Tag: skin

I’m So Glad I’m a VIB—What I’m Saving on at Sephora’s Holiday Savings Event

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I don’t think anyone gets quite as excited as I do for Sephora’s annual Holiday Savings Event. If you’re a beauty fanatic like me, I’m sure you’ve got your eye on a few things already. But if you’re a VIB member at Sephora, this is your gentle reminder that starting today, you can receive 15% off through November 7 with the code SAVINGS.

Not a VIB? No problem. If you’re a Rouge member, you’ll receive 20% off through November 7. First-tier Insiders will receive 10% off starting November 3 through November 7.

As a bonus, all Sephora Collection items are 30% off regardless of tier—a true holiday treat from the retail giant. I know, enough talking, more shopping. If you’re curious about what I’ve got queued up in my cart, keep scrolling.

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Shawna Hudson

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November 1, 2022
Derms 100% Endorse These Under-$16 Body Lotions You Can Buy at the Drugstore

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“Look for a body lotion that contains a blend of emollient, humectant, and occlusive ingredients to protect and hydrate the skin,” says Josh Zeichner, associate professor of dermatology and director of cosmetic and clinical research in dermatology at Mount Sinai Hospital. “Occlusives like petrolatum form a breathable seal on the skin to keep hydration in and environmental aggressors out. Humectants like hyaluronic acid or glycerin act like sponges to pull in hydration to the skin. Emollients, like fatty alcohols and natural oils soften the outer skin layer.” Zeichner also recommends opting for a fragrance-free option, which is better for sensitive skin.

Zeichner recommends applying body lotion twice a day if possible. If you’re applying after the shower, be sure to slather on body lotion within five minutes to help seal in moisture. Keep reading for some of the best drugstore body lotions out there and why they’re tough to beat.

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Katie Berohn

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October 28, 2022
Feature: Answers to Your Psoriasis Questions

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If you’ve just been diagnosed with psoriasis, you may have a few questions about it. Here are answers to some of the more common ones people ask.

What’s the difference between psoriasis and eczema?

To an untrained eye, these conditions may seem alike. But while they’re both skin diseases, they’re not the same. In fact, “They’re 100 percent different,” says Whitney High, MD, an associate professor of dermatology and the director of the Dermatopathology Laboratory at the University of Colorado Anschutz Medical Campus.

Psoriasis doesn’t usually affect children, High says. But eczema, or atopic dermatitis, is a childhood disease. Eczema also tends to be itchier than psoriasis. Only about a third of people who have psoriasis say they have itchiness.

And the conditions are likely to appear in different places. Eczema often shows up on kids’ faces and buttocks and the inside of their knees and elbows. Psoriasis isn’t typically found in those places.

Plus, “The same person that has childhood eczema doesn’t get psoriasis. And the person who has psoriasis as a young adult usually didn’t have childhood eczema,” High says.

What causes psoriasis?

Doctors aren’t exactly sure. “I get that a lot of times; ‘Why do I have it?’” says Melvin Chiu, a doctor of dermatology at the David Geffen Medical Center at the University of California, Los Angeles. “I don’t really … have a good answer for that. It’s a big mystery, I think, right now.”

Chiu says researchers believe the two main culprits behind psoriasis are your genes and your environment. Scientists are still tracking down which genes are to blame, but they think that about 1 out of every 10 people got at least one of the genes that can lead to psoriasis from their parents. But only about 3% of people who have those genes get psoriasis. That’s where the environment comes into play.

Researchers think things like infection (especially strep throat), an injury to the skin, certain medications, smoking, and other things may trigger the condition.

What’s the cure?

“There is no cure at this point,” Chiu says. “It’s a chronic condition. … You may have times when it’ll be worse, and there may be times when it’ll get better.” He also says there may be some lucky people in whom it’s very minimal. Or it gets better and doesn’t get worse again. But, he says, most people “can expect it will be persistent.” Treating it can make it better. But when treatments stop, it often comes back.

“There are some really excellent treatments,” he says. “There are newer treatments in the pipeline, and many treatments [that] are available currently … work very well.” Those treatments don’t cure the disease, he says. “But they significantly improve the disease and make [people] feel better.”

What are the treatments?

The most common ones are medicines prescribed by your doctor. They include foams, solutions, ointments, or creams, called topicals, that you put on your skin, along with drugs you take that affect your whole body. Your doctor also may recommend light therapy.

“Consult with a board-certified dermatologist, and they’ll be happy to discuss any and all of these options, including over-the-counter options when they’re appropriate,” High says.

What works for one person may not work for another. That’s why you and your doctor need to talk about what your treatment plan should be.

Chiu says that with the treatments available now, “we can get skin a lot better.” He says that 20 to 30 years ago, psoriasis patients had much worse options and many fewer ones than people do now. “I tell people, it’s kind of an exciting time in psoriasis.”

Can the sun help?

Some research says a little every day can help with your symptoms. But, as always, you have to be careful not to overdo it. A sunburn may lead to a flare-up.

Is psoriasis contagious?

You can’t “give” it to anyone, and no one can “catch” it from you.

“You can touch psoriasis all day long,” High says. “As a dermatologist … I see at least one person if not a few people with psoriasis [every work day], and I don’t have it.” High adds, “My wife doesn’t have it. I didn’t bring it home. I don’t do special laundry. I don’t undress in the garage or anything like that.”

What is psoriatic arthritis?

Up to 30% of people who have psoriasis get this condition as well. It causes inflammation and swelling in your joints that can lead to pain and stiffness.

If you have psoriasis and feel any discomfort in your joints, tell your doctor. It’s important to treat it quickly so your joints don’t get damaged.

Are any other conditions linked to psoriasis?

Research is still under way, but scientists think people with psoriasis and psoriatic arthritis may be more likely to have other serious diseases.

“There’s an increasing appreciation that psoriasis can manifest in other ways: increased risk of cardiovascular disease, increased risk for obesity … a natural risk for diabetes,” High says. “It might impact your life in ways that you can’t even really fully predict now.”

Besides cardiovascular diseases and obesity, psoriasis also has been linked to cancer, Crohn’s disease, depression, and liver disease, among others.

That’s even more reason to stay in touch with your doctor and make sure you have a plan.

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October 24, 2022
Vitiligo: My Life With This Skin Condition

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By Mark Braxton, as told to Kendall Morgan

In 1996, I discovered a small white spot on my thumb. It itched. I thought it was a scab or something. I didn’t think too much about it. Then, I started noticing other small white spots. They were spreading.

The first dermatologist I went to looked at me and walked right back out of the room. He came back in with a pamphlet and said, “This is what you have: vitiligo.” At that time, there wasn’t a lot of information. The doctor gave me a topical cream for it. I tried it for 6 months. It didn’t seem to me it was helping, so I stopped. I felt deflated.

Thankfully, when I went to another dermatologist, it was a different experience. He shook my hand. He knew immediately I wanted to know about the spots. He explained that I have vitiligo, which is a skin condition. It’s not contagious, which is important for people to know. There’s no cure or way to stop the loss of skin color. He told me that it could spread or maybe some of the pigment would come back. Then he asked me a question I didn’t expect, “How is your self-esteem?”

At that time, I felt good. It was just a couple of small spots. Over the years, as it started to spread and I could see changes, I started to feel more insecure. I have it around my mouth now and all over my body in spots. I stopped wearing shorts. I stopped going to the beach and the pool. I would avoid social settings where people could look at me. It was insecurity and sometimes slight depression and anxiety.

The mental aspect is probably the biggest challenge I’ve dealt with. Vitiligo changed my outlook on myself. I didn’t see myself how others saw me. I struggled socially with friendships and relationships. One of the worst things I’ve found that people can say is that it doesn’t bother them. I understand you may say it doesn’t bother you, but until you walk in my shoes, you don’t understand. You don’t have to look in the mirror watching your body or skin change over time. There’s this fear of the unknown.

I haven’t sought treatment, although it has been offered. The creams I tried at first didn’t seem to help. Light therapy is an option, but it’s time consuming and I didn’t want to risk getting burned. I thought I could do this all on my own. In 2019, I realized I’d been failing. Something a child said helped me start to shift my perspective. I was working at a camp and this little girl told me that I was a butterfly. She identified my spots as a butterfly, as something beautiful.

I decided it was time to open up. I joined the North Carolina Vitiligo Support Community after avoiding it for years. It was the best decision I ever made. For so long, my vitiligo was something that I never talked about. My family and friends didn’t know how I felt about it. I started sharing my journey with other people, and it helped so much.

I’m now one of two leaders for the North Carolina Vitiligo Support Community in Raleigh,. I’m also on the board of directors for VITFriends, which is a national organization that nurtures peer-to-peer relationships in the vitiligo community. I host a podcast called Living Life and Love, where others with vitiligo can share their journey. I found that sharing my own journey with such a large audience released me from a personal prison I’d been living in for too long.

Having this skin condition has opened my eyes in many ways. I’ve come to a place of acceptance. I’ve learned how to live with vitiligo and love myself. Some days are still hard if someone whispers or stares too hard. Kids are often curious and that’s OK. I try to educate people about what vitiligo is.

When it comes down to it, my skin looks different, but I still have interests, hobbies, and talents. I enjoy writing poetry and short stories. I like to paint and draw and be creative. I’m a big fan of science fiction and superheroes. We all have much more in common than we don’t. I’ve gone from being insecure to being secure in myself. I often say that it’s a process for all of us in the vitiligo community. Every journey is different. Everyone has a story to tell.

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October 3, 2022
Vitiligo: Challenges for the Newly Diagnosed

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By Nada M. Elbuluk, MD, as told to Susan Bernstein

One of the most challenging aspects of generalized vitiligo is how much it will progress. This is different for each person. People who are newly diagnosed often ask: “How much will it spread or how stable will it be?” Some people may have stable disease for years. But others may have vitiligo that spreads at any point in their lifetime. If you’re on treatment, this can help your condition stay stable. If not, you can develop new patches.

[Choosing to camouflage vitiligo] is a very personal decision. Each person with vitiligo handles this differently. Some people want to conceal it. Other people are more comfortable with the way their skin looks and they don’t want to wear makeup. First, we will have a conversation about camouflage. I want to know how you feel emotionally about your skin’s appearance. I may also ask, “Do you want to begin treatment, or have your treatments not responded?” There are makeup products for vitiligo that you can acquire over the counter. Some people also use self-tanners that help to camouflage the areas of skin.

I also direct people to different support resources that are available, such as the Global Vitiligo Foundation. They have a section on their website about support resources for patients with vitiligo, as well as support groups across the nation. It may help you manage your feelings to meet with other people who also have vitiligo. Talking with others in a support group can be a very supportive, positive experience. There are online support groups for vitiligo, too. I try to suggest credible sources of information online.

Emotional Impact of Skin Color Changes

Research has conclusively shown that you can have a profound psychosocial and emotional impact from vitiligo. For one, you no longer feel that you have control over how you look — how your skin appears. Vitiligo changes your skin’s color, and you may develop white patches anywhere on your body, including your face. There is also a great deal of variability in vitiligo and how extensive it is on your body. People also feel uncertain about their vitiligo’s progress: Will I have a flare? Will these patches get bigger?

Vitiligo can affect people of all skin colors. I have patients of all colors. We see it in both

adults and children. It can first appear earlier in life, but it can develop when you’re an adult. For children, it can be difficult to understand what is happening to them, and it can also be difficult for other children they are around to understand it.

Therapy and support groups for people living with vitiligo can be very helpful. It depends on the degree to which you are affected, but seeing a psychologist or psychiatrist can be helpful, too. We encourage any individual who is feeling any negative emotions to seek medical care.

Famous Role Models Decrease Stigma

Winnie Harlow was one of the first people with vitiligo to be public about it in a proud way. She is beautiful and a successful model, and she often models without using makeup to cover her vitiligo. This has helped decrease the stigma of vitiligo. There has been a positive wave in recent years about self-acceptance in general. People are starting to accept beauty in all forms which is so important. CoverGirl also recently selected their first spokesmodel with vitiligo. Mattel released a Barbie doll with vitiligo. You are seeing retail stores and marketing campaigns using models with vitiligo.

Self-acceptance of your vitiligo doesn’t take away the need to have treatment options for those who want them. But everyone should know that they are beautiful and have self-worth. It’s important to educate our society about vitiligo. People may ask you if it is contagious — it is not. My patients also ask if it is hereditary. While there is a genetic and hereditary component to vitiligo, the chances of it occurring in the next generation is low. There is less than a 10% chance that you will pass it down to your children.

Protect Your Skin From Sun Exposure

If you are not treating it and just choose to live with your vitiligo as is, then you may not need to see your dermatologist regularly. If you are on treatment, or if you have vitiligo that is spreading quickly, then usually, you should see a board-certified dermatologist every couple of months just to monitor your condition and any changes.

My message to anyone who questions if they have vitiligo or if they’ve been diagnosed with vitiligo is to see a board-certified dermatologist, particularly one who specializes in vitiligo treatment. Again, it is completely up to each person if they want to seek treatment for it or not. Your dermatologist can guide you and talk you through all of your options.

If you have vitiligo, you should wear a sunscreen of 30 SPF or higher, just as we would recommend to anyone. We used to worry that people with vitiligo were at increased risk of skin cancer. However, with more research, we have found that this is not the case, and in fact, you’re at lower risk of melanoma. Still, we recommend sunscreen as a general precaution, and if you’re out in the sun all day, reapply it every 2 hours.

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October 3, 2022
Vitiligo: Treatment Options and Innovations

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By Bassel H. Mahmoud, MD, PhD, as told to Susan Bernstein

Vitiligo is mainly an autoimmune disease of the skin that targets pigment-producing cells called melanocytes. This results in patches of depigmentation in the form of chalky white areas on the skin that can range from very small to very large, even covering most of the skin surface.

Vitiligo affects anywhere from 0.5% to 2% of the population, both adults and children, and affects people of all ethnic groups and all skin types. Vitiligo, although most of the time considered a cosmetic problem, can have a devastating psychological effect on patients and can affect their quality of life.

Treatments for vitiligo include topical and systemic immunosuppressant medications. The one that may be best for you depends on how extensive and active your disease is. There is also phototherapy, which uses ultraviolet light and laser. Other options include surgical treatment.

Immune T cells Attack Pigment Cells

Recent research studies have looked at the pathogenesis of vitiligo, which simply means the chain of events leading to this disease. These studies showed that vitiligo is an interferon-gamma driven disease leading to recruitment of CD8-positive T cells. These are cytotoxic T cells that engage with the melanocytes, or cells producing pigment in the skin, and kill them. Now that we have a better idea of how vitiligo occurs, we can develop better treatments to address this process. These newer treatments target and block these chains of events.

Recently developed drugs for vitiligo that have shown promising results are Janus

kinase (JAK) inhibitors. Examples include ruxolitinib and tofacitinib. Both are immune-suppressing medications that disrupt the cytokine signaling in the interferon-gamma pathway. Some of these new medicines can be used at topic creams or taken by mouth. It does take a few months to start seeing repigmentation of the vitiligo skin.

Many conventional treatments are still used and can be effective for vitiligo, such as oral and topical corticosteroids, which can have side effects if taken for a longer period of time, even topical steroids. The main side effect of topical steroids is skin atrophy, thinning of the skin. Calcineurin inhibitors, such as tacrolimus, are nonsteroidal alternative topical treatments, and they do not have the risk of skin thinning.

Light and Laser Treatments

Phototherapy is also a common, conventional treatment for vitiligo. The most used is narrow-band ultraviolet B light. It’s effective and relatively safe when used under supervision of a board-certified dermatologist. Another type of phototherapy is called PUVA, which is still used in some countries, but studies show that if it’s used for too long, it can cause skin cancer.

Previously, phototherapy treatments were done only at the dermatologist’s office two to three times a week. While it only takes a few seconds to a few minutes to get the treatment, you would still have to leave your work or school to come to your doctor’s office. Now, there are home phototherapy devices available, including many that are covered by insurance with a dermatologist’s prescription.

There is also a laser treatment for vitiligo called excimer laser. You must go to your doctor’s office for this treatment. A machine is used to target the vitiligo areas of the skin with an excimer laser. This treatment is in the ultraviolet range, but it’s a laser, not light. It’s stronger and can have a good effect on the areas that do not respond to treatment with UV light. You need to get the treatment two to three times a week.

New Cell and Tissue Transplant Surgeries

Cell transplant surgery is an option for recalcitrant vitiligo, which means when your vitiligo patches fail to respond to other conventional medications or light therapies. There are very few places in the U.S. that offer this surgery; one of them is at our department of dermatology at the University of Massachusetts. In vitiligo, there is a loss of the melanocytes in your skin, but the hair follicles in this area may have it and act as a reservoir of melanocytes. But if the hair also becomes white, then the reservoir of melanocytes is lost, and this vitiligo area will not respond to conventional therapy, and this is when a cell transplant procedure would yield the best outcome.

One type of surgical treatment is tissue transplant, such as punch grafting from normal skin and applying it to the vitiligo area. But the surface area to treat with this type of transplant is very limited. Also, the outcome is not optimum as it can cause a “cobblestone” look, which may be cosmetically unacceptable.

The other type of surgical option, which is the one I perform, is a cell transplant technique. We take a small amount of normal skin from a donor area, usually a hidden area on the body such as the upper thigh or buttock. Then, we extract the melanocytes from it and suspend them in a solution. While doing this step, we use a laser to resurface the vitiligo areas. Then, when the cells are ready, we apply them to the vitiligo patches and cover them with a bandage. This technique only requires a small area of skin to be taken from the donor site to cover a much larger area of vitiligo, which is a major advantage. The outcome leads to homogenous repigmentation without the cobblestone effect. The procedure is all done under local anesthesia as an outpatient procedure. The complications are minimal with excellent outcomes.

Talk About Your Options

When a patient with vitiligo comes into our office, they are counseled regarding the nature of their condition, different treatment options, techniques, and complications in detail. Then we come up with the best treatment plan for you. There are also many resources to help you understand vitiligo and treatment options that can be found on the American Academy of Dermatology’s website, so please visit www.aad.org for more information on skin, hair, and nail health, and www.umassmed.edu/vitiligo/ for our Vitiligo Clinic and Research Center at UMass.

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October 3, 2022