Pre-Appointment Info

Water hydrates and plumps skin cells to make your skin look brighter, vibrant, and more youthful. However, lack of water can cause skin to lose its plumpness and elasticity—leading to dryness, flakiness, fine lines, wrinkles, and sagging skin. Water even helps reduce acne and other skin problems by flushing harmful toxins from the body. If beauty products and skin treatments are failing to improve the appearance of your skin, drink more water to achieve a more youthful appearance and to reduce or improve skin problems.

The sun gives off rays of light that can help and harm us. These are known as ultraviolet (UV) rays. There are three different types of UV rays: UVA, UVB, and UVC.

UVA rays are the most common form of sun exposure. UVB rays make up less sun exposure, but are more intense. UVC rays are the worst. Luckily, we are not at risk of UVC rays. The earth’s ozone layer blocks these rays.

Even though you can’t see UV rays, they can go through your skin. The outer layer of skin is the epidermis. The inner layer is called the dermis. Your nerves and blood vessels are located in the dermis. Epidermis cells contain a pigment (or dye) called melanin. People with light skin have less melanin than dark-skinned people. This is why very fair-skinned people burn easier.

Melanin protects our skin and also creates vitamin D. When your body defends itself against UV rays, your skin tans or darkens. Too much sun exposure allows UV rays to reach your inner skin layers. You know this as sunburn. This can cause skin cells to die, damage, or develop cancer.

Too much sun exposure can be harmful. It can lead to:

• Skin changes
  Some skin cells with melanin can form a clump. This creates freckles and moles. Over time, these can develop cancer.
• Early aging
  Time spent in the sun makes your skin age faster than normal. Signs of this are wrinkled, tight, or leathery skin and dark spots.
• Lowered immune system
  White blood cells work to protect your body. When your skin gets burnt, white blood cells help create new cells. Doing this can put your immune system at risk in other areas.
• Eye injuries
  UV rays can damage the tissue in your eyes. They can burn your outer layer called the cornea. They also can blur your vision. Over time, you can develop cataracts. This can cause blindness if left untreated.
• Skin cancer
  Most skin cancer is non melanoma. It is very common, but also very treatable. Melanoma skin cancer is not as common, but is more severe. Skin cancer can spread to other areas in your body, especially if left untreated.

Uv Filters

• PABA
• Oxybenzone
• Octocrylene
• Octylmenthoxycinnamate
• Benzophenone

Dyes and Coloring Agents

• Coal Tar Dyes
• Amines
• -P –Phenylenediamine

Acids
Alpha Hydroxy Acids

• Glycolic
• Lactic
• Malic
• Citric
• Tartaric

Beta Hydroxy Acids

• Salicylic Acid

Emollients

• Petrolatum
• Isoparaffin
• Polybutene
• Mineral Oil
• Silicone
• Methicone/ Dimethicone
• Lanolin

Humectants

Avoid in severely compromised barrier defense (rosacea, senstive skins):

• Hyaluronic Acid
• Sodium PCA
• Lactic Acid

Humectants:
Avoid in dry climates:

• Butylene Glycol
• Diethylene Glycol
• Pentylene Glycol
• Glycerine
• Glycereth-26
• Sorbitol Trioleate

Humectants:
Health Hazard Concerns:

• Ethylene Glycol
• PEG-4
• Propylene Glycol
• Sorbic Acid

Emulsifiers
Emulsifiers without risk, other than depleting the bilayers:

• Glycerl Monosterate
• Sodium Stearates
• Sodium Stearoyl Lactylate
• Sorbitan Stearate
• Laurate

Emulsifiers associated with risk:

• Polyethylene Glycol (PEG)
• Polysorbates
• Cetyl Alcohol
• Stearyl Alcohol

Surfactants

• Sodium Laureth Sulphate
• Sodium Lauryl Sulphate
• Ammonium Laureth Sulphate
• Ammonium Laury Sulphate
• Benzalkonium Chloride
• DEA
• TEA

Fragrance

• Lemon/Lime
• Orange/Tangerine
• Bergamot
• Lavender Oil (Lacandula Angusifolia)
• Ylang-Ylang
• Diethylhexyl Phthalate (DEP) (10)
• Fragrance
• Parfum
• Eugenol
• Geraniol
• Linalool
• Citronellol
• Limonene

Preservatives- Formaldehyde Releasers

• Quaternium -15
• Diazolidinyl Urea
• Imidazolidinyl Urea
• DMDM Hydantoin

Preservatives – Citrus –Derived

• Citric Acid
• Grapefruit Seed Extract
• Limonene

White bread, bagels, popcorn
“Foods with a high glycemic index give you a sugar rush that will be terrible for your skin,” says Ava Shamban, an assistant clinical professor of dermatology at UCLA. “When you increase sugar levels in the bloodstream, the sugar that’s not picked up by the liver can get into your collagen, which your body may then identify as damaged goods and chew up.”

Red-velvet cupcakes, pistachio ice cream cones
Sweet stuff that’s irritating on your Instagram feed—looking at you, artfully arranged plate of macarons—is even worse for your skin. Once again, too much sugar can break down collagen and elastin, making your skin look dull and causing wrinkles over time. When you can substitute for sugar, “honey is the best sweetener since it’s loaded with antioxidants,” says Shamban.

Yogurt, cappuccinos
Dairy gets a lot of flack for being bad for your skin, but the truth is “we don’t have enough data to know for sure, so we can only say it’s a potential culprit,” says Shamban. So far, studies have shown a correlation between dairy and acne but not causation, and anecdotal evidence is less reliable than you’d think. “If you gave up eating yogurt or drinking skim milk every day and had fewer breakouts, you wouldn’t know if it were because of the dairy or its sugar content,” says Shamban. Your best bet is to look for dairy that’s made
a) without added sugars and
b) from cows that are not treated with hormones.
“The hormones cows are fed can be steroid analogues, which can make you break out,” she says.

Bottled water
 “The BPA in water bottles is another steroid analogue, which means it could act like hormones in your body,” says Shamban. “You don’t think about your bottled water breaking you out, but we don’t know yet—and anyway, there are a thousand reasons not to use plastic bottles all the time.”

Your morning coffee
If it gets you out of bed, don’t give it up. But you’d be wise to balance your coffee or fancy-pants espresso by chugging a glass of water, too. “Coffee acts as a diuretic, and that won’t make skin pretty, that’s for sure,” says Shamban. “Our skin cells are made of water, and anytime they shrivel up, you lose that glow and plumpness.” That means fine lines, like the ones we all have around our eyes, look worse. But as long as you add back hydration, there are plenty of benefits to drinking coffee, too: The polyphenols in coffee could mean younger-looking skin in the long run. Women who drank about three cups a day had the fewest age spots in a study in the International Journal of Dermatology.

Rounds of margaritas
If you’ve ever had a hangover, you already know that having more than a few drinks dries out your skin the next day—it’s why lines look worse (like, way worse) on Sunday morning. Pile on the moisturizer and, if you’re lucky enough to look puffy, too, try pressing a compress with half-and-half or whole milk under your eyes. The proteins in whole-fat milk bring down bags.

…And the salt on the margarita rim (or in a bag of chips)
“Just as coffee and alcohol do, too much salt will dehydrate your skin,” says Shamban. It’s why some dermatologists go to extremes: “I put all of my patients on a zero-added-salt diet—if you’re making chicken, you can cook it with rosemary, thyme, and pepper, no salt. Fish is olive oil, garlic, and basil. And restaurants function on salt, so I tell them no dressings, sauces, or salt,” says Harold Lancer, a dermatologist in Beverly Hills.

Milk chocolate—but not dark chocolate (woo-hoo!)
It’s the sugars that make milk chocolate hard on your skin, but for the record: “There’s no reason to skip dark chocolate,” says Shamban (Look for 70 percent cacao or higher).

Anything caliente
If you have rosacea, don’t pour hot sauce on your pizza. “It’s the skin condition that’s most sensitive to food,” says Shamban. “And spicy foods trigger inflammation and flushing.”

Our skin is very much ruled by our hormones. There are those times of the month breakouts, and then there’s the pigmentation known as Melasma that can rear its head when you’re pregnant. The thing is our hormone levels change as we age, rising when we’re children, peaking in our late teens (the horror) and declining in our 30s. One of the most obvious indicators of these hormonal changes is our skin.

Adolescent Years
The Hormone Situation: Adolescence is defined by the transitional stage of physical maturation and psychosocial development, generally occurring from puberty to adulthood. Prior to your teenage years, acne is uncommon. However, during puberty, your hormones surge with rises in estrogen, progesterone, and testosterone, which in turn can cause the sebaceous glands to produce more sebum (grease), which can lead to acne. Acne will affect almost every teenager to some extent, however, the level of acne varies enormously, but so too does the way in which people cope with it.

During Pregnancy
The Hormone Situation: Many pregnant women notice an increase in their skin pigmentation, which is more marked in women with darker skin types. This darkening of the skin is often one of the first signs of pregnancy and is related to increased levels of estrogen, progesterone and other hormones that stimulate pigment cells. Women suffering from this condition will notice that areas that are already pigmented such as the nipples and abdomen will become darker during their pregnancy, but this will generally settle down after delivery.

Menopause
The Hormone Situation: Menopause is defined as the day a woman has been diagnosed as not having a menstrual period for 12 consecutive months. There are a number of structural and functional changes that occur in the skin as our hormone levels decline with age, especially during menopause. These include dryness, due to decreased oil production (sebum synthesis), and lower water content in the skin. This dryness can lead to itching and even eczema. Our skin will also begin to lose its firmness as we age, as the levels of fibroblasts and collagen decrease. This can also lead to a loss of skin thickness, resulting in wrinkles and easy bruising. Lastly, as your skin ages, there are changes in the immune function, which can lead to delayed wound healing and an increased risk of skin cancer.

Polycyclic aromatic hydrocarbons (PAHs )
Toxic and carcinogenic compounds that occur in the environment and derive from two classes processes: petrogenic and pyrogenic processes. PAHs have long degradation periods, and recent studies show high accumulated concentrations in soil, aquatic, and atmospheric environments.

Volatile Organic Compounds (VOCs)
VOCs include a variety of chemicals that can cause eye, nose and throat irritation, shortness of breath, headaches, fatigue, nausea, dizziness and skin problems. The health effects caused by VOCs depend on the concentration and length of exposure to the chemicals.

Nitrogen oxide (NOx)
The species represents one of the most threatening air pollutants due to their prevalence and harmful impact on the environment and human health. Such damages lead to pathologies of lungs, cardiovascular system, and skin because these organs represent the first barrier toward the environment.

Particulate Matter (PM)
Studies have concluded that fine particles with a diameter less than 2.5 microns – PM 2.5 – might impair the skin barrier functions causing damage and reactions including immune dysregulation, activation of melanocytes and collagen breakdown.

Ozone (O3)
Recently it has been reported that a chronic contact with O3 can be deleterious for the skin. Our group and others have shown a progressive depletion of antioxidant content in the stratum corneum and this can then lead to a cascade of effects resulting in an active cellular response in the deeper layers of the skin and cigarette smoke.

Some drugs that tend to cause photosensitivity include:

• certain antibiotics, including tetracycline
• sulfa drugs
• antifungals
• antihistamines
• retinoids, such as isotretinoin
• statins
• diuretics
• some NSAIDs

Many drugs can cause erythroderma, including:

• sulfa drugs
• penicillins
• anti-seizure drugs
• chloroquine
• allopurinol
• isoniazid

What is a drug rash?
Drug rashes are a side effect of a drug that manifests as a skin reaction. Drug rashes are usually caused by an allergic reaction to a drug. Typical symptoms include redness, bumps, blisters, hives, itching, and sometimes peeling, or pain.

Why do drug rashes happen?
Drug rashes and reactions happen for several reasons, including:

• an allergic reaction
• a buildup of the drug that causes toxicity to the skin
• a drug makes the skin more sensitive to sunlight
• interaction of two or more drugs

Sometimes drug rashes can be spontaneous and develop without a cause. Certain factors can also increase your risk for developing a drug rash, such as being older and female.

Other risk factors include having:

• a viral infection and taking an antibiotic
• a weakened immune system due to an underlying condition or other drug
  cancer