Have you ever found yourself in the cosmetic isle at the grocery story wondering what you should buy for your skin? Soon, you are overwhelmed by the number of brands, colors, shapes and the many words you see including humectant, toner, moisturizer, sunscreen, brightener, etc. It is not surprising that a recent report stated that the cosmetic industry in the United States is close to 62.4 billion dollars. Many companies are competing for your attention and ultimately your business. Don’t forget the countless blogs, YouTube videos, Instagram posts and on and on. How are you supposed to make a good decision when it comes to skin care? As a practicing dermatologist, there is not a single day that I don’t get asked the question “what moisturizer do you do recommend?” Or “What is the best sunscreen?”
When it comes to skin products, I believe, the least you do is best. So, what should you put on your skin? I believe in 5 main categories or “CRAMS”: Cleansing, Retinols, Antioxidants, Moisturizers and Sun protection.
First, cleansing your skin.
There are 3 main categories when it comes to “soaps”. These are soaps, syndets and combars. The main point about these types of cleansers has to do with how close they are to the natural pH of your skin. In this sense alkali soaps tend to give you the feeling of “tightness” following a bath while more neutral soaps give you the “moisturizing” or “creamy” feeling. In my practice I recommend syndets (pH 5.5-7) which include Cetaphil bar or Dove bar.
These products are a form of vitamin A. Retinols are used in skin care to help reduce the appearance of age and to correct fine lines, wrinkles and color variation. It usually takes 3-6 months to see evidence of improvement. The main side effect is local skin irritation which can be minimized by the use of moisturizers, using it less frequently or changing the strength of formulation. There are retinol products that are sold at stores and they are usually seen as less potent as the ones that are prescribed by dermatologists. Common names you will hear are: retinol, tretinoin, adapalene, tazarotene and retinoic acid.
UV radiation as well as our environment lead to the production of free radicals or chemicals that can damage your skin overtime. The use of antioxidants can help minimize some of the damage on your skin. In this category I often recommend green tea polyphenols. Polyphenols have shown to have anti-inflammatory and antioxidant properties. Other antioxidants I often recommend are vitamin C and niacinamide. Many products have these ingredients and these can be in combination with moisturizers or sunblocks.
The word moisturizer is somewhat deceiving as people often think these products increase water or humidity to the skin. In reality, these products are intended to retain or slow down the loss of water from your skin rather than increase it. The most effective “moisturizer” is the one that provides the most occlusion. Petrolatum is the most occlusive, but it is often too “greasy” for everyday use. I often recommend Eucerin or CeraVe cream which are easy to use daily. Another method of moisturizing the skin is using humectants which attract water. Hyaluronic acid is an excellent humectant.
Finally, sun protection.
Remember simple is better. Focus on sunblock vs sunscreen. What this means is that you want an agent that blocks UV radiation. These sunblocks include titanium oxide and zinc oxide. These are not only great blockers, but they are less irritating to your skin and safer for the environment. The main choice comes down to the way these agents are applied to your skin. There are creams, lotions and sprays. In recent years, the development of small particle formulations has allowed the use of sunblocks without the “thick pasty” feeling of applying sunblocks. Daily use of sunblock will not only help your skin look younger and healthy, but it will help prevent skin cancers. There are many companies that have these types of sunblocks. I often recommend Elta MD, Neutrogena and skinceuticals.
Staring at 100’s of products in the cosmetic isle at the grocery store does not have to be a daunting task. Speak with your dermatologist about what products are best suited for you. Remember, less is best and your approach to skin care should not be complicated. Start with CRAMS; cleansing, retinols, antioxidants, moisturizers and sun protection.