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Need to Know: The Skinny on Spring (and Summer) Skincare

Now that we can officially say good bye to winter (we hope), most of us will be spending a lot more time outdoors. Our skin has been inside for the past 5 months, so what do we do to prepare it for the next few seasons? We asked local mom and Board Certified Dermatologist, Dr. Julie Cantatore Francis (, some questions:

juliecantatore1Q: Parabens seem to be of concern to everyone right now. Can you break it down for those of us not in the medical industry?

J: Parabens (methylparaben, propylparaben and butylparaben) are the most widely used preservatives in personal care products such as shampoos, mascara, foundations and body lotions and creams. They extend the shelf life of these products ; they stop fungus, bacteria and other microbes from growing in your favourite creams and makeup, especially in the moist, warm environment of a bathroom. Without parabens we would would have to keep these products in the refrigerator and buy them much more frequently.

Parabens started being questioned when a study was published liking them to breast cancer. Parabens were found in malignant tumors of the breast, however, noncancerous tissue from healthy breasts wasn’t examined to see if parabens were also present there. In addition, presence of parabens in tumors doesn’t prove that they caused the cancer. Other studies have shown parabens to have a very weak estrogenic effect. All this leads to concern about the unknown. Parabens have been around the longest of most preservatives and have a good safety record. So far there’s no good scientific evidence to support a link with any form of cancer.

Currently, the amount of parabens in any product is typically quite small.

Regulatory agencies including the U.S. Food and Drug Administration, the World Health Organization and the Cosmetic Ingredient Review found that parabens’ use in products never even comes close to becoming unsafe.

I tell my patients that, sometimes, decisions on ingredients are made based on marketing and a label suggesting paraben-free suggests that the product is somehow superior, though there may not be much data. If it helps, there are a number of paraben-free products on the market available both over the counter and in dermatologist’s offices.

Q: Really, how much spf do we need and how much do our kids need?

J: SPF refers to the ability of a sunscreen to block ultraviolet B (UVB) rays, which cause sunburns, but not UVA rays, which are more closely linked to deeper skin damage. Both UVA and UVB contribute to the risk of skin cancer.

The SPF rating is a measure of the time it would take you to sunburn if you were not wearing sunscreen as opposed to the time it would take with sunscreen on.

An SPF 15 product blocks about 94% of UVB rays; an SPF 30 product blocks 97% of UVB rays; and an SPF 45 product blocks about 98% of rays. Sunscreens with higher SPF ratings block slightly more UVB rays, but none offers 100% protection.

I recommend SPF 30 products for daily protection and an spf of 45 or higher for spring and summertime outdoor activities for both kids and adults.

Whatever product you choose, I (as well as the American Academy of Dermatology) recommend using a water-resistant sunscreen applied liberally one half hour before going outdoors. Sunscreen should be reapplied at least every two hours or after swimming, drying off, or sweating.

Q: Our generation loved the sun 20 years ago. Is there anything we can do now to reverse or slow down the signs of aging?

J: Treatment of aging skin includes (a) measures to prevent against UV damage and (b) medications and procedures to reverse existing damage.

Ways to combat aging include :

1. Sun protection- wearing a daily sunscreen with an spf 30 or higher; make sure the sunscreen will protect against both UVA and UVB rays ; wearing sun protective clothing (long sleeve, hat , sunglasses) ; sun-protective behavior (no use of tanning beds, avoid midday sun , avoid sun bathing and seek shade)

2. Retinoids – (retinoid acid/Retrinol/ tretinoin) Numerous studies have shown that extended use of these molecules will reverse long-term photoaging and rebuild collagen damaged by UV radiation. This helps with skin texture and wrinkles too!

Try to use on a daily basis, at night. There are different strengths so you want to start out with a lower one and gradually increase so your face does not get red and irritated. Insurance will not cover these prescriptions for anti-aging.

3. Antioxidants- These work in a different way than retinoids or sun protection. All antioxidants help the body capture and remove free radicals. Free radicals are byproducts of the body’s natural processes but can damage neighboring cells as they build up. Vitamin C was the first topical antioxidant. Others include green tea, copper, coffeeberry and resveratrol from grapes.

Topical antioxidants and sunscreens when applied together are synergistic in reducing free radical and UV damage in the skin. You can find products that have both in them or you can stack products. Antioxidants should be applied during the day with the sunscreen but can also be used at night.

4. Wound healing products. Wound healing factors and growth factors are cultured and placed in many anti-aging cream to help the skin recover from the wounds related to sun damage and age. These tend to be physician-dispensed products. These products are developed from proteins found in early human skin, which are significantly reduced as we get older. They can be used under retinoids, antioxidants or by themselves.

5. Anti-aging procedures :

a) Increasing Collagen- collagen and blood vessel walls are damaged by sun and free radicals. Fillers can stimulate collagen and provide a volumizing/rejuvenating substance for wrinkles in the mid and lower face (Restylane and Juvederm) ; Laser Resurfacing (Fraxel, Co2) gets energy into the dermis where damage collagen is found

b) Decreasing Dynamic Wrinkles- neurotoxins such as Botox/Dysport are most helpful along the brow, forehead and eye to rejuvenate

c) Decreasing Brown and Red spots- IPL or intense pulsed light is a multiple wavelength light device, not a laser (for brown spots and redness) . Vbeam or Pulsed dye laser (for red spots/patches, rosacea and individual brown spots)

d) Peels- using acids to help even skin tone and color through exfoliation

Q: Many of our friends have never had a skin cancer screening. At what age do you recommend we start going for checks and how often?

J: If there is a family history of skin cancer or very atypical or dysplastic moles , I recommend a baseline examination in kids. If not they can be followed by their pediatrician but make sure to point out any moles you may be concerned about.

I recommend a full body exam for anybody who is 18 years or older whether they have a family history or not. I counsel all my patients on the ABCDE of changing moles (Asymmetry, Border irregularity, Color, Diameter (if enlarging or greater than a pencil eraser), Evolving or any change noticed)

It is really never to young to have a full skin check.

Q: We are always looking for beauty bargains. Can you give us 3 drug store finds that you cannot live without?

J: I love the CeraVe product line- well tolerated by all skin types; I like the renewing cream for dry flaky skin; the PM facial moisturizer for night application and the foaming facial wash to kick off your anti aging routine AM and PM

I also like the Neutrogena make-up removing towelettes- they are easy to use and are effective in removing make up and all good for all skin types

Last, I like the Neutrogena pure and free baby sunscreen for kids and adults it has zinc and titanium dioxide which are physical sunblocks but are mercerized so they do not look too white. It also comes in a facial sun stick – easy to put on faces (especially small ones) and easy to carry around.

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Q: Last, what do YOU do to stay fit in CT?

J: I love to run – I usually pick a nature preserve or beach trail. I usually take one of the boys. My husband and I pick a local race to run every few months to keep us motivated which is fun. We like the races that have a fun run so we can all participate as a family.

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