← Derm Approved
Derm Approved
Body Skin Breakdown: Solutions for stretch marks, cellulite, bumpy skin, body acne, spider veins, ingrown hair, and more!
00:55:03
<p>In this solo episode of <em>Derm Approved</em>, I dive into the world of <em>body skin health</em>! From stretch marks and cellulite to bumpy skin, body acne, and even spider veins, we’re covering it all. Learn about the causes behind these common concerns, why they happen, and most importantly, how to address them.</p><p>I share affordable at-home treatments, like skincare products and daily habits, as well as in-office solutions ranging from prescriptions to procedures that actually work. Whether you’re dealing with ingrown hair, eczema, hyperpigmentation, or skin laxity, this episode is packed with actionable tips to help you feel more confident in your skin.</p><p>Tune in for expert advice, relatable insights, and science-backed solutions that fit your lifestyle and budget.</p><p>Connect with me on social media <a href="https://www.instagram.com/dr.sheila_derm/?hl=en" rel="noopener noreferrer" target="_blank">@dr.sheila_derm</a> and <a href="htt...
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The following podcast is a Dear media production I'm Dr. Sheila Farhang and welcome to Derma Proved, your number one source for all things dermatology from skin and hair health to the latest celeb cosmetic treatments. I'll be providing you with valuable science backed information so you can feel more knowledgeable and empowered as you navigate and make decisions about what's right for you and your journey. So let's get into today's episode. In this solo episode of Derma Proofed, I dive into the world of body skin health. From stretch marks and cellulite to bumpy skin, body acne and even spider veins, we are covering it all. Learn about the causes behind these common concerns, why they happen and most importantly, how to address them. I share affordable at home treatments like skin care products and daily habits as well as in office solutions ranging from prescriptions to procedures that actually work.
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Whether you're dealing with ingrown hair, eczema,
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hyperpigmentation or skin laxity skin, this episode is packed with actionable tips to help you feel more confident in your skin. Tune in for expert advice, relatable insights and science backed solutions that fit your lifestyle and budget. But before we get into today's episode, this show was made possible from four of my favorite beauty and wellness brands. Here is more about them. As a dermatologist, I often get asked if gel manicures are bad for the nails. The truth is it's not the gel polish the but rather the improper application or removal that causes problems.
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That's why I recommend CND Shellac to my patients.
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It's the original gel polish brand tested to ensure no damage to your natural nails when used correctly. There are many brands out there that don't follow the latest regulations which can lead to damage or allergic reactions. So keep your nails looking and feeling healthy. With C and D Shellac you can Visit c&d.com to find a C and D salon near you. As a board certified dermatologist that specializes in integr of Derm, I'm always looking out for the most effective clinically tested supplement on the market. HA is a once daily skin supplement clinically proven to reduce wrinkles and fine lines and increase skin smoothness. In 90 days you can start hair to minimize wrinkles without compromising on clean science. Hyacinth from Ritual is a clinically proven skin supplement that you can actually trust. You can get 25% off your first month@ritual.com doctors. You can start Ritual or add Hyacra to your subscription today. That's ritual.com Dr. Sheila 2025 for 25% off at home Devices I get asked about this all the time, so let's talk about red light therapy. One of my favorites from Solo Wave is their 4 in 1 radiant renewal skincare wand that combines four scientifically backed proven skincare technologies for the ultimate non invasive at home skincare treatment. And in addition to the Solo Wave devices, they also have a skincare line which is a blend of pre and probiotics which helps benefits the skin microbiome. You can visit mysolawave.com and use code doctorsheela at checkout for 25% off your first order. So that's M Y S O L a w a v e.com and you can use Dr. Sheila for 25% off your first order as a board certified dermatologist, many patients ask me what they can do at home to treat wrinkles and one of my all time favorite anti aging drugstore brands is Roc Skincare. I've been working with them for years. Every ROC product is science led, developed and tested to ensure highest quality and efficacy. Every single ROC product is clinically proven with over 100 clinical studies, 75 safety studies and 35 patents. Every ROC formula is scientifically crafted and clinically tested to ensure the best results for your skin. For more info on this skincare product visit www.rock skincare.com all right, let's get back into the episode.
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Welcome back to Derma Proof, the podcast on all things dermatology. I'm Dr. Sheila Farhang and in today's episode we are going to be talking about all things body skin. I did a poll on Instagram and listed a whole bunch of topics and you guys picked your faves from cellulite, stretch marks, ingrown hairs, spider veins, body acne, hyperpigmentation. So I'm going to go through briefly some causes of these and what you can do to maybe prevent them. And I'm going to go through some treatment options, both affordable at home options that you can do and some more professional treatments that you can do at our office that includes some prescriptions and procedures. So let's get into it. All right, first let's talk about stretch marks. I'm sure we all know what they are. We all have them and basically they are from rapid skin stretching and shrinking. And I will say they are largely due to genetics. So you know there isn't so much that you can do to completely prevent them because you can't control your genetics. But I will go through some things that you can do to prevent them, especially during pregnancy. I'm going to be focusing on that. And if you do have them, how you can treat them both at home, affordable options and in the office. Stretch marks actually start off as pink. They're red, they're inflamed. You want to decrease that inflammation and hydrate the skin, improve that skin barrier. That's this phase, the white conventional stretch mark that we all have. And there's different treatments for this with the atrophic, which is that thin skin from the skin being stretched out. And you want to stimulate collagen, you want to really help increase that cell turnover to help thicken that skin that has basically been thinned out. These are three ingredients that actually help prevent stretch marks. And I like this during pregnancy because they are pregnancy safe. Number one being scintilla. This is found in a lot of over the counter products such as Mederma Stretch Mark Cream and Palmer's Stretch Mark Cream. So just look that it has the scintilla in there because sometimes Palmer's just had shea butter, which moisturization really doesn't do that much to help prevent. I think it's fine because it's massaging it in, but you really want to look for ingredients that are actually doing something. Number two, almond oil. There's a really viral product here actually called belly oil and it's by Hatch. And so this is a super cute bottle, but I was really glad to see that it actually had almond oil in it because that is something that has been shown to help prevent stretch marks too. So if you are someone that's using that, it does do something. And number three, hyaluronic acid, which we're familiar with for skin care on our face. So you can really use any brand. Neutrogena Hydro Boost has hyaluronic acid. Rock has a whole bunch of hyaluronic acid based products. You just want to make sure that if it is a thinner kind of serum, you do your serum first and then your moisturizing cream and then your oil last. Next is why are we always moisturizing or why are there so many moisturizing ingredients in pregnancy? Belly butters and things like that, things like shea butter or like coconut oil, things like that. And the biggest thing is hydrated skin and moisturized skin is just healthier overall and so it helps it in that early phase. They're like pink and violations. You do want to moisturize, you do want to really make sure the skin barrier isn't like open and dry and itchy and cracking. So that's why a lot of products out there just have moisturizing products. But again, my thing is if you're going to go in and you want to actually use ingredients, look for the scintilla almond oil or hyaluronic acid. So while you're pregnant, since those are pregnancy safe, a lot of these will also have moisturizing ingredients in there. And then the fact that you're rubbing it and increasing that circulation, that helps a little bit too. Okay, so you have stretch marks. They're white, they're older. What can you use over the counter? You know, retinols really help. Retinoid, as we know, we use it for the face, it stimulates collagen, increases that cell turnover and then things that are kind of like exfoliants. So lactic acid, glycolic acid. So looking for ingredients that have a combination of those. I personally, if you're able to, would prefer a prescription strength tretinoin. So you would be using this after you of birth or perhaps breastfeeding, whatever you're more comfortable with because a prescription drink. Retinoids such as tretinoin has been really shown to help decrease the appearance of stretch marks. Okay. The one treatment that works by far the best in my office for stretch marks is radio frequency microneedling. This is something like Morpheus. So when you think of an older stretch mark lesion, they're white, they're stretched out. This skin is essentially like thinner in that area. So what radio frequency marking does is it stimulates collagen. So it helps build up that tissue. But then also, and that's the deeper level. So three and a half, four millimeters deep and then on that like half millimeter depth.
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So it's like resurfacing.
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It helps strengthen that skin and it really helps just improve that skin quality where typically that's how we would treat a scar. So in General, will it 100% make it go away? No, but it really helps tighten that skin. Skin helps with that dermal process and helps with the irregularities. If you are looking to do a treatment in an office, radio frequency microening has been shown to have the best results. Okay, next topic is cellulite. There are two really main types of cellulite. Number one, the fibrous type where it's really thick, indentations very, very prominent and they're almost like thick. And then you have more of these softer cellulite, more rippling skin, skin, thinner skin. It's associated with skin laxity or volume loss. So there's Two very different types of treatment approaches for these different types of cellulite. Here's some at home things that you can do for cellulite that actually work. Number one being massage. Two, there are certain topicals over the counter that help and then three, there are some oral supplements that may help as well. One of the biggest question I get is if massage works. And believe it or not, it actually does. You know, with cellulite you have this like microcirculation and lymphatic that's almost impaired. So by going in and massaging this area, it increases that circulation to that area, which is always a good thing. And number two, it actually gets rid of some of that like congested lymphatic fluid. And so that's why visually when you see yourself after a massage or a lymphatic massage or going in with one of those tools, it really does help visually. Does it help long term and does it help like the etiology of like, why that's there? Maybe not, but I do think it's worth doing. There are lots of tools out there. From Skinny Confidential has one. It's called Lispoon and it's almost like a square type. And that one looks really easy to use. And then there's a few. Skin Gym has one and there's just a few on Amazon. Just make sure it's like thick enough and that you're not going in really hard and bruising yourself. As far as topicals for cellulite, the two that actually work the best include retinols and caffeine. These have been studied the most. And with something like retinoid, you want to make sure you're not pregnant while you're using it. And what that does is it stimulates collagen.
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Right.
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And that's what we want while we are dealing with something like cellulite, especially kind of the rippling part. And caffeine has actually been shown to really help. So some of the ingredients that you're looking for in products, just make sure they have those ingredients and massage them in. So, so you get like a two for one. All right. And oral supplements that may help. Cellulite, of course you want to make sure you have a healthy diet, right? Some diet rich in antioxidants. Fish oil has been shown to help with cellulite. Collagen supplements, believe it or not, has been shown. And that makes sense because studies on collagen supplements, the ones that are actually good, so vital proteins is one that I recommend to my patients sometimes just gets the sourced. I Think. Well, it helps with elasticity and collagen simulation. So do we think that this replaces like sunscreen or something for anti aging? No. But for the way of cellulite, there was a study that showed that you had to take at least six months to see some type of improvement. So doesn't hurt. The two main things that we do at my office that have the best results for cellulite, number one, if you have the thick fibrous type of cellulite, so deep indentations by far, subcision is the best. So subcision is when I'm actually going in, you're numb. So it's very tolerable. I go in and I'm basically releasing, with a little blade or needle, releasing those fibrous bands that are causing this like network where the fat is kind of getting pushed up through them. So by releasing that like fibrous network, you're releasing that fat so it's not pressured and pushing up and creating indentation so it smooths it out. Oftentimes for the best results, I like to go in and inject something like sculpture, which helps stimulate fat and collagen in that area. Or we can do traditional fillers. That is by far the best. And then more for the rippling, thin laxity, cellulite, radio frequency microneedling. So what this does is it stimulates that collagen, but not only that, it helps improve that lymphatic drainage. So it's really kind of just healthy overall. We really want to improve the dermal, which is the deep skin and the epidermal integrity. And so that's why something like radiofrequency maculating is nice because it can really strengthen that top layer of skin, but also go deep because you do want it to go at least 3.5 millimeters deep to really help stimulate that collagen so that I've seen the best results from. And then if someone of course, has a combination of those things or they have a little bit of in between, I do both of those treatments, sometimes the same day or sometimes I split them.
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Okay, let's take a quick break from the show. As a board certified dermatologist, I'm only usually recommending products that I actually use and have vetted. Ritual has been one of my favorite supplements for years. I love their science. I love that they're very specific with their claims. And when I learned about their new wrinkle support skin supplement, I had to try it. Hyacinth is a once daily skin supplement clinically proven to reduce wrinkles and fine lines and and increase skin smoothness in 90 days. And what I love is that it's rigorously tested and validated by a third party for allergens, microbes and heavy metals. If you're obsessed with reading the skincare labels, this is for you. Haasera is made traceable so you know the form supplier and studies behind its key ingredients because not all skincare ingredients are create equal as you know. I love that it's formulated with hyaluronic acid, which naturally occurs in our skin but decreases with age. The decrease in hyaluronic acid can cause thinner, drier and make your skin more prone to wrinkles. Ritual's Hyacra supplement is clinically proven to reduce wrinkles and improve skin smoothness. You can start Hyacinth to minimize wrinkles without compromising on clean science. Hyacinth from Ritual is a clinically proven skin supplement you can actually trust. Get 25% off your first month at ritual.com drshiela25 you can start ritual or add hair to your subscription today. That's ritual.com drshiela25 for 25% off off from running between my dermatology practice, performing skin cancer surgeries and balancing with my other projects, I notice eye bags. I've been talking about eye bags a lot lately on my podcast and when I'm not getting enough sleep. If my diet is not the way it's supposed to be, with a lot of carbs or salty foods, and if I'm traveling these eye bags will show up. It's usually due to fluid or sometimes a little fat pad that's showing up there. But there's other things with the eyes too, such as dark circles that can show up if you are again not getting enough sleep, if you're dehydrated or fine lines that can just happen over time as we mature and with some damage. So it's so important to do skin care as part of the regimen to help with the eye and eye issues. And of course when it comes to skincare, I am looking for things that are scientifically backed, that are drugstore and affordable and and Rock is a brand that I've worked with with years. They have a Rock dual eye cream. It's a two in one eye treatment really for that age defying result. With this product, in just one week 96% saw the look of lines plus puffiness reduced and in two weeks 90% experience visibly lifted eyelids and reduced darkness. Which is really great when it is something that you can do at home, it's affordable. Every Rock product, like I said, is science led and developed and tested to ensure the highest quality and efficacy. And every ROC product is clinically proven with over 100 clinical studies, 75 safety studies, and 35 patents. And this is a brand that has been around for over 65 years. For more information, you can visit www.rockskincare.com. okay, let's get back into the conversation.
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All right, next up, let's talk creepy and loose skin. So creepy skin is oftentimes caused by aging skin, sun damaged skin. This is really prominent in my mature patients. And then loose skin or skin laxity, I've seen a lot because it's from weight loss, it's from postpartum. This is really common now because of a lot of those medical weight loss medications. So as far as the treatments, I'm going to lump them together because they are very similar. Of course, a lot of skin laxity or looseness may need surgery, like a tummy tuck or something. But I'm going to talk about mild to moderate skin laxity and loose skin and what you can do both in office or at home to help improve it. One thing you can do at home, lifestyle wise for creepy and loose skin is actually increase muscle definition. When you're increasing that muscle tone, you're creating this like foundation under that skin. And so the skin looks a lot more toned. There's definition, there's more blood flow to the area. So I really noticed that in my office we have a muscle stimulation device called Truflex. So for my patients that have really kind of creeping skin skin or loose skin, the buttock area, the abdomen, the arms, will put them on this muscle stimulation device and it makes such a big difference. And then of course, we're going to be addressing some of the skin texture and loose skin as well. But in general, the bulk of it, if you want to try to avoid getting a skin lift or skin surgery where they're cutting off the skin, this is something so easy that I think is oftentimes not really thought about, especially if you're on those medical GLP1 ozempic things like that, like protein working out, you really want to do that. Okay, next up, two ingredients that actually work that you can buy topically over the counter for crepey and loose skin are retinoids and peptides. So retinoids, as we know, stimulate collagen, strengthens that skin, increases that cell turnover, and peptides. And what peptides do is they basically just optimize different pathways in your body. So the combination of those work really great together. There are some face ingredients or some body ingredients. There's like body retinoids. Olay has some necessary, has some hyaluronic acid will help the appearance. Another ingredient that doesn't necessarily reverse the crepey skin but helps it is hyaluronic acid because it's pulling in that moisture. And when you have a moisturized, hydrated, more plump skin, it really helps the appearance of that creepy skin. So that's really important. Okay. And in my opinion there are really just two products that work very well for creepy or black skin. They are well researched and they have been developed for this specific issue. And these are a little bit splurgy. So they might be like 200, around 200 each. Number one being revisions body firm. So this has, they have proprietary blends but essentially what they're doing is stimulating collagen, really thickening that dermal epidermal junction of the skin. This one actually has caffeine like I mentioned like topically that it works and then as glucosamine too. So this one I've had patients, some of my mature patients use because I still have the office and they have seen a difference and a little bit goes a long way. I just have them like rub it in once a day. Another one, if you're a fan of elastin products is transform. This one is also a little bit smaller splurgy. It's the body treatment and this has like Trihex technology which again helps stimulate collagen, helps strengthen that skin. A lot of these also help moisturize the skin in, in addition to actually going on a cellular level and doing something. So that's what I like about these. It's not just like moisturizing or plumping or hydrating. It's actually doing something and it, it may be worth it. Next, what in office treatments work best for creepy or lack skin. And there's really three main ones. Number one, we want to stimulate that collagen, we want to strengthen that skin. And so that's radio frequency microneedling. Number two, there are certain injectables such as Sculptra or Hyper dilute Radiesse that are injected into the skin massaged and that helps stimulate collagen as well. And number three, in my office I have a device called Ellacor which is tissue microcoring. So it's actually removing micro cores of tissue about 8% non surgically and then the skin heals tighter. And so this is a really good kind of off label indication for skin laxity as well. Okay, next up, let's talk hyperpigmentation on the body. The three main kind of things that I see in my office include post inflammatory hyperpigmentation, such as, like acne scarring from scars, things like that. Number two is melasma. So melasma is caused like by hormones. And although we see it usually on the face, I will see it on the neck in some people too, and almost like the traps. And so that's an area that we really want to treat as well in some people. And then number three, really common is just like age spots and skin darkening from aging and sun damage overall, thankfully, there are a lot of great topical treatments that you can get over the counter for things like hyperpigmentation on the body. So you want to look for things that help brighten. These are exfoliators, right? Lactic acid, glycolic acid, Kojic acid, mandelic acid. These increase that cell turnover because in general, acne scarring will fade over time, especially if you're sun protecting. But it just can take so long, it can take six months for an acne scar to go away like the darkness. So you want to increase that cell turnover. And that's why a lot of these acne treatments, acne spot treatments, have a lot of these exfoliators in them. And so that's a really good place to start. Just make sure you're not doing, like so much at one time because that can cause a lot of skin irritation. But thankfully, the body skin is a lot more resilient than the face skin. I rarely see people coming in, putting on so many products on their back and their back getting irritated. Yes. Maybe their neck and chest. But if it's like on your arms or your back or your legs, it's a little bit more forgiving. So retinoids also help to increase that cell turnover. Although it's not technically brightening it, it's really helping just get new skin, get the old out, get the new in. And that's why a lot of these skin brighteners will have retinoids in them. Vitamin C helps. It's not like a product that I think about in my head for brightening. It's an antioxidant. Yes, it can help brighten a little bit just in that process. But you really want to look for those, like, brighteners, those exfoliators that really target that increased melanin production and those like hyperpigmentation scars for that. Along the same lines, treatments for hyperpigmentation for acne scarring is very similar to melasma. Melasma is so difficult to treat. So I usually have to recommend stronger things for melasma. But you can absolutely start with a lot of these ingredients like Kojic acid, glycolic acid, lactic acid. Thing with melasma especially on the neck and chest is you don't want to go too hard, you don't want to get red and peely. And then with sun damage usually those are sunspots. And yes, brighteners really help with that. There's a product by skin better called Even tone Corrector that I think is really efficacious. It's non irritating and I have patients really use it on their like arms, will face of course neck and chest area just to help even that skin tone. Next up, some prescription strength ingredients they give my patients for hyperpigmentation, whether it be post inflammatory from acne or scars or melasma. And that is two main ingredients. One is hydroquinone which works great. We know it. It's a true and tried product. It is a little bit more regulated now because we don't want people willy nilly using it for months and months and whatever percentages. So when it's under the direct care of a provider, used four months and then a holiday, I can really get up there 11, 20% and it works really well to help decrease hyperpigmentation, especially on the body. Another ingredient that's really underrated is systemine. Senti has a really good product called Cispra and the main ingredient is Systemine. So for patients who really don't want to use hydroquinone, I will offer them systemine which works really really great to help decrease that melanin overproduction and the combination of both of those actually work really well.
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Okay, I'm sure you love getting your nails done as much as I do, but we want to ensure we keep them healthy in between salon visits. One of the best ways to do this is by incorporating a cuticle oil into your daily routine. My absolute favorite is CND Solar Oil. It's actually an award winning cuticle oil that will transform your nails and cuticles and all it takes is applying a few drops every day. I literally keep mine of my night's stand. Make sure I use it every night before I go to bed. The C and D solar oil formula is a blend of naturally light oils such as Jojoba oil, vitamin E, rice brain oil and sweet almond which get right into your nails, the skin and the cuticle it penetrates deeply by entering through the layers of nail polish in the tiny spaces in the nail plate, filling them with nourishing oils while pushing out any damaging moisture. So this keeps your nails moisturized, supple and looking healthy. There's no more peeling, there's no more dryness, or no more breakage. Plus it can help your manis last longer. I've been using C and D solar oil for months now and my nails have never looked better. They're stronger, they're shinier, and the skin around my nails look moisturized pretty much all the time. Whether you're at home or at the office or on the go, you can use C and D solar oil as your perfect little companion for maintaining beautiful hydrated nails. You can head to Amazon.com and try C and D solar oil for yourself. Okay. As a dermatologist, one of the top questions I get is how to stimulate collagen at home using devices. So first let's get into what collagen is. Collagen is so important. It's basically what gives our skin structure and we start losing 1% of the production starting the age of 20 every year, and then 30% the first five years after menopause. So it's super important to really think about collagen in your anti aging skincare routine. What I love to recommend is Solo Wave's 4 in 1 Radiant Renewal Skincare wand that I've been using for years now. It uses a red light therapy technology. It also has galvanic current, a warm therapeutic massage, which is really nice because it helps decrease that inflammation, maybe that fluid retention that's there. And then of course, the red light stimulates collagen. And then what's also nice about the red light, it helps decrease breakouts and discoloration. And as a dermatologist, I'm always looking out for what patients can do at home and in the office. But I think finding something that's a affordable, that they can use, that actually a science behind it is so important. I think if you're looking for a safe and effective way to improve your skin's appearance and you want to do something at home, Solo Wave is worth considering. Its product combines multiple technologies all in one device. So it really saves you time and money on that aspect. And it's pain free, no needles or anything. Also, don't sleep on their skincare line. They have pre and probiotics in their skincare line, which I'm all about, a good balanced skin microbiome. Probiotic skincare is really nice to help hydrate and boost the skin barrier. You can visit mysolawave.com to use Dr. Sheila at checkout for 25% off your first purchase. That's mysolawave m Y-S-O l a W-A-V e.com and use code doctorsheela for 25 off your first order. All right, let's get back into the
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episode and then let's talk about topical treatments for hyperpigmentation on the body. I will say one thing, so lasers and ipl, when you're getting this treated on the body, this is where issues can happen. We don't have as many oil glands on our body and the healing process is not as good as the face. So the number one burn issue that I see are IPL burns on the arms and on the chest. And these can leave some very, very disfiguring, permanent white scarring. So just be really, really careful about doing lasers willy nilly on the arms, the face. Because of its healing. Just it's able to heal a lot better. It turns over a lot faster. We have those oil glands that actually help protect us and like for whatever reason, moisturize the area and just like decrease risk of burns and things like that. You want to be really careful about like IPL on the neck and chest. IPL on the neck and chest for like sun damage. Sunspots is so great. But just make sure you're going to a really good provider. This is where I see a lot of issues happen. This is where I see a lot of track marks happen because someone wanted all their moles removed and someone ipled them. So I do think they work really well. You just have to be very careful, make sure you're not have even sunless tanner on or tan or sunburn. So sometimes just going and using those topicals first, maybe a little bit better. Sometimes I even pre treat my patients and have them use hydroquinone first and then we'll do the laser or the IPL and then I actually will post treat with something that decreases inflammation, like steroids and stuff like that topically. And that is like a really good way to make sure we're treating their skin on their body with something like lasers, but not causing more hyperpigmentation. And then of course one thing that's really underrated that you can get at an office are chemical peels, which are those same ingredients such as lactic acid, glycolic acid, that are exfoliators but on a much stronger level. So professional grade. And I love this for like back acne and acne scarring where we'll just going in with a really strong peel and just really, really help speed up that process for that, that pigmentation that's there. Sun damage that's there. Okay. Next is a really common thing I see in the office and that is bumpy skin, which is strawberry skin. The medical term is keratosis pilaris. It's something that is very common from kids all the way to adults. It's usually seen on the upper arms or the thighs. If you have eczema, you probably have kp, just keratosis pilaris for short. And what's great about this is usually this can be taken care of by topical treatments bought over the counter. Number one, you want to make sure you're moisturizing because again, this is more of like an eczema type of thing. You want to make sure your skin barrier is healthy and intact. So moisturization is key. So what keratosis pilaris is is basically dead skin getting stuck in the hair follicle and that's why it feels bumpy and that's why we have to exfoliate. So I prefer a chemical exfoliation like lactic acid, glycolic acid, these are some stronger ones. And then urea, which is both a humectant which helps hydrate the skin and helps renew the skin. So urea is really good. If you have really sensitive of skin so you want to hydrate, you want to moisturize and then you want to use an exfoliator. If you absolutely love physical exfoliation, I think that's fine to do as long as you're doing the first two, which is moisturizing and chemically exfoliating. Dry brushing I think is really nice. There are some exfoliators out there that are both physical and chemical and those can be used like on the body. The body's a little bit more resilient so it can kind of take on some of that physical exfoliation versus they don't really recommend it it on the face as much, especially the dry brushing. So if the over the counter treatments are not working for you or getting completely rid of your KP in office, I can prescribe a stronger strength. Like I usually like to compound urea or a little bit of cell acid or lactic acid and just like really good exfoliators. Sometimes people have kind of this redness associated with Kpop. So I want to make sure I'm using ingredients that are also calming the skin down. Once we Got the bumpiness down and the patient is happy with that. Sometimes residual redness is there, like little red dots. And that's where I can use lasers or energy based devices like IPL is really great to get rid of that residual redness just from like the inflammation that was there. So that's a really good combination to do in office after you've tried some of the over the counter stuff. Okay. Next up is eczema, which is very, very common, especially where I live because my main practice in Tucson is in
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the desert in Arizona.
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So eczema. The medical name is atopic dermatitis. Eczema is actually like a big like, I guess umbrella term. But atopic dermatitis is a specific thing. You're born with it, get it when you're a little baby and then you kind of grow out of it as your oil glands are really revved up during puberty. And, and then as we mature and we're like 60 plus 70 plus 80 plus, that's when I see kind of that eczema come back, that dry skin come back in a lot of my mature patients. So it's a little bit like bimodal, I guess you could say. Okay. My top recommendations for something like eczema include making sure you have a good moisturized skin barrier. Your skin barrier needs to be healthy and intact. So how do you do that? You got to moisturize. You want to use ingredients that are like the cerave, the cetaphil, La Roche Posay, Aveeno Skinfix is really good too. And Roc has some products too for eczema. And so you want to make sure you're using these ingredients that have ceramides that actually decrease inflammation. I really love thermal spring water, oatmeal based things. So you don't want to get fancy, you don't want to get too expensive, expensive. You don't want to get fragranced with things like eczema. Keep it simple, keep it kind of medical. So that's number one that you need to be doing. And then of course there's lifestyle, right? You want to decrease your length of hot showers, especially in the winters when everyone can get really dry. Skin baths are actually better than showers, believe it or not, because you have that water around your skin. So if you have a, like a little baby with eczema, baths are better than, I guess if they want to shower like a little toddler. And then at my office we have this whole handout where we tell patients to get a humidifier. If you live somewhere that's really, really dry humidifier in your bedroom makes such a difference. Just make sure your skin's hydrated and healthy. And then you also want to decrease. And you probably already know this if you've been dealing with eczema, but you want to decrease any really irritating preservatives, formaldehyde, phthalates, things like that, as well as fragrances. Again, fragrance is not an issue for everyone. But those with eczema can get a little bit more flared with things like fragrances. And that means like in the air too. So like those diffusers and things like that. So that is like kind of the main thing there. Of course, if your eczema gets really bad, then I want you to use like something like Aquaphor or Vaseline. Wear a glove at night, slather it on, do the whole slugging thing. And if things aren't getting treated with just these lifestyle things, then you may need to see a dermatologist like myself and use some creams such as topical steroids or non steroidal anti inflammatories to help decrease that inflammation. And it's, I don't love it for long term unless you have really bad eczema. Why we recommend it all the time is we need to decrease that inflammation so your body can repair itself. Get that strong barrier and your eczema essentially in that little area goes away. Because if it's like irritated, irritated, irritated, you're itching, it allergens are getting in. It's just not. It's very hard for it to heal on its own. So we kind of have to stop that inflammation, process, do all the other things, of course, and use it kind of just as an as needed basis. One thing that is oftentimes part of this eczema category is allergic contact dermatitis, which means you are allergic to something that's coming in contact with your skin. They usually go hand in hand. But if you feel like you're doing all the nice eczema things, hydrating your detergent is all free and clear preservative, free, all the things. And you're getting specific areas that are getting red, itchy and almost burning. Like I see it around the eyes a lot, I see it around the neck a lot or the hands. It may be a specific ingredient, such as a preservative. It may be color blue dye, formaldehyde, something that you're getting in contact with. Even if it's in like safe products. People can boom, all of a sudden get so allergic to something also, like nickel, gold, Things like that. So in this case it's really important to do contact dermatitis testing. Derms do it, but allergens do it as well. You sometimes may need a referral. And it's basically a process where on your back, very similar to the seasonal allergies, but those are needle pricks. This is basically a sticker test. So basically it's on your back. We go in, we put a whole bunch of, we have the true test and then we have a whole bunch of other panels based on what your hobbies are or what you do. Do you like arts and crafts? Do you work with leather? Do you go in the garden? So there are so many different panels out there based on your day to day exposure. And we see you back like a few days after and then a few days after that, can't shower your back. And we basically see how much reaction you have on your back where that allergen was, which is just a sticker. And this makes such a difference for patients. I've had patients come in actually for skin eye creepiness and they thought that they had some allergies and this and that. And then I sent them to get testing done and they came back with just specific things. They cut those out and they look so much better, they feel better. Their eyes aren't as crepey and red and dry and just irritated. So if anything, that is the one thing you need to figure out if you're getting this constant flare up and it's like not just eczema. Okay, now moving on to back acne, let's talk about what's causing it and how you can get rid of it. So in my office I will say the two biggest contributing factors for back acne in my male patients include whey protein, so people bulking up and testosterone. These are of course in my like more mature patients, but this causes a very severe inflammatory cystic acne on the back for guys that are like wanting to get like super toned or bulked up or sculpted. So if you are dealing with acne and you're on those two things, maybe consider number one, changing to a plant based protein like pea protein or something like that. I know it's not as efficacious, but really it's that testosterone, which is the hormones that are causing that huge flare in the back acne. And really in a lot of my male patients that are like 50 plus that I have, that are just starting testosterone for multiple reasons. Another reason for back acne is just sometimes poor hygiene too. We work out we sweat a lot. Sometimes we'll wash our face, but then we'll go run errands, do this, do that, and that bacteria can really build up. Or if we're wearing the same workout shirt, maybe like, once or twice, that can cause it. So a little poor hygiene. But typically when people have acne on their face, they do have it on their back and chest, but oftentimes they don't. And I'm just dealing with it on their chest back. But I do want to be really aggressive because some of the really deep cystic ones can cause, like, thick hypertrophic or keloidal scars. So what can you do? Number one, a lot of great topical treatments for body acne are out there. So things like benzoyl peroxide to help decrease that kind of inflammatory bacterial cascade. They have, like, sprays now, too. So I always like things that are in the shower, like washes, like benzoyl peroxide washes, because I'm going to bleach your clothes. So this is really nice to use. But if someone doesn't want to do that, they have, like, sprays now, which I think are fine. Salicylic acid, if you feel like your back is really oily, that's going to really help, help kind of break down that oil that's clogged up. So salicylic acid is really nice. And there are sprays that you can use, too, or washes or just topicals and then a retinoid. So a lot of the acne treatments out there, especially for the body, they will have a retinoid in there as well. And you can be pretty aggressive when it comes to your back or body acne in general, because, again, the skin on our body is a little bit more resilient. So you really want to go in and kind of throw the kitchen sink at it from all angles because of that acne cascade. There's this a big pathway. So you want to hit it from inflammation, you want to hit it from antibacterial. You want to hit it from, like, whiteheads, clogged pores, oil. So if you can hit it from, like, every little angle, it'll really kind of help decrease the acne in that sense. Of course, if you have a deep cystic acne, that's when you want to see a dermatologist. When I see patients with, like, severe body acne, I will try prescription strength topicals first. So sometimes I'll go in with clindamycin, which is antibacterial, and then a really strong tretinoin something like Kazarak or ac leaf just to help decrease that acne in that area. If that doesn't help, chemical peels work really well too. We'll go in there and we'll add it for some patients too, because it helps with the acne scarring as well. Sometimes I do have to have patients get on Accutane or a lower dose of Accutane, especially on their own testosterone because that's just like a constant like trigger of acne, especially body acne. So probably like micro dose something like Accutane and have them use it a little bit more long term while they're on the testosterone or something like that. But things like acting will essentially kind of be the closest thing to a cure. We definitely want to look out at some of the triggers lifestyle wise first. Okay, next up, let's talk about ingrown hairs. This was really a popular topic when I brought it on to my social media asking for like you guys favorite topics for me to discuss. So ingrown hairs is typically seen really in the bikini area. The skin there is really thin and the hair there is really thick. That's an area where I have a lot of patients coming in and they're dealing with ingrowns. So what causes ingrowns? Basically the hair is instead of going up, it kind of curls in and goes down. And then that's a foreign object because it's your hair that's the top of it's not supposed to be going down beyond the follicle back into the skin where it's not the actual hair follicle. So it creates like there's a foreign object here. So it creates a scar around it. It creates like a, like an inflammatory cascade. So you get like a huge pimple or a cyst in that area. It's painful and it can lead to scarring and bumps. So number one, I think good shaving techniques are so, so important. Making sure your razor blade is newer. Some of those, like multi blades are a little bit better. Shaving technique actually going with the crane and not not against the grain. I know, it's a kicker. It's like what? But you're actually supposed to go with the grain, not against the grain. Because the going against the grain is going to increase the, the risk of ingrown hairs. So that's something to think about. It's still, if you're using a really good razor, it still works fine. Venus, I work with them a couple years ago, but I remember them having a really good set of topical products. They had like an exfoliating serum. They had like a, like a healing topical. Afterwards they had like a gel that you can use while you're going in and shaving. That works a little bit better than shaving gels. So you want to make sure that the products that you're using are really good. And like why you're getting thin grown hair, is it getting like irritated and red? Then maybe you need to hydrate the skin more and use like an aftershave type of healing ingredient. Is it that the, the hair is getting irritated in there? You want to make sure you're shaving again with the grain and you're not using an older razor blade. Of course, laser hair removal is a great option. If you're constantly getting razor burn in this area. Things like waxing can help to help decrease the risk of that. But if you have really sensitive skin, sometimes that waxing can cause some skin irritation. But that's something to kind of consider as well. Topicals that you can use if you get a lot of inflammation include like benzoyl peroxide. Benzoyl peroxide is a really good option. Help decrease that. For men on their beard area, if they're getting a lot of like irritation, I'll prescribe something called clindamycin, which is kind of just an anti inflammatory anti antibiotic that will help decrease the risk of those whiteheads. But you really want to know why your ingrowns are getting caused and kind of break it down that way. Okay, and last topic is spider veins. This was a really popular topic. I see a lot of patients in my office that we're treating for spider veins as well. So spider veins are. Think of them as these smaller vessels. They're about a millimeter or smaller. We are not talking about varicose veins, which are the deep kind of rope, like, like thick veins. Those, of course, some derms treat those with venous ablation and things like that. But that's something that you really actually want to get checked out by a vascular surgeon. Because if you have really bad varicose veins, you know your risk of throwing a clot is a little bit increased. So you definitely want to make sure that that's taken care of. On a medical side, I'm kind of more talking about like aesthetic purposes like the blue and the in the red little veins that we get. These are caused by a few things. So spider veins are caused by hormones. So that's why more women get them estrogen based. That's why we get them after pregnancy. They're Typically on the legs really, because you get like a little bit of venous insufficiency. And that means that the valves in your, in your vessels just aren't working as well. They first start off a little small and then the veins get bigger and bigger. There is a big genetic proponent to this too. Just beyond the genetics of being a female. And estrogen, there's a genetic proportion to it too. And of course, lifestyle, right? If you're just have a job where you're standing on your feet all day or you're flying a lot and you have a lot of swelling in your leg, where you have a more sedentary lifestyle, this is going to be a risk for getting those like spider veins a lot more quickly early on. Okay, so let's talk about some lifestyle things that you can do to help prevent spider veins. Number one, compression stockings. So especially all of my staff and while I'm doing surgeries and for almost like more than a decade now, I'm always wearing compression stockings. So if you're in the medical field or if you are standing all day, retail job or anything, if you're able to wear compression stockings, that's going to help decrease the risk of developing and worsening spider veins, they are worth it, trust me. And then by the end of the day, not only does it help that, but it helps like decrease that heaviness and like leg swelling that you, that you may have if you're just standing up on your legs all day. So for us, it's a must. Oh my gosh. There's like so many brands out there. You can start off with like the Amazon brand that aren't too tight and then kind of work up, up, depending on how tight you want them, especially while you're pregnant. I think that's not a bad thing to do. Another thing is if you fly a lot, you want to make sure that you're wearing compression stockings then. And even when you're in really long flights, making sure you're walking around and that really just altogether helps decrease the risk of clotting because as you can imagine, blood is going down, we have gravity, so it's kind of hard for it to come back up. And as we get older and, and as we're getting more kind of pressure in this area and that like the veins aren't working as well, it's really hard for the blood to go back up to where it needs to go. And so that's why we get like those enlarged vessels and those little spider veins starting to come out Moving around lifestyle, working out, not having a sedentary lifestyle. If you're after surgery, make sure your legs are kind of lifted. If you have a desk job, walk around every once in a while, maybe get a walking desk or one of those, those steps. Lifestyle super, super important. Of course you may be on like things like birth control and that you just can't like help. So just kind of knowing it is worsened by like estrogen and pregnancy. So what can you do at home for spider veins? There isn't much. There are some studies to show, you know, arnica, vitamin K, these can help. Arnica is, you know, we know it as like post filler, like bruising. It'll help with that. Arnica kind of just helps helps decrease inflammation as well. There are a few like alternative type of ingredients if you want to like topically rub that on. And that's like horse chestnut, grapeseed oil, ginkgo that has been shown to be anti inflammatory and may help the integrity of those vessels. So you could try that and I think just it's nice because you're massaging that in there so you could do that. Beyond just the lifestyle, which I think the lifestyle is a little bit more important. And then some oral supplements that have been shown to be helpful again is something called horse chestnut, something called gotu kala and butcher's broom, which I know those all sound really crazy, but there are some okay studies to support that. Some of these help strengthen the vessels. So if you want to kind of go the holistic route, you can do that. But you just have to be careful, run it by your doctor, make sure some of these things kind of increase your risk risk of bruising. So if you are about to get surgery or something like that, just keep an eye out for that next step. What can you do for spider veins in office? Because once they're there topically, there's not much you can do about them. It's prevention is key when it comes to spider veins. So there are kind of two main ways at my office, at least that I like to treat them the best, best way I think if you can get, if you go somewhere with a laser, I think that's the best. We have a laser, a specific vascular laser that helps treat these vessels. So the vessels get treated by a way of something called photocoagulation. So it actually goes in, targets the blood vessel and not the skin overlying the blood vessel and basically kind of contracts and gets rid of those blood vessels. So at the end of the treatment they look like little cat scratches. They may not 100% go away, but. But we're definitely like decreasing them. So you might see like a little sliver of pink if they were like a little bit more like super red, thicker or blue. So that's kind of like a good, like end point. Or sometimes we can really kind of fade them. The thing with spider veins is because of lifestyle, because of who we are, they do come back with time. So I always tell my patients that. So I do love lasers. Number one, there's an option of sclerotherapy where you're injecting a chemical into the vessel. I think that's a fine option. I stopped doing that at my office because I have the laser. But you may go somewhere and they may do that. And I think that's perfectly fine if they're a little bit bigger. So you're getting more into the bigger veins, not the little tiny spider veins, more of the varicose veins. Some derms do the laser ablation. That's like a whole other topic. But if you've thought about it, if you've researched it, that is a valid treatment for big vessels. So that is the treatment and cause for spread veins. Okay. We went through so many body skin topics. I know I went through a lot. If there's any follow up questions, definitely reach out to me on Instagram, it's dermaprovedpodcast or Dr. Sheila Derm. And let me know if you guys want me to do a part two for season two. And of course, it's always so helpful for you guys to rate and review. I look at all the comments on Apple podcasts and Spotify. I'll see you guys next week.
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Thank you for tuning in and taking time to invest in yourself. Be sure to catch new episodes of Derma Proved every Thursday and I'd love
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to hear from you.
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Drop any questions or comments on social media at Dr. Sheiladerm and Derma proved Podcasts.
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Don't forget to follow and leave a rating and review. See you next week.
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This podcast is for informational and educational purposes only. The discussion and opinion shared by the host and guests are not a substitute for professional medical advice, diagnosis or treatment. If you have a specific medical concern, please consult your licensed dermatologist or healthcare professional who can provide personalized advice and treatment tailored to your situation. Please note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.