FAQ

/fa/ SKINCARE FAQ - COMPLETE MIRROR

Contents:
- Basic routine, skincare guide, and products tips
- How to pop pimples, remove blackheads and whiteheads
- Why you shouldn't use ordinary soap on your face
- How to improve your skin tone through diet
- Studies on how diary and sugars create acne
- How your skin is affected by sleep, sun, masturbation, controversial skincare ingredients

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Basic routine, skincare guide, and products tips

I have put together a list of basic skin care products that I feel the most confident in.
Several of the cleansers and moisturizers works for people with sensitive skin (dryness, dermatitis, rosacea).
The recommendations are based off dermatological literature, forum recommendations, and online product reviews.
The products in the list should have near-universal approval and quality.

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Recommended basic morning routine:
1. (Cleanser) - unless you are very oily
2. Toner
3. Sunscreen - UV exposure depends on location, but sunscreen generally needed for all locations in the summer season.

Recommended basic evening routine:
1. Cleanser
2. Toner
3. Moisturizer
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If you have dry and sensitive skin:
Wash less often, and use A) mild cleansers, B) a smaller amount of cleanser, and C) lukewarm water.
Clean your skin once daily at maximum, or just every other day (or even less).
Don't shower too warm, as hot water is better at removing oils.
If you also want to manage light acne, focus on using water-based AHA/BHA toners (and also seeing a derm if the need arises).
Moisturizing is key for you. Apply your moisturizers to damp skin, to help maintain the moisture levels in the skin.

If you have abnormal (aka "normal") problem-free skin:
Wash once a day, in the evening - or not at all. An AHA/BHA toner can help maintain your clean skin.
Moisturizers will help keep your skin soft and elastic. Clay masks/various exfoliators can also help your skin become smoother.
A sunscreen will help protect your lovely skin from aging signs caused by sun exposure (photodamage).

If you are oily:
Wash ~2 times a day (using healthy pH-balanced syndet cleansers, see list), and avoid thick occlusive-based moisturisers.
A mattifying foundation, as well as blotter pads, can help as well. Clay masks can help remove excess oil.
Using a lesser amount of moisturizer, and diluting it with some water (mixing it up in your hands), could be optimal if your moisturizer is too thick.

If you have acne:
If you also have oily skin, go with the oily routine and make sure to use AHA/BHA toners 1-2 times a day.
Benzoyl peroxide (@ 2.5%) treatment is the go-to OTC treatment.
Keep in mind that acne is a skin disease, and can often be successfully treated by a dermatologist.
Note 1: Accutane is great, but reserved for severe cases due to harsh side-effects.
Note 2: Diet is a component in acne. Main factors: high diary intake, and high GI-load foods.
(see the acne-diet studies FAQ link on this)

http://www.health.harvard.edu/healthy-eating/glycemic_index_and_glycemic_load_for_100_foods
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Recommended skin care products for the face:

Cleansers:
Cetaphil Gentle Skin Cleanser
CeraVe Foaming Facial Cleanser
Aquanil Cleanser

Toners/Exfoliation:
StriDex Medicated Pads, Maximum Strength (2% salicylic acid)
Paula's Choice 2% BHA Liquid Exfoliant (salicylic acid)
Alpha Hydrox Oil-Free Treatment 10% AHA*
Paula's Choice 8% AHA Gel Exfoliant*

Moisturizers:
CeraVe Moisturizing Lotion
Cetaphil Daily Advance Lotion
Eucerin Skin Calming Daily Moisturizing Creme
Cetaphil Moisturizing Cream**
CeraVe Moisturizing Cream**
Vaseline Petroleum Jelly**

Sunscreens***:
COUI Skincare Facial Advanced Protection SPF 30
Paula's Choice Hydralight Shine-Free Daily Mineral Complex SPF 30
Elta MD UV Clear SPF 46
Kiehl's Ultra Light Daily Defense SPF 50
Shiseido Senka Aging Care UV Sunscreen SPF 50
Neutrogena Age Shield Face Sunscreen Lotion SPF 110 (Overkill)

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*Increases sun sensitivity. Use in the evening.

**Heavy/thick. Will probably leave your face shiny.
Primarily intended for the body, or for evening use on face.

***All of these offer UVA + UVB protection. Can be used on the body.

Try to use a minimal routine, because there is a "functional limit" to how many products you can effectively use on your face at the same time.
The products interfere with each other. Cleanse + clay mask + toner + exfoliation + spot treatment + serum + eye cream
+ moisturizer + sunscreen is simply an expensive and ineffective clusterfuck.

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How to pop pimples, and remove blackheads/whiteheads
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>someone told people to "never pop acne"

I wouldn't tell people to "never pop acne". In general though, it could be wise to ask people to not "pop" different kinds of acne as people in general do it in harmful ways.

"Popping" of acne can generally be split into the treatment of pimples, and whiteheads/blackheads:

- Popping of pimples (generally pustules - pus-filled sacks in the skin): Most people try to make their pimples "pop" by squeezing them with their fingers in order to make the the pimple break, allowing for pus to come out and cleaning of the area and healing of the pimple. Some people also utilize needles and squeezing.

- Squeezing of blackheads/whiteheads (open/closed comedones): Most people try to extract what they believe to be comedones by squeezing the area using their fingers, and sometimes a needle, in order to allow the area to heal once the comedo is removed.

Treating pustules is generally more hazardous, as the contents can spread across the skin during the procedure - as well as spreading deeper into the area by improper lancing (needle, ish) techniques. Both the popping of pimples and comedones can cause local tissue damage as you compress your skin to harshly. There is never a need to use a great amount of force when popping pimples/comedones.

This guide to dealing with pimples/pustules is okay:
http://www.webmd.com/skin-problems-and-treatments/teen-acne-13/pop-a-zit?page=2

Bear in mind that:
- An ordinary "straight pin" should not be used, as these are in general too thick and can cause unnecessary tissue damage. Use the sharpest and thinnest needle available.
- Sterilizing a needle using a flame could cause soot (carbon) to cover the tip of the needle. If it pierces your skin incorrectly, then this soot could end up in your skin and create a basic kind of tattoo. Sterilize the needle with alcohol.
- Alcohol should not be used to sterilize the wound after lancing the pimple. Alcohol pains your wounds because it hurts the general area. Healing time is increased, and will most likely increase local flushing (red skin). Use chlorhexidine or some other mild antibacterial agent.

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This is a good guide to dealing with blackheads/open comedones:
https://www.youtube.com/watch?v=TeGsRMC8J_c

Notice how ineffective fingers are at applying pressure locally to the target area. They are too blunt, and are more likely to harm the skin in the area. I think you're all familiar with this - the red and painful area around pimples/comedones after you've popped them using blunt fingers and too much force. Get a specialized tool on Amazon or whatever. Try to use that instead of your fingers.

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Regarding whiteheads/closed comedones:
They are to be lanced like pustules, and then squeezed gently with fingers - or preferable by the use of special tools (like the one linked to above).

Please note that both closed and open comedones are prone to recurring. "Mechanical extraction" is a very unnecessary thing to do. They'll most likely return in a couple of weeks unless you start treating the area chemically, with stuff like salicylic acid.

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Why you shouldn't use ordinary soap on your face . On soap, pH, irritants and synthetic detergents

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Do not use soap, made from "saponified" vegetable/animal fats. They are generally far too alkaline for your skin, and dries your skin out and irritates it.

Synthetic detergents can also dry your skin out, but they are generally much lower in pH than your ordinary soap - and therefore doesn't disrupt the naturally low pH of the skin. It's generally better for the healthy bacterial flora of your skin.

Maintaining the low pH of your skin can help prevent various kinds of dermatitis/eczema, as well as acne.

You should use a cleanser that is not soap, that is non-irritating and with a somewhat skin-neutral pH. Use a cleanser based on only synthetic detergents ("syndet"). Not all of these synthetic cleansers are good, but most of them are.

Based on "Irritant effect of cleansers - Correlation between pH and irritant effect of cleansers marketed for dry skin" (Baranda, et al), and some other derma literature, I've found that some of the most non-drying, non-irritating and recommendable cleansers are:

- Cetaphil Gentle Cleansing Bar
- Avene Cold Cream Emollient soap-free cleansing bar
- Dove: White Dove (bar), Dove Baby (bar), Dove Pink (bar), Dove Liquid Cleanser for Hands.

The above works for all parts of the skin, way better than most other things you've put on your skin. CeraVe Foaming Facial Cleanser (for the face) as well as Cetaphil Gentle Skin Cleanser are two great options.

As for moisturizers, here's two I can recommend:

http://www.amazon.com/CeraVe-Moisturizing-Lotion-12-oz/dp/B000YJ2SLG

http://www.amazon.com/Cetaphil-Daily-Advance-Lotion-Hydrating/dp/B00352MHE2

Articles:

"The pH of the skin surface and its impact on the barrier function."
http://www.ncbi.nlm.nih.gov/pubmed/16864974

"The skin surface pH and its different influence on the development of acne lesion according to gender and age."
http://www.ncbi.nlm.nih.gov/pubmed/23279122

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How to improve your skin tone through diet

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>someone asked about eating carrots in order to get a healthy-looking "tan"

The thing is that it's not a matter of a "tan", since that's related to increased skin melanin due to sun (UV) exposure. It's therefore nothing you can affect through sun exposure. It's rather a matter of making the skin a bit more red/orange, by eating things that contain different "carotenoids". These substances end up in your skin, to varying degrees. This seems to work as a cue for "healthy person" when people examine faces. This apparently affects how attractive people are rated by others.

It is absolutely possible to change your skin hue, and seems likely that it will impact how others perceive you. +4-7 portions is what's recommended based on the 1st-2nd studies. Carrots, tomatoes. Pills work as well. Dosage depends on the brand.

Don't worry about carotenosis. Increase your intake gradually. The hue change should take weeks, and will disappear in months.

http://www.plosone.org/article/info:doi/10.1371/journal.pone.0032988

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780675/

http://www.st-andrews.ac.uk/~go10/wp-content/media/Evolutionary-Psych-paper-2012.pdf

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Studies on how diary and sugars create acne

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Main concerns are different dairy products, and foods with a high GI load.

https://en.wikipedia.org/wiki/Glycemic_index#Classification

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Diet and acne: A review of the evidence

>Recently, well-designed, controlled, prospective studies have supported the association between specific dietary factors and acne.

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-4632.2009.04002.x/pdf

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A low-glycemic-load diet improves symptoms in acne vulgaris
patients: a randomized controlled trial

>These observations suggest that lifestyle factors, including diet, may be involved in acne pathogenesis

http://ajcn.nutrition.org/content/86/1/107.full.pdf

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Diet in Acne: Further Evidence for the Role of Nutrient Signalling in Acne Pathogenesis

>Recent evidence underlines the role of Western diet in the pathogenesis of acne.

http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-1358&html=1

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Effect of Milk and Dairy Products upon Severity of Acne for Young People

>There is a strong reliable correlation between milk and dairy product consumption frequency and the risk of acne occurrence and development. Pathogenetic influence of milk and dairy products upon acne is proved.

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.388.4968&rep=rep1&type=pdf

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Dietary Implications for the Development of Acne: A Shifting Paradigm

>When observational epidemiological evidence is augmented by biological plausibility studies and confirmed by randomized controlled trials, the case for causality becomes ever-more convincing.

https://www.zentrum-der-gesundheit.de/pdf/akne_16.pdf

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Evidence for Acne-Promoting Effects of Milk and Other Insulinotropic Dairy Products

>Well-designed prospective studies published since 2005 provide evidence that components of Western diets, particularly milk and dairy products and diets enriched in carbohydrates with high glycemic index and glycemic load are associated with acne.

https://www.nestlenutrition-institute.org/resources/library/Free/workshop/BookNNIW67/Documents/NNIW67_booklet_27.pdf

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How your skin is affected by sleep, sun, masturbation, controversial skincare ingredients

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HOW SLEEP DEPRIVATION AFFECTS A E S T H E T I C S

- Face becomes paler
- The face gets puffier overall (cheeks, for example)
- The eye area get puffier (both bags underneath the eyes, as well as swollen eyelids)
- You're more likely to get dark circles underneath the eyes
- Your eyes will probably have more visible veins in them
- You're more likely to suffer from dry eyes, and therefore blink more often and be irritated and have dry, red edges on your eyelids
- You're more likely to get styes around the eye.

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>Looking tired is strongly related to being LESS ATTRACTIVE, looking less healthy and less
trustworthy, and being perceived as a poorer employee and leader.

>One of the studies assessed facial features commonly associated with looking tired,
showing that sleep deprivation results in eyes which appear more swollen
and red, with dark circles and hanging eyelids, as well as paler skin with
more fine lines and wrinkles.

>When sleep deprived, people were also perceived as more sad. In conclusion,
the four studies show that sleep loss and a tired appearance affect how one is
perceived by other people.

>These perceptions may lead to negative evaluations in interpersonal situations,
both personal and professional

http://su.diva-portal.org/smash/get/diva2:800892/FULLTEXT01.pdf

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HOW SUN MAKES YOUR SKIN GROW OLD FASTER

Sun damage to the skin is not overplayed. "Photoaging" is one of the main factors to skin aging.

>Clinical signs of aging are essentially influenced by extrinsic factors, especially sun exposure. UV exposure seems to be responsible for 80% of visible facial aging signs.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3790843/

>Many of the changes that occur in skin structure as a result of aging are expressed prematurely in photodamaged skin, a phenomenon known as photoaging.

http://cdn.intechopen.com/pdfs-wm/45002.pdf

>Extrinsic skin aging is superimposed on intrinsic skin aging process and is due primarily to UVR (solar ultraviolet radiation) and partly by other factors, such as infrared light, smoking and air pollutants.

http://www.anti-aging.gr.jp/english/pdf/2009/6-8.pdf

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Image of trucker exposed to sun damage to mainly the left side of the face:

https://i.imgur.com/pHS6K6f.jpg

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MASTURBATION -> TESTOSTERONE -> ACNE ?

Nope.

http://examine.com/faq/does-ejaculation-affect-testosterone-levels/

http://www.ncbi.nlm.nih.gov/pubmed/11760788
Endocrine response to masturbation-induced orgasm in healthy men following a 3-week sexual abstinence.

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SHOULD I GET A TAN TO IMPROVE MY ACNE?

Within dermatology, many has thought that acne generally worsens during winter (main factors here are humidity levels and UV exposure), but this has been proven pretty wrong later on [1, 4].

The point of sunlight on acne is mainly related to the UV exposure. It has been shown to kill acne bacteria in the skin in studies [2, 3], and therefore help with symptoms. It's not proven though that sunlight "works in the same way", or rather that the exposure amount and kind is not the same [4].

Your doctor therefore has no scientific reason to recommend it in order to get rid of your acne. Bear in mind that your house doctor is most likely a specialist in family medicine - and not a specialist in dermatology.

Sun exposure is something I would consider if I had a limited amount of acne, though, since the red spots you get when you have acne are less prominent when you have a bit darker skin. Your acne will therefore be less visible to other people if you have color.

UV damage to healing acne wounds and scars is something you should take into consideration, though. Check out "skin tone and diet" in the FAQ if you want to change your skin tone in a safer way, and consider using a discreet foundation/spot concealer.

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1. http://www.ncbi.nlm.nih.gov/pubmed/12227481

2: http://www.verilux.com/pdfs/Journal-of-Cosmetic-and-Laser-Therapy.pdf

3. http://www.neuglow.com/Info%20Sheets/Blumod_Clinical_Trial_China.pdf

4. http://fampra.oxfordjournals.org/content/22/1/62.full

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TOXIC INGREDIENTS IN SKINCARE PRODUCTS, AND WHY YOU DON'T NEED TO GIVE A FUCK

A lot of people post links to GoodGuide/CosDNA and similar websites, and tell you to not use
products because they contain some harmful ingredient. That's mostly bullshit.

The advice on GoodGuide/CosDNA is mostly not helpful, and here's why:

1st of all:
Has the ingredient a potential for harm?
In most cases, the answer is yes. Most substances has a capacity to cause harm to organisms if they get a high enough exposure. This is even true for things we need - like water, ordinary table salt (hypernatremia), and even oxygen (hyperoxia). Toxicity is always DOSE-DEPENDENT.

2nd:
The above brings us to the concentration of a substance in a product. This factor is essential since this affects the final amount of the substance that we are exposed to. Manufacturers always have a legal responsibility to not exceed the established safe limits for product ingredients. They generally tend to use concentrations way below that maximum limit.

3rd:
Is the potentially harmful properties of the substance "preserved" in the final formulation of the product? Highly corrosive sodium hydroxide (NaOH) is added to many products to balance out a too-acidic pH, but that doesn't mean that the final formulation is highly corrosive - since the ingredients often react with each other. The fact that a harmful substance has been added to a product doesn't mean that it still has a capacity to cause harm.

4th:
How is the product used? Even if a product contains a potentially harmful "active" substance at a safe concentration, the product can still cause harm if it is used wrong. Apply AHA to your face 20 times a day, and you will be exposed to harmful levels of AHA. Allow a wash-off product to be left on your skin, and your skin will probably be irritated. Painkillers will kill your liver if you eat too many. Safe products are only safe as long as they are used the way they're supposed to be used.

Substances are used because of their chemical properties, and you need to find the balance between their desired function and their possible side-effects.

Following the usage recommendations on the products will keep most people safe from harmful side-effects, while allowing the products to work the way they should and help you.

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RE. PARABENS

Cetaphil is still good.
CeraVe is still good.

>The Cosmetic Ingredient Review (CIR) reviewed the safety of methylparaben, propylparaben, and butylparaben in 1984 and concluded they were safe for use in cosmetic products at levels up to 25%. Typically parabens are used at levels ranging from 0.01 to 0.3%.

The above was re-evaluated in 2005 and left unchanged.

>FDA believes that at the present time there is no reason for consumers to be concerned about the use of cosmetics containing parabens.

http://www.fda.gov/Cosmetics/ProductsIngredients/Ingredients/ucm128042.htm

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WHY CERAVE IS STILL OKAY

>a mild, soap-free cleanser, such as Cetaphil (Galderma) [...] should be applied with the fingertips and rinsed with water. A gentle moisturizer (such as CeraVe Moisturizer (Coria)) should be applied after cleansing.

- The Diagnosis and Management of Mild to Moderate Pediatric Acne Vulgaris - Joseph B. Bikowski, MD

>CeraVe Lotion, Cream, and Cleanser (Coria Laboratories) are ceramide-dominant topical formulations that feature multi-vesicular emulsion (MVE) technology.

- CeraVe Lotion is on the list of "Recommending Topical Moisturizers: Clinical Benefits and Practical Considerations", by Practical Dermatology

>A novel ceramide based MVE skin care line (CeraVe) is also currently available and includes a hydrating cleanser, cream and lotion.

- Recommended moisturizer in the "What's new in the medicine chest? - New options improve treatment outcomes" by James Q Del Rosso, Clinical Associate Professor of Dermatology.

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written & compiled by STHLM !!6Gk3cvqPqbL

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