Last week we examined the physiology and causes of acne, an affliction from which as many as 50 million Americans suffer. This week we will examine in detail various options for treating acne and acne scarring. Continue reading What you should know about acne – Part #2
Dr. Crutchfield recognized as a ‘skin care expert’ in In Style magazine. Discussing the latest trends in beauty products. Download & own InStyle’s May 2015 issue today on Itunes.
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Sunscreen still isn’t worn daily
Despite the fact that sun protection is necessary daily, not every American wears sunscreen every day of the year, which is another reason for the influx of skin discoloration. “The increased social and cultural trend of tanning is another reason why hyperpigmentation is on the rise,” says Minneapolis, MN, dermatologist Charles E. Crutchfield III, MD.
What Happens to Untreated Pigment?
Hyperpigmentation is more of a cosmetic problem than a skin health condition according to Dr. Narukar. In most cases, hyperpigmentation will eventually resolve on its own if it is not treated. “But, the question is, how long it will take to lighten up? There’s no way to know and a lot of people just don’t want to deal with discoloration because makeup can hide it so much.” If you skin is prone to pigmentation, always take preventative measures, especially with sunscreen. Dr. Crutchfield points out that failing to protect pigmented skin from sun can cause discolored areas to become even more pigmented.
The Great Hydroquinone Debate
Hydroqinone, a chemical ingredient in lightening products, may be the go-to for hyperpigmentation. It stops about 90 percent of tyrosinase activity, but it has its disadvantages. “We almost always treated spots with hydroquinone but patients want natural alternatives, which is why there are so many options,” says Dr. Narurkar.
by Frederick Lowe
Gregory Cooper, a slender 26 year old, sometimes wears a scraggly beard that detracts from his good looks because he can’t shave every day.
When he does shave with a blade, his face becomes inflamed with razor bumps caused by his naturally curly hair becoming imbedded in his face.
“Eight hours after shaving with a razor blade, my face breaks out in whiteheads,” he says. Continue reading Razor Bumps
National report — When treating patients with skin of color, dermatologists face a number of challenges, and they must choose products and therapies carefully.
Diagnosis is the first challenge; common dermatological conditions may have a slightly different appearance in skin of color, depending on the hue of a patient’s skin, says Charles Crutchfield III, M.D.
“If you’re used to something looking pink or red and then you see it in brown skin, it looks completely different,” says Dr. Crutchfield, clinical professor of dermatology, University of Minnesota Medical School, Minneapolis/St. Paul, and medical director of Crutchfield Dermatology, Eagan, Minn.
Furthermore, dermatologists will encounter a number of conditions more commonly found in patients with skin of color, such as papular pityriasis rosea, razor bumps and keloids, he explains.
“One of the most significant things is the postinflammatory discoloration, both lighter and darker, that you see in skin of color,” Dr. Crutchfield says. “Any time there is inflammation or injury you can have dramatic change in skin color — usually darker, but sometimes lighter, that has to be managed. Sometimes it can take months to correct.”
To help prevent postinflammatory hyperpigmentation, it’s important to choose the right skincare products, says Zoe Draelos, M.D. Preparations that are recommended in white patients may not be suitable for patients with skin of color.
“The most important concern that’s different from Caucasian skin is that you have to be sure that the products that you recommend, whether they’re prescription or over-the-counter … cause absolutely no irritation of the skin at all,” says Dr. Draelos, consulting professor of dermatology, Duke University School of Medicine, Durham, N.C., who is also in private practice in High Point, N.C.
For example, Dr. Draelos says, over-the-counter acne products containing benzoyl peroxide can be irritating in Asian, Latino and African-American patients and ultimately darken the skin. In addition, exfoliants containing glycolic acid or scrubs containing granules or beads also can irritate the skin, resulting in postinflammatory hyperpigmentation, she says.
In patients with acne, Dr. Crutchfield explains to them that postinflammatory changes can be a particular problem with skin of color. Therefore, they need to understand that he must address the inflammatory papules and pustules as well as the postinflammatory hyperpigmented macules that remain after acne heals. Unfortunately, patients with these macules often believe their acne has returned.
In addition to relying on products that are not irritating, Dr. Crutchfield uses anti-inflammatory products to prevent irritation. To manage dyspigmentation, he uses a combination of alpha hydroxy acids and high-dose hydroquinone or hydroquinone metabolites. He also uses a product compounded by his pharmacist that contains hydroquinone, vitamin C, retinol, kojic acid and a steroid.
A number of new products are being used to manage dyspigmentation of the skin. “Many companies are trying to get away from hydroquinone because of the safety issues that have been raised,” Dr. Draelos says. Therefore, physicians are turning to products such as arbutin and deoxyArbutin, kojic acid, lignin peroxidase (Elure, Syneron/Candela), and licorice extract products such as glycyrrhizic acid, she says.
“Sometimes, people will use a bearberry extract if they’re looking for something in the botanical realm,” she adds.
To address concerns in this population, Dr. Draelos says, cosmetic companies are testing products in people with skin of color before they go on the market. “Usually when we test a new cosmetic, we use a broad, multiethnic panel,” she says.
Furthermore, companies work to formulate products with ingredients that have a low potential for irritation and may include an anti-inflammatory to prevent irritation before it occurs, she adds.
When treating dyspigmentation, Dr. Draelos educates patients about the importance of using sunscreens. “If the sun is darkening the skin and you’re using these products to try to lighten the skin, you find that you end up nowhere,” she says. “So sunscreen is very, very important, and sun avoidance is very important also.”
To maintain skin quality and health, Dr. Crutchfield also suggests moisturization and hydration. “I recommend a good moisturizing lotion that contains ceramides at least twice a day, but especially after bathing,” he says. “That goes a long way to correct dermatitis associated with dry skin.”
He suggests a combination of CeraVe Moisturizing Cream (Coria) and Vanicream Cleansing Bar (Pharmaceutical Specialties), which doesn’t strip away the skin’s natural oils.
Dr. Draelos says she finds that patients with skin of color often want to try other products.
“So I tell them to put a very, very small amount in front of their ear for five nights in a row, and if they have no trouble there, then they can use it broadly over their face.”
Following this course can sometimes prevent overall facial problems. “Predicting a problem before it occurs is always the best way to deal with it,” she says.
Disclosures: Drs. Crutchfield and Draelos report no relevant financial interests.
When stressed or dry skin needs relief (ASAP!), slather this on- “especially in the winter,” says Eagan, Minn., dermatologist Charles Crutchfield.
The non greasy, fragrance-free formula works year-round, “hydrating delicate areas and tough spots alike,” says N.Y.C. dermatologist Francesca Fusco.
$13 at Walgreens.
Also, call Dr. Crutchfield’s office today to schedule your skin care exam and treatments. 651-209-3600
Dr. Crutchfield is a dad of 11- and 5-year-old daughters and an 8-year-old son, a board-certified dermatologist, a clinical professor of dermatology at the University of Minnesota Medical School, and the medical director of Crutchfield Dermatology.
What was the biggest challenge you faced while your wife was pregnant, and how did you overcome it? The biggest challenge that I faced was being exquisitely in tune with my wife’s needs. I can’t imagine being pregnant. I had to check to make sure that her needs were being met by doing this on a daily basis. As with most things for me, this became a habit after about 21 days!
What’s the most surprising thing being a dad has taught you? That you can absolutely love another human being so much that the depth of the love defies the ability to put it into words.
What’s the one bit of advice about fatherhood you wish someone had given you much earlier? Spend time with your kids. Those are moments that you will never get back. Also, when you say you will do something, do it. Remember, the parents are in charge, not the kids. I see too many people begging their kids to behave. I can’t count how many times people have come up to us in restaurants or on airplanes and commented on how well-behaved our children are. It’s for a reason. I rarely have to discipline them. (Although I am the enforcer: I often hear my wife ask, ”Do you want me to get your father in here?”) I simply sit them down and tell them that if they continue their behavior, they’ll be in trouble and get punished. If they stop and apologize and refrain from doing it anymore, we can move on. It’s completely their choice! They almost always choose to behave, and we move on. If they don’t behave, then I will punish them to make sure they understand I will honor my word.
What’s the one thing about being a new dad that shouldn’t be missed? Being there at the delivery!
What’s the most overrated thing about fatherhood? Nothing.
What’s the most underrated thing about fatherhood? How important being a father is. Your job is not necessarily to be the child’s best friend, but being friends is desirable and great. Your job is to teach the child right from wrong, good from bad, so someday when you’re not there, they’ll make the right decisions.
Why are fathers important? They provide stability, a role model, and a support system for the child.
Career, marriage, kids … how does a guy stay sane? Easy: Have a great wife!
Dr. Crutchfield’s Q&A
In Minnesota, when someone says the name Dr. Crutchfield, most people — especially African Americans from Minneapolis, St. Paul and surrounding areas — assume they mean the legendary obstetrician and gynecologist Dr. Charles E. Crutchfield, Jr., a doctor known for the delivery of at least 10,000 Minnesota babies in the Land of 10,000 Lakes over the last 45 years.
But in 1994 another Dr. Crutchfield arrived on the scene in Eagan, Minnesota. He too goes by the name of Dr. Charles E. Crutchfield, but he is known as the third (III) and is the son of Dr. Crutchfield, Jr, who he calls Dad.
Dr. Charles Crutchfield’s expertise is highlighted in this Star Tribune article
The number of men getting cosmetic procedures has risen more than 88 percent since 1997, according to the American Society of Plastic Surgeons. Botox injections are among the most popular procedures. One reason? The pressure to look young while job hunting, says Dr. Charles Crutchfield of Crutchfield Dermatology in Eagan (www. crutchfielddermatology.com).
Arnold S. Leonard, M.D., Ph.D., Mark Mueller and Charles E. Crutchfield III, M.D
Why are oils extracted at cold temperature from fruit, herb and spice seeds amazingly good for your skin and superior ingredients for a great variety personal care products?
The short answer is; seeds are the antioxidant and nutrient powerhouses of the plant. They are the mother lode of natural protection mechanisms for the regenerative but fragile plant embryo. Oils extracted at cold temperature contain all the vital nutrients, essential fatty acids, trace minerals like zinc, magnesium and calcium necessary to sustain the plant germ in its first days of life. The plant chemical protection mechanisms of seeds are complex, diverse and biodynamic, involving literally dozens, even hundreds of different plant chemicals that protect the fragile embryo from oxidation, damage from UV light, and the onslaught of a myriad of environmental microorganisms such as fungi and molds. These natural protection mechanisms are so effective the embryo in some seeds have been known to be viable for hundreds of years.
A company on the forefront of the exciting frontier of extracting novel fruit, herb and spice seed oils is Botanic Oil Innovations, Inc.* Using its’ proprietary NatureFRESH-Cold Press process, it produces nutrient dense, biodiverse, super potent antioxidant novel fruit, herb and spice seed oils for the dermatology and personal care products industry. Botanic Oil Innovations produces these novel oils from such plants as cranberry, blueberry, raspberry, blackberry, grape, black cumin, milk thistle and pomegranate to mention a few.
Oils extracted from seed using this cold process are raw foods, unadulterated by heat, solvents or additives. The resulting oils have a rich and diverse range of protective phytochemicals that function to protect the seed from oxidation, ultra violet light and to ward off attack from microorganisms. Often these novel fruit, herb and spice seed oils contain the full range of eight different forms of natural vitamin E in the form of tocopherols and tocotrienols, not just the alpha tocopherol (given a bad name by a number of periodicals). And they contain a great variety of other antioxidants, like the carotinoids carotein, lutein and zeaxanthan, cryptozanthin and literally hundreds of other plant chemicals like quinones and polyphenolics.
Is there any wonder then that these same protection mechanisms for the plant embryo aren’t also good for your body’s natural protective covering, the largest organ of your body, your skin? Benefits from these novel oils include protection against skin bacteria, protection from UV light, improved antioxidant protection, accelerated healing, increased collagen expression, and increased elasticity and more pliable skin. Botanic Oil Innovations, in conjunction with other Universities, has conducted extensive laboratory testing demonstrating the functional protective values. Here are some things they are researching and finding:
The novel botanical oils are natural emollients. They prevent dryness and protect the skin, acting as a barrier and healing agent, as well as a soothing and softening agent of the skin. They reducing roughness, cracking and irritation and may even assist with retarding fine wrinkles. While water is the best emollient, it evaporates too quickly to be effective unless it is used in conjunction with oils in an emulsion. Natural botanical oil emollients nourish the skin with concentrated nutrients including which may prove beneficial in treating inflammatory conditions of the skin such as acne, psoriasis, eczema and rosacea. The antioxidant properties may prove to have some of the most effective rejuvenating properties of any know topical skin treatment to date. (Charles E. Crutchfield III, MD, Clinical Professor Dermatology, et. al., Univ. of Minnesota)
Cox-2 inhibition activity of many NatureFRESH-Cold press fruit and herb oils according to laboratory assays conducted by Liangli Yu, PhD at the University of Maryland, are many times greater than aspirin. Cox-2 is an enzyme linked to inflammation and inflammation is associated with many skin disorders ranging from sunburn to roseacea, psoriasis, acne and dandruff.
Antioxidant Protection to the Power of 10
The NatureFRESH-Cold press process preserves the natural antioxidants in the botanical seed oils resulting in superior free radical quenching. Many of the botanical oils contain a broad mixture of Vitamin E isomers, often acting synergistically with other antioxidants that result in a total antioxidant level ten times, twenty times and even forty times or more than the fruit overall. The cranberry and raspberry fruit seed oils for example have rich concentrations of the tocotrienol form of Vitamin E. The tocotrienol forms of vitamin E are just now being scientifically understood. They are the less saturated form of Vitamin E, enabling them to move around more freely and efficiently in cell membranes where they intercept and neutralize free radicals than can the tocopherols. Research by noted scientists at the University of California discovered the tocotrienol form of Vitamin E can be 40-60 times more effective in neutralizing free radicals than alpha tocopherol.
Anti Microbial Activity
Many skin disorders are known to result from or are exacerbated by bacteria and fungi living on the surface of the skin. The antimicrobial activity of super potent antioxidant botanical oils is very strong enabling them to act as a bactericide against a broad range of microorganisms and even pathogens such as E. coli and listeria. Potent antioxidant botanical oils have been shown in research at the University of Maryland to not only inhibit growth of a broad range of microorganisms but also to reduce them to a zero survival rate.
There’s an old saying, the best approach is to mimic nature as nature knows best. So, when it comes to protection for the skin, NatureFRESH-Cold Press oils seem to work well. The NatureFRESH Cold press oils have the right combinations and right mixtures of antioxidants, essential fatty acids and nutrients to protect and nourish the skin in multiple ways. Hopefully, more skin care specialists will realize the potential of these natural ingredients and use them in their daily patient treatment programs.