- My face is always red. Does that mean I have rosacea?
- My skin is so dry. Do I need to drink more water?
- I want to get rid of some of these deep wrinkles around my face. Will Botox help that?
- Why am I getting all these pre-cancers on my face? I never go out in the sun anymore.
- Is skin cancer inherited?
- Is it true that if you get laser treatments you can never go out in the sun anymore?
No. A red face and rosacea are overlapping, but not necessarily the same problem. It is true that many people who have pink-appearing cheeks, chin, and mid-forehead are prone to rosacea. Almost all patients who have rosacea acknowledge that they flush easily with exercise, embarrassment, spicy food, or exposure to extremes of temperature. But people can have red faces from skin allergies, eczema, irritation from products, seborrhea (a dandruff-like condition), or diseases like Lupus.
Redness with a tendency to develop pimples, particularly in the central part of the face, is more likely to be rosacea, and those symptoms are likely to improve with treatment that may involve a change of skin products, topical medications, and sometimes oral antibiotics. A red face and the dilated blood vessels that people often refer to as "broken capillaries" are likely to benefit substantially from laser treatments, or light based treatments such as BBL (Broad Band Light). At our clinic that treatment is called Fotofacial ©.
Yes and no. Water is vital to health and, except in rare circumstances, it's healthy to drink as much as possible. It's true that a person suffering significant dehydration, will have dry, loose skin in addition to other symptoms, but simply adding fluid does not correct the appearance of dry-looking skin in other circumstances. Skin appears dry because of irritation and scaling, or defects in the membrane surrounding skin cells that functions to prevent water loss. Those types of problems may need to be addressed by a variety of interventions: less irritating cleansing regimens, diets richer in essential lipids which improve cell membranes, and correct use of moisturizers to improve the barrier function of outer skin cells and prevent ongoing water loss.
Botox is highly effective in reducing the appearance of dynamic facial lines, those wrinkles that become visible or exaggerated during specific facial movements. Which are the dynamic facial lines? Glance into a mirror and frown: Those deep parallel lines above the nose are dynamic. Raise your eyebrows: Those horizontal lines forming across the forehead are dynamic. Smile broadly: Crow's feet lines radiating away from the eyes are dynamic. Botox relaxes facial muscles and make all those facial gestures associated with aging appear softer and more relaxed; those lines become less conspicuous. But it does not change the deep lines that so many people develop alongside the nose, jowl lines, wrinkles of the eyelids, lips, or sides of the cheeks. Some of these lines respond best to fillers. Some of them require laser treatments that brighten and tighten the skin. And some require plastic surgery to achieve measurable improvement.
Yes, but you once did. Sunshine is composed of ultraviolet energy which is a form of radiation, and, as with all radiation, the real damage typically takes years to develop. What you encounter now may well be the result of childhood sun exposure. It's been estimated that many of us get 90% of our lifetime sun exposure before our adult years. But it does pay to be wise about ongoing exposure. Studies have shown that ongoing use of sun protection or UV avoidance prevents a significant number of future skin cancers.
Although there are rare forms of inherited skin cancers, more often we are looking at family members who have simply inherited factors that increase baseline risk, like fair skin and a tendency to sunburn. Family members are likely to share environmental risk factors as well: outdoor activities, vacations to the beach, and a shared value for "wearing" a tan. If we develop skin cancers like out parents, it is likely that it is because we inherited their skin type, and have taken on their habits as well.
That said, there appears to be a strong inherited family link with a form of melanoma called the "Dysplastic Nevus Syndrome" or "Familial Melanoma Syndrome" in which affected family members develop an increased number of abnormal moles that are large and asymmetric and contain a variety of shades and color. These individuals have a high lifetime risk of developing melanoma skin cancer, and benefit from increased surveillance and screening.
No. It is only important that during a series of laser treatments and for a defined period afterward, that you limit direct exposure to sun. For one reason, tanning interferes with the laser's ability to reach its skin target, making the treatment less effective and the risk of burning greater. A second issue is that recently treated skin (by laser) will tan abnormally, leaving dark areas or white spots that show up after treatment, fading only slowly.
Finally, most laser procedures are undertaken specifically to reverse the ill-effects of previous sun exposure. It stands to reason that patients will want to take precautions such as wearing sun screen and protective clothing to prevent long term sun damage to skin that's just been repaired. Going out in the sun is not the problem. Going out in the sun without adequate protection is.