Thursday, June 5, 2008

Question & Answer with Dr. Jeannette Martello

While reading an article on skin care, I stumbled on a post with Jeannette Martello, a board-certified M.D. She's the Editor-in-Chief of Skin Deep, a magazine that talks about skin care, cosmetics as well as health issues. She states that "The desire to enhance one’s image has worldwide appeal. People want to feel good both inside and out. Our goal at SKIN DEEP is to educate the public regarding lifestyle, fashion, beauty, health, nutrition, fitness, skin care, anti-aging and so much more."
Jeannette Martello answers questions from her readers:

Q.
Why do I still break out with acne as an adult?

A.
Due to exposure to unfriendly, environmental influences, the pores on our face enlarge. In addition, as we get older, our skin cell turnover cycle lengthens. It takes longer for a skin cell to live, die and then fall off of your face. This is a perfect set-up for adult break-outs. The dead skin cells occupy your enlarged pores for a longer period of time and can result in adult-onset acne.

Q.
Why can't I use Accutane to treat my acne if I'm trying to get pregnant or am pregnant?

A.
Accutane is a very potent prescription-strength medication that is used in non-responsive cases of cystic acne. This medication has been associated with birth defects. In addition, Accutane is so potent, that you should not plan on any elective, non-emergent surgery for approximately nine months to one year after stopping Accutane. Accutane can also negatively affect wound healing.

Q.
Why do I always wake up with pimples?

A.
As we age, our pores enlarge secondary to exposure to negative environmental influences. Also, dead skin cells tend to stay on our face for a longer period of time and fill in the enlarged pores. This situation is made even worse when applied makeup is allowed to overfill the pores even further, especially when left on overnight.

Q.
Why do wrinkles form?

There are basically two types of wrinkles: dynamic wrinkles and static wrinkles. Dynamic wrinkles include crow's feet, bunny lines at the top of the nose and lip lines that are made worse when you pucker up. Dynamic wrinkles are produced by facial expressions created by the muscles underneath the skin and soft tissue. Static wrinkles are stationary wrinkles that are formed by deeper attachments from the upper layers of the skin to the deeper layers. We had those attachments when we were 10 years old. Unfortunately, as we age, there is just no stopping gravity. Since these attachments remain stationary and the skin and soft tissue move downward, these static wrinkles become apparent as we age.

Q.
Why do I have more wrinkles on the left side of my face?

A.
Everyone's face is asymmetric. It is extremely rare for a person to have a perfectly proportioned face. The underlying action of the muscles may be stronger on one side of the face than the other. We also tend to express ourselves on one side of the face more than on the other. Most importantly, when you drive, both ultraviolet A and B rays attack the left side of the face more than they do on the right. In fact, UVA can penetrate through glass and clothing, and is even present indoors!

Q.
If I were able to do only one thing to look younger, for example, a tummy tuck, breast augmentation or skin treatments, what would you suggest?

A.
Being an aging woman myself, I can completely relate to your situation. This is how I look at it: I consider the face and therefore the skin--the largest organ of the body--to be the first thing most people see. That is why I consider making your skin look as good as you can to be the most important thing you can do to improve yourself. This is more important than undergoing changes that can only be accomplished with a scalpel.

Q.
Why do I have brown spots on my face?

A.
Brown spots can occur in anyone, but they appear to be more common in women. Brown spots can become more prevalent during various hormonal changes in one's life, including pregnancy and menopause. Synthetic hormonal influences, including birth control pills and hormones taken after menopause, can also increase the occurrence of brown spots. Exposure to UV rays can also increase their frequency. Special skin creams can help, but make sure they have been developed in conjunction with a skin specialist such as a plastic surgeon or dermatologist.

Q.
Why do I have large pores?

A.
Some people have genetically enlarged pores. In general, though, as we age, we are exposed to a variety of toxins, first-hand cigarette smoke (which contains more than 4,000 toxins), secondhand smoke, pollution, ultraviolet A and B rays and toxins we ingest. All these environmental influences affect the enlargement of pores.

Q.
I have a mole I'm concerned about. How can I tell if it is a skin cancer?

A.
If you have a mole you are concerned about, you should definitely have it checked out. Start with your primary care physician. Some tell-tale signs of possible malignancy or cancer include:
A change in color--any change in the color of the mole.
A change in size--for example, if a flat mole becomes raised or a small mole starts to spread or enlarge.
Any sign of itchiness or irritation.
Any sign of ulceration or bleeding. If you have any of these signs or if you think a mole just doesn't look "right," contact your primary care physician immediately.

Q.
I tend to flush red when I drink alcohol and break out with whiteheads on my red-appearing nose. What's wrong with me?

A.
You may have a skin condition known as rosacea. With this condition, certain events can trigger a flushing episode, including pollution, smoke (first-hand or second-hand) and alcohol, to name a few. I would consult with a board-certified dermatologist. In a majority of cases, rosacea can be controlled with oral and topical medications.

Q.
How does Botox work?

A.
Botox works by temporarily paralyzing the underlying muscles that create wrinkles. Botox comes from the toxin that is produced by the bacteria, Clostridium botulinum. The amount of Botox injected to achieve cosmetically desirable results is very little. This toxin is known to cause botulism or lethal food poisoning, but in astronomically greater doses than those used cosmetically in humans.

Q.
Do I really need to use toner?

A.
Consider toner as a second step in your cleansing routine after the first step of using a cleanser. Toner also helps balance the pH of your skin since pH can vary in different parts of the face. Equalizing the pH helps other corrective products work better after the toner's application.

Q.
I have been told never to use tissue or toilet paper when I apply astringent or toner. Why?

A.
When applying any fluid, including a toner or astringent, small fibers can break off and stay on your face. Instead, use a cotton ball or cotton pad to apply toner. The fibers are longer and inter-woven, and therefore are much less likely to break off and remain on your skin.

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