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Best of Ask the Dermatologist

WebMD revisits your top Ask the Dermatologist questions about skin, hair, and nail care.

Question:
What kind of foods should I include in my diet to prevent wrinkles?
Answer:

It's helpful to ingest foods that are high in antioxidants. These foods can help absorb the free radicals created in your body by UV light exposure, which can break down collagen and create fine lines and wrinkles. Foods high in antioxidants include dark berries such as blueberries, cranberries, blackberries, and raspberries. Beans are also high in antioxidants, including red beans, kidney beans, and pinto beans. Also, drinks that may be helpful include green tea, red wine, and coffee, all in moderation of course.

Question:
I am a black woman with a medium brown complexion. I have small dark bumps on my upper arms, on the back of my thighs, and on my upper back. They look like a combination of freckles and acne scars. But I don't have freckles or an acne problem, and I never have. What could this be and how can I get rid of it? Other women in my family have the same condition.
Answer:

It is likely that these are seborrheic keratoses, which are benign growths that can develop over the trunk and extremities. They can certainly run in families and may be removed if they are cosmetically bothersome. See your local dermatologist for further treatment options.

Question:
Does dermabrasion work as well as microdermabrasion? What’s the difference?
Answer:

Dermabrasion is a surgical treatment, and is a much more invasive treatment than microdermabrasion. It involves the use of a wire brush, an ablative laser, or sandpaper to remove several layers of the skin. It may result in pinpoint bleeding and can require one or more weeks to heal completely. It has been used for acne scarring and deep wrinkles. 

Microdermabrasion is much less invasive and can be performed by non-medical personnel, such as an aesthetician. Afterward, there could be slight erythema (pinkness) to the cheeks, but minimal downtime otherwise.

Question:
What foods and nutrients are essential for maintaining healthy skin?
Answer:

Most people who have a well-rounded diet will be able to maintain healthy skin. However, to really brighten the skin, I recommend ingesting plenty of beans, berries, and citrus foods, which are high in vitamin C and other antioxidants. Lycopene is a powerful antioxidant that can combat damaging free radicals in the skin. It can be found in raw tomatoes, watermelon, pink grapefruit, and papaya, among others.

Question:
What kinds of the OTC products are best for getting rid of liver spots?
Answer:

Brown spots on the hands and face have been called liver spots. But there is no connection whatsoever between these spots and the liver. These brown areas of pigmentation are actually due to sun exposure and skin aging. Hydroquinone is a bleaching molecule that can help lighten the spots. However, it is only available in only 2% strength over the counter. If this kind of product does not work for you, see your physician to obtain a prescription for a 4% hydroquinone treatment, which may work faster and more effectively. Lastly, laser treatments may ultimately be the best way to resolve these brown spots.

Question:
What are the best kinds of moisturizers for dry, itchy skin?
Answer:

Ceramides are natural skin components which, when lost, can lead to dry, itchy skin or eczema. Look for products containing ceramides to help repair your skin barrier.

Question:
I have large, visible pores on my face, especially my chin. How can I reduce them?
Answer:

One of the best treatments for large pores is topical retinoic acid, or tretinoin. Tretinoin can be obtained either by prescription from your dermatologist or over the counter as various derivatives, such as retinol or retinyl aldehydes.

Question:
What is the relationship between what's in your diet and whether or not you develop acne?
Answer:

High-glycemic index diets -- containing lots of simple, refined sugars -- appear to contribute more to acne breakouts than low-glycemic index diets. Consuming complex carbohydrates such as whole wheat or multigrain breads and pastas should not worsen your acne and may even help to improve it.

Question:
Can doing facial exercises help relieve wrinkles?
Answer:

The short answer to this is no. In fact, the reason we use Botox (botulinum toxin) in the field of dermatology is to reduce the movement of facial muscles so that their overuse will not create fine or deep creases in places like the glabella (between the eyebrows) or across the forehead.

Question:
How can I get rid of dark acne scars?
Answer:

A combination of glycolic or salicylic acid chemical peels, topical hydroquinone (a bleaching cream), and topical tretinoin can help lighten dark scars.

Question:
I am 21 years old and I have stretch marks on my knees (front and back), my hips, and my bottom. I've always been lean. So it makes no sense to me that they're there. How can I get rid of them? Do laser treatments work for removing stretch marks?
Answer:

You might try using a topical retinoid (retinol, retinoic acid, or retinyl palmitate) to help repair your stretch marks. However, even topical retinoids -- which can help repair skin cells -- may not be enough to erase your stretch marks. If there is redness in the stretch marks, the redness may be lightened by pulsed-dye laser therapy or other vascular laser treatments. At present, there is no miracle treatment for the removal of stretch marks. So beware of products that claim to erase them.

Question:
What products or treatments should I try to get rid of hair bumps and the skin discoloration I have from shaving?
Answer:

Look for products containing retinol, which helps unclog pores and increase the turnover rate of cells to prevent hairs from ingrowing. You might also try skin-lightening agents such as azelaic acid, kojic acid, hydroquinone, and glycolic acid.

Question:
I have very oily skin, especially on my forehead and nose. What is the best kind of over-the-counter product I could use to get rid of some of this oil on my face? I'm a man, so makeup isn't an option.
Answer:

First, try a topical retinol cream or gel. These products will shrink and tighten pores and reduce oil secretion. 

There are also mattifying gel products on the market that contain micro-particles that can trap and absorb excess oils from your skin for over an eight-hour period. These products are well-liked by most of my patients with oilier skin.

Question:
What can I use for skin toning or skin tightening that can be purchased over the counter?
Answer:

Topical retinoids and peptides have been shown to dramatically improve signs of skin aging, such as enlarged pores. You may also benefit from using topical antioxidants such as vitamin C and E creams. These can applied in the morning and will work all day to help repair the damaging effects of free radicals that are created by overexposure to UV light.

Question:
I'm 45 and I have severe acne. I've used numerous products to minimize it. But nothing has worked. What can I do?
Answer:

Your next step may be to consider an oral medication called isotretinoin. This remains one of dermatologists’ most powerful tools in treating acne. It will completely remodel your skin cells, and you may have dry skin and lips during the course of the six-month treatment. See your dermatologist for more advice and treatment recommendations.

Question:
What are the best kinds of OTC products for under-eye crow's feet and occasional puffiness?
Answer:

Eye creams with caffeine in them can help reduce under-eye puffiness. Topical retinoids (vitamin A derivatives) can also be helpful. Be careful when using retinoids around the eye because they can cause irritation. Botox is an excellent choice for crow’s feet because it will help prevent the formation of these lines.

Question:
What OTC products are available for getting rid of dark under-eye circles? I have a medium skin tone.
Answer:

You may try a variety of skin lightening and brightening agents, such as products containing kojic acid, azelaic acid, or topical retinoids. Start with gentle formulations of each first.

Question:
Dermatosis papulosa nigra runs in my family, and I want to have my moles removed. What kind of questions should I ask to determine whether or not my local dermatologist is qualified to treat this condition?
Answer:

This is an easy condition to treat. Most dermatologists use a hyfrecator instrument to gently cauterize the lesions from your skin at very low heat. Removing them with a blade or liquid nitrogen can increase the risk of leaving you with light or white spots on your skin.

Question:
I am 42 years old and I have fine wrinkles on my forehead. Is there any way to lessen or remove these wrinkles?
Answer:

Yes. Botox is probably your best choice because it will cause these muscles to relax. Repeated motion is what causes these fine lines to form. So if you are never moving them the lines will never form.

Question:
What do you think about the effectiveness of laser treatment for wrinkle removal?
Answer:

Fractionated lasers work best for addressing fine lines and wrinkles in the skin. They are very effective!

Question:
How can I prevent brown spots from showing up on my skin?
Answer:

To prevent brown spots from showing up on your skin, the best thing you can do is avoid prolonged, unprotected sun exposure. Use an SPF foundation or moisturizer of at least 30 or above on a regular basis. Apply it before you go out in the sun, rather than waiting until you are already outside.

Thank you for joining us for WebMD Ask the Dermatologist.

WebMD Ask the Specialist Transcript

Reviewed by Nicole Rogers, MD on May 10, 2012

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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