Dr. Ulmer answers "How Can I Deal With Acne and Aging Skin?"

By Pacific Derm on April 14 2020

ASK THE KIT - HOW CAN I DEAL WITH ACNE AND AGING SKIN? - It’s time to pare down and refocus on the basics

Ask The Kit

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I struggle with acne and sensitive skin over the years. I’ve tried many skincare products not knowing how they would react. Now I’ve finally hidden my mirror in the garage and am seeing some improvement. Acne sufferers want to ensure we are using products that don’t interfere with acne treatment, and I am hoping you can help me fill the gap when it comes to acne and aging skincare. —Dorothy, Toronto

I am in a relatively philosophical headspace these days, as I’m sure many of us are, after weeks spent exhaustingly triaging even the tiniest daily choice. Do I pull the trigger on a run to the store yet? Answer: Not if we still have one wilted carrot left. Can I fashion a game for my kids based around watching me send emails? Answer: No, sadly. What’s going to help my peace of mind more—washing the floor or lying face down on it? Trick question: Neither.

So, in my current state of mind, your very practical skincare question also seems to strike right into the heart of what so many of us are grappling with this during this pandemic: How can I move forward sensibly while dealing with the unknown? And, importantly, how can I avoid making a tricky situation worse? I don’t know about you, but I’ve been spending a lot of time staring out my window, watching the buds start to collect at the tips of branches and pondering those very questions.

Dr. Marcie Ulmer, Pacific Derm

Dr. Marcie Ulmer, Pacific Derm

Some very smart doctors—shoutout to national treasure Dr. Theresa Tam—have offered suggested answers to those larger questions: practise physical distancing no matter how much it hurts; and I know, it hurts. So I called a specialized pro to discuss your specific dilemma: Dr. Marcie Ulmer is a dermatologist at Pacific Derm in Vancouver who has dedicated experience treating both acne and rosacea—two common skin concerns that are, unfortunately, also commonly misunderstood. “First of all, for mature patients especially, the pimples of rosacea are often misdiagnosed as acne,” she explains. “And if you treat these patients like they have acne, the skin will get much worse because they have such sensitive skin.”

Both conditions involve red bumps, of course, but rosacea is a chronic condition that tends to progress as we age, while acne tends to wane—so older adults who presume they are dealing with acne should explore whether their issue might, in fact, be rosacea. (Acne, importantly, also typically causes black-and whiteheads, while rosacea doesn’t.)

Though I might be implying that the situation is even more frustratingly complicated that it seems, you can breathe deeply knowing that the initial treatment is soothingly clear: if you have skin concerns, start by paring back at first. “People should start by consistently following only a simple skin care routine in the morning and at night: cleanse, moisturize, apply SPF,” explains Dr. Ulmer. “It’s amazing that when we look at skin care trials for a new topical acne or moisturizing cream, the placebo group, which is often just using good cleanser and moisturizer, actually sees an improvement. There’s scientific evidence to show that just basic skin care is really helpful for a lot of underlying skin conditions—and it’s especially useful as a starting point.”

So the answer to your skin care question is perhaps incredibly straightforward. How can you make sure that your skin care isn’t interfering with any medication? Start by using a couple of products that have few-to-no active ingredients. This may not be what blogs or sales associates are telling you; this isn’t a routine to brag about on social media; it won’t serve as a pastime during the pandemic; but it might be what your skin wants and needs.

“While skin care is super individual, I recommend a fragrance-free gentle cleanser twice a day,” says Ulmer. “Your skin shouldn’t feel tight after washing because whether you have acne or rosacea or sensitive skin or mature skin, you want a cleanser that improves your skin barrier, not one that just strips away moisture.”

The second step is applying an uncomplicated good-quality moisturizing cream or lotion. “It’s a misconception that people with acne or pimples from rosacea shouldn’t use a moisturizer, but they actually need one to help boost their barrier, especially since skin tends to get drier as we age.” Look for a facial moisturizer that is non-comedogenic, so it’s not going to clog pores, that has a humectant to attract water like hyaluronic acid and an emollient to lock that moisture in like glycerin. Ceramides are another useful key word to look for on labels.

Then apply a good quality physical broad-spectrum SPF 30 sunscreen “every single day—because you can still get sun damage if you’re inside, as UVA rays can penetrate through windows,” says Ulmer. And while chemical sunscreen might aggravate certain skin conditions, products that use minerals like titanium dioxide tend to be non-reactive, so there isn’t an excuse to skip this important step. (Once you have stuck to this non-routine routine for a month or more, you can gauge if you’re seeing benefits and whether it’s necessary or useful to introduce some active ingredients. Vitamin C in the morning and retinol at night, says Ulmer, are clinically proven options for those interested in anti-aging benefits. But retinol can be drying and potentially irritating, especially for rosacea, so start low and slow. “Just start with one product at a time and watch for flare-ups, since you might learn it’s a trigger.”)

The main route to consider if you’re looking for skin care benefits, while worried about potential negative interactions, is looking closely at your lifestyle choices. “Aging is determined by intrinsic influences like genetics, which we can’t change—and extrinsic factors, which we can alter and are proven to help your skin: eating a healthy diet rich in antioxidants, getting adequate exercise and enough sleep, limiting alcohol consumption, obviously avoiding smoking and unprotected sun exposure, adding a humidifier to your space and avoid screaming hot showers or saunas.”

These days, there’s another common culprit of skin woes that we should all be cognizant of: our emotions. “We try to learn to manage our stress and anxiety as best we can by responding to emotional triggers in the healthiest way possible, which not only helps with our overall well-being, but can also soothe skin flare-ups.”

So if, say, putting your mirror in your garage helps you stop obsessing over your complexion and eases your anxiety, then that’s a simple and smart strategy to help your state of mind and the state of your skin. But if it’s because you don’t want to look at yourself, if it’s because you have trouble appreciating your own reflection, then bring it back into your home and embrace yourself. As Ulmer says: “Aging is a natural part of life and, as we’re all seeing these days, it’s truly a privilege to age.”

 

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