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Beauty Tips for Your 20s: Ask the Dermatologist

Susan Evans, MD, answers questions about skin care routines, sleep, smoking, good nutrition, and more.

Question:
I am 26 years old. I have a lot of whiteheads and blackheads. They keep coming back. I am an Asian and I have uneven, brown skin. I want an even skin tone. My skin becomes oily 1 or 2 hours after washing. Certain places on my skin are rough and patchy. Can you suggest something for me?
Answer:

Your first step is to evaluate your current skin care regimen. Harsh soaps, detergents, or products with high alcohol content will irritate the skin, which may lead to further oil production. You should use gentle cleansers and exfoliate weekly with compounds that contain salicylic acid and are non-comedogenic.

Along with your exfoliating regimen, your physician can recommend skin-brightening compounds that will work in conjunction with salicylic acid, which will even out your skin tone.

Question:
I've noticed dark purple blotches under my inner eyes. Is there a way to clear this up? I do not smoke, I get 7 to 8 hours of sleep every night, I drink about 64 ounces of water a day, exercise, and am a healthy eater.
Answer:

A purple color under your eyes may be attributed to the tiny blood vessels within your lower eyelid. The skin in this area is quite thin and stretched over the bony prominence, which will make these blood vessels more noticeable.

Question:
My 23-year-old stepdaughter just moved to Las Vegas, Nevada with us from Oahu, Hawaii. She has the most beautiful skin I've ever seen. She is Hawaiian, Filipino, and Japanese. Since she's been here, her skin has started breaking out and she doesn’t know how to treat it. She works out at the gym every day. She’s a vegetarian so she eats very well. I think it may be the climate change. How can she stop the breakouts?
Answer:

A variety of conditions may lead to changes in your skin. Acne breakouts can occur secondary to stress or hormonal changes. Very hot weather can stimulate oil gland production and clogged pores, which may lead new breakouts.

Make sure your stepdaughter is using the correct moisturizer. I always recommend moisturizers that are non-comedogenic or non-pore-clogging.

Question:
How do I remove blackheads from the tip of my nose?
Answer:

Several major skin care companies manufacture a "blackhead extractor." Blackhead extractors are small stainless steel devices that are specifically designed to gently remove unwanted comedones (blackheads). They are readily available for under 10 dollars.

Along with removing your blackheads, adopt a skin care regimen that will exfoliate your skin. Exfoliation will help minimize the recurrence of blackheads.

Question:
I had my belly button pierced years ago and then I took out the ring. After a couple of years, I had the belly button pierced again. Now the piercing I had previously has opened up, creating an opening for the muscle -- or whatever -- to ooze out. What should I do?
Answer:

One of the unfortunate consequences of multiple piercings is the potential for wound infection. The blood supply adjacent to the area of the piercing(s) may be compromised. This will also delay healing. If you suspect an infection, you should have this area evaluated by your physician.

Question:
I'm 24 and I'm concerned about laugh lines and forehead wrinkles that are already apparent on my face. What can I do to slow down the progression?
Answer:

Sun damage and smoking are the number one reasons for premature aging or wrinkling of the skin. Therefore, you should incorporate the use sunblock in your daily skin care regimen.

Next, utilize a daily skin regimen that exfoliates your skin, which will help remove dead skin cells. This should be followed by a non-comedogenic moisturizer that contains vitamins (C & E) and rebuilds peptides for your skin.

Question:
What are some good things to do to have a glowing, pinkish skin? How can I prevent having dry, dull skin?
Answer:

The key to having healthy, glowing skin is to utilize sunblock followed by a skin care regimen that includes exfoliation, hydration, and nutrition. Within your diet, include vitamins that are good for your skin such as folic acid, magnesium, and omega-3 fatty acids. If you moisturize and hydrate, your skin and body you will be much less likely to develop dry skin.

Question:
I am 20 years old and there is a white spot birthmark on my face. How can I get rid of it?
Answer:

Birthmarks can be difficult to conceal. Your first step is to exclude any underlying medical causes that may lead to superficial skin changes, such as any type of infection. Once medical causes are excluded, your options may include laser treatment, medical tattooing, or a medical grade concealer.

Question:
I am allergic to the sun. Is there anything I can do besides staying out of it? Also, my skin is very dry and I have tried everything under to moisturize. Do you have any advice for me?
Answer:

Sun allergy, or photosensitivity, should incorporate the following precautions:

  • Before you go outdoors, apply a sunscreen that has a sun protection factor (SPF) of at least 30, with a broad spectrum of protection against both ultraviolet A and ultraviolet B rays.
  • Use a sunblock on your lips. Choose a product that has been formulated especially for the lips, with an SPF of 20 or more.
  • Limit your time outdoors when the sun is at its peak. In most parts of the United States, the sun is at its peak from about 10 a.m. to 2 p.m.
  • Wear sunglasses with ultraviolet light protection.
  • Wear long pants, a shirt with long sleeves, and a hat with a wide brim.
  • Be aware of skin care products and medicines that may trigger a photo allergenic eruption. These include certain antibiotics and oral birth control pills, as well as prescription medicines that are used to treat psychiatric illness, high blood pressure, or heart failure. If you are taking a prescription medication, and you normally spend a great deal of time outdoors, ask your doctor whether you should take any special precautions to avoid sun exposure while you are on the drug.
Question:
I have a red spot on my leg about the size of a quarter near my ankle. It does not hurt but I can feel that it is hard underneath. What could this be?
Answer:

Your dermatologist should evaluate skin changes or abnormal spots. A lesion that feels hard may be scar tissue. However, you should be evaluated for any underlying skin cancer.

When evaluating your skin, look for changes in the area, border, or color of the skin. These are the "ABCs" of skin cancer detection.

Question:
I'm 20 years old and I have pimples on my cheeks filled with fluid.
Answer:

Acne on your face that is filled with fluid may be cystic acne. Cystic acne represents its own unique challenges to treat.

Treatment may include topical cleansing, antibiotics, and -- in more severe forms -- surgical drainage may be required. Your first step is to have an evaluation by your dermatologists.

Question:
Is it true that blackheads cause holes in your face? How do you get rid of these holes?
Answer:

Blackheads do not necessarily cause "holes" in your face. Blackheads are a result of clogged pores that are exposed to air that become oxidized and turn black. A good skin regimen that promotes exfoliation and contains tretinoin will promote skin turnover and new healthy skin growth.

Question:
I have been having a problem with my hair falling out. I'm a vegetarian but I try to make sure I eat enough protein by eating fish, peanut butter, and avocadoes, as well as plenty of veggies. What can I do to help slow down or stop my hair shedding, especially around my face?
Answer:

Your first step is to exclude any underlying medical conditions that may affect your hair growth, such as hormonal or endocrine diseases. Next, make sure your diet includes biotin, folate, magnesium, and essential fatty acids (omega-3s). These components are essential for healthy skin and hair growth.

Question:
I want to have a clear upper lip and underarms. Which hair removal treatment is the best? What is the success rate of laser treatment and electrolysis?
Answer:

There is no one hair removal system that works for everyone. Every hair removal system has certain advantages and disadvantages for each skin type.

Your best course of action is to find a physician that is familiar with your skin type and skin color as it relates to hair removal. Laser hair removal can be a very effective method to remove hair in experienced hands. Electrolysis has several disadvantages, including painful treatments and the potential for scarring and hyperpigmentation.

Question:
I am 24-year-old nonsmoker and non-drinker. I have to work under the sun. I have wrinkles under my eyes and crow’s feet, which look worse when I smile and laugh. What can I do about this?
Answer:

Sun damage is the number one cause for premature aging of the skin. If you have to work outdoors, try to avoid the sun between the peak hours 11 a.m. and 2 p.m. UVA and UVB penetration are strongest during the early afternoon. Use a sunblock with an SPF of at least 40. And wear a wide brim hat while outdoors, drink plenty of fluid to keep your skin and body well-hydrated.

Question:
What can I do about facial hair on my chin? I am a 29 year-old female.
Answer:

Laser hair removal is an excellent choice to remove unwanted hair for all skin types. When choosing your laser specialists make sure that your physician is familiar with your skin type and skin color. Make sure that your laser treatments are physician supervised. While undergoing laser treatment, you should not concurrently undergo waxing or electrolysis. This may lead to damage of your skin.

Question:
Please tell me how I can use duct tape to get rid of warts. I have one on my forearm and would love to have it gone.
Answer:

Duct tape supposedly starves the wart of oxygen and blood supply and, in theory, the wart will go away. I have not used duct tape in my practice to treat warts. Currently we utilize topical medications and laser removal.

Question:
What is the best way to condition my skin before a cosmetic procedure?
Answer:

Skin preparation is a very important part of many cosmetic procedures. Especially in darker skinned patients who may run the risk for post inflammatory hyperpigmentation (darkening of the skin). Your physician may prescribe a combination of topical exfoliating agents along with skin brighteners in order to prepare your skin prior to your cosmetic procedure.

Question:
My daughter is 26 and has been diagnosed with amyloidosis of the skin. No one seems to know how to treat this. What can we do?
Answer:

Amyloidosis may take several forms. In most cases, amyloidosis is a systemic disease, meaning that it affects the entire body. Treatment for this form will require a specialized regimen depending on the organ affected. Amyloidosis develops when amyloid protein inexplicably builds up in the organs or tissue, including the heart, liver, kidneys, spleen, gastrointestinal tract, and nervous system. Cutaneous lichen amyloidosis, confined to the skin, can be treated with a variety of approaches, including cryotherapy, intralesional steroid injections, surgical excision, or phototherapy (PUVA). Unfortunately there is no specific treatment for systemic or cutaneus manifestations of amyloidosis. Therefore, therapy is usually directed at the target organ to provide symptomatic relief.

Question:
Is there something over-the-counter to fade an unwanted tattoo?
Answer:

Several of the popular over-the-counter agents, including skin bleaching agents and topical acids (salicylic), have been used to fade tattoos. Unfortunately, many of these products require continuous use for 6 months, and they work by removing the outer layer of the skin. Very colorful and deeper tattoos may be more difficult to completely fade using this approach.

Question:
I am 21 years old and still having breakouts. About 8 months ago, I stopped using birth control pills. My skin is very sensitive and it seems to me that everything that I use causes my skin to break out. I try to eat well, limiting my sugar intake and drinking lots of water. Is there anything else I can do to heal these breakouts and prevent new ones, as well as the acne scars?
Answer:

Your first approach is to exclude any underlying medical issues, such as hormonal or gastrointestinal issues that may be affecting your overall health. Your next step is to visit your dermatologist or an allergist that is familiar with skin patch testing. During skin patch testing, your doctor assesses the skin as it is exposed to various potential allergens and monitors your skin's response.

Question:
Is there anything I can do about puffy bags under my eyes?
Answer:

Your first approach is to ensure that you are receiving an adequate amount of rest. Apply cool compress around your eyes in the morning with green tea bags. Avoid excess alcohol consumption and very salty foods. You also need to weed out any underlying medical issues such as sinusitis, allergies, or a reaction to contact lens.

Question:
I'm 22 years old. In the past few months I have started breaking out all over my face, all the time. I have never had breakouts that were this bad. Should I start seeing a dermatologist?
Answer:

Yes. You should have an initial evaluation with a dermatologist. Once evaluated, your physician can guide you towards the best skin regimen for your skin type. During your consultation, your physician should also be able to assess if there are any underlying medical conditions that may have attributed to your new breakouts.

Question:
I have a mole on my lower lip on the right side. Is it removable? It's flat just like the skin around it, not bumpy or raised. I am just curious about how it can be removed.
Answer:

Lower lip moles can be removed surgically. Make sure that your dermatologist or plastic surgeon is comfortable with removing your mole and is able to preserve your natural lip aesthetic landmarks. Careful attention to these landmarks will allow your final scar to heal without being very noticeable.

Question:
I'm 28 years old and my skin has changed dramatically over the past year. My pores have gotten really big and I've noticed a lot of wrinkles around my forehead and eyes. What can I use without having to use Botox?
Answer:

Your first step is to avoid the sun. Sun damage and smoking are the primary causes of premature aging. You should include sunblock in your daily skin regimen. Next, incorporate a skin care product in your regimen that will exfoliate (such as salicylic acid or papaya enzymes), hydrate (hyaluronic acid), nourish (vitamins and peptides ), and rebuild collagen (retinol).

Question:
Is it possible to have scabies that don't itch?
Answer:

Yes. Newly infected areas may not itch. As the number of female mites multiply and lay eggs there are local secretions from the mites along with a local histamine release that leads to itching.

Question:
My warts are almost the size of my nails. Everyone who sees them asks what's wrong with my hand. Is there any way to get them off without using the freezing, burning, or surgical methods?
Answer:

There are several topical solutions to help remove warts. Many of these compounds contain salicylic acid, which penetrates the warts and allows them to peel off. If salicylic acid doesn't help remove your wart, your doctor may recommend treatment with cantharidin, a prescription-strength topical medication. Cantharidin causes the wart to blister within three or so hours after application. The blister lifts the wart off your skin, allowing your doctor to remove the dead part of your wart.

Question:
I am a 16-year-old boy and I have dark circles under my eyes. I have tried a natural eye cream, but it didn't work. Is there a natural way to get rid of the dark circles?
Answer:

At age 16 I would avoid many of the harsh chemicals that are available. It may be wise to have an evaluation by your doctor to determine if there are any underlying medical issues. Next, implement simple measures, such as getting at least 8 -10 hours of sleep every night. Don’t leave the weekends to "catch-up" on your rest. Apply cool a compress with green tea bags around your eyes. This will help with puffiness.

Question:
I am 28 years old and have very sensitive skin. I would like to know if I'm too young to start using age-defying products.
Answer:

Your antiaging skin care regimen should start in your 20s. Begin with a sunblock, followed by a gentle exfoliater and tretinoin-based creams to help rebuild collagen. This combination will work towards maintaining a rejuvenated appearance.

Question:
I have oily skin. What kind of cream can I use to prevent excess oil?
Answer:

You should use moisturizers that are non-comedogenic (non-pore-clogging). For individuals with oily skin, the use of products that clog pores may lead to increased oil production. Oily skin needs special cleansing with plenty of warm water and soap to prevent the pores from being clogged. Avoid harsh products that strip your skin of oil and encourage flakiness. They can cause a reaction known as reactive seborrhea, where the oil glands work overtime to compensate for the loss of natural oils. Avoid skin care products that leave your skin feeling taut and dehydrated. They cause the upper layers of the skin to shrink. This restricts oil flow through the pores, leading to blockages and breakouts.

Thank you for joining us for WebMD Ask the Dermatologist. Be sure to come back on March. 16 at 1 p.m. ET when we will discuss makeup safety. Sign up if you'd like an email reminder the day before our next event.

WebMD Ask the Specialist Transcript

Reviewed by Susan Evans, MD on February 17, 2011

The opinions expressed in this section are of the Specialist and the Specialist alone. They do not reflect the opinions of WebMD and they have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance or objectivity. WebMD is not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your doctor or other qualified health provider because of something you have read on WebMD. 

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