DermHelpCentral

Scleroderma

The New York Times Health section featured Scleroderma in September 2008.
The Unfolding Mystery of Scleroderma is an ecxellent place to start if you are interested in reading about this subject.

"Like many autoimmune ailments, scleroderma remains a great unknown. Despite decades of research, the cause of this rare and complicated disease has yet to be discovered. But the good news is that doctors have a pretty clear understanding of how scleroderma progresses — a natural history, they call it — and are better than ever at extending and easing their patients’ lives." 

The full article can be accessed at Permalink.

S.A.D.: Severe Atopic Dermatitis

In today's NY Times, there is an incredible article about S.A.D. by science writer Ingfei Chen.  It touches on the role of staph in exacerbating the eczema, the need for soothing baths, the role of antibiotics in treatment and more.  Ms. Chen's article could be a primer for starting to learn about SAD.

In some way, SAD, and related inflammatory dermatoses, are orphan diseases.  At present, they don't have really expensive therapies that would induce drug companies to throw money at them (for secondary gain).  These patients take time and are very complex, and we dermatologists want to see a new patient everey ten to fifteen  minutes.

If you want to start to understand S.A.D. please read this article.  It can be accessed at Permalink.

Albinism

NY Times, June 8, 2008

"Many people in Tanzania — and across Africa, for that matter — believe albinos have magical powers. They stand out, often the lone white face in a black crowd, a result of a genetic condition that impairs normal skin pigmentation and strikes about 1 in 3,000 people here. Tanzanian officials say witch doctors are now marketing albino skin, bones and hair as ingredients in potions that are promised to make people rich.

Discrimination against albinos is a serious problem throughout sub-Saharan Africa, but recently in Tanzania it has taken a wicked twist: at least 19 albinos, including children, have been killed and mutilated in the past year, victims of what Tanzanian officials say is a growing criminal trade in albino body parts."

To read the full article, go to Permalink

Dark Circles Under Eyes

"Roughly 53 percent of the 13,000 Clinique users surveyed by the company in 2006 cited under-eye circles and puffiness as their No. 1 beauty concern.

'We were really shocked,” said Dr. Mammone, who has a Ph.D in molecular and cellular biology. “We knew many of our people in distribution and sales suggested that it was a concern, but we didn’t really know until the survey that it is a major issue.'

Full article at:  Permalink

You may also want to visit this Blog: Mydarkcircles

Cosmetic Minimalism

New York Times
January 4, 2007
Skin Deep Section
The Cosmetics Restriction Diet
By NATASHA SINGER

Download cosmetic_restriction.pdf

Dr. Fran E. Cook-Bolden, a dermatologist in Manhattan, is an advocate of skin-care minimalism. When a patient recently arrived for an appointment toting 20 different products she was using regularly — including an eye cream, a vitamin C cream, a wrinkle serum, a pigmentation cream, a mask, a peel, a scrub and “some sort of special oxygen detoxifying cream” — Dr. Cook-Bolden said she confiscated all but three.

“It gave me a headache just to look at all of those products,” Dr. Cook-Bolden said. “Just two products, a gentle cleanser and a good sunscreen, are enough daily skin care for most people, and you can buy those at a drugstore or a grocery store.”

Dr. Cook-Bolden is part of a back-to-basics movement among dermatologists. At a time when beauty companies are introducing an increasing number of products marketed for specific body parts —including necks, creases around the mouth and eyelids — or for apocryphal maladies like visible pores or cellulite, these doctors are putting their patients on cosmetics restriction diets.

They are prescribing simplified skin-care routines requiring at most three steps: soap; sunscreen every day, no matter the weather or the season; and, if necessary, a product tailored to specific skin needs, whether a cream for pimples or pigmented spots, or a vitamin-enriched moisturizer for aging skin. Each product, they say, can be bought at drugstores for $30 or less.

Among those doctors who have become experts at uncluttering their patients’ vanity tables and medicine cabinets is Dr. Sarah Boyce Sawyer, an assistant professor of dermatology at the School of Medicine at the University of Alabama at Birmingham.

“My New Year’s beauty resolution for patients is: cut down on skin-care products and cut your skin-care budget,” Dr. Sawyer said. “Cut down on those $100 potions.”

For some doctors, simplifying skin-care routines is a way to make patients follow a regimen or a means to soothe irritated skin. But some dermatologists are also suggesting patients use fewer, less expensive products because they believe there is little scientific research to justify buying an armload of pricey cosmetics, Dr. Sawyer said.

“We have good medical evidence on prescription products,” she said. “But the science is fuzzy with a lot of cosmetics.”

Unlike drugs, cosmetics are not required to prove their efficacy.

Prescription medications like Accutane for acne and over-the-counter drugs such as sunscreen ingredients must undergo rigorous clinical testing before they gain approval from the Food and Drug Administration. But cosmetics are not subject to the agency’s scrutiny before they go on sale. The F.D.A. defines cosmetics as topical products that do not alter the structure or function of the skin.

Dr. William P. Coleman III, the vice president of the American Academy of Dermatology, said consumers should view moisturizers and wrinkle creams as no more than superficial treatments.

“You have to think of cosmetics as decorative and hygienic, not as things that are going to change your skin,” said Dr. Coleman, who is a clinical professor of dermatology at Tulane University Health Sciences Center in New Orleans. “A $200 cream may have better perfume or packaging, but as far as it moisturizing your skin better than a $10 cream, it probably won’t.”

According to F.D.A. regulations, beauty manufacturers are responsible for the safety of their cosmetics and for their own marketing claims. Although many beauty companies perform studies on their products, they are not required to conduct clinical trials on the level of medical research or to make their proprietary research available to the public.

Dr. Mary Ellen Brademas, a clinical assistant professor of dermatology at New York University Medical Center, said the paucity of rigorous published science on cosmetics makes it difficult to determine how well creams work, whether they cost $10, $100 or $1,000.

“People are spending $450 on a jar of cream just because it is made out of something exotic like salmon eggs or cocoons,” Dr. Brademas said. “But the cheapest products work just as well as the more expensive ones.”

A study of wrinkle creams published last month by Consumer Reports concluded that there was no correlation between price and effectiveness. The study, which tested nine brands of wrinkle creams over 12 weeks, also concluded that none of the products reduced the depth of wrinkles by more than 10 percent, an amount “barely visible to the naked eye.”

The Consumer Reports study found, for example, that a three-step regimen of Olay Regenerist products costing $57 was slightly more effective at reducing the appearance of wrinkles than a $135 tube of StriVectin-SD or a $335 combination of two La Prairie Cellular lotions.

“I am seduced by fancy packaging as much as the next person,” Dr. Brademas said. “But I have a theory that all these skin-care things come out of the same vat in New Jersey.”

John Bailey, the executive vice president for science of the Cosmetic, Toiletry and Fragrance Association, an industry trade group in Washington, said that skin care varies widely in price because of amounts spent on research and development of ingredients and product formulas, and the cost of manufacturing and packaging.

But, he said, it is difficult to measure performance differences among products.

“Cosmetics don’t have the same quantitative analysis as drugs, so you don’t have a set gauge you can use to determine perceived and actual benefits,” said Dr. Bailey, who has a Ph.D. in chemistry. “Ultimately, consumers will have to try products out and find what works best for them.”

THE back-to-basics skin-care regimen is based on practicality rather than marketing claims. It does not rely on exotic ingredients grown on far-flung islands hand-picked by natives only under a full moon.

Dr. Diane C. Madfes, a clinical instructor at Mount Sinai School of Medicine, said that basic skin care requires washing one’s face to remove dirt, sweat and bacteria, and using sunscreen to impede sun damage. People who worry about wrinkles, pimples, dry spots or pores may want to add one or two treatment products, she said.

Dr. Cook-Bolden, who has been a paid consultant for several mass-market cosmetics brands, suggested a mild liquid cleanser for the face. Instead of using toners, which may strip skin, or gritty exfoliation beads and microdermabrasion systems, which may irritate skin, she recommended using a washcloth to slough off dead skin cells.

“If you have dry, sensitive skin, you just pat the washcloth on your face gently in a circular motion,” she said. “If you don’t have irritated skin, you can put more speed and pressure on the washcloth.”

Dermatologists disagree whether a moisturizer is then needed. Dr. Brademas said it is superfluous.

“Moisturizer is optional unless you are in the Arctic,” said Dr. Brademas, who favors Vaseline petroleum jelly for dry hands, feet, knees and elbows. “I’m not sure moisturizers do very much except for creating a smooth surface so that makeup can go on without drag.”

Dr. Cook-Bolden took a more agnostic position.

“If you need a moisturizer, moisturize,” she said. “If you want less moisture, use a lotion. If you want more, use a cream. And if you have acne-prone skin, use a gel or a spray.”

Although the dermatologists interviewed for this article disagreed about moisturizer, they agreed on one point: the importance of sun protection, including hats, avoidance of midday sun and the use of an effective sunscreen. They recommended that consumers look for formulas that include ingredients — like zinc oxide, titanium dioxide or Mexoryl SX — that impede damage from the sun’s longer wavelength UVA rays, a protective effect that is not indicated by a product’s SPF rating.

Beyond soap and sunscreen, Dr. Madfes said that one or two additional products might be added to personalize a skin-care routine.

“People who see wrinkles around their eyes are going to reach for an eye cream,” Dr. Madfes said. “Someone who looks in the mirror and sees large pores may want to use a cleanser with salicylic acid, which can reduce clogged pores.”

She is also a proponent of night creams that combine retinol, a form of vitamin A that may help speed up the turnover of skin cells, and antioxidants such as vitamin C, vitamin E or lycopene that may help thwart environmental damage to the skin. People with skin conditions like severe acne or people interested in topical anti-wrinkle drugs should consult their doctors about prescription medications, she said.

On an expedition last week to a CVS Pharmacy at Columbus Circle with a reporter, Dr. Madfes examined the product labels on skin-care items from a variety of mass-market brands and recommended a few basic products, including Cetaphil cleanser and La Roche-Posay Anthelios SX sunscreen.

“Higher end, more expensive products may look better in the box and feel better on your face, but they don’t necessarily work better than less expensive products as long as you look for ingredients that are known for efficacy,” Dr. Madfes said.

But she did see one benefit to splurging.

“The thing is, when someone buys a $200 cream, they are going to use that cream,” Dr. Madfes said. “So, in the end, their skin may benefit.”

January 11, 2007
Protecting Our Skin (1 Letter)

To the Editor:

“The Cosmetics Restriction Diet” (Thursday Styles, Jan. 4) reminds us that using multiple products may cause the skin to break out.

Each cosmetic may contain 30 or 40 chemicals, some of which cause irritation or allergy. The skin is the essential barrier between our internal organs and the outside world. It is the largest organ and is a remarkable protector, but exposure to many substances can be harmful.

We often advise patients to refrain from using anything nonessential to reverse adverse reactions. We should show great respect to our wonderful “container.”

Stephen Danziger, M.D.

Brooklyn, Jan. 4, 2007

The writer is chief of dermatology at New York Methodist Hospital.

Cosmetic Dermatology

New York Times
January 25, 2007
SKIN DEEP
A Word From Our Sponsor

By NATASHA SINGER

Download cosmetic_derm.pdf

WHEN Clinique made its debut in 1968, the cosmetics brand altered America’s beauty landscape by using scientific language and clinical iconography at a time when highly perfumed, elaborately packaged creams dominated department stores.
Clinique hired a prominent dermatologist, Dr. Norman Orentreich of Manhattan, to help develop the line. It outfitted its sales force in pristine white lab coats and installed them at cosmetics counters where they diagnosed the skin types of customers. Even its name carried a clinical aura.
But now Clinique has gone one step further in aligning itself with therapeutic imagery — and in the process has raised the ante for beauty companies seeking affiliations with doctors.
Officials today are scheduled to open the new Clinique Skin Wellness Center at Weill Medical College of Cornell University in Manhattan. The project, financed by a $4.75 million donation from Clinique along with $2.25 million from an anonymous donor, involves medical research and the construction of a clinic within the dermatology department of the medical school.
At the clinic, made up of examination rooms and a workstation, doctors will conduct skin examinations, with a particular focus on educating patients on how to prevent skin cancer and maintain skin health. Patients at the center may also make on-site appointments with Clinique representatives to learn about makeup that can cover skin redness or facial scars.
But critics said the sponsorship is the clearest example yet of what they see as the blurring of lines between medicine and the beauty industry.
At a time when some doctors in private practice can earn six-figure consultancy fees from the makers of facial injections or wrinkle creams, Weill Cornell’s alliance with a cosmetics firm, critics say, has the potential to further diminish the stature of academic medicine as an unbiased authority and give the impression that dermatology is for sale to the highest bidder.
“I think the image of our specialty is particularly tarnished by myriad physicians hawking their own eponymous skin-care products and by academic departments appearing to sell their names to beauty companies,” said Dr. Amy E. Newburger, a dermatologist in Scarsdale, N.Y. In an editorial last month in the Archives of Dermatology, Dr. Newburger and Arthur L. Caplan, chairman of the medical ethics department at the University of Pennsylvania, warned medical schools away from alliances with beauty companies.
“Is dermatology for sale? Well, yes,” Dr. Newburger said.
Dermatology is not the only field struggling with commercial interests. In a climate of reduced federal financing for basic research and fixed fees imposed by managed care for services, medical institutions and individual doctors are increasingly looking to industry sponsorship.
Pharmaceutical companies regularly pay for research on diseases that can be treated by their own products, with the studies frequently published in influential medical journals. Doctors whose research has been sponsored by industry or who are consultants to companies regularly lecture on these studies at national medical meetings. Drug company representatives routinely visit doctors’ offices, handing out free drug samples and providing meals to staff members.
Dr. Jeffrey J. Meffert, a dermatologist in San Antonio who exposes the methods by which companies try to sway doctors, said that some medical schools have prohibited drug representatives from visiting their campuses or providing speakers for hospital grand rounds to try to curb the influence of industry.
BUT potential conflicts of interest seem particularly troubling in dermatology, where doctors can make a seven-figure income by performing expensive — and entirely elective — cosmetic treatments, which are often paid for out of pocket because they are not covered by insurance. Some dermatologists also conduct research for companies or have lucrative contracts as consultants for drug, device or cosmetics companies.
The question of the relationship between medicine and the beauty industry came to the forefront last year when researchers affiliated with Johns Hopkins Medicine signed a contract to vet a new skin-care brand. The researchers were to review studies of a skin-care line called Cosmedicine, produced by Klinger Advanced Aesthetics, and the institution was to receive company stock. Signs posted in Sephora stores touted the relationship with Hopkins.
But after articles about the deal appeared in newspapers, the medical school gave up its equity position in Klinger. (Though doctors associated with Johns Hopkins Medicine have also helped the company design model cosmetic medical offices in malls in Dallas and Chevy Chase, Md., where nurse practitioners treat patients.)
There are reasons that beauty companies might seek an alliance with a medical institution or with doctors. Americans spent about $7.8 billion last year on skin-care products, according to Euromonitor International, a market research firm. In such a competitive market, cosmetics companies like to ally with doctors and medical schools because such relationships can infuse a brand with an aura of scientific credibility.
In the last decade, nearly two dozen dermatologist skin-care brands have appeared in stores. And established brands like Lancôme, Dior and Prescriptives have hired dermatologists as consultants.
Clinique, which created the quasi-scientific image, is now the best-selling prestige skin-care brand in the country, according to statistics from Euromonitor.
Lynne Greene, global president of Clinique, said the company’s new relationship with Weill Cornell should further enhance the brand’s image.
“At Clinique, we see ourselves as the last stop before the dermatologist and the first stop after the dermatologist,” Ms. Greene said. “The Weill Cornell partnership emphasizes our position as the skin-care authority.”
But Dr. Richard D. Granstein, chairman of the dermatology department at Weill Cornell, distinguished the medical school’s relationship with Clinique from other academic-cosmetic partnerships. Weill Cornell will not research cosmetics, test cosmetics, vet cosmetics, sell cosmetics or allow its name to be used in product promotion, he said. The center, he said, is merely a “naming opportunity” for Clinique.
“We are not in the beauty business,” said Dr. Granstein, who is receiving research financing from Clinique. “You are not going to walk into a Sephora and see a sign that says ‘Weill Cornell,’ or I’d resign.”
Clinique is giving a five-year grant to the medical school that covers research and the construction of the dermatology clinic.
One project involves research to investigate how stress can affect the skin’s immune system, making it vulnerable to everything from skin cancer to allergies. Clinique has also endowed a research fellow to be known as the Clinique Clinical Scholar; the first recipient, Dr. John A. Carucci, studies genetic changes linked to skin cancer. In addition, the company will also sponsor an annual scientific conference and public lectures on topics like skin cancer and skin maintenance.
But the most visible aspect of the arrangement is the Clinique Skin Wellness Center, a unit of the medical school’s dermatology department. There, doctors will conduct skin exams and advise patients about preventive skin care. Clinique representatives will also be available to offer suggestions on how to camouflage skin conditions or post-treatment inflammation.
“If you are 22 and you want to know what you can do to prevent skin cancer, or you want to avoid looking like your mom whose sun damage makes her look 80 even though she is only 50, we now have a center to deal with that,” Dr. Granstein said.
Ms. Greene said that Clinique initially plans to hold monthly office hours at the center. If there is sufficient demand, Clinique representatives could potentially visit the center weekly, with up to 500 patient consultations a year, she said.
She said the company’s consultants will offer general suggestions on products like gentle cleansers or sunscreens, but not recommend specific products by name. The company will also distribute its own educational brochures — with titles like “Can a tan signal DNA damage?” and “Is a wrinkle a wound?” — which discuss skin care in layman’s terms, she said.
“There is a chance here to be really helpful to patients,” said Dr. Granstein, recalling a recent patient who was so embarrassed about burns on her leg that she had stopped wearing skirts until she learned about camouflage makeup. “I don’t care if they go buy the Clinique whatever-it-is or the L’Oréal whatever-it-is.”
But critics said that, even without on-site cosmetics sales or specific product recommendations, the arrangement would appear to patients as an endorsement of the beauty industry. It is believed to be the first time that a cosmetics firm has branded a medical researcher and a skin-care center at a medical school and also the first time that a medical school has set up an on-site program allowing a beauty firm access to patients.
Dr. Caplan said that cosmetics, which are defined by the Food and Drug Administration as products that do not fundamentally alter the skin, have no place in mainstream medicine. He added that patients would interpret the Clinique sign, beauty advisers and brochures as the medical school’s seal of approval for the brand.
“With that kind of Clinique billboarding, you have totally left the realm of neutral medical provision and decided to open a beauty parlor on your premises,” Dr. Caplan said.
Dr. Newburger said that such a setup could also unconsciously bias doctors and affect patient care. In the absence of other competing brands, the presence of Clinique could lead dermatology residents to familiarize themselves with fewer products or to delegate post-treatment recommendations to beauty advisers, she said. She added that patients would be vulnerable to the incidental marketing.
“When a patient sees a doctor in a private setting, the patient expects the individual doctor to have a profit motive,” Dr. Newburger said. “But you don’t expect it when you go to a medical school, a place which is supposed to be above the fray and not involved with one company or another.”
Dr. Granstein called relationships with beauty companies a “slippery slope” for medicine. But he said that beauty was not a new territory for medical schools because dermatology inherently involves a patient’s appearance. Acne and psoriasis, for example, are “essentially cosmetic diseases,” he said.
“I recognize the potential for conflict here, especially in having someone give advice to a patient,” Dr. Granstein said. “If it turns out that we can’t do it right, then we won’t do it.”

Xerosis (Dry Skin)

January 5, 2006
Skin Deep
Help Skin Survive a Cruel Season
By NATASHA SINGER

WHEN the arctic air of winter makes faces red, itchy and flaky, beauty companies are ready with exotic and often expensive solutions. Products like Murad Winter Hydration Set ($50), Clarins Thirst Quenching Hydra-Care Serum ($50) and Chanel Hydramax + Serum Intense Moisture Boost ($65) promise to drench parched skin in water and coat it with lubricants.
But there are less-expensive ways to protect the skin from winter air. Inhabitants of some of the coldest places on earth, who are well accustomed to the season's harsh effects, often rely on cheaper, simpler solutions.
In Grise Fiord, Northwest Territories, where the sun sets in October and doesn't rise again until February, and the winter temperature rarely rises above 16 below, the most reliable skin protection system is outerwear: a wool scarf, a thick hat, warm mittens and a down parka.
"When I go outside, I put on a parka that has a hood lined with fur," said Ray Richer, the general manager of the Grise Fiord Inuit Co-op. "You pull that around your face, and that saves your skin." At latitude 76 degrees North - about 960 miles from the North Pole - Grise Fiord is the northernmost community in Canada. The temperature there last week was minus 29 degrees.
If it gets any colder, Mr. Richer also insulates his skin with lotion. "What with my delicate skin, when it gets down to minus 70 degrees and I need a little extra protection, I put Dove body lotion on my face at night," Mr. Richer said. "It's simple, but it works."
Mr. Richer and other veterans of harsh weather - like skiers, winter runners and dermatologists who practice in cold climates - say that simple moisturizing products are best at keeping skin from getting dry, flaky and irritated because they are denser and more durable than expensive creams and therefore can provide greater and longer-lasting protection. And winter experts also have ways of keeping skin from drying out in the first place.
"In the old days the Inuit never took baths because they were afraid of washing off the natural oils which protected their faces from frostbite," said Lonnie Dupre, a polar explorer who lives in Grand Marais, Minn., near the Canadian border. He plans to cross the Arctic Ocean this April in a white-water canoe. "If you can bring yourself to bathe less often, you can keep the natural protective lanolins on your face."
It is not the cold itself, but the dryness it brings to the air, that parches the skin, breaking down its natural protective layer of dead cells. Made of both proteins and fats, this layer, called the stratum corneum, forms an oily coating that usually helps to keep moisture in the skin. When it dries out, the skin is more vulnerable to the elements, slower to heal from injuries, and more prone to flaking and cracking.
"Cold winter air that blows in from the Arctic holds less water than very humid tropical summer air," said Dennis Feltgen, a meteorologist at the National Oceanic and Atmospheric Administration's National Weather Service headquarters in Silver Spring, Md. Colder air, he explained, cannot hold as much water vapor as warm air can, so it is drier. "Then we pipe that dry air inside our apartments and heat it up, making the already dry air even drier." The heat causes the air molecules to expand, so you end up with even less moisture in a room than before, he said.
Humidifying indoor air is one way to help maintain healthy skin, dermatologists say.
"Faces are just like wooden furniture, which dries out in the winter and becomes fragile and gets unglued if the air is too dry," said Dr. Ann Lott, a dermatologist in Lincoln, Neb. "A humidifier works for both."
To help retain moisture, dermatologists also recommend avoiding scalding showers and harsh soaps, which can strip away the oily layer.
"If you use lukewarm water instead of boiling water and a soap with moisturizing agents like Dove or Olay, those two things alone may be enough to keep your skin in shape for the winter," said Dr. Jerome M. Garden, a dermatologist in Chicago, where last week the temperature hovered around 31 degrees. The idea is to keep bacteria and other irritants out of the skin and hold water in, Dr. Garden said, "keeping cells as plump and protected as possible."
Dr. Brian D. Zelickson, a dermatologist in Minneapolis, recommends adding a little fragrance-free oil like RoBathol (sold in drugstores) to bath water for increased hydration. After a bath or shower, he said, it is better to gently pat yourself dry than to rub and buff the skin with the towel. Then, he said, "While you still have water droplets on your skin, you can coat yourself with a humectant to seal the moisture in." Basic moisturizers like Aveeno or Purpose work well, he said. "But you could also use a little olive oil or Crisco."
Dr. Lott's favorite winter moisturizer is the original Nivea Creme. "That's the grand old one that your grandmother used," she said. "There are newer, fancier products with faddish ingredients like vitamins, soy and green tea, but Nivea has stood the test of time." Dr. Lott uses Nivea or Vaseline to coat her skin when she is running marathons in cold weather.
Hannah Hardaway, a former Olympic freestyle mogul skier who has taken up extreme backcountry skiing in Park City, Utah, has learned the importance of skin protection the hard way: by suffering frostbite on her nose three times.
"It's really gross," said Ms. Hardaway, who spends up to five hours a day skiing when the snow conditions are to her liking. "Your skin scabs, turns brown and peels off for a few weeks." Now she uses Kiehl's All-Sport "Non-Freeze" Face Protector SPF 30, which coats the face in a layer of beeswax and castor oil. "Kiehl's is a wind stopper that prevents your skin from chapping."
Kristina Joder Casey, a former Olympic cross-country ski racer who coaches junior teams in Boise, Idaho, prefers Dermatone, made with beeswax and lanolin, to shield her face from windburn; it is sold at sporting goods stores like REI and Eastern Mountain Sports. "You have to put it all over your face, including your ears, or you can get frost nip," Ms. Casey said. (Frost nip is a superficial freezing of the skin that is a precursor to frostbite.) "And make sure your hat covers your ears."
Oil-based products like Dermatone work well for winter sports because they won't freeze. On the other hand, dermatologists say, oily treatments can sometimes trigger pimples.
"Even in winter, acne-prone people like me should avoid putting oily products on their faces," said Dr. Jeanine B. Downie, a dermatologist in Montclair, N.J., who is an author of "Beautiful Skin of Color: A Comprehensive Guide to Asian, Olive and Dark Skin." She recommends using water-based products like Replenish Hydrating Cream from M.D. Forté (a brand sold by dermatologists) on the face and relegating oil-based products to the hands and feet.
"It's great to coat your hands and feet at night in oily products like Aquaphor, cover them with socks, and sleep like that," said Dr. Downie, an avid runner who exercises outdoors unless the temperature drops below 20 degrees. "It's Grandma's remedy, but it still works. You wake up with really soft skin."
Lips, too, are vulnerable to dry air.
"The wind burns your lips and the sun cooks them," said Mr. Dupre, who liberally coats his mouth with Dermatone when he's out on expeditions.
Dr. Lott has a product-free solution for chapped lips: stop licking them. "The more you lick dry lips, the drier they become," she said.
When windburn and cold winter air cause the corners of the lips to crack and split, Dr. Zelickson recommends covering them with A+D Original Ointment, a diaper rash cream made with lanolin that helps treat irritated skin.
"Protecting skin during the winter is basic common sense," Dr. Zelickson said. "If your skin gets itchy and irritated, you can go see a dermatologist. You can also put hydrocortisone on your face twice a day and take an antihistamine like Benadryl," which can help reduce itching. "A lot of times you can just treat these things yourself."

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