Dr. Lara Butler, MD

The American Academy of Dermatology recommends using broad-spectrum sunscreen with an SPF of 30 or higher. An SPF of 30 blocks about 97% of UVB rays, and an SPF of 50 blocks about 98%. An SPF of 100 blocks 99%, but giving people a false sense of security as they may stay in the sun longer and get more sunburns. It is important to reapply every 2 hours regardless of SPF.
 
Transcript: "So the American Academy of Dermatology recommends sunscreens be broad-spectrum, UVA/UVB coverage, that is an SPF of 30 or higher. And what that means, SPF of 30, is that it blocks about 97% of the sun's UVB rays. And UVB is what's responsible for burns and skin cancer. When you get up to an SPF of 50, you're blocking about 98%. And when you're at an SPF of 100, you're blocking 99%. So certainly that higher SPF is going to give you a little better blockage. But what we found is that these higher SPFs of 100, give people a false sense of security. And then they end up in the sun longer, and then they do get more sunburns. So what's important to know, regardless of the SPF, you need to reapply every 2 hours. If you have an SPF of 100, that doesn't mean it will last longer. Every 2 hours, you need to reapply an SPF 30, an SPF 50, or an SPF 100. So you know, pick your whatever sunscreen you're actually going to use, whether it's a lower number or a higher number at least 30 or higher though, and just reapply every 2 hours."

You can tell if your skin is dehydrated by doing a pinch test where you pinch the skin on the cheek or on the chest. To rehydrate, drink 8-12 cups of water per day and add in a lemon wedge for vitamin C. Use topical moisturizers with ceramides and hyaluronic acid serums to help lock in moisture. Eat plenty of fruits and vegetables for added hydration.
 
Transcript: "Hi there. Dr. Lara Butler, board-certified dermatologist here to answer the question, how can you tell if you are fully hydrated? Well, when your skin loses moisture and becomes dehydrated, you'll be able to see noticeable changes in the skin. Your skin tone will be a little dull. You'll notice more fine lines and wrinkles. Even the dark circles under the eyes will be more pronounced. So you can also experience things like headache, fatigue, decreased urination. But in terms of skin symptoms, that's what we're going to be talking about today. You can tell if your skin is dehydrated by trying to do a pinch test where you pinch the skin on the cheek or on the chest. And it should retract and not leave a wrinkle. If it does leave a wrinkle or take a while to retract, usually, that means that the skin is dehydrated, and you need to start rehydrating. So how can we do that? Well, we do it from the outside in and the inside out. From the outside, we can start hydrating by drinking a ton of water, 8 to 12 cups a day. And if you can super boost that by adding in a lemon wedge, that just adds some vitamin C, which is an antioxidant that's going to help with collagen synthesis. And that's just going to help to boost and plump the skin even more. In terms of sports drinks, we kind of recommend steering clear of those because they can have a high amount of sugar in them and that can counteract what you're trying to do with hydrating the skin since the sugar can then dehydrate the skin more. In terms of outside in, putting on a topical moisturizer or something with a ceramide, that's the key ingredient you want to look for. Ceramides are lipids, which are basically fat molecules that are going to help to lock in that moisturizer or that moisture. For extra hydration, you can add a serum like a hyaluronic acid. The serum should go in first and then the moisturizer on second. Hyaluronic acid serums are going to help the water bind collagen for that extra plumping. Otherwise, eating a ton of fruits and vegetables that can help to plump the skin with hydration are always a good option. So we get about 20% of our hydration from what we consume. So just be aware of what you're putting in your body, drink a ton of water, use some great moisturizers, and hopefully that will help plump the skin. Take care."

Skin cycling is a four night skincare routine introduced by dermatologist Dr. Whitney Bo, which involves exfoliating with an alpha hydroxy acid on the first night, using a retinoid on the second night, and focusing on recovering nights (intense moisturizing) on the third and fourth night. Wear sunscreen during the day to protect your skin from the active ingredients used in skin cycling.
 
Transcript: "Hi there, Dr. Lara Butler here, talking about skin cycling, so the concept of skin cycling was introduced by dr. Whitney Bo who is a board certified. Dermatologist very well respected in the field and she introduced this as a way to streamline your skincare routine and make it more effective and I'm absolutely a fan of it. It's a great way to approach your skincare routine because the world of skincare has just become overly complicated with so many active ingredients and there's this obsession with more is better. And by putting on too many ingredients that don't play well with one another, you can lead to a lot of blotchiness in irritation, which isn't your skin purging It's actually an irritant dermatitis which is not beneficial for your skin care routine. So by looking at skin cycling you're just going to be able to optimize the outcome of the ingredients, you are putting on your skin and you're really going to make those products work better for you. So what it is is a four night routine. Your first night is going to be exfoliating With some sort of an alpha hydroxy acid. So, either a glycolic acid, a lactic acid, or a salicylic acid or the most common as tolerated and that's going to help to turn over the top layer of your skin. The second night is a retinoid night and that's going to penetrate a little bit deeper into the second layer of the skin called the dermis and that's where you have collagen and elastin being produced. So that's going to help more with Fine Lines, wrinkles the third, and fourth night are going to be recovering night. So they're basically intense moisturizing. Tonight's and those are the most important nights because they allow Your Skin Barrier to recover, they optimize the outcome of your first and your second nights of kind of the more active ingredients. So if you haven't started cycling, it's a great time to start. Make sure you focus on your face, your neck, and your chest, and make sure to wear sunscreen during the day, because all of these active ingredients are going to make your skin more sensitive to the Sun. So if you're listening, get started and I hope this helps"

Skincare routines depend on your individual goals, but typically involve chemical exfoliation, retinoids, vitamin C and SPF in the morning, and hyaluronic acid serum in the evening. It's best to get a dermatologist's opinion before starting a routine. However, if you're beginning at home, start gentle and listen to your skin.
 
Transcript: "Okay, so what does a skincare routine look like? And how do you start one on your own? Well, it really depends what your ultimate goal is, you know, are you trying to just get a better glow or you trying to prevent fine lines and wrinkles? Are you trying to help your acne breakouts or any hyperpigmentation or discoloration? You know, each of those goals is going to dictate what type of products you're using. So for your best outcome, of course, I think you should see a board-certified dermatologist to assess your skin and give you the right direction on what type of chemical ingredients to use. To improve your concerns. But if you're going to be starting at home, the best way to start, is to consider a skin cycling routine. So something where you're going to be, helping that Skin Barrier recover when you are applying the different chemical ingredients onto the skin, usually skin cycling involves the first night of a chemical exfoliation, a second night of a retinoid, and a third and fourth night of just recovery with just intense hydration. Moisturizing, everybody's skin care routine and Maya. Opinion, should involve a vitamin C in the morning and an SPF, of course, and a hyaluronic acid serum and then in the evening, you know, the different chemicals and retinoids that you're using or all going to depend on what your goals are. So ultimately, I think you should come in and see one of us for your best results but if you're going to start at home just start gentle listen to your skin if you're getting irritated back off."

Treating blackheads at home can be done with salicylic acid and retinoid face wash, moisturizer, clay masks, strips, and an optional comedone extractor. If none of these work, see a board-certified dermatologist for prescribed treatments.
 
Transcript: "Hey Dr. Lara Butler answering the question about how to best remove blackheads at home. Well, blackheads are stubborn, they're basically an oxidized version of oil and dead skin cells that clog up the pores and they can be removed by physical extraction or chemical degradation. So what you should focus on in your skin care, routine is adding a salicylic acid and a retinoid salicylic acid is going to just dry up the oil gland and the retinoids going to help turn over the top layer of those sticky cells. So the Sal acid face wash, you can start using morning and night. And a retinoid, I would introduce every third night, just a tiny little bit in the areas, you're getting the blackheads and hopefully over the next few weeks that would help to extract some of those blackheads on their own. While you're using these acids and retinoids you do want to have a strong focus on, moisturizing the skin. Because if you're stripping the skin too much of its oil you could then actually cause your skin to make more oil which will then make more blackheads. So moisturizing is key. Every day despite thinking your acne prone, if you want to use a scrub is Al acid-based. Scrub can be helpful but you need to limit it to once a week. If you're overly scrubbing and exfoliating you're just going to make more oil in your skin. In terms of extractions, you could certainly consider seeing a licensed esthetician to do some of the steams and extractions. If you're going to do it at home, make sure you have clean hands and just perform the procedure very Only if they're not coming out on their own then leave them alone if you have access to it comedone extractor. That's actually going to be most sterile way to remove those blackheads. You could also consider doing some clay masks at home that are going to dry up the oil. You could use the little strips that help to unplug those pores. That's only removing the dead skin cells. It's not actually affecting the oil production so you can do these diy things at home but make sure that you're also doing the Kind of chemical ingredients that I just talked about and then if none of these things are working, you need to see a board-certified dermatologist for some more prescription-strength options to try to improve the results. Good luck."

Melanoma is a type of skin cancer that needs to be caught early. To check for melanoma look for asymmetry, irregular borders, multiple colors, evolving diameter and any other changes. If you notice any concerning moles it's important to see a dermatologist right away.
 
Transcript: "Hi there, Dr. Lara Butler answering the question. What features of a skin spot or concerning for melanoma? So melanoma is a type of skin cancer that's formed from abnormal moles. It only makes up two percent of cancers but it can be very deadly. So need to be caught early and the things to look for to catch them. Early are typically, the abcdes of melanoma. So, a is a symmetry. You want to look at how symmetric that mole is. Is one side. The same as the other, if it's a Asymmetric, that's not a good feature borders. You want borders to be regular if borders are irregular or indistinct kind of drag it on one side or the other. That's a kind of a warning sign C is for color. You want to look at a nice uniform brown color. If there's two different colors forming or if you're seeing blacks purple's Greys and not mold, that's not a good sign, D is for diameter. You want most moles to be about a quarter inch which is like a pencil eraser. You want them to be that size or smaller, but if they're growing, eat Evolution, if that model is evolving and becoming bigger than that quarter inch size, that's a concerning feature. So anything that's changing in those abcdes, should prompt you to see a dermatologist and have your moles evaluated. Typically, your dermatologist will take a look at your moles with something called the dura mater scope, which just allows us to check the structure out to determine whether we're going to just clinically monitor that. Abnormal mole or take a little skin biopsy, but when caught early melanoma can be treated, it has a 99 percent cure rate when it's caught early. So really important to check your skin at home. Do self exams and if you have any concerning moles, just come in and see your dermatologist right away."