should be filled to the brim with antioxidants, water-binding agents, and anti-inflammatory ingredients. If you have persistent or exceptionally dry skin, the moisturizers you use should also contain various forms of lipids such as lecithin, cholesterol, glycerol, glycerides, and plant oils.

   3. Apply and reapply moisturizer. Whenever your skin starts feeling dry, put more on. It is also important to be diligent about reapplying moisturizer every time you wash your hands.

   4. Avoid soap—use only gentle, nondrying cleansers. Never use a cleanser that leaves a dry feeling on your skin. Do not overscrub skin—you can’t scour away dryness.

   5. Avoid soaking in the bath tub, or long showers. Water can be bad for skin because it breaks down the skin’s protective covering (the skin’s intracellular matrix) destroying the substances that keep skin cells intact. Keep showers or baths as short as possible.

   6. Get a humidifier, low humidity is the cause of most weather-related dry skin, whether it is winter or a desert environment.

   7. Don’t forget your lips, they are the least capable of staying smooth and soft when the air becomes dry. They lack the lipids and cell structure the rest of the face has and, as a result, are far more vulnerable to the effects of dry air. During the day apply and reapply an emollient lipstick or gloss. At night be sure to do the same.

  8. Never use products that contain drying or irritating ingredients.

Best wishes from Brazil!

Dr. Érica Monteiro

Cosmetic Dermatologista

www.dermatologia.com.br

Here in Brazil is winter and It is cold and dry, these can worsen dry skin.

These are 5 tips for dry skin:

1- Body Moisturizing

Dry skin is usually sensitive and, since winter tends to worsen the condition, it requires thorough care. Every day after showering, pat your entire body with a cream or a lotion ( cocoa butter, shea butter are some options that contain naturally occurring nourishing ingredients, such as essential oils).

2- Skin face

If your  skin face is dry clean it with an alcohol-free cleaning lotion, toner, or cosmetic milk, and avoid detergents soaps.

3- In shower

If your skin is dry and sensitive, try to cut back on the amount of time you bathe or shower. Use the mildest soap available and do not overdo it - use soap every other day only.

4. Look your diet

If your skin or scalp develop dry, irritated, itchy spots, do your best to avoid scratching. Apply shea butter or coconut oil several times a day and try to prevent water from splashing on irritated areas. Dry skin is prone to eczema and other uncomfortable skin conditions. A good preventive measure is to augment your diet with essential oils contained in raw organic butter, cod liver oil, Omega-3 eggs, coconut oil, and fresh cold-water fish.

5. Humidifier

In cold and dry winter months, consider investing in a humidifier. The additional moisture in the air will help your skin condition improve almost immediately.

Take care the skin you are in!

Best wishes from Brazil!

Dr. Érica Monteiro - Cosmetic Dermatologist

www.dermatologia.com.br

Cosmetics have been used for years to help women (and men) look and feel younger, but for those with sensitive skin using cosmetics can be an expensive challenge of trial and error.

These tips can help you find the best cosmetics for sensitive skin:

   1. Choose powder when possible.
      Powder cosmetics are not only great at removing shine, they have very few preservatives and contain minimal ingredients that can cause skin irritation.

   2. Avoid waterproof cosmetics.
      Waterproof cosmetics require a solvent to remove them that also removes sebum, the oily substance made by the sebaceous glands in the skin. Without this oily barrier, skin is exposed to potential irritants.

   3. Do not use old (expired) cosmetics.
     
   
   4. Check sunscreen ingredients.
      For women or men with sensitive skin, look for sunscreens that contain the physical sunscreen ingredients zinc oxide or titanium dioxide.

   5. Use products that contain no more than 10 ingredients. Simply stated, the fewer ingredients in a product, the less likely it is that the product will cause a problem.

   Best wishes from Brazil!

Dr. Érica Monteiro - Cosmetic Dermatologist

www.dermatologia.com.br

Dismorphophobia or Body dysmorphic disorder (BDD) is an obsessive preoccupation with a perceived defect in one’s physical appearance which the individual persistently seeks medical attention to correct surgically.

Any body part can be the focus of concern (most often, the skin, hair, and nose), and most patients engage in compulsive behaviors, such as mirror checking, excessive grooming, or excessive skin make up.

Approximately half are delusional, and a majority experience ideas or delusions of reference. Nearly all patients suffer some impairment in functioning as a result of their symptoms, some to a debilitating degree. Psychiatric hospitalization, and suicide attempts can occur. BDD often goes unrecognized and undiagnosed, due to patients’ reluctance to divulge their symptoms because of secrecy and shame.

Much remains to be learned about BDD, it is important that doctors screen patients for this disorder and accurately diagnose it. There is need for interdisciplinary interactions between the dermatologist and the psychologist. Referral to a psychiatric to clarify the diagnosis.

Best wishes from Brazil!

Dr. Érica Monteiro - Cosmetic dermatologist

www.dermatologia.com.br

Reloxin is a botulinum toxin type A (NBTX-A ) that is a potent neurotoxin derived from the bacteria Clostridium botulinum.

Botulinum toxin is one of the most poisonous naturally occurring substances in the world. Though it is highly toxic, it is used in minute doses both to treat muscle spasms, and as a cosmetic treatment for facial dynamic lines and wrinkles.

In Brazil, we have three reliable products: Botox, Dysport and Prosigne, and we have Xeomin and Neurotox pending for approval.

Dysport and Reloxin are exactly the same product but they are sold commercially under different brand names.

Botulinum neurotoxin type A is one of the most important cosmetic procedure performed today. Although  NBTX-A  treatment can be combined with other procedures, it can produce impressive results when used alone. We have been using Dysport/Reloxin for several years and we have published papers demonstrating that NBTX-A  Dysport injection is safe, satisfying and well tolerated treatment for dynamic facial wrinkles.

We have similar results using both Botox and Dysport/Reloxin.

This is a clinical trial using Dysport/Reloxin for facial lines:

http://www.cibersaude.com.br/revistas.asp?fase=r003&id_materia=3907

Now that you know more about Reloxin, you have a new option to treat facial wrinkles!

Best wishes from Brazil!

Dr. Érica Monteiro

Cosmetic Dermatologist - Brazil

www.dermatologia.com.br

Freckles or ephelids or lentigines orbrown spots that appear on skin areas that have been exposed to the sun (example: face, hands, chest). Freckles are common in lighter skin who sunburn easily.

Freckles and brown spots are among the many signs of photoaging. Photoaging occurs when chronic and excessive sun exposure accelerate the skin’s natural aging process. In addition to freckles and brown spots, photoaged skin may also show signs of mottled pigmentation, surface roughness, fine lines and wrinkles and dilated blood vessels.

Treatments for freckles and brown spots include cosmetic foundations, sunscreens, bleaching creams including alpha hydroxy acids, retinoids, hidroquinone and more. Usually we include freezing them with liquid nitrogen, and/or procede a chemical peels, and/or laserand IPL (intense pulsed light) treatments. Results from a full series of treatments usually last for a year or more with good sun protection.

If you have freckles and/or brown spots and light skin type it is better schedule an appointment with your dermatologist to check them every year cause you must prevent problems with skin cancer in the future.

Best wishes from Brazil!

Dr. Érica Monteiro - Cosmetic Dermatologist

www.dermatologia.com.br

Sometimes, not always, oily skin can benefit from the use of moisturizers. But the wrong moisturizer can cause greasy feeling, blackheads and acne. Choosing the right moisturizer is very important. Here are some tips that will help you to find the right one.

- Creams are heavier than moisturizing lotions, if you have a oily skin choose a lotion or serum.

- Choose a moisturizer labeled oil-free and noncomedogenic. Oil-free products don’t have oils that can leave a greasy feel to the skin. Noncomedogenic products are much less likely to clog the pores and cause breakouts.

- Look for SPF. Many moisturizers contain SPF, and using a sunscreen daily will protect your skin from aging and skin cancer. This is especially important if you are using acne treatments that cause photosensitivity, or increase your sensitivity to the sun.

- Some moisturizers contain exfoliating ingredients, as alpha hydroxy acids (AHA), salicylic acid (BHA), retinol or other exfoliating ingredients. These ingredients are helpful to control oily skin and in improving acne.

- If you are a sensitive skin, choose a hypo-allergenic formulation.
  
- If you have oily skin and acne, it is better consult your dermatologist and follow his/her recomendations.

- Remember you do not need to have a bad day with your oily skin!

Best wishes from Brazil!

Dr. Érica Monteiro - Cosmetic Dermatologist

www.dermatologia.com.br

Although there is no cure for eye´s dark circles, it is possible improve their appearance:

- Make-up can be used to disguise the dark color.

- Sunscreen and sunglasses: the more you are exposed to sunlight, the more natural pigmentation that is affected. This contributes to the appearance of dark circles.

- Do not scratch the under eye skin.

- Sleep well. Sleep for sufficiently long hours.

- While you are sleeping, you can use an overnight facial masque or eye cream that help reduce the appearance of puffiness and discoloration. These products can be vitamin A, retinol, vitamin C, vitamin E.

- Eat healthy foods full of vitamins and anti oxidants that protect our skin from free radicals.

- Laser treatment to treat the vessels and the dark pigment (ask your dermatologist).

Best wishes from Brazil!

Dr. Érica Monteiro - Cosmetic Dermatologist

www.dermatologia.com.br

Periorbital hyperpigmentation is the official name for this condition. It occurs when there is more melanin produced around our eyes than usual, giving them a darker colour.

Eye dark circles around the eyes has many causes, such as: 

- Heredity: dark circles under the eyes run in some families.

- Vascularization: inherited eye blood vessel condition.

- Aging

- Dehydration

- Pallor - the paleness of the skin may accentuate the dark rings.

- Sleep difficulty - you can see many causes of sleep difficulty symptoms, e.g. stress, depression, sleep disorders, etc.

- Allergies (atipic dermatites, eczema,…)

Next post: dark circles treatment.

Best wishes from Brazil!

Dr. Érica Monteiro - Cosmetic Dermatologist

www.dermatologia.com.br

Here are common Foot Problems:

Fungal and Bacterial: fungal and bacterial conditions, including athlete’s foot, occur because our feet spend a lot of time in shoes - a warm, dark, humid place that is perfect for fungus to grow. Fungal and bacterial conditions can cause redness, blisters, itching, scale, pain. To prevent these infections, keep your feet clean and dry - mainly between your toes.

Callosity: they are caused by friction and pressure when the bony parts of your feet rub against your shoes. Wearing shoes that fit better can solve the problem.

Warts: warts are skin growths caused by viruses. They are sometimes painful and can spread. If you have warts see your doctor. These are some treatments performed by dermatologist to treat warts: topical medicines (acids), freeze the wart off (criotherapy), lasertherapy, and surgery in some cases.

Ingrown toenail: it occurs when a piece of the nail breaks the skin and can happen if you don’t cut your nails properly. A dermatologist can remove the part of the nail that is cutting into the skin. Ingrown toenails can often be avoided by cutting the toenail straight across and level with the top of the toe.

Osteophytes or spurs: It is calcium growths that develop on bones of your feet. They are caused by muscle strain in the feet. Things that can make it worse include: standing for long periods of time, wearing badly fitting shoes, being overweight. Sometimes spurs can be very painful. Treatments for spurs include using foot supports or heel pads. Surgery can be performed in some cases.

Best wishes from Brazil and happy New Year!
Dr. Érica Monteiro - Cosmetic Dermatologist
www.dermatologia.com.br