Dermatologist Dr. Erin Gilbert Answers Your Skincare Questions

I was completely honored and excited to get the chance to interview dermatologist Dr. Erin Gilbert. I had her answer quite of few questions  and she was completely gracious to answer all our questions and concerns about skincare and skin health.

Check out 14 questions and answers below that many of you submitted:

1. What is your favorite skincare brand that you recommend to your patients for each of the following: Prescription? High end? Budget friendly that you can get at any supermarket?

My favorite prescription strength skincare brand is a retinol called Atralin. There are many well-known trades on the market, each of which has different qualities (Rtein-A, Differin, Renova, etc). I like the fact that this one contains a high concentration of hyaluronic acid. It is non-chalky and goes on smoothly without over-drying the skin when used properly. My favorite “high end” skin care brand is probably Sisley. It is extremely expensive but it contains very nice emollients and botanicals and my patients love it. A slightly less expensive line that is very effective and a favorite is the skinceuticals line. They have great antioxidants, eye creams and sunscreens. The Roc skincare line is a highly effective line of cleansers and anti-aging retinoids with sunscreens that are available over the counter.

2. Best treatment for scars from surgery when vitamin e and Mederma doesn’t work? Is plastic surgery the only option? Maybe laser surgery?

Plastic surgery for scars may improve the appearance of botched, hypertrophic (enlarged)/keloid or large scars but unfortunately only leaves more scars! Lasers can reduce the redness in scars and can often even out the surface of a scar after several treatments be but aware that these are stepwise “percent” improvements, and not full scar removals.

3. Why am I only breaking out now that I am in my 30s? What can I do to prevent or treat? Is there a different treatment for African American skin?

Adult acne is extremely common. For many of my patients it is the result of using the wrong products (i.e. products that are too heavy for your skin type). For others it is the result of early hormonal shifts that can be addressed by a thorough history taking. Many of these patients benefit from a topical acne regimen not unlike those I prescribe for a younger acne patient. Some also require oral antibiotics to get them “over the hump” until the topicals kick in. Most patients do respond well to topical retinol, which has the added benefits of treating acne as well as aging. They reduce fine lines and wrinkles as well as sun damage.

4. If my beauty routine in the morning includes a moisturizer with SPF 30 and then I put a foundation on top with an SPF 15, what SPF coverage am I wearing?

Kudos for wearing double SPF! Sunscreen use on a daily basis is a crucial part of an anti-aging regimen, so you are on the right path. It is very hard to gauge the actual SPF in your regimen when using a moisturizer or make-up containing an SPF because the coverage factor or quantity applied is not precisely measured. You can safely assume that you are between an SPF 15 and a 30. I get around this question by simply replacing a moisturizer and a foundation with a tinted SPF 50 containing zinc oxide- there are many great ones out there including those by Skinceuticals and La Roche Posay.

5. Dermatitis, can this be caused by diet or an immune deficiency if I know it is not a soap allergy?

Dermatitis, or skin irritation, is rarely linked to diet (avoid these 4 diet mistakes) or immune deficiency in adults or in children.

There are, however, many contact allergens in our environments including things like nickel, latex, dyes, plants, and many other substances we wouldn’t normally even think of! If you have a persistent rash in a specific area I’d suggest getting a “patch test” by a dermatologist. This involves having two taped strips applied to your back for 72 hours that contain common allergens and then evaluated to see if you are allergic to these substances.

6. With all the information out there with chemicals, UVB and UVA coverage, what brand of SPF moisturizer and sunscreen do you recommend?

There is a tremendous amount of information out there right now about sunscreen labeling and warnings about ingredients and it can be very confusing. First we are warned about skin cancer, then we are told that sunscreens cause cancer! The latest is that spray sunscreens are flammable! I tell my patients to look for zinc and titanium containing sunscreens since they are not “chemical” sunscreens and are highly effective. The newer formulations are micronized and don’t have that chalky white lifeguard look. Some of my favorite brands are: La Roche Posay, Elta MD, Skinceuticals , and even Aveeno Baby Sunblock Lotion.

7. Some red bumps on the back of my arms, I was told that is caused from too much insulin, is that the case, or is it just hereditary?

What you are describing is called pityriasis rubra pilaris. It occurs when the skin around the hair follicles gets plugged, creating little rough spines. The redness is often more notable after exercise or in the summer. It is genetic and related in many cases to eczema. It is very difficult to eradicate and does well when treated regularly with a softening treatment like an ammonium lactate lotion, available over the counter.

8. Son is bi-racial with white spots on his face that do not fade with being in the sun. Can you tell me what it is and how I can even out his skin tone?

What you are describing is called pityriasis alba- a form of facial eczema. When there are patches of dry skin on the face the irritation causes mild inflammation that is more notable in pigmented skin types. The first step is to practice gentle, moisturizing skin care. I’d suggest washing his face with a very gentle non-lathering face wash like Cetaphil Gentle Skin Cleanser or Aveeno Eczema Therapy Soothing Bath Treatment. I’d then moisturize with CeraVe Moisturizing Cream – skin like his probably lacks ceramides, the key oils in skin that is not prone to dryness. The key to not having the spots lighten with the sun is sunscreen use. For the face I like Aveeno Baby Sunscreen.

9. Are scented lotions and sunless tanners harmful to our bodies?

Scented lotions pose no threat to our bodies unless you are a believer in the paraben problem, in that case stick to paraben free products.

Sunless tanners contain DHA, which is simply a dye that stains the top layer of dead cells of the skin which is sloughed off after about a week. It may smell funny, but there is no evidence that it is harmful. Many dermatologists far prefer this option to the spray tanning option, which exposes you to inhaled DHA particles. We don’t yet know the effects of this on the lungs.

10. The best budget eye cream that you recommend. I have also been told to skip the eye cream because they don’t work and to go straight to injections.

I like Roc’s Retinol Correxion Sensitive Eye Cream. It is effective at reducing crow’s feet around the eyes but is non-irritating. Injections with botulinum toxin (Botox, Dysport, Xeomin) are the right choice for many people, but not for all. Some people are reluctant to undergo the treatment, and others who tend to suffer from very puffy eyes or allergies aren’t great candidates in my experience.

11. With age, my pores have gotten so much larger, especially on my nose. Is there a treatment or cream to help to make my pores smaller?

Any retinol will help improve the appearance of pores, whether it be over the counter or prescription. My favorite trick is to inject tiny quantities of botulinum toxin over these areas to reduce pore size and it lasts for up to 6 months.

12. What is the average shelf life for sunscreen?

All sunscreens will be marked with an expiration date and you should follow that date. Any sunscreen that is left in the heat or direct sunlight should be discarded after three months. As a general rule, I say buy new sunscreen for the season, then swap it out!

13. I’ve heard there is no such thing as anything over SPF 30. I know they sell SPF much higher, but anything over 30 is all the same. Is that true?

You are indeed correct. There are small incremental increases in sun protection factor (SPF) over SPF 30 but the practical benefits are minimal. The American Academy of Dermatology recommends that you wear an SPF 30 daily and that you reapply every 20 minutes (hard to do!) or after water exposure. I tell my patients to apply sunscreen 30 minutes before hitting the sun and then to reapply at least three times during the day between 10am-4pm when the sun is at its peak.

14. For years, we have been told that skin cancer is genetic or hereditary, but now some reports are saying it isn’t connected. Is that true? Also, is there any connection with melanoma and other cancers like breast or ovarian?

The propensity for skin cancer does run in families but is more dependent upon your personal history of skin cancer and on your history of sun exposure. When I take a history, I do take a family history as well as a personal skin cancer history. It is important to gather that information prior to your visit to your dermatologist. It is also important to know what kind of skin cancer your family member or you may have had, as they behave differently (some are more aggressive than others). Melanoma is most strongly linked on a genetic level with pancreatic cancer, but there are newer cancer susceptibility genes being discovered all of the time. At the moment the strongest predictor is a family history of melanoma in a first degree relative.