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Frequently Asked Questions Answered by Dr. Dennis Gross

  • What’s the most common mistake people make with skincare?
    One of the biggest mistakes is not properly cleansing and removing makeup before bed, but it’s not too late to break that habit! Make a point of thoroughly removing makeup before going to bed. When makeup remains on skin, it enlarges the pores which is a sign of aging. Additionally, leaving makeup on the face could lead to inflammation, which can generate free radicals and lead to collagen breakdown.
  • Any tricks to make your skincare products more effective?
    Daily exfoliation is key, and I advise my patients to use a gentle blend of alpha and beta hydroxy acids to exfoliate every day, as can be found in the Alpha Beta® Face Peels. These ingredients weaken the links between cells in the outermost layer of dry, dead skin and speed up cell turnover. The post-peel surface is smoother and clear of obstacles, so skin can more easily absorb your skincare ingredients.
  • What's the right order to apply your products in? Why?
    Skincare routines will vary depending on each individual’s needs, but there is a right order for your basics. To maximize the benefits of your regimen, apply products with a thinner consistency then work your way up to thicker, creamier formulas. Products with heavy consistencies can block lighter-weight ones from penetrating the skin and doing their job. Here is a sample application order:
    1. Liquids, such as anti-acne or peel pads for exfoliating and collagen building, or any kind of toner.
    2. Serums or gels, which are slightly heavier than a liquid but lighter than a lotion and can do everything from moisturize to deliver vitamin C or offer sun protection.
    3. Lotions, which are milky, slightly thicker liquids, and can include moisturizers with antioxidants or exfoliating acids.
    4. Creams, which can do all of the above but are thicker, richer substances that won’t spill out of a jar if it’s turned over.
    5. Ointments, generally petrolatum-based solids that come in a tube and squeeze out very slowly.
  • What’s the most effective cleansing technique?
    Apply the cleanser to dry skin—don’t wet your face or hands first. I specifically designed the All-In-One Cleanser with Toner to work this way. The benefit of applying the facial cleanser to dry skin is that it gives you a very concentrated cleansing, allowing the cleanser to adhere to dirt and impurities more easily. When the water is added, it continues to release even more dirt and oil, and then the toner is activated.
  • How can I find the best anti-aging product for me?
    Skincare today offers many options to address the signs of aging that will work for people of all ages and skin types. Active ingredients have reached a sophisticated level and can reduce and prevent wrinkles but you must a) know what ingredients to look for, and b) use products with multiple active ingredients in them. If you have the luxury of getting treatment in a doctor’s office, then the more you know and the better care you will receive. Know what’s tried and true (proven) not just what’s “hot this month.”
  • Can your pillow really cause wrinkles?
    Pressing our faces into a pillow causes trauma to the skin. Over time, this trauma, aggravated by the friction of a cotton pillowcase, can create permanent creases as our collagen breaks down. In addition, the weight of our faces impairs circulation to the part we have pressed to the pillow, which compromises the skin’s regenerative abilities. Sleeping on your back is actually the best position to preserve a youthful-looking complexion.
  • How important is it to wash your face after a workout?
    It’s very important to cleanse after exercise to avoid the build-up of bacteria from sweat. Rinsing immediately and changing out of sweaty clothes can help prevent breakouts. I recommend applying cleanser to dry skin because it will more effectively bind to dirt and oil molecules. Sebum is easier to remove in a warm shower, so it’s easier to deep clean pores.
  • Will scrubbing your face more eliminate acne?
    No. A critical mistake in treating acne is over washing and overusing drying acne treatments, which will actually produce MORE oils. Avoid scrubbing, as it can irritate sensitive skin, and opt for gentle microexfoliation instead - in the form of a peel.
  • Do chocolate and greasy foods cause breakouts?
    It is a common misconception that eating chocolate or greasy foods will cause breakouts. I have found this to be untrue. It can take 2 to 3 weeks before a pimple even appears on the surface. This is because the pores are very deep and it takes time for the bacteria to build up before the pimple will become inflamed, swollen and red on the surface.
  • What effects do pollutants in tap water have on skin and how can you remove them?
    Tap water can contain heavy metals such as lead, zinc, magnesium, copper, and iron as well as calcium. The heavy metals are actually free radicals that generate even more free radicals that destroy collagen. These metals convert the skin’s oils into a waxy, gland-blocking substance, resulting in acne, blackheads, stretched out pores, redness, and irritation. They can also aggravate existing conditions such as rosacea and inflammation.

    I recommend incorporating products that contain chelators into one’s daily skincare regimen. Chelators are a class of detoxifying ingredients and are a major untapped resource to protect skin from heavy metals in tap water. Chelators engulf the heavy metals on the surface of the skin, preventing them from penetrating deep into the pores and causing free radical damage.
  • How does charcoal help deep clean skin?
    In general, charcoal is known to remove unwanted toxins from your skin. This helps reduce instances of acne and remove excess oil. However, activated charcoal can be very messy and stain your clothing as well as nearby surfaces. A less messy and more effective alternative is colloidal sulfur.
  • Is it better to shave in the shower?
    Yes, because hairs are soft and the skin is more flexible. Make sure you always watch what you are doing. Losing focus can have painful consequences.
  • How can men make shaving less irritating?
    A lot of men are shaving incorrectly, which is a big grooming mistake for several reasons. First, they should be shaving in the shower when hair is soft and the skin is supple to help reduce ingrown hairs. Install a shaving mirror and pay attention to what you’re doing. In addition, many men shave against the grain and that is not the best way to shave. You should shave in multiple directions, always with the grain. Also note, it is better to go over the area 10 to 15 times lightly than 2 to 3 times harder. If too much pressure is applied to the razor when you shave this grinding can irritate the skin and cause razor bumps.
  • What’s the best exfoliating routine?
    I recommend to my patients to incorporate a once-a-day, gentle, 2-step chemical peel with a blend of Alpha and Beta Hydroxy Acids into their at-home regimen. If you want to use acids to their best advantage the key is to blend multiple acids together. It is far better to use something every day that is not super concentrated than something radical all at once. Daily peels are like steady exercise to the skin. You will get the best results and avoid irritation.
  • Is salt water harmful to skin?
    Salt water can be drying to the skin, but may actually have a therapeutic benefit as well. Some skin conditions, such as acne and psoriasis actually improve with salt water, but since it’s drying, you should rinse after swimming to avoid dry, flaky skin.
  • How can I avoid swelling when I travel?
    Getting up to walk frequently during your flight keeps your circulation moving and will help to prevent puffiness and bloating. If you engage in aerobic exercise after the flight this will increase your pulse, also providing more circulation to the body, which helps with the removal of swelling. It’s also important to stay hydrated during travel to avoid puffiness.
  • What can I do before traveling to avoid puffiness?
    Vitamins B and C are natural diuretics and taking the proper amount before, during, and after your flight will help with “jet bloat” and swelling. Be sure to minimize your salt and alcohol intake before, during, and after the flight as well.
  • If I travel frequently, what can I do to keep my skin healthy?
    It’s not only the water we drink that can affect our skin; it’s also the water with which we wash our faces. I have patients who travel and return from their trips with blemishes, rosacea, excessive shine, or irritation that they didn’t have before. I believe this is because the tap water in their hotels has different minerals from the water in their homes. If skin is not accustomed to certain minerals, they may cause adverse reactions. I have found that the best way to combat this travel-related skin problem is to simply pack an Evian mister or a spray bottle filled with tap water from your home when you travel. I also recommend incorporating products that contain chelators (such as Hydra-Pure Smart Spray) into ones daily skincare regimen. Chelators are an organic complex that engulf the heavy metals on the surface of the skin, preventing them from penetrating deep into the pores and causing free radical damage.
  • Is red wine good for the skin?
    Like most things in life, too much of a good thing can be bad. Red wine contains resveratrol which has been shown to have antioxidant effects on the heart and the nervous system. In general anything that’s good for the heart is good for the skin. So red wine in particular may be, in part, a fountain of youth. But too much alcohol causes free radicals which leads to aging of the skin. So your best option is to drink in moderation.
  • How much impact does the food you eat really have on your skin?
    There is no question that diet is important for your skin. A good guideline to follow is what’s good for the heart is good for the skin. Skin requires essential fatty acids, so eating things like avocado, cheese, dairy products on a daily basis can be beneficial in keeping skin hydrated and healthy.

    If you are prone to redness, avoid spicy foods, red wine, and caffeine. Both spicy foods and red wine can cause flushing and aggravate rosacea. Also, limit salt and alcohol intake. Salt collects in the skin, which in turn causes puffiness. Alcohol causes blood vessels to become leaky, so the water exits skin, leading to puffiness in vulnerable, or delicate spots, like the under eye area. Avoid processed foods and sugars if you can—I believe raw food added to the diet helps the skin as well.
  • What foods can I eat to make my skin look healthier?
    Essential fatty acids help regulate cell function for a healthy cell membrane. The body doesn’t naturally produce essential fatty acids, so eating avocado, cheese, salmon, mackerel, herring, sardines and dairy products on a daily basis can be beneficial. Fish oil, canola oil, flaxseed oil, and walnut oils consumed as uncooked liquids (as in salad dressing) or in supplements are beneficial to the skin because omega-3 fatty acids are known to improve skin’s appearance and help reduce inflammation. Protein is also good for the skin because it is full of amino acids that help to create collagen. Some good vegan protein options are chickpeas, almonds, tofu, and peanut butter.

    I also recommend the tri-color salad approach: If you order a salad, make sure there are a several different colors on your plate--red peppers, green lettuce, orange carrots. Eat vegetables that vibrant color because nature color codes vegetables for us. The more colors you eat, the more antioxidants you’re ingesting.
  • Will I get the same benefits from eating healthy foods as I will from skincare?
    It is important to note that while ingesting antioxidants and vitamins will improve the skin’s overall health and appearance, the results cannot compare to applying the ingredients topically.
  • What ingredients are good for soothing redness?
    Different ingredients address the different causes of redness. For example, Bisabolol is an anti- inflammatory ingredient derived from Chamomile, which reduces inflammation. Licorice Root Extract and Cucumber Extract both soothe and calm the skin irritation. Gatuline prevents dilation of blood vessels. Green Tea Extract is a natural, soothing antioxidant as well.
  • How can I make sure exfoliation won’t irritate my skin?
    Overdoing one form of exfoliation can be harsh on the skin and can lead to irritation. Manual exfoliants, such as scrubs with granules or sloughing sponges, are problematic because many people overuse them and scrub too vigorously. When used carefully, and as directed, they can be effective, but are not as effective or gentle as chemical exfoliation.

    Chemical exfoliation in small amounts every day is better for your skin than using one high concentration ingredient that can be harsh and cause redness. The skin is not tolerant of acids at high levels. A more gentle, effective method is to use alpha and beta hydroxy acids in a 2- step peel. Beta hydroxy acids break down the bonds between the cells, while alpha hydroxy acids cause the cells themselves to detach. The pH flux (neutralizing step) is so important because it brings the skin back to normal. It’s the blend of these two acids and the controlled exfoliating effect that I’ve found to be most effective and gentle.
  • Why is sleep so important for your skin?
    The reason chronic lack of sleep (and to a lesser extent occasional sleepless nights) affect us so negatively is because the body responds to it by setting off our fight-or-flight response because it sees our intense fatigue as a mild state of emergency. The production of the stress hormones cortisol and epinephrine (aka adrenaline) are triggered, which then prompts the body to divert a disproportionate amount of blood flow, oxygen, and nutrients away from our external organ (i.e., the skin) to the major internal ones, such as the heart, brain, and kidneys. When the skin is getting less than optimum fuel, it can become dull and pale with dark under-eye circles. Lack of sleep can be so stressful that it actually causes our bodies, including our skin, to generate free radicals.
  • Will I really get wrinkles from lack of sleep?
    You might find that not getting your beauty sleep results in lines and wrinkles looking more firmly entrenched. The reason? Our sympathetic nervous system involuntarily contracts our muscles in response to the overall stress the body is experiencing. Think about how tight your neck and shoulders can get when you are really stressed out. In the case of our faces, when our muscles are contracted, such as when we clench our jaws or furrow our foreheads, our problem areas become more pronounced.
  • How does stress affect your skin?
    Stress increases your adrenaline levels. Adrenaline is a hormone also known as norepinephrine. When adrenaline is elevated, the skin is affected because oil glands have receptors for it. This in turn leads to a chain reaction which changes the quantity and quality of oil produced. While no clinical data demonstrates how long it takes, in theory it could trigger a flare up in a day but typically would take several days. Stress can show up in your skin in the form of acne, rosacea, oily skin, eczema, and dullness.
  • What is the connection between skin and weather?
    There is absolutely a connection between the environment and your skin. Acne in particular and all complexion issues in general seem to be worse in the heat of summer. Oil production increases and clogs pores. Bacteria levels increase as well. There is also seasonal eczema, which is a result of airborne pollen. By the end of summer, many women are dealing with the results of months of sun-exposure, including sunburn, peeling, redness, and dry skin, making re- hydrating the skin essential.

    On the other side of the spectrum, in the winter, skin produces less natural oil due to the absence of sunlight and heat. Additionally, there is less humidity in winter air and this causes moisture to evaporate off of our skin. Winter’s harsh, cold air can leave skin dry, itchy, irritated, and red. Broken capillaries can occur more frequently in the winter because you are exposing the skin to extreme temperatures – hot inside and then cold, dry air outside. The warm baths and hot showers (which we are inclined to take during the cold winter months) have a drying effect on skin and the chlorination in our tap water is stripping.

    Remember that dry skin is skin that is out of balance and it behaves like sensitive skin and will become easily irritated which will exacerbate the redness. To avoid irritation, try chemical exfoliation with gentle alpha and beta hydroxy acids.
  • How should you adapt your skincare routine for winter weather?
    There are plenty of simple things people can do keep skin balanced all year round:
    • Use a humidifier at night. The air during winter months tends to be drying because there is less moisture in the atmosphere along with the usage of household heaters. It is a good idea to sleep with a humidifier in your room at night as this may help those with extremely dry skin.
    • Steam your face. Steaming your face for 15 minutes twice a week helps open up clogged pores and exfoliate away dull, flaky skin. Try our Steamer Solutions for at home steaming.
    • Avoid harsh acne products in winter. Acne-fighting ingredients can backfire by intensifying redness in already sensitive skin. Plus, drying out the skin with harsh ingredients can create dry skin cells that clog pores.
    • Switch moisturizers. Give up your oil-free moisturizer (you can go back to it in May for the summer months) and switch to a heavier moisturizer.
    • Remove makeup. One big mistake is not removing makeup before bed. If you don’t, it could clog pores and oil glands. When the makeup becomes impacted in pores, it can make them appear larger. This is important to remember in cold weather months AND in warm weather months.
  • What steps can you take to transition skincare regimens from winter to spring?
    The changes in seasons can definitely affect how your skin, body, and hair look. Your basic routine should still remain the same, but a lot of my patients use a heavy-duty moisturizer in the winter, and then switch over to an oil-free or lightweight lotion in the summer because it is hotter and there is more of a tendency to perspire.

    As the sun gets stronger, the skin naturally thickens with more oil and dead skin (a feature called “hardening”) so spring is an ideal time to give skin a deep clean process and begin gentle, daily chemical exfoliation if you had not been through the dry winter months. I advise my patients to use a gentle blend of alpha and beta hydroxy acids to exfoliate every morning, as can be found in the Alpha Beta® Face Peels. These ingredients weaken the bonds between cells in the outer layer of dry skin and speed up “shedding.”

    Also, if you were not using a sunscreen in the winter, you should certainly be using one as the weather warms up, and continue using it all year.

The Dr. Dennis Gross Difference


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