Skin Problems
October 18th, 2021 by Dr. Hannah Sivak
Keloids are benign tumors of the skin caused by faulty healing. They are not dangerous (cancerous) but they can still make life miserable for the person who suffers from this healing disorder. A keloid originates in local trauma and it’s a growth that extends beyond the scar’s boundary. There are at least two distinct keloid types: the superficial-spreading/flat keloids and the bulging/raised keloids. This is one of the many skin problems that are treated without a good understanding of what causes them, an approach that leads to bad results. What we do know is that wound healing is a complex process and that many things can go wrong with the…
September 23rd, 2021 by Dr. Hannah Sivak
You may assume that a prescription medicine is the best for your condition, and you may be right in some cases. But just like taking an antibiotic may be a bad idea when you have a cold, so could be using a “strong” medicine for a skin condition. A steroid cream used long-term will make your skin thinner and give you “steroid acne”. And a prescription medicine used to treat rheumatoid arthritis may be a bit too much treatment for a skin condition. Recently, the FDA has approved the prescription drug Ruxolitinib as a medication for the treatment of eczema. Does this mean you should go for it? Let’s look…
September 11th, 2021 by Dr. Hannah Sivak
…and that oral antibiotics work on too slowly (for an inpatient grandmother)? …and that adapalene doesn’t seem to alleviate? Try Skin Actives Zit Ender! It makes me happy that my grandson now thinks that I am a genius. Eventually he will realize that I’m not, but in the meantime it feels great. What’s in SAS Zit Ender? Sea Kelp (Lactobacillus/Kelp Ferment Filtrate) Bioferment, Salix Alba (White Willow) Bark Extract, Water, Camellia Sinensis (Green Tea) Epigallocatechin Gallate, Kaempferia Galanga (Galangal) Root Extract, Oleanolic Acid, Zinc PCA, Dipotassium Glycyrrhizate (Licorice Extract), Aloe Barbadensis (Aloe Vera) Leaf Extract, Galactoarabinan, Fucoidan, Beta Glucan (Yeast), Beta Glucan (Oat), Opuntia Ficus Indica (Prickly Pear) Extract, Pyrus…
August 28th, 2021 by Dr. Hannah Sivak
There is an advantage to oily skin: it seems to age more slowly than dry skin. Myth: Moisturizers Make Acne Worse in Patients With Oily Skin Not true: moisturizers can help with retinoid or salicylic acid treatments, alleviate dryness, and make the skin feel more comfortable. Moisturizers for oily skin Oily skin may need moisturizing; just make sure that you use the right products and don’t add “bad” oils to already oily skin. A light moisturizer can also help protect your skin after washing and make-up for a “breached” skin barrier. Go for a lotion rather than a cream. Lotions are a water/oil emulsion and contain more water than creams…
July 21st, 2021 by Dr. Hannah Sivak
Yes, but with difficulty. At present there is no magic cure; the best that can be hoped for is to control it and there are several tools available. Let’s look at them. What you see in vitiligo: milky-white spots in an otherwise normally pigmented skin. What we know Melanocytes are absent in the stratum basale of areas affected by vitiligo. The causes of vitiligo are only partially understood: autoimmune mechanisms, oxidative stress, and viruses may contribute to it. At present, there is no cure for vitiligo. Children and young adults may need counseling to prepare them for an extended fight to control vitiligo. There is a genetic component to vitiligo,…
June 9th, 2021 by Dr. Hannah Sivak
What happens when you drop some oil on water? The molecules in the oil form a very thin layer at the top and that’s it. They are not going anywhere. What is my answer to itchy, sensitive skin? I prepare a bath with warm (but not hot) water, drop some Nourishing skin serum with hemp extract in it, and then I go in. The thin layer of nourishing lipids that my skin needs so badly transfers instantly to every square inch of my body, much more efficiently than if I try to apply it patiently (I have no patience). The myriad itches go away and my skin looks great. A…
April 18th, 2021 by Dr. Hannah Sivak
I don’t know of any papers that address this issue in skincare. But we know that microbes can adapt to the environment and even mutate, giving us bacteria that become resistant to antibiotics. I also know that even if products stay the same, the skin doesn’t. You may think that your kin has become “resistant” to an ingredient used to decrease sebum secretion, while what actually happened is that your skin has changed in response to the hormonal cycle. A product may have been bad for you from the start, and your skin may be responding to a constant change in acidity. Frequent peels will decrease the efficacy of the…
April 18th, 2021 by Dr. Hannah Sivak
We ignore the menstrual cycle at our own peril because it matters. Acne is common in postadolescent women, and an increase in lesions may be noted in the last 7-10 days of the menstrual cycle. Why? Changing hormones across the menstrual cycle produces measurable variations in immune function and susceptibility to disease. The skin and scalp have estrogen and progesterone receptors in both the dermis and epidermis. Levels of estrogen and progesterone fluctuate during the cycle and influence numerous characteristics of the epidermis, including lipid secretion and sebum production, skin thickness, fat deposition, skin hydration, and barrier function. Dermal collagen content, which contributes to skin elasticity is also affected. Estrogen…
August 3rd, 2020 by Dr. Hannah Sivak
Whether you are 13 or 31 you still have to think long-term: your skin will be the barrier to protect you from the environment for the rest of your life (which I hope it will be long and happy). Because you have to think long term, you have to be careful when you buy an anti-acne product. Why? Because many companies don’t think long term about your skin when they formulate their products. Many companies only think of making money fast and their interests are unlikely to fit with yours. What should be your objective? To control acne without damaging your skin or aging it prematurely. And yet, many ingredients…
July 16th, 2020 by Dr. Hannah Sivak
What’s special about eyebrows? They grow slowly. Not so special: they can die. Teenagers eager for some sort of control on their bodies often go for eyebrows, not knowing (or caring) that they can lose them, actually losing all control! On top of innocent-looking tweezers, now there is also lasers, offered by medical looking facilities that will make you sign documents with really small text where you promise not to sue them if …(here a long list of complications). Fashions come and go, but if you keep plucking your eyebrows you will not get them back. Just like the scalp can stop making hairs, so your skin can stop making…
July 5th, 2020 by Dr. Hannah Sivak
Filaggrin (filament aggregating protein) plays an essential role in the organization of keratin filaments and the development of the cornified layer (stratum cornueum) of the skin, which is an essential part of the skin barrier to epidermal water loss and to the entry of microbes and noxious substances. (There are some strange aspects to filaggrin, which point to influence beyond the skin. For example, filaggrin mutations are associated with asthma.) Figure: skin layers Dermatitis, a.k.a. eczema is the almost normal state of the skin in which the skin feels tight, itchy, even painful at times. You will see swelling, and the lesions may eventually lead to scarring. Is filaggrin involved…
June 27th, 2020 by Dr. Hannah Sivak
As we age, crucial DNA mutations accumulate in our cells, and the mechanisms that regulate cell division fail. Out of control cell division plays havoc with our bodies: it’s called cancer. As the general population ages, the incidence of cancer increases. Science had progressed enormously in the understanding and treatment of cancer, and some amazingly sophisticated therapies do exist forme some specific types of cancer. For many other types of cancer, a big part of the treatment involves removing and killing cancerous cells. Thus, surgery to remove cancerous tumors is often followed by radiation therapy. In addition to dealing with sutures still healing, the patients (us) have to contend with…
May 19th, 2020 by Dr. Hannah Sivak
The basics of skin pigmentation are the same for different skin colors. Here they are. My skin color is different from my daughter’s. In fact, all skin colors are different, because there are infinite combinations of amounts and types of pigments present in human skin. The color of our skin is partly due to the pigment called melanin. Other factors are the content of diet carotenoids, the bluish-white color of connective tissue, and the abundance of blood vessels in the dermis and the color of blood flowing in them (oxy- and deoxy-hemoglobin). Other minor pigments (minor unless you have a bruise) are bilirubin (the yellow hemoglobin degradation product that colors…
February 27th, 2020 by Dr. Hannah Sivak
Every woman knows that if she lives long enough, menopause will happen. We’ve seen it happen in our grandmothers, mothers, friends and eventually it will happen to us. Ovaries will naturally decrease their production of the sex hormones estrogen and progesterone, and the decline will affect the whole body. We know what to expect: not fun effects, but tolerable with some adjustments and some help from the MD. This is normal and to be expected unless you decide to go for hormone replacement therapy, in which you take extra estrogen and progesterone, oral and/or in patches. Many women will have to face a different kind of menopause: induced menopause. This…
January 1st, 2020 by Dr. Hannah Sivak
Answer: We understand the seriousness of the problem and we face it differently. The key concept is that the skin is alive and quite capable of doing its job, until it isn’t. What has changed? The skin ages, or is damaged, or the environment changes and overwhelms the defenses. Our answer: we replenish the skin’s natural defenses, by carefully following the established antioxidant system already at work in our skin. We don’t innovate in the sense that we don’t build from scratch, we only refresh, “top-up” the natural order. We can achieve this because we understand how the skin functions: its anatomy, physiology, biochemistry, and molecular biology. Amazing scientific advances…
November 14th, 2019 by Dr. Hannah Sivak
We have all done silly things to ourselves. Let’s hope we learnt something and don’t repeat the same mistakes (we will make new ones!). One of the mistakes most women do is ignore how fragile the eye area of the skin is, especially the eyelids and even more specially, the area that form the eyelashes. It is not just our fault, but that of the unscrupulous people who advertise dangerous ways of becoming more beautiful. They don’t tell you that those methods are dangerous, and that the effects are fleeting and then you are left with damage that, sometimes, is not fixable. In this list: people who advertise permanent makeup,…
November 10th, 2019 by Dr. Hannah Sivak
The dermal-epidermal junction is so thin (in a microscope it is just a line that we may be tempted to ignore it completely. And yet, it is crucial to skin’s health. It is also critical to some problems that many of us consider very annoying: sun spots that appear as we age. Others don’t have to wait that long: they are afflicted with melasma or vitiligo much earlier in life. These are all disorders of pigmentation, and, apparently, disruption of the dermal/epidermal junction may be the starting event in disorders of pigmentation initiated by factors like UV radiation. Once the chain of events is initiated, keratinocytes don’t adhere properly and…
November 10th, 2019 by Dr. Hannah Sivak
If the wall in your home has a crack in it, you call a painter. He will patch up the wall, prime it and paint over. The wall will look like new. If your left eyelid is a bit “droopy”, and your first instinct is to see a plastic surgeon, think again. Because your skin is alive and it is silly to think of surgery as the only option. Your skin is not like a wall: your skin is alive and capable of changing for the better. %0, 60 or even 70 does not mean that you have yo give up on skin care, on the contrary. Almost anything good…
September 24th, 2019 by Dr. Hannah Sivak
Look at your face and hands and see what last Summer, the one that just ended, did to them. Ouch! Pigmentation is more irregular, plus there is a new scar or two and, how about those new wrinkles? First of all, as the Hitchhiker’s guide to the Galaxy will tell you: Panic is the worst advisor when you have any problem, especially a health problem, panic makes you take bad decisions. My suggestions 1) NOT suitable for sensitive skin: A good start would be a super light “peel”: 15% Vitamin C serum or alpha/beta exfoliator, but not both. More is less, in this case. Follow the instructions carefully. Rinse the…
September 16th, 2019 by Dr. Hannah Sivak
What’s special about the soles of our feet? They lack sebaceous glands (like the palms of your hands) and are thick. Are these “special” characteristics a problem? They can be. Thicker skin that produces no sebum will tend to crack, especially after alternating between the pool and wearing sandals. This is a tough combination: you are likely to end up with cracked soles, and they may even be painful. If you let it go on without correcting the problem, inflammation and more pain will ensue. The cracks will make it easier for fungus to colonize the area. What not to do: don’t go for aggressive abrasion. Instead, try a moisturizing…