Almost every patient that I saw last week had dry skin; chapped hands, scaly arms and legs and some folks even had early signs of dry skin eczema (itchy red scaly patches).

When the weather turns cold and you turn on your indoor heater, it’s time to start a good practice of hydrating skin care!

There are 2 steps to hydrating skin care:

1. Cleansing your skin without stripping all its natural oils
2. Moisturizing immediately after cleansing with an effective product

These 2 steps are simple, the tricky part is knowing how to actually pick the right products and how to use them effectively.

Dry Skin Care Step 1

The first step to treating dry skin is cleansing without drying.  We love clean and with a few cleansing ‘tweaks’ you can have really clean AND really moist skin.

Dry Skin Cleansing 101:  The big point here is mild cleansers, sparingly applied and totally rinsed off with warm water!

Harsh foamy soaps strip your skins protective natural oils. Hot water makes this worse in the same way it’s better for washing greasy dishes.  As your skin loses its oils it becomes even more sensitive to drying out from contact with harsh soaps, more vulnerable to chapping from the weather and more likely to be irritated by harsh chemicals that you can normally tolerate like house cleaners.  The end result is itchy, dry, chapped skin.

Use only mild cleansers for your winter skin care such as;

1. The many lovely glycerin soaps and  soaps made from natural oils such as olive oil.  These are available at specialty boutiques or natural food stores.  My personal favorites are Avalon Organic Botanicals Glycerin Hand Soap, Noble Zinc Bar (a medicated olive oil based soap with retained natural glycerin that can be used on the face and body), and Whole Foods’ 365 Vegetable Glycerin Bar Soap (a deal at about $2 a bar).
2. Soap-less cleansers that clean without the irritating foaming ingredient sodium laurel sulfate.  Toleraine Cleanser is an excellent example of a non-foaming ‘soap-less’ cleanser. Sodium laurel sulfate is the foaming agent in cleansers and has other names including sodium laureth sulfate, ammonium laurel sulfate.  Adding oil to a harsh foaming cleanser doesn’t compensate for its irritating effects  so don’t be fooled by fancy claims.  If your skin feels dry and tight after bathing then your cleanser is too harsh for you!

In addition, all soaps and cleansers need to be rinsed completely off the skin using warm water.  Avoid really hot water.  Remember, hot water strips oils more that cooler temperatures.

Also, only apply soap to areas of your skin that need to be cleaned. These include the areas with body odor glands and a lot of oil glands.  We all know where these are:  the armpits, groin, buttocks and feet have body odor glands, oil production is greatest on the face, ears, upper chest and back.

Remember mild cleansers, applied where needed and rinsed well with warm water!

Dry Skin Care Step 2

Exposure to harsh winter weather and dry air means using a skin moisturizer is a must!

Dry Skin Moisturizing 101: Even if you’re perfect at follow my cleansing recommendations in Part 1, you’re going to need moisturizers.  The big news here is timing and product quality.  Moisturizers work by holding water inside the layers of your skin right after you bathe.  The water evaporates fast meaning that for effective hydration, you have to apply moisturizers within 3 minutes after toweling off following bathing/washing your skin! Simple… but key.

Product quality is more complicated.  The most effective moisturizers add oil, bind water and strengthen the skin barrier.

1. Oil ingredients include petrolatum and mineral oil.  You can also find products with natural and food based oils including shea butter, jojoba oil and sesame seed oil to name a few.
2. Water binding ingredients include glycerin (as in Glycolix Facial Creams and Intensive Hand Cream), lanolin or wool alcohol (Bag Balm and  Eucerin products), hyaluronic acid (Replenix CF Cream) and the alpha hydroxy acids (AHA’s) which are lactic acid (Amlactin Cream) and glycolic acid (Glycolyx Elite Facial Cream 15% and  Glytone products)
3. Barrier strengthening ingredients work by tightening the outermost cell layer of the skin called the stratum cornium.  They make the skin smooth and polished.  My favorite barrier enhancing ingredients are the alpha hydroxy acids (AHA’s). My elbows and knees are a great example of the power of AHA’s, they are velvety soft after years of using Glytone Body Lotion. For the face, I like Glycolix Elite Facial Cream 15% (normal skin) and Glytone Facial Cream #2 (dry skin).  You need to know that AHA’s can be irritating to chapped skin.  For chapped skin, moisturize for a month or two first with a gentle non-AHA moisturizer (such as Glycolix Facial Creams, Nivea Cream or Dr. Hauschka’s Rose Body Moisturizer or Rose Day Cream) before you start using an AHA product.

I recommend that in the winter you use a heavy moisturizing product with a high oil content (except on areas of your skin that are acne prone).  Apply a thin layer of your moisturizer immediately after you’ve bathed/washed your skin and toweled dry. The best way to apply moisturizer is to put a small amount in one palm, briskly rub your palms together to warm and spread the moisturizer over the palm surface, pat the product over the general area to be covered, then rub it in well.  Apply only what you can rub into the skin.  There’s no need to feel greasy or sticky after moisturizing.

My favorite winter hydrating skin care moisturizer regimines:

1. For your hands: Wash with a glycerin soap and use Intensive Hand Cream after as many of your daily hand washings as possible.   If your hands chap anyway, give them a hydrating drink with a heavy lanolin containing ointment like Bag Balm at bedtime and cover them with cotton gloves overnight.
2. For your body: Use my Antiaging Body Kit 2 or 3 times a week.  For the other 4 or 5 days of the week wash with a glycerin soap and moisturize with a pure oil like jojoba oil or a heavy cream like Nivea or some other wonderful rich and creamy product that you’ve found.
3. For your face: Wash with Noble Zinc or Toleraine Cleanser then use the Replenix CF Cream twice a day.  In the morning follow the Replenix CF Cream with Glycolix Facial Cream (use the Elite if your acne prone and the Fortified if you’re not acne prone) then Citrix sunscreen.  At night follow the Replenix with either your Glycolix Facial Cream, or your antiaging skin care treatment products (glycolic acid or Tretinoin).

If you found this post helpful, you may also want to read:

Chapped Lips: The Remedy Depends on the Cause

Dermatologist’s 3 Simple Steps for Sandal Ready Feet by Spring

Dermatologist’s Simple Tips for Athlete’s Foot Fungus Treatment

Brilliant Skin Care For The New Decade

Pandemic Of Dry Hands: Hand Sanitizers, The Swine Flu And Tips To Save Your Hands

Dermatologist’s Tips For Dry Flaky Skin on Your Face and Scalp-Tis the Season for Seborrheic Dermatitis

Making Sense Of The Vitamin D Dilemma And Sun Exposure

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This year more than ever, quality, value and relevance will guide our gift giving choices. Because everyone uses skin care products they make great gifts. The trick is picking good products out of the millions of hyped options. The same applies to skin care services, like facials.

Let me be your adviser for this search. I’ve already picked the OTB Skincare products because they’re made from the highest quality ingredients and live up to their claims. Plus, my office’s aesthetician services are also extraordinary. My aestheticians, Danielle and Sara, and I have built uniquely effective skin care services that combine spa pampering with medical office effectiveness.

Here’s my ideas for great, ‘sure fire’ skin care gifts:

Great Skin Care Product Gifts

1. Sunscreens: Protect the skin of the people you love. Everyone needs sunscreen all year long. Do your friends and family a favor and get them the best, most effective product they’ll ever use (with 5% micro sized zinc oxide).  All my sunscreens are safe for acne prone skin.

1. Solbar Zinc ($13) Waterproof protection for outdoorsy types and swimmers
2. Citrix ($22) Everyday facial protection that’s cosmetically elegant.
3. Ultimate Sun Kit ($47.50) Everything but the hat for ‘turn-key’ sun protection.

2. Facial Cleansers: Everyone needs soap and we have the best facial cleansing products made.

1. Noble Zinc Bar ($10) My favorite facial soap/cleanser for people 30 years or older. This gentle, silky, nondrying bar soap helps fix most of what ails our skin as we age. This makes a great stocking stuffer
2. Glytone Mild Gel Wash Cleanser ($28): A great cleanser for anti aging skin care, uneven pigmentation or acne
3. Toleriane Cleanser ($18): A super mild and creamy cleanser. You’ll never find anything milder for people who struggle with sensitive skin.
4. Buf Puf Facial Sponge ($5): Use it with any cleanser for a polished, luminous complexion. Give it alone or add it to your facial cleanser gift. A great stocking stuffer!

3. Facial Moisturizers: You can’t go wrong giving a facial moisturizer.  Every body needs to switch moisturizers every now and then because the skin gets used to a product and needs a change. Plus, trying different moisturizer products is the best way to find the perfect fit for a person’s skin. OTB’s moisturizers have the right ingredients and great prices. These moisturizers compare to high end products at a fraction of the price.

1. Glycolix Elite Facial Cream ($15): The perfect moisturizer for normal to oily skin and people who are acne prone. This pretty little jar is a great stocking stuffer!
2. Glycolix Fortefied Facial Cream ($18): My favorite moisturizer for people with dry skin who need a little oil to hydrate
3. Sumbody Facial Cream: (available only in my office, not online) A luxurious botanical, natural facial moisturizer with organic oils to hydrate dry skin.

5. Antiaging Skin Care For The Body: Give velvety soft skin for the holidays. OTB’s Anti Aging Body Skin Care Kit ($61) has everything a person needs for moist, soft skin. If you love it, turn someone you love on to it! (Glycolic acid can irritate sensitive skin so it’s not for everybody)

6. Stocking Stuffer Ideas:

1. The Detecto Ring ($2.50): It’s just plain fun to see the little beads color up when everyone thinks they’re safe from the UV rays.
2. Salux Cloth ($5): Way better than a luffa sponge for body exfoliation
3. Ceralip ($13): The best little lip balm I’ve ever found.
4. Intensive Hand Cream ($12): Save your loved ones hands from winter chapping and hand sanitizer irratation! Super effective without being greasy. (Print out my blog post on hand care and give it with the Intensive Hand Cream)

Professional Skin Care Services

Giving a facial is always a yummy and appreciated gift and my office aesthetician services are unique. My two wonderful aestheticians and I have created aesthetician treatments that are medically therapeutic AND spa pampering and you just can’t get that anywhere else. We provide my strict level of medical office cleanliness, a beautiful spa treatment room, medical level treatments and top notch aesthetician. Both of my aestheticians come from high end spa settings and do beautiful treatments. Give a gift certificate for one of their facials. We’ll wrap it in a pretty package ready to give.

Remember too, that before the year ends, you want to deplete your FLEX plan with medical expenses and some of your skin care products may qualify. Products that you use for the treatment of an active medical condition, such as acne products or sunscreens may qualify. Ask your plan administrator, tax specialists or doctor.

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My husband picking small green olives

What started as a practicle tree choice for a landscaping project has turned into a great source of extra virgin olive oil for my family.  Saturday, we harvested 280 lbs of olives from these lovely 10 year old trees and took the olives to the community press day at our local olive press.  Our olives are being pressed with olives from other small growers in Sonoma County and we’ll get delicious, antioxidant rich high quality extra virgin olive oil in 2 weeks.

The climate where we live in Coastal Northern California is similar to Province France or Tuscany Italy so olives do well here.  I choose olive trees because they’re attractive, draught tolerant and the right size and shape for shading the outdoor dining table in my herb garden.  The added bonus is the olives.  Our trees produce large meaty olives that make wonderful oil and cured olives.

To harvest olives for oil you have to wait until 80% have turned from green to black, which for us is between Thanksgiving and mid December.  One year, we harvested the day after Thanksgiving with a house full of my daughter’s college aged Thanksgiving guests.  It was a sight to see lovely young adults brimming with youthful vitality up in the trees and on ladders picking olive.

This year the harvest was up to my husband and I.  We have to get the olives to the press within 24 hours of harvest.  It’s a joy to rake the fruit off the branches, hearing it fall on the tarps like rain on a roof.  The fruit is absolutely beautiful; glossy plump olives ranging in color from  of olive green to black.  I love to see bins full of olives going up the conveyor belt to the press.  In 2 weeks we return to the press and pick up our oil.  I expect to have 8 gallons or more!

Olives going up into the press

We let our new oil mature for several months before we use it.  This allows the flavors to mellow. (‘Green’ oil is really peppery)  When ready to use, our oil’s flavor is extraordinary!  I’m a believer in concept of ‘terroir’ , the idea that the flavors of a  food (or wine) reflect the soil and growing conditions specific to where the food originated.  Pairing foods grown in similar locations creates harmonious flavors.  I think my olive oil pairs well with the produce form my vegetable garden and I love using them together.

We use almost no butter in my kitchen because of this bounty of olive oil.  I drizzle it on most salads, mix it with roasted bell peppers to top crostini,  drizzle more on goat cheese as an appetizer, then  drizzle more on soup to add an Italian flavor etc etc….

Extra virgin olive oil is a rich source of polyphenol antioxidants.  My lovely garden with it dappled shade has turned out to be a natural dietary super-food source.  I could prevent the trees from fruiting, but instead, we enjoy the wonderful oil that comes from our landscape trees.

If you liked this blog post, you may also want to read:

A Simple and Nutritious Fish and Veggie Dinner

Cynthia Bailey MD’s Recommendations for The Alkaline Mediterranean Diet

The Alkaline Mediterranean Diet-A Dietary Magic Wand for Overall Health and Beauty

Natural Skin Health: Dermatologist’s Diet Recommendations for Healthy Skin

Dermatologist’s Recommendations for Natural Skin Health: Kefir the best probiotic for healthy skin

Now is the best time of the entire year to fix your uneven pigmentation and lighten your age spots, and the most effective home treatment is the Obagi Nu Derm System.

Before Obagi Nu Derm

After Obagi Nu Derm

I love the Obagi Nu Derm results.  I’ve started using it again for the fall and my skin just glows! No other combination of home skin care products can match the ‘wow’ effect that I get with Obagi.

Obagi Nu Derm is a 3 to 4 month home treatment course of powerful skin lighteners, exfoliators and skin penetrators.  You stop using your normal skin care products and use only the Nu Derm products because they work synergistically.  The exfoliators and penetrators allow the skin lighteners to reach down deep into the skin to treat the really stubborn pigment.

In my practice,  patients use Obagi for a total of 3 or 4 months because the powerful skin lightening medicine (hydroquinone) isn’t something I think should be used indefinitely.  Patients are instructed on product use by my two wonderful aestheticians who have been certified and trained in the Obagi System.

The powerful ingredients in the Obagi Nu Derm System can be irritating to skin and my aestheticians are available to help patients troubleshoot product usage.  Calming facials work wonders to soothe the skin during the Obagi Nu Derm treatment process and I highly recommend them given at monthly intervals.  If the skin begins to flake or peel, a gentle microdermabrasion treatment followed by a calming facial can really get the skin looking lovely.

I used Obagi about this same time last year and right now I’m 2 weeks into my current treatment course.  My husband keeps looking at my skin telling me how pretty it looks.   The Obagi company claims that the Nu Derm system is ‘transforming’ and in my experience the results really are.

Here’s the instructions we give patients in our office:

Dermatologist Dr. Cynthia Bailey’s instructions for using Obagi Nu Derm

In the morning:

1. Wash with the Cleanser (step  1) and rinse well
2. Apply the Toner (step 2) with a cotton ball
3. Apply a generous layer of the Clear (step 3)
4. Apply a thin layer of the Exfoderm or Exfoderm Forte (step 4) where tolerated.  See Trouble Shooting Below
5. Apply a generous layer of Healthy Skin Protection Sunscreen (step 6)

In the evening

1. Wash with the Cleanser as above
2. Apply the Toner as above
3. Apply the Clear as above
4. Wait 15 minutes
5. Mix the Blender (step 5) with the tretinoin and apply where tolerated. See Trouble Shooting Below

Nu Derm Kit Products

Trouble Shooting:  The powerful exfoliators and skin penetrators can be irritating and contrary to the official Obagi package information,  you don’t need to let your skin get irritated to get great results.  When your skin begins to get red and sensitive, stop using the Exfoderm or Exfoderm Forte for a day or so until the sensitivity subsides.  The same goes for the tretinoin.  You may find that only certain areas  of your face are sensitive and in that case, I recomment that you just stop using these products in those areas.

The Obagi Nu Derm results really are transformational.  Skin becomes luminous, pigment more even and the skin texture is refined.  The best results are obtained with supervised counseling by knowledgeable skin professionals who are experienced with the Nu Derm program.  The ultimate process is to combine the Nu Derm system with monthly calming facials and if needed, microdermabrasion treatments.

Before Obagi Nu Derm

After Obagi Nu Derm

If you found this post helpful, you may want to read these other posts:

Dermatologist’s Own Personal Tricks To Control Age Spots, Sun Spots and Uneven Pigmentation

Brilliant Skin Care for a New Decade

Dermatologist’s 3 Simple Steps for Sandal Ready Feet By Spring

Now, Between Early Fall and Late Spring, It’s The Best Time To Reclaim Soft Skin and Treat Age Spots and Uneven Pigmentation

Falling On Your Face

Today I lost my first post. It was a nice little post. The writing ‘gods’ had smiled on me as I wrote it; it was succinct, flowed well and said what I wanted to say. I got up early before work to write it and everything was going along nicely. I had the big idea to compose it directly in WordPress (the system I use to publishe my blog). Not being an experienced blogger, I thought that’s what experienced bloggers did. Well…..it was a mistake because WordPress ate my post.

I did everything the same way I’ve done it before, but this time… poof, gone. I should have known something was up when I did a spell check and it said I had no spelling errors (anyone who knows me would know that’s impossible). I’m not a computer techie type so I asked a really experienced one to help me and sure enough, my nice little post is really gone. Unfortunately, so are the writing ‘gods’ and as I try to rewrite it after work all that comes out is awkward sentence structure and cumbersome vocabulary.

I’m a practicing dermatologist and an unlikely blogger. Speaking is easy for me, but writing takes work. It feels good to share my little WordPress misadventure. Another hurdle as I try to express as a blogger what comes so naturally for me in the office.

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