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Looking Good in Your 30s: Ask the Dermatologist

Dermatologist Susan Evans, MD, answers questions about beauty shortcuts for busy women, sleeping in makeup, waxing, new ingredients, and healthy routines.

Question:
I have had redness on my upper cheeks since I was 27. The doctors and specialists I visited prescribed cortisone cream on a long-term basis, but it had no effect. It flares up in the sun, and if I sunbathe I start to see signs of it around my knees and on my arms. It does not itch, it is just very unsightly. I am a smoker. I have visited numerous skin specialists and I have not seen any improvement in my skin in over three years. What should I do?
Answer:

First and foremost, I am extremely concerned about the fact that you are smoker. The combination of sun exposure and smoking can really accelerate the damage to your skin. You may be suffering from photosensitivity as well as pre-cancerous skin lesions. I strongly urge you to visit a dermatologist and have your skin lesions biopsied.

Question:
I am unable to wear a wristwatch with a metal or leather strap because I get rashes on my wrist. Also, clothing brand labels and tags inside my clothes cause skin irritation. What do you suggest?
Answer:

You may suffer from a nickel allergy. Most metals (even gold) contain small amounts of nickel. Consider applying a small amount of clear nail polish on the metal that is adjacent to your skin. For the brand labels, consider removing them or changing your detergent to a fragrance free, hypoallergenic solution.

Question:
How do I deal with broken capillaries around my nose and on my chin? I also have oily skin -- which I know helps prevent premature aging -- but it makes my pores look open and large! Is it possible to reduce the size of my pores?
Answer:

You may be suffering from rosacea. Your dermatologist will be able to make the final determination. Topical antibiotics and tretinoin containing compounds will help control oil production and increase cell turnover.

Question:
I have had a chronic earlobe problem for the last six years. My earlobes develop hard, crusty patches of skin and scabs and are sore at times. I have tried an antibiotic ointment called Bactroban and been to several dermatologists and doctors. I try to moisturize them and it bothers me that I can’t get rid of it. Any advice?
Answer:

You may be suffering from a secondary fungal infection. This can usually be treated with topical antifungal cream, along with a topical hydrocortisone for the inflammatory component.

Question:
I am 37 years old and I'm having trouble deciding which products will be the most beneficial for my skin. I have a fair complexion, but it's dull and oily. My skin is sensitive and I have trouble with black spots and acne. Please help me choose a product that will work for me.
Answer:

Follow a skin regimen that includes exfoliation (AHA, salicylic acid, and papaya enzymes). Hydrate your skin with natural oils that are non-comedogenic (non-pore-clogging), such as almond oil or avocado oil. Rejuvenate your skin with natural skin peptides, collagen builders, and tretinoin.

Question:
What are the most important things you should do to have healthy skin in your early 30s?
Answer:

The two most important actions are to avoid direct sunlight (use a sunblock) and steer clear of smoking. Next, follow a skin regimen that includes exfoliation (AHA, salycilic acid, and papaya enzymes). Hydrate with natural oils that are non comedogenic (non-pore-clogging), such as almond oil or avocado oil. Rejuvenate your skin with natural skin peptides, collagen builders, and tretinoin.

Question:
I’m a 32 year-old Asian woman. During my teenage years I had normal skin. But now I’m suffering from dry, sensitive, acne-prone skin, along with fine lines. My skin also looks very dull with no glow. What can I do to improve my skin?
Answer:

Your first step is to exclude any underlying medical problems such as endocrine, or hormonal, or collagen vascular issues that may lead to a change in the condition of your skin.

Next, your goal is to continue rehydrating your skin, especially after showers. Avoid very hot shower and use rehydrating natural oils that contain hyaluronic acid. Continue to use compounds that contain tretinoin. Topical tretinoin assists with cell turnover and collagen building.

Question:
I have plaque psoriasis that appears on my scalp, face, neck, and around my pants line. What can I use to keep it under control?
Answer:

Plaque psoriasis needs to be addressed primarily by your physician. Plaque psoriasis can be treated with topical and systemic medications. There are also other treatments for plaque psoriasis without the possible side effects of systemic medications.

Question:
I am 38, and I recently gave up eating gluten for other health reasons. But I've noticed that my complexion has significantly improved. Is there a correlation?
Answer:

Yes. For some people there is a strong correlation between the presence/absence of gluten in their diet and the occurrence of rashes.

Question:
I have had a vitiligo patch now for 10 years. Please help me.
Answer:

Vitiligo can be treated with a variety of approaches including topical steroids, UV light therapy, photochemotherapy (for persons with greater than 20% of their body surface affected), or fading the rest of the skin to match the areas that are already lighter.

A few surgical options include skin grafting, medical tattooing, and autologous melanocyte transplant, which is a procedure still in the experimental phase. Finally, simple noninvasive therapies include the use of cosmetics, self-tanning lotions, and sunscreens.

Question:
At age 30, what should I look for in an antiaging facial cream?
Answer:

The No. 1 cause of premature aging is sun exposure. So your first step is to implement a facial care regimen that includes sunblock. Next, use compounds that will exfoliate (AHA, salicylic acid), hydrate (hyaluronic acid), and rejuvenate (tretinoin, peptides) your skin.

Question:
I have darker skin on certain areas of my body, including my rear end and in my armpits. Are lemons good natural skin faders? What are the pros and cons of using lemons to lighten the darker areas of my skin, including the perianal area? If lemons are not a suitable solution, what else can I use?
Answer:

The acidic component in lemons does contain some natural lightening properties. In general, it is safe to use. Avoid using lemons on any area that has recently been waxed or shaved. Lemons may cause irritation in the perianal regions.

Unfortunately, trying to lighten your skin with lemons will take a long time. Consider using hydroquinine, kojic acid, alpha-hydroxy acids, or bearberry as more effective lightening agents.

Question:
I have a problem with my complexion. Many of the women in my family have facial hair on their chins, jaw line, and even neck. I tried shaving, and now I have dark marks on my neck and jaw line. The bumps have diminished but I can't find anything that will help with these dark ugly marks. Can you help?
Answer:

You may want to consider having the hair removed with a laser by a trained professional. Between treatments consider using hydroquinone, kojic acid, alpha-hydroxy acids, or bearberry to help lighten the dark spots.

Question:
I am a 35-year-old female. Within the last 6 to 9 months my face has become extremely oily. I feel like I have tried everything. I wash my face at least twice a day. I use makeup specifically for oily skin types. I use an astringent and I moisturize. After I wash my face, it's like an oil pool again within 30 minutes. What can I do or use to make this go away? It makes me feel so gross. I always have a shine on my face.
Answer:

Overwashing or the use of astringents that are too harsh will further increase oil production. Make sure that your astringents are non-drying and paraben- and alcohol-free. Also, your moisturizer should be non-comedogenic (non-pore-clogging). Use moisturizers that are derived from natural oils such as almond or avocado oils.

Question:
I have lost 74 pounds from exercising. Now I have wrinkled, saggy skin. What is the best natural product I can use to help increase collagen and elastin production?
Answer:

Congratulations on your weight loss! Tretinoin contains compounds that have been shown to increase cell turnover and collagen formation. Unfortunately, with severe weight loss there can be a loss of elasticity in your skin. Therefore, you may want to discuss these "problematic" areas with your dermatologist or a plastic surgeon.

Question:
I’m 34 and I need to get rid of some bad wrinkles around my eyes. My eyes look shaggy and red all the time. Help! I want to look younger again!
Answer:

Most women want to look younger. At age 34 you are young, and too young for wrinkles of the type you describe. The red, shaggy description suggests there may be other skin concerns that you should consider.

You owe yourself a trip to the dermatologist. Let them evaluate you and make sure you have not developed an allergic reaction, an infection, atopic dermatitis, or any other kind of skin condition. After you address any underlying skin issues, you'll probably look healthier and younger. Use sunscreen and a moisturizer that contains vitamins C, E, and A. Also, be sure to exfoliate in order to maintain a more youthful appearance.

Question:
I've tried all sorts of eye creams to reduce the bags under my eyes. Are there any laser treatments or other nonsurgical remedies to remove these bags under the eyes?
Answer:

Eye bags are a problem for many people. The easiest nonsurgical option is to make sure you are fully treating any allergies you have. Proper use of antihistamines, vasoconstrictors, and light compression on the eyes at night can make a big improvement, also. Lasers are sometimes used to decrease wrinkles, but this would not really decrease the bags.

Some dermatologist and plastic surgeons are skilled at using fillers to fill in the groove that outlines your eye bags. This is a great nonsurgical answer for many men and women. Make sure the doctor is skilled and understands your skin type.

Question:
I was told by a doctor that the age spots on my hands are caused by hormones. I always thought it was from sun exposure. Was he correct? What product can I use to lessen the appearance of these spots? Usually on the labels for products I've tried, the makers recommend stopping usage after a certain period of time -- and then the spots come back.
Answer:

There are several pigmented skin problems caused by hormones. Age spots are very common. And you're correct, they are caused by sun exposure. There are several agents that lighten them, including licorice extract, niacin, hydroquinone, and others. It's very important during and after the use of a brightening agent to apply sunblock, or the spots will return.

Question:
I have a stressful job that keeps me on the move. I rarely have time to take a seat. Despite the stress, how can I make sure I look radiant and young in my late 30s?
Answer:

Looking young and radiant in your 30s is simple if you use sunscreen daily and moisturize your skin with vitamin A, C, and E. Remember to lightly exfoliate daily with an alpha-hydroxy acid, and to perform a weekly scrub. Try to minimize your stress and the facial expressions associated with stress, like wrinkling between your eyebrows. At home, put a piece of scotch tape there, and monitor how much you frown. If it's often, begin training yourself not to.

Question:
How does birth control help or hinder acne and hyperpigmentation? How long do I have to wait for it to work?
Answer:

Certain kinds of birth control pills are known to improve hormonal acne, and thereby hyperpigmented acne scars. It takes approximately 3 months for you to see the difference. Other hyperpigmented skin problems -- such as melasma or butterfly mask -- may get worse on birth control pills. Consult your gynecologist and dermatologist.

Question:
I’m 30 years old. I continually have breakouts and my face is oily. What is the best cleanser, toner, or moisturizer to use on my face?
Answer:

Generally speaking, there are several acne lines on the market that will work. But you may want to use an oil-free moisturizer. At 30, there may be a hormonal issue behind your breakouts. They may also be makeup related. See a dermatologist to help you make the best over-the-counter choices.

Question:
I have little tumors around my eyes. I was told by a dermatologist that they were because of cholesterol. I was told by an ophthalmologist that they could be removed, but that they would come back and be hanging. I am confused!
Answer:

There are deposits around the eyes that can be associated with high cholesterol. If that is indeed the case, it's most important to address your cholesterol. Heart disease is serious. After you correct your cholesterol, you can have the lesions removed without them returning.

Question:
Other than using bleaching creams, what can I do about dark patches on my cheeks?
Answer:

Sunblock is an effective first step for controlling dark patches. Certain lasers will reduce pigmentation. However, for darker skin patients, lasers should be only be used by professionals that are familiar with your skin type. Inadvertent use may result in increased pigmentation.

Question:
What are good treatments for rosacea at age 36?
Answer:

Your first step is to avoid direct sun exposure, alcohol, or any other lifestyle factors that may irritate your skin and trigger rosacea outbreaks. There is no cure for rosacea, but with treatment you may be able to control the symptoms. Antibiotic pills and topical creams may treat symptoms. Topical tretinoin compounds and lasers may be used to control refractory rosacea.

Question:
I am a woman in my late 30s. I have undergone laser hair removal treatments for my chin. However, after several treatments the hair continues to grow back. I also have a dark patch because of plucking over time. This dark area is a problem for me. Are there options to lighten the skin as well as remove the hair?
Answer:

Laser hair removal will need to be repeated because your hair grows in different cycles. Dark hair on darker skin types is particularly difficult to treat because the laser works by “distinguishing” the pigment in your hair follicle from the pigment in your skin. Your dark patches can be treated with topical skin lightening agents such as hydroquinone, kojic acid, or bearberry derivatives.

Question:
I have tried many skin products to get rid of the brown patches on my cheeks (pregnancy mask) and nothing has worked. Please help.
Answer:

The mask of pregnancy, or melasma, can be very difficult to treat. Melasma is treated with a combination of chemical peels and topical skin lightening agents along with sun-blocking compounds. Unfortunately, you may need to visit your dermatologist to receive prescription-strength compounds if your melasma is not responding to over-the-counter treatments.

Question:
I have a mole under my arm that was flat and raisin-like. Recently, it turned into a little red ball. Should I be concerned? FYI, I’m pregnant.
Answer:

Skin tags are benign (noncancerous) overgrowths of skin -- typically in skin folds -- that are fairly common with pregnant women. However, you should have your dermatologist evaluate your skin to eliminate any growths that may not be benign.

Question:
I am 32 and my lips have become severely chapped. It’s not the infrequent, normal kind of chapping. It’s lasts for weeks and looks like a lot of dry, dead skin on my lips. I have applied vitamin E, but it doesn’t seem to be working. Can you give me any advice?
Answer:

Non-healing areas of sun-exposed skin -- such as the lips, ears, and nose -- should be evaluated by your dermatologist to exclude any precancerous growths. Once you have excluded any precancerous causes, consider applying topical hydrocortisone to reduce the inflammatory process.

Thank you for joining us for WebMD Ask the Dermatologist. Be sure to come back on Feb. 16 at 1 p.m. ET when we will discuss beauty secrets for your 20s: skin care routines, getting enough sleep, smoking, good nutrition, and more. 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 January 20, 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. 

WebMD does not endorse any specific product, service or treatment. If you think you have a medical emergency, call your doctor or dial 911 immediately.