Skin Problems
September 5th, 2022 by Dr. Hannah Sivak
If Winter is tough on your skin because of the heating and the dry air, Summer is surely tougher. To the dryness of air conditioning, add the UV radiation of those days at the beach (or on your recliner in the backyard). Not all is bad news. Our skin is NOT a wall, for better and for worse. Skin can heal itself if you give it a chance and will do even better if we help it. We should have been protected with sunscreen and applied more after swimming removed most of it. We should have been applying moisturizers of some kind. But even if we did, we still have…
July 1st, 2022 by Dr. Hannah Sivak
What is alopecia areata? Severe alopecia areata (AE) can cause a total loss of body hair, including eyelashes and eyebrows, nose hair, and hair in the ears. How does this happen? AE is one of the many autoimmune diseases where our immune system malfunctions and doesn’t recognize molecules in our bodies, treating them as foreign and dangerous. What is JAK? The Janus kinase family of enzymes is involved in signal transduction by cytokines. Cytokines control cell growth and the immune response by binding to specific receptors. Once activated, these receptors are phosphorylated by Janus kinases, and the modified receptors recruit transcription factors that modulate gene transcription. Block these kinases, and…
July 1st, 2022 by Dr. Hannah Sivak
What is atopic dermatitis? It’s a common, chronic inflammatory skin disease characterized by skin barrier dysfunction, inflammation, and itch. Steps to control eczema and atopic dermatitis Patch-up skin barrier disruption with topical occlusive products Keep the skin well hydrated. Avoid further disruption: avoid bubble baths, alcohol, abrasion, and prevent scratching at all costs Avoid ingredients that are allergenic like some fragrances and tea tree oil. Unfortunately, some “natural” products supposedly formulated for sensitive skin, contain allergenic ingredients, practically ensuring that eczema will develop or worsen. Avoid UV: this type of radiation promotes inflammation and production of ROS* (reactive oxygen species) Control opportunistic allergens like Malassezia with antifungals and pre-biotics (bee…
June 29th, 2022 by Dr. Hannah Sivak
Atopic dermatitis (AD, eczema is one of its forms) is a common, chronic inflammatory skin disease characterized by skin barrier dysfunction, inflammation, and itch. The exact mechanisms behind the pathogenesis of AD are very complex and still being studied, but we know that its development and persistence require interaction between skin barrier dysfunction, inflammation, and itch. Eczema is a complex, multifaceted skin condition that has a strong genetic component. More than 30 genes have already been identified as implicated in eczema. Knowing the genes involved is not enough to understand the mechanisms involved but progress is being made all the time How does it start? It seems that abnormalities in…
June 19th, 2022 by Dr. Hannah Sivak
A ubiquitous biological material, keratin represents a group of insoluble, usually high-sulfur content and filament-forming proteins, constituting the bulk of epidermal appendages such as hair, nails, claws, turtle scutes, horns, beaks, and feathers. These keratinous materials are formed by cells filled with keratin and are considered ‘dead tissues’. Nevertheless, they are among the toughest biological materials, serving various interesting functions, like scales to armor the body, horns to combat aggressors, hagfish slime as a defense against predators, nails, and claws to increase prehension, hair and fur to protect against the environment. Thinking about keratins familiar to us, it’s hard to think of how they could make an ingredient in skincare,…
May 21st, 2022 by Dr. Hannah Sivak
Ingrown hairs, a.k.a. razor bumps. Very common, almost normal but they can still be problematic. An ingrown hair is one that’s grown back into your skin instead of rising up from it. It can lead to pseudofolliculitis barbae (PFB), which sounds more serious than it is because it’s in Latin. PFB is a chronic, inflammatory reaction characterized by papules and pustules secondary to ingrown hairs. Even in English, PFB is not that pleasant and can get complicated. PFB requires a genetic predisposition, plus a traumatic hair-removal practice; sharp-pointed hair shafts curve back into the adjacent epidermis, causing inflammation, and may lead to an abscess. Curly hair is a major risk…
May 16th, 2022 by Dr. Hannah Sivak
In radiation treatment for cancer, noxious radiation is used, in a VERY focused way, to kill cancer cells. Using information from PET scans and more, the physician/math/physics expert, designs a treatment strategy suitable for the type and location of cancer cells. The objective is to kill cancer cells without harming the healthy tissue around them. This is easier said than done. There will always be damage to healthy tissue, even when using top-of-the-line methodology and equipment. Fort example, the skin is on the way when targeting breast cancer cells “hiding” within the bones. What will happen? Let’s concentrate on the fact that cancer cells will be destroyed, adding months or…
May 13th, 2022 by Dr. Hannah Sivak
When we were living in caves and fighting wild lions, we didn’t make it to menopause. Now, we do. Estrogen does a lot for our bodies, including our skin and scalp. Estrogen deficiency, like the one that comes with menopause, leads to aging and delayed skin repair. In addition to “normal” menopause (around 50), many women go through early menopause, have to contend with the effects of removal of the ovaries or deal with estrogen suppressants (to control the growth of a tumor that responds to estrogen). How does menopause affect skin and hair? The answer is complicated, so I hope you will bear with me. But first, why is…
April 20th, 2022 by Dr. Hannah Sivak
Are you having fun extracting blackheads with a nose strip? They can be useful, but they are just a start. But first, what’s a blackhead? From my book Pores secrete sebum. One of the effects of the not-very-useful sebum is acne, so I can see why pores’ popularity is low. Pores get larger and more visible during adolescence when hormones increase sebum secretion. Pores can get clogged with sebum, keratin, and dead cells, resulting in an environment lacking in oxygen and favorable to the growth of the acne bacterium, C. acnes. The products of bacterial metabolism cause the inflamed pimples characteristic of acne, a real problem that good skincare can…
March 28th, 2022 by Dr. Hannah Sivak
Who didn’t see the Oscars’ story on Will Smith? I totally understand the reaction, it’s like if somebody made a joke about your wife having cancer. We don’t joke about people’s illnesses, except for the sufferer her/himself. And yes, alopecia is a symptom of an illness. It may be temporary or long-lasting. Do you have to shave your head? No. But you must be ready to decrease the stress level on your scalp. If the only way you can do that is by shaving your hair, then go ahead. Alternatives? You can wear your hair shorter, this will “hide” small areas or hair loss. And forget about drying hair with…
January 16th, 2022 by Dr. Hannah Sivak
Upper back acne may be less obvious than facial acne in daily life but wait until Summer and it will remind you of its existence. The causes are the same: blocked pores, and excess sebum that feeds bacteria. The solution: keep pores open, decrease sebum secretion, keep bacteria under control. What can you do? Wear clothes that don’t promote sweating. It used to be that only pure cotton worked but nowadays many synthetic fabrics keep the skin cool and allow sweat to evaporate. The great advantage of the back (over the face) is that you don’t use makeup on your back, and makeup is, for many people, a trigger for…
January 7th, 2022 by Dr. Hannah Sivak
Not a wall! Once upon a time, people thought of their skin as an inert “wall” that could be polished and would glow. Wrong! Think of the skin as a complex organ that contains neuronal networks, linked to the rest of the body also via blood vessels and lymphatic vessels. Ignore the skin complexity and vitality at your own risk. Stress Psychological stress arises when people are under mental, physical, or emotional pressure. It happens when we perceive that pressure exceeds our adaptive power. The brain perceives stress and stress hormones such as corticotropin-releasing hormone (CRH), glucocorticoids, and epinephrine are released, triggering a wide range of physiological and behavioral changes…
January 4th, 2022 by Dr. Hannah Sivak
There are acne patches that will cover up the lesion, they are small, sticky, and made of hydrocolloids. What can they do? Very little but they may be enough if the acne lesion is very minor. The hydrocolloid will absorb the fluids produced by the acne. It will also hide the lesion and help prevent you (or your kid) from touching the zit and spreading of infection. You can improve on these “inert” patches by using them in conjunction with Zit-ender. Apply just a hint of Zit-Ender to the pimple and stick an acne patch on top. If you don’t have acne patches at home, you may be able to…
December 22nd, 2021 by Dr. Hannah Sivak
In my book, I told you that there is no reason why older people should live with paper-thin skin. And there isn’t if you live in the USA or Europe or a relatively rich country and have a moderate income. First: why does the skin thin as we age? The paper-thin skin of the very old can’t do its job correctly – can’t keep infectious agents out, keep water in, etc., and it feels uncomfortable. There’s no reason why aging should thin our skin to that extent; we should keep our skin not just looking young, but “working young.” Often, a consumer may choose to undergo plastic surgery (where a doctor will stretch…
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…