WebMD Ask the Dermatologist

Dry Skin and Skin Tone Help: Ask the Dermatologist

Dermatologist Nicole Rogers, MD, answers your questions about skin tone issues and relieving dry skin.

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 a 46-year-old woman. What kind of face cream would you recommend I use to keep my healthy-looking?

Answer:

Topical retinoids are some of the best products to use for the prevention of ultraviolet damage and aging. They can be applied at bedtime and can be extremely effective with continued use.

 

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.

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:

How can I remove -- or at least minimize -- the dark circles around my eyes?

Answer:

Dark circles are often due to the presence of a vascular plexus located just under the eyes. The skin there is very translucent. So it can result in the appearance of a bluish tint under the eyes. Most patients respond to topical retinoids (vitamin A derivative cream), which can help thicken the stratum corneum and minimize the translucency of the skin under your eyes. Because the skin there is so thin, it is wise to start treatment with a gentle retinoid, such as an over-the-counter retinol first.

Question:

Can topical silicone in makeup and primers have a negative effect on my skin? Could it clog my pores?

Answer:

Silicone-containing products are excellent at providing a light, smooth emollient to repair dry, flaky skin. They have also been found to improve the appearance of scars. It is an inert ingredient with a very good safety profile. It should not clog pores because its large molecules actually allow for the passage of gaseous molecules, making it very breathable.

Question:

I have dark patches on my face. How can I even out my skin tone? I've already tried numerous fade creams.

Answer:

If you've already tried fading creams, your next step would be to speak with a dermatologist about various laser technologies to help clear these up. The choice of laser treatment will depend on the nature and type of hyperpigmentation you have, as well as your overall skin tone.

Question:

I am a 45-year-old woman. For the past year I've had a rash and a dark ring that goes around my neck. I put lotion on the area to stop the itch. But the dark ring will not go away. What could be the cause of this and how can I clear it up?

Answer:

First, speak with your primary doctor to be sure you do not have an insulin-resistant condition such as diabetes mellitus. Some women develop a thickening and darkening of the skin around the neck or under the arms called acanthosis nigricans. It can be improved with topical creams, peels, and washes. But it cannot be fully resolved until blood glucose levels are brought under control.

Question:

How can I moisturize the areas around my eyes when it's cold, and the skin feels and looks more wrinkled and dry?

Answer:

Many people complain of a general "crepiness" that develops around the eyes, especially in dry weather. First, you may benefit from injections of botulinum toxin, which is one of the best ways to eliminate creases around the eyes. Also, you might consider adding a moisturizing product to your skin care routine, such as those that contain silicone, dimethicone, or cyclomethicones.

Question:

I have spots on my face that look like pimples. But they're very hard to the touch and they don't go away. I have been told that these are the result of plugged oil glands. Does this sound right to you? What can I do to get rid of them?

Answer:

These are probably milia, which are hard white collections of keratin that form right below the skin's surface. They can be prevented by applying topical retinoids to the skin. But the best treatment is usually to have your dermatologist remove them.

Question:

I develop scratch marks on my skin very easily and they can take a long time to heal. I don't even realize I've been scratched until I see the welt mark. Could this indicate something more serious?

Answer:

Skin can become very fragile with increasing age. It sounds as though you may be suffering from Bateman’s purpura, which is a type of bruising that can occur easily on the hands and arms after even the slightest bit of trauma. See your dermatologist for the best treatment recommendations and try to avoid further scratches to your skin.

Question:

Can using shea butter help to lighten acne scars on your face?

Answer:

No. Shea butter is an excellent moisturizer, but it will not help lighten dark marks on the skin.

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 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 over exposure to UV light.

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 can I do to get rid of the dry, flakey skin around my mouth and chin area?

Answer:

First, you should probably see your local board certified dermatologist to understand exactly why your skin is reacting this way. It may be as simple as dry skin due to the winter months. But it may also be something more complex, such as a contact dermatitis to certain mouthwashes, chewing gums, or toothpastes. Visit your dermatologist so he/she can see your skin and determine the best treatment.

Question:

I'm allergic to products with any SPF in them. What can I use to protect my skin from the sun?

Answer:

It is probably not that you are allergic to "any SPF", but rather that you are allergic to the chemical ingredients used in certain sunscreens. You should choose a sunscreen with a "physical blocker" such as zinc oxide or titanium dioxide before you throw in the towel altogether on using sunscreen.

Question:

How often should I exfoliate my face? Is once a day OK?

Answer:

Daily exfoliation is not a requirement for healthy skin. However, gently sloughing off the top layers of the skin with a beaded wash or loofa sponge can help make the skin glow and help prevent breakouts. Depending on how vigorously you scrub, I recommend that you not exfoliate any more than once daily to avoid any skin irritation.

Question:

What kinds of skin care products are best for dry skin that is also sensitive? I have brown spots on my face and would like advice on how to get rid of them also -- with treatments for sensitive skin, of course.

Answer:

If you have very sensitive skin, you may not be able to tolerate the traditional methods for treating dark spots. Talk to your dermatologist about various laser technologies, such as the intense pulsed light (IPL) or the newer fractionated laser treatments.

Question:

My skin is dry in some places and oily in others. It is also sensitive. I heard about argan oil as a treatment to help even skin tone and help with acne. What do you think? Could it really help my sensitive, combination, acne-prone skin?

Answer:

Argan oil is extracted from the kernels of the argan tree which is endemic to Morocco. This oil has been used for many centuries for both cosmetic and culinary products. It is high in oleic and linoleic fatty acids, which lend shine to the hair or skin when applied to these surfaces. It also contains tocopheral (vitamin E) which provides antioxidant effects to the skin. Despite these qualities, there are no specific studies investigating the use or effectiveness of argan oil for acne-prone skin.

Thank you for joining us for WebMD Ask the Dermatologist. Be sure to come back on March 8 at 1 p.m. ET, when we will discuss African American skin. Sign up if you'd like an email reminder the day before our next event.