Skin Problems
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…
September 14th, 2019 by Dr. Hannah Sivak
Striae distensae or stretch marks are deep scars caused by the skin being stretched beyond its capacity to stretch, followed by ineffective repair of the damage. Latin does not make them any less noticeable. They may start as striae rubra, which are reddish streaks (indicating increased blood flow), and “mature” to as striae alba, which are hypopigmented atrophic bands. Location: abdomen, thighs, breasts, more or less anywhere when the skin was stretched too fast. What you see is skin that has less elasticity, more roughness, and lower dermal density than normal skin. At the molecular level What you see at the molecular level is that in normal skin, dermal collagen…
September 14th, 2019 by Dr. Hannah Sivak
We need to start with the basics: what is a pore, and why they are so important. There will be some repetition here but I hope our readers will not mind too much. As usual, feel free to skip whatever is too boring, but, hidden within the boring stuff you may find some useful facts you have not heard about in the past. Celebrities’ photos how no pores. This is not because celebrities have no pores but because magazines use Photoshop to a ridiculous extent. Is this a problem? I think it is. False advertising makes women buy products that can’t possibly have the effect advertised, which was obtained with…
September 13th, 2019 by Dr. Hannah Sivak
What is dull skin? It depends on who you ask. In my opinion, it is a non-existing skin condition, The opposite of dull skin, however, does exist, on babies and in Photoshopped pictures. The famous “glow” of the actresses photographed in the 1920s was obtained by careful lighting, make up and touch-ups. Photo: the great Greta Garbo. Now we have Photoshop and people still dream of the after-Photoshop skin of Julia Roberts. But remember that before Photoshop, her skin is just like yours and mine. . Photo: Julia Roberts: beautiful with or without Photoshop. What a smile! Incidentally, some insects can actually make light. It is called bioluminscence. The insect…
August 22nd, 2019 by Dr. Hannah Sivak
1. What causes dark spots? Dark spots: a.k.a. sun spots, liver spots, age spots. They happen when the (very complicated) mechanism that should give you a sun tan, goes wrong. Making a pigment like melanin under the influence of the sun makes sense: if you are going to be in the sun, making a pigment that protects the skin from further damage is a good solution. Next time you are in the sun there will be less damage produced by the high energy rays because the pigments in the skin will give some sun protection. The process to make the pigment and accumulate it in the skin is very complex…
August 16th, 2019 by Dr. Hannah Sivak
If you think that cellulite is a medical term, you are wrong. So, what is it? It is what you want it to be. Or, rather, what skin care companies and plastic surgeons want it to be. We all know what cellulite looks like, but let me assure you that it is NOT a disease. Still, I managed to find a review on cellulite published in a relatively obscure medical journal (European journal of dermatology and venereology, 2000, 14: 251-262). Despite the lack of recognition of cellulite in the medical field, this “condition” managed to gather a few medical-sounding names, like gynoid lipodystrophy, nodular liposclerosis, oedemato-fibrosclerotic panniculopathy and panniculosis. It…
August 16th, 2019 by Dr. Hannah Sivak
If you ever feel the temptation of instant “lifting” and “plumping”, resist! I will explain why. It is true that wrinkles and skin pigmentation problems are the typical mark of aging, but so is the change in shape of your face, including the “under eye” shadows that bother so many women. And yet, nobody talks about that change o shape, except maybe to try to sell you products for skin sculpting. This is pretty silly, because “skin sculpting” is not possible. It is an advertising formula that has no meaning in real life. Our faces are not made of butter or clay, they cannot be sculpted. Buy why is this…
August 10th, 2019 by Dr. Hannah Sivak
I have discussed before in this blog the importance of the skin as a barrier and what happens when it gets disrupted. The skin barrier and how it works. This is about sensitive skin. A quick search of the blog will take you to dozens of posts related to the skin barrier. The “acid mantle” is part of the skin barrier, and probably one you don’t have to worry about unless you keep washing your hands with an antiquated alkaline bar of soap. Most soaps now are milder, more acidic and contain detergents rather than alkaline soap (or a mix). Even when washed with the wrong kind of soap, the…
August 6th, 2019 by Dr. Hannah Sivak
Combination skin is probably the norm, in the sense that some areas of the skin produce more sebum that others. The so called “T-zone”, includes the forehead, nose, and chin, and tends to be more oily than the rest of the face. As people age, sebum secretion decreases, even in the T-zone. This is the main reason why the incidence of acne also decreases as we age, as the sebum fatty acids is what keeps acne bacteria going. What to do then, if you have combination skin? Just use the same products all over, and reserve some T-zone serum for the area of the forehead, nose and chin, as needed.…
July 4th, 2019 by Dr. Hannah Sivak
Note that most people use this term for “bumpy” skin, common in children and teenagers. Some types of keratosis pilaris (with longer names) are related to severe genetic problems. Keratosis pilaris is a (usually) temporary disorder of keratinization, The problem resides in the upper portion of the hair follicle, which fills with scales instead of exfoliating normally. In bumpy skin, actives that improve keratinization and skin renewal will help a lot. These include alpha hydroxy acids, salicylic acid (so called “beta hydroxy”), and vitamin A. Other actives that can help are those that will help keep the skin moisturized but will not “plug” pores. K.P. is normal, if we define…
June 27th, 2019 by Dr. Hannah Sivak
It is hard to find a precise definition of sensitive skin, but sensitive skin does exist: more and more people are defining themselves as having sensitive skin, reaching numbers as high as 50%. We may have to re-define normal, because once more than half of us have sensitive skin, this becomes the new normal. Clearly, there must be something that we are doing wrong. In “we” I include people and manufacturers of skin care products. What is “exaggerated” reaction? It can be pain, stinging, dryness, inflammation, redness, reactions to products or environmental conditions that usually are not described as irritating or allergenic. In my opinion, this huge increase of people…
June 25th, 2019 by Dr. Hannah Sivak
Two products, not counting those for eyelashes and eye brows. As always for Skin Actives, look at the ingredient list. First, let me tell you about some of the ways that eyes are special. We have to be careful not to irritate them and be very careful not to increase the chances of getting an eye infection. Styes, infections in the eyelids, are also very uncomfortable. Also, the skin of the eyelids and in the eye area is thin and gets thinner with age, making what happens in the capillaries below very visible. Eyes, like the lungs, are open to the environment and exposed to pollutants and irritants. What do…