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Monthly Archives: December 2016

Choosing the Right Skin Care for You

Selecting skin-care products can be a daunting task, what with all the choices filling pharmacy aisles. You’ll find dozens of over-the-counter products with such labels as “maximum strength,” “clinical strength,” and “original prescription strength” — plus seemingly identical products that are available only by prescription. What do all these labels mean, and how do you know which product is the best one for you? Here are some answers.

How Much Active Ingredient?

The active ingredient in an over-the-counter product is often the same as the one found in its prescription counterpart, but at a lower dosage. Over-the-counter dandruff shampoo contains a lower dosage of the active ingredient ketoconazole (1 percent), while the prescription-strength versions contain 2 percent. Inhydrocortisone anti-itch cream, the maximum over-the-counter dosage is 1 percent, while prescription-strength creams contain 2.5 percent. According to U.S. Food and Drug Administration (FDA) regulations, once a product’s active ingredient reaches a certain percentage — such as 1.5 percent for hydrocortisone, or 2 percent for salicylic acid in acne treatments — it requires a prescription from a doctor.

Sometimes It’s Just a Marketing Strategy

Because the FDA does not closely regulate over-the-counter skin-care products, a company can label a product “maximum strength” or “clinical strength” for any reason it sees fit — and the label is no guarantee that the product will actually be any stronger than others on the market. The best way to find out whether you are really getting the “maximum” strength of an ingredient is to check the ingredients label, says Robyn Gmyrek, MD, assistant clinical professor of dermatology at Columbia University College of Physicians and Surgeons. “Compare the label with other products on the shelf,” says Dr. Gmyrek, and check the percentage of the active ingredient in each product.

Although an increase in the active ingredient in a product of 1 percent may not seem as though it would significantly affect the strength, it can, says dermatologist Doris Day, MD, director of Day Cosmetic, Laser and Comprehensive Dermatology in New York City and a professor at NYU Medical School. For this reason, it’s best to test a new skin-care product by applying a dime-sized amount on your forearm, to see if it causes a reaction.

Prescription Products Must Be Approved by the FDA

For the FDA to approve a product’s switch from over-the-counter to prescription-strength status, regulations require a company to show that even a slight increase in the amount of active ingredient (for example, 1 percent) “changes the structure or function of the skin.” All prescription products are reviewed by the FDA and have gone through numerous clinical trials, says Debra Jaliman, MD, a New York City dermatologist. The FDA also decides what dosage level constitutes a prescription. Some OTC products may be labeled “original prescription strength,” which means a prescription from a doctor was once required, but the product is now available without one.

Finding the Right Product for You

How do you know which product to try? Stronger dosages can have harsher effects on your skin, so it’s generally safer to start with a lower dosage. Try the basic OTC product for a minimum of two weeks to gauge the results, then move on to a maximum- or clinical-strength product, if necessary, or request a prescription, says Dr. Day. For acne, you should expect to wait a little longer — from four to six weeks — to see results. And if any product irritates your skin or makes symptoms worse, see your doctor immediately.

Dangerous Metals in Lip Products

Kiss your lipstick goodbye! The beauty-enhancing cosmetic may make you look sexy on the outside, but it could be poisoning you on the inside, according to a study published in the journal Environmental Health Perspectives.

Researchers at the University of California, Berkeley, School of Public Health evaluated more than 30 common brands of lipstick and lip gloss, and found that most of them contained high levels ofheavy metals — lead, cadmium, chromium, aluminum, and manganese — that could put women at risk for health issues including stomach tumors or nervous system problems. Kids who experiment with makeup could also be at risk.

Cosmetics generally contain trace amounts of metals, but the Berkeley researchers say some lipsticks may contain dangerously high concentrations of these metals and are therefore potentially toxic.

“Just finding these metals isn’t the issue; it’s the levels that matter,” said study principal investigator S. Katharine Hammond, PhD, professor of environmental health sciences at UC Berkley, in a press release. “Some of the toxic metals are occurring at levels that could possibly have an effect in the long term.”

“We did not find a pattern in which brands or types of lipsticks or lip gloss contained toxic metals at levels of health concern,” said study lead author Sa Liu, MS, MPH, a UC Berkeley researcher and doctoral candidate in exposure assessment, in an email. “But there are hundreds of products out there and they are constantly changing.”

Concern over heavy metal exposure from lipstick and lip gloss is greater than that for other cosmetics because small amounts of these products can be ingested when you’re drinking, eating, kissing, or blotting — all daily activities of women wearing lipstick or lip gloss.

Based on a previous study, the UC researchers noted that the average lipstick or lip gloss user consumes 24 milligrams daily, while heavier users — defined as those who constantly reapply or administer lip products thickly — consumed an average of 87 milligrams per day. But how much is too much?

“It depends on many factors such as how much one uses, what the metal concentrations are in the products one uses,” Lui added. “It also depends on one’s per-existing health conditions.”

“For a woman with renal disease or diabetes, we may have more concern about exposure of cadmium which deposits in the kidney and causes damages there,” said Lui. “Additionally, a metal may cause more than one adverse health effect at different levels, so it also depends on what health effects one is concerned about.”

The researchers believe their findings are cause for more stringent surveillance of metals in cosmetics, which are all currently unregulated in the United States aside from lead impurity in color additives. “I believe that the FDA (Food and Drug Administration) should pay attention to this,” Liu said in the press release.

“[T]he lipsticks and lip glosses in our study are common brands available in stores everywhere. Based upon our findings, a larger, more thorough survey of lip products and cosmetics in general is warranted,” Liu added.

The Secrets of Buying Face Makeup

It happened again: After spending hours looking for the right face makeup, you bought a foundation that doesn’t match your skin tone. Here’s a minor comfort: Getting the right foundation shade is one of the most difficult beauty products purchases a woman can make. But Helga Surratt, president of About Faces Day Spa & Salon in Towson, Md., says your quest will be easier if you do some homework first.

Suit It to Your Skin Type

Before choosing a foundation, “determine your skin type,” Surratt says. “Is it dry skin, oily, combination, sensitive, or prone to breakouts?”

  • Dry skin: It looks dull since it lacks oil, and it reflects light poorly. It may itch, be irritated easily, and be prone to scaly or flaky patches.
  • Oily skin: It looks shiny, feels greasy, and may have larger pores than normal skin.
  • Combination skin: In this very common skin type, cheeks are dry, but the T-zone (your forehead, nose and chin) is oily.

Choose the Right Formula

Look for foundations designed to do the best job of enhancing your complexion:

  • People with dry, combination, and normal skin can use emollient-based foundations. Look for the words “liquid,” “tinted moisturizer,” “cream,” or cream-to-powder.”
  • Powder-based-foundations can be used by people with oily, combination, or normal skin. If you have dry skin, avoid this type as it will highlight wrinkles and dryness.
  • Moisture-rich or hydrating foundations are good for dry skin. They moisten your skin and help you avoid a feeling of tightness or irritation.
  • Oil-control, oil-free, water-based, or matte foundations can be used by those with oily or combination skin. These formulas reduce the appearance of oil, making your face look less shiny.
  • Light-reflecting foundations are best for dry or more mature faces. They provide a surface that allows light to reflect off your skin and brightens dull or dry complexions.
  • Line-smoothing foundations fill in facial lines to reduce their appearance and de-emphasize wrinkles.
  • Color-matching foundation comes in different shades that adjust to and blend with your skin tone — perfect if invisible coverage is your goal. Look for formulas with more or less oil, depending on your skin type.

Consider the Degree of Face Makeup Coverage

Choose a formula with light, medium, or full coverage, depending on how many imperfections you’d like to “erase.”

  • Light coverage. Some liquid formulas and tinted moisturizers offer light coverage that creates a natural look.
  • Medium coverage. This formula still looks natural but can conceal blemishes and age spots. Powders, liquids, cream-to-powder, and mineral-based foundations all come in medium coverage.
  • Full coverage. Women who want to cover skin discoloration, scars, and other imperfections should consider this option. “Cream in a stick or compact form, cream-to-powder, powder foundation, and mineral-based formulas are your best bets,” says Pam Messy, a makeup consultant with the cosmetics firm Mary Kay.

Find the Right Color

“Foundation is made with a yellow, a pink/red, or a neutral undertone,” Surratt explains. “You want a foundation to match your skin’s undertone. One way to determine your skin’s undertone tone is to look at the veins in your wrist in sunlight or quartz lighting, which gives a truer color rendition. If they are blue, then you have a cool undertone. If they look green, then you have a warm undertone.” Women of color generally have a warm undertone.

Take the Face Makeup Test

Don’t take the word of a salesperson when testing a foundation’s color. Test it yourself. A common mistake is to test the foundation on your hand, rather than your face. “You don’t wear foundation on your hand, so why to test it there?” says Messy. “The best place to test foundation is just above your jaw line. Dab on a little product, blend, and see how the color looks on your skin.”

Where you test beauty products is also important. If you try a product in a drugstore with fluorescent lighting, you may not see its true color or how it will really change the appearance of your skin. Fluorescent lights have low red light and high green light. Normal skin tones have lots of green. If the makeup has green elements, the problem is exaggerated. Some makeup mirrors have adjustments for different types of lighting, but they are not usually available in stores.

Consider bringing a large hand mirror with you and stepping outside to look at the shade in natural light.

As for the best place to buy your beauty products, there are pros and cons to each kind of store. Messy and Surratt agree that if you can afford to, go to a reputable makeup artist who will likely have the proper lighting for foundation selection and good products. If you go to a department store, you may be able to get free samples to try at home, but these brands can be expensive. The drugstore probably won’t have samples for you, but their beauty products are more affordable, and many chains have recently started adding department store-quality lines to their offerings.

The next time you need to buy foundation, remember to focus on what you want your foundation to do for your skin. Do some investigative work to find the right formula for your face. Odds are that your shopping trip may actually turn out to be fun and successful — just as should be!

Tanning Salon Tax No Deterrent

A 10 percent federal tax, imposed on tanning salons in 2010 as part of the U.S. Affordable Care Act, does not seem to deter those who like the bronzed look all year long, a new study finds.

This is true, the researchers discovered, even though tanning salon customers typical pay the tax themselves, rather than the salon owners absorbing the extra fee.

“When the tax first went into effect, many tanning salon owners said they would pay it themselves rather than pass it onto customers,” said study author Dr. June Robinson, a research professor of dermatology at Northwestern University Feinberg School of Medicine in Chicago.

She and her colleagues surveyed 308 Illinois tanning salons to assess the effect of the new tax. “The surprise is that almost none did this [absorb the cost],” she said. Instead, the salons are passing the tax on to customers. What’s more, they found the customers don’t seem to mind.

The study is published in the January issue of the Archives of Dermatology.

Among Robinson’s findings:

  • Eighty percent of the salons collect the extra 10 percent from customers through pricing, rather than absorb it.
  • About the same number of customers come to the salons now as before the tax. The median number of customers per day is 41.
  • Seventy-eight percent of the salons said customers don’t seem to mind paying the extra 10 percent.

Experts such as Robinson are concerned about the increased risk of skin cancer that comes from using the tanning beds. For those under 18, she said, complete bans are needed.

California now has what is considered the strictest regulation on tanning salons, banning use for those under 18.

Most other states regulate use by minors in some way, according to California government officials.

The regulations banning those under 18 from tanning salons should be coupled with fines, Robinson said. “This model follows that of seat belt wearing with enforcement by police in traffic stops and fines in the hundreds of dollars.”

If a tax were to work, she said, it would probably have to be higher, say 30 percent, and be combined with fines.

The new study suggests that for some, “the desire [to tan] is stronger than the 10 percent tax,” said Dr. Jeffrey Dover, a Boston-area dermatologist and an associate clinical professor of dermatology at Yale University School of Medicine in New Haven, Conn. He is a spokesperson for the American Academy of Dermatology.

Another aspect of the problem, Dover said, is that tanning salons often offer package deals, making each session relatively inexpensive.

Other measures are needed, he agreed.

Meanwhile, Robinson said parents can help dissuade their teens. “Parents can behave as role models and offer substitutes to tanning to looking and feeling good,” she said. “Parents provide both the financial means and emotional support that can influence the teen’s behavior.”

In a separate study published in the same issue of the journal, other researchers from several universities found that about half of 181 women aged 18 to 38 surveyed who said they used sunless tanning products — considered safe — still had used a tanning bed in the previous 12 months.

Yet another study, published online in December in the same journal, found that young women who used sunless tanners tended to spend less time in the tanning beds and tanning outside.