Lasers used for Hair Removal

Laser energy, through the principle of selective photothermolysis (a process that involves selective absorption of an intense light pulse at wavelengths that are absorbed by the hair follicles, but not by the surrounding tissue), targets the pigment in the hair follicle. This causes destruction of hair follicles while sparing surrounding structures (i.e., the skin). Growing hair is more sensitive to destruction than resting hairs. Many of the lasers listed below utilize epidermal or skin cooling techniques. The effect of cooling the surface of the skin serves to minimize discomfort during treatment while increasing the effectiveness of the laser treatments.

1. Ruby Laser (694 nm, normal mode)
   - All patients will see a growth delay of their hair. Some patients will see a permanent reduction in hair growth.
   - This laser is more effective for dark hair. Blonde and gray hairs are more resistant.
   - White hairs do not respond to treatment
   - Epilaser® (Palomar) and Epitouch® (Sharplan) are examples of ruby lasers
2. Alexandrite Laser (755 nm, normal mode)
   - All patients will see a growth delay of their hair. Some will see a permanent reduction in hair growth.
   - It is effective for dark hair. Blonde and gray hairs are more resistant.
   - White hairs do not respond to treatment
   - It is potentially safer for darker skin than the ruby laser
   - Rapid repetition rates of the laser will reduce treatment time
   - Apogee® (Cynosure) uses a cooling gel on the skin
   - Gentlase® (Candela) uses dynamic cooling spray
3. Pulsed Diode Laser (800nm)
   - Patients with thick or coarse hair will see a delay in hair growth. Some patients will see a permanent reduction in hair growth.
   - It is effective for dark hair. It is not effective for fine hair.
   - Potentially, it is safer for darker skin types
   - LightSheer® (Coherent) uses contact cooling
4. Intense Pulsed Light Source (500-1200 nm)
   - It is effective for dark hair, both fine and coarse
   - It is potentially useful for darker skin types
   - Epilight® (ESC) uses cooling gel
5. Nd:YAG Laser (1064 nm, Q-switched)
   - Permanent hair removal has not been demonstrated
   - It can temporarily remove light hairs
   - It is potentially safe for all skin types, and causes the least epidermal damage of all treatments.
   - Carbon suspension is applied to skin in some treatments
   - There is a lower risk of epidermal damage
   - Short operative times are required
   - It causes the least discomfort of all laser hair removal treatments

Shaving 101

Your legs must be wet for at least two to three minutes before applying your cleanser or scrub. That way the hair is soft and pliable, easier to cut. Don’t use soap, it just dries out your legs and makes for a poor shave.

Make sure you have the right tool. There are various styles of shavers, but not all legs or hair growth are the same. Triple blades work well, but no matter the blade type you use, change it frequently – but be careful with sharp edges – if not done carefully, shaving can irritate the skin, the hair follicle, and the oil gland, which causes a rash. Ingrown hairs also pose a chance of infection. See a dermatologist for the right solution.

Choose a shaving cream or gel that contains emollients for a hydrating effect, and one that is fragrance free to avoid irritation to your skin. So steer away from products that contain irritants including alcohol, menthol and peppermint. Find yourself out of shaving cream? Hair conditioner or body cleanser works just fine.

Apply even pressure and shave against the growth of hair. Follow up with a moisturizer to keep your skin moist and supple. (Read about Skin Moisturizers), but avoid creams with AHAs because the glycolic acid can irritate freshly-shaven skin.

Are there shaving alternatives?

Indeed there are. While temporary hair removal can be done by shaving, waxing or by epilation (electrolysis and thermolysis) another method is removing hair with a laser.

What is laser hair removal?

Light energy produced by a laser is targeted at the pigment in hair. This causes destruction of hair follicles while sparing surrounding structures (i.e., the skin). Total temporary hair removal, which lasts for several months, can be done in almost all patients. However, total permanent laser hair removal is not commonly done. Stable permanent hair removal may be possible in some cases and usually requires multiple treatment sessions. You can read about Laser Hair Removal frequently asked questions

Who benefits from laser hair removal?

Almost anybody, however, this process works well for light-skinned, dark-haired individuals. There is no laser treatment yet that is effective for white, blond or red hair.

Be aware of some cautions if you go this route; such as dealing with existing bacterial or viral infections, psoriasis, or if you are on certain medications such as Accutane®. See your dermatologist for more details if you are considering laser hair removal.

Laser hair removal facts

• The process can be mild to moderately uncomfortable.
• Most patients require three to six treatments. Long-lasting results depend on hair color, type of laser, and location treated.
• Complications are rare if performed by an experienced physician.
• Expect some pain, swelling and redness around the hair follicle after each treatment session.
• Check with your dermatologist about pre-operative care concerns.

Folliculitis alert

Shaving can also cause a condition called folliculitis, which is an inflammation or infection of hair follicles. It most often appears in areas that become irritated by shaving, the rubbing of clothes, or where follicles and pores are blocked by oils and dirt. Ask our dermatologist about solutions such as Bactroban© ointment to help heal these irritations. (Read more about Bacterial Skin Infections)

What to watch for:

• a reddened rash
• raised, red, often pus-filled lesions around hair follicles (pimples)
• itching at the site of the rash and pimples

How to prevent it:

• shave with an electric razor instead of a blade razor
• keep skin clean
• avoid clothing that rubs against the skin, damaging hair follicles

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Closer Look At Facial Masks

A facial mask is generally defined as a substance that is applied to the face, much like smearing on cream. It is thick, and often resembles clay. Many masks make use of clay or gel as a base, as these will stay in place when applied, and they are generally harmless to most skin types (although gel is used most for sensitive skin, as heavy clay irritate it). Masks are meant to cover the entire face and then remain in place for a few minutes before washing off. The materials in most masks are safe to be washed down the sink.

Facial masks are more than just silly tricks that women try to get their “beauty rest.” They are an important part of skin care. It is recommended that you use a facial mask at least once a week. While it is not necessary to go overboard and wear one every night, a weekly facial mask session cannot only help your skin receive moisture, but it can also ease skin disorders. Facial masks can be soothing or energizing, and the actions and rituals often involved with applying a facial mask can be an effective stress reliever.

Most facial masks include both deep cleaning and moisturizing agents in the mask. This allows the cores in the face to be cleansed deeply, getting rid of oily build up and trapped dirt. This can help reduce or even prevent acne. Additionally, many masks help slough off dead skin. The dead top skin is dull and lusterless. When it is gently removed, the mask brings the top layer of dead skin cells off with it. This leaves younger, healthier cells exposed as the face’s surface. This means tighter skin and a more brilliant complexion. It can also reduce the look of fine lines and small wrinkles to carry out a regular facial mask.

Another reason that facial masks are so popular involves the soothing and relaxing motions associated with applying a facial mask. If you decide to have one applied in for relaxation as well as the benefits it has for the skin on the face, then you can have a very enjoyable experience. In spas, these masks are applied with special techniques and often include a massage. You can give your own face a gentle massage just prior to applying the mask, and if you are systematic about it, you can apply the mask in a way that is singularly soothing. All masks should be applied to a freshly cleaned face, rinsed with warm water. This opens the pores and allows the mask to do its thing. Warm water is very calming and soothing, and many people find this part of the application to be one of the more enjoyable stages.

Apply the mask in a circular motion until it covers the face. This is calming and stimulating at the same time. Let the mask sit on your face for 15 to 20 minutes (although some are meant to be worn all night). Many women like to lie down and relax. The effect can be enhanced by the addition of candles or incense and some soothing music. Finally, when it is time to rinse the mask, do so in cold water. This will help close the pores, protecting them against dirt and oil, and also energize your face.

Many people enjoy making their own facial masks from common household products like bananas (for wrinkles), avocados, and honey (antibacterial). Butter can also be used as a remedy for dry skin. Other masks can be created using different types of clays, and different essential oils can be used for different skin types. Fruit purees also have different effects and yogurt and milk can soften the skin. Oatmeal is extremely soothing, and most sensitive skin types can use masks of this sort. Adding rose petal powder can enhance your fragrance without the need for perfume, while citrus fruit peel powder acts as an astringent.

When you decide to make use of facial masks, you are certain to feel the good effects of it later down the road. And if you apply them once a week, you can help keep your face healthy-looking and your complexion brilliant with a healthy glow.

Rosacea Basics

Rosacea is a long lasting, non-scarring skin condition of the face that is often misdiagnosed as adult acne. It varies in severity and does not always worsen with time. Typically, you will experience inappropriate flushing that is not usually associated with sweating and/or persistent facial redness. It is common to have broken blood vessels (telangiectasias) on your cheeks. You may also experience bouts of inflammation that cause red papules (small bumps) or pustules. However, comedones (blackheads and whiteheads) are not part of rosacea.

About 50% of those with rosacea suffer eye involvement, including such conditions as conjunctivitis, blepharitis, dry gritty eyes, and recurrent sties. Nose enlargement (rhinophyma) is uncommon but mostly seen in men. It is only very rarely seen in women.

Key Features:

• Facial symptoms - burning and stinging
• Facial flushing, blushing evolving to persistant redness
• Inflammatory papules, pustules (pimples)
• Cheeks are not warm
• Telangectasiae, (blood vessel lines)
• Eye involvement
• Soft tissue hypertrophy or skin thickening (rhinophyma)

Facial flushing	Telangectasias	Rhinophyma

Who Gets Rosacea?

This condition is most commonly seen in those who have fair skin and is sometimes referred to as the “Curse of the Celts” or a “Peaches and Cream“ complexion.

Where Does Rosacea Occur On The Skin?

You will usually see rosacea around the central area of your face. It may occasionally be isolated to one patch.

When Does It Usually Start?

Onset usually occurs between 20-40 years of age.

How Does Rosacea Affect Us?

• Rosacea can be very embarrassing, flushing can be a source of social discomfort
• Many may feel that they are perceived as heavy drinkers
• Eyes can be gritty and uncomfortable
• Older men are frequently ashamed if their nose becomes bigger and knobbly

How Your Lifestyle Affects Your Skin

Researchers have found that diet and lifestyle alone will suffice to prevent about two-thirds of all skin cancers. While anyone can develop skin cancer, the risk is greatest for people with light-colored skin that freckle easily, researchers said. But what about other factors of your skin’s care?

How often have you skipped your meals just because you were too busy to eat or may be too tired to eat? Our highly materialistic life and hectic schedules have made us too busy to even think about what we are eating. Professionals who do not have time to waste on cooking would simply go and grab a burger or a hot dog along with cola and call it lunch.

For the time being, a burger and a cola would be just enough to satiate your hunger but have you ever given a thought to the long-term implications of such a diet and lifestyle?

The human body’s nutritional needs are highly specific. It needs a certain amount of carbohydrates, proteins and fats. Foods like burgers, pizzas or ice creams do not meet our nutritional needs. You don’t have to plainly eat to satiate hunger instead you should eat to meet your body’s nutritional needs. A diet deficient in all the essentials would eventually catalyze the effect of various potential diseases.

Skin reflects the kind of diet you take. You may have often wondered why there is a healthy glow on some people’s skin. Well, one of the possible factors apart from genetic would be a healthy diet and lifestyle. You might have noticed people who are chronologically younger but look way older than their age and vice versa. With good care of your skin you can control the effects of time on your skin and aging process.

Wrinkles appear on your skin when your skin’s ability of produce collagen reduces. Low collagen levels ultimately lead to the deterioration of the elastin tissues. The skin eventually looses its elasticity and firmness and starts to sag giving creases and folds i.e. wrinkles.

In order to slow down aging, you need a major diet and lifestyle change. You should eat right and healthy. Avoid fatty, oily foods and also foods with high glycemic index. Eat right amount of proteins in right quantities, loads of natural foods like fruits and vegetables and drink plenty of water. Make healthier choices and avoid fast food.

You also need to quit smoking if you are a heavy smoker. Quit alcohol and drugs too. You should incorporate a mild to moderate exercise like jogging, walking or running. Or you could detoxify with yoga. These changes will work wonders on your skin, giving it that healthy glow you always wanted.

These changes when incorporated at an early age, definitely slow down aging and the onset of diseases those come with age.

What are White Spots on the Skin?

White spots on the skin, also known as hypopigmentation, is the loss of pigment in the skin resulting in greater whiteness than in the surrounding area. As melanin pigment is not produced in an area of the skin, the affected area losses color.

There are a number of things that may cause this spotting:

Skin Damage:

skin infections, lasers inappropriately applied, burns or blisters, or other forms of skin trauma may result in hypopigmentation and a loss of color in the skin

Albinism:

Albinism is a genetic disorder passed onto children from their parents. Melanin is not produced in people who have albinism resulting in a total absence of pigment in the skin, hair or eyes. People with albinism are at serious risk for sun damage and skin cancer and as such should be sure to wear sunblock at all times.

Vitiligo:

Vitiligo is a chronic skin disorder resulting in large, irregular discolored patches on the skin. Most of the affected areas lose pigment, though pigment may come back as melanin is reproduced in the affected areas.

Treatments for Aging Hands

Because of sun and weather exposure, years of minor scrapes and cuts, and for some, constant exposure to water and detergents, our hands sometimes age faster than other parts of our bodies, and detract from our appearance. Fortunately is it now possible to rejuvenate the hands, restoring their appearance and sometimes also improving the thickness and health of the skin on the backs of the hands.

Fun loving, hard working hands don’t get the sun protection they need. The backs of the hands are sometimes overlooked when sunscreen is applied - or the sunscreen is washed off or accidentally wiped away. Gardening gloves, golf gloves, bike gloves work gloves can help to protect our hands from sun and from trauma.

Daily moisturizing your hands is critical to keep your skin supple and prevent dryness and cracking. Wearing gloves and moisturizing in the cold weather helps protect your hands from chapping and cracking.

For some people, dry cracked hands are a chronic condition called contact dermatitis, or hand eczema. Often caused by your daily routine, one which involves constantly having wet hands (i.e. hairdresser, surgeon, homemaker), this condition results in red, scaly, and very itchy hands. If you suspect your have this, read more at http://www.eczemaguide.ca/basics/eczema_like/hand_eczema_hand_dermatitis.html

There are some solutions to rejuvenating the look and feel of your hands:

• There are numerous special hand creams available, more being introduced almost every week! Creams with vitamins A, C, E and alpha hydroxyl acids are key ingredients which can help prevent and restore your youthful looking hands.
• Restisol-A® 0.01% cream contains tretinoin (which prevents and corrects some aspects of sun damage) and also has an SPF 15 sunscreen. When Retisol-A cream is applied to exposed areas like the face and the backs of the hands EVERY morning - year after year - the aging process is slowed down, and sometimes after a year or two the skin will actually start to look and feel younger and healthier.
• Sunscreens which have the ability to stick to the skin (for example, Anthelios-45® Waterproof Sunscreen) can be very helpful on active parts of the body like the hands, and can also act as a moisturizer. The sunscreen should be applied before sun exposure, even if you are using Retisol-A as a base coat for your skin every morning.

When the skin on the back of the hands has become old looking and freckled - and sometimes also thinned out - it is possible to correct these problems and give your hands a fresh, more youthful look:

• Brown spots (sometimes called freckles, “age spots” or “liver spots”) can be faded using fading creams and also by using the Medlite C6 laser. Treatments take only a few minutes, are well tolerated, and great improvement is usually obvious within a couple of weeks.
• Thin skin on the backs of the hands can be quickly improved by treatment with Restylane™. This not only improves the appearance of the hands by making veins and bones less obvious, but also restores the fullness found in youthful skin and gives some protection against bumps and bruises. The benefits of a single treatment can be seen immediately and often last 6-12 months, sometimes longer.
• In some cases Artecoll™ can also be used to improve the thickness of the skin on the backs of the hands. Artecoll™ costs more to use, and several treatment sessions 2-4 months apart may be required, but Artecoll™ has the advantage of producing an improvement which can last for many years.

Like most things, prevention is your best solution. Keep your hands beautiful by remembering to moisturize, use a sunblock and protect your hands from exposure - the same way you look after your face. For more information on cleansers, moisturizers, sunscreens, and general skincare, go to SkinCareGuide.ca.

About the author:
Dr. Kevin Smith is a dermatologist in Niagara Falls, Ontario with a particular interest in protecting the skin and in correcting skin problems resulting from aging, rosacea and sun damage. He is an expert in the use of Botox®, fillers, lasers and intense pulsed light to maintain and enhance the appearance of the skin, and have lectured on those subjects across North America, and in Europe, Asia and Mexico. Read more at www.smithlaser.com

Removing Age Spots

The Sun. The term ‘age spots’, or lentigines, refers to the brownish spots on your nose which come from being out in the sun unprotected too long. As we age our skin is subjected to more and more sun damage. Our skin has melanin pigment which absorbs sunlight and helps naturally protect our skin from UV rays. However as we age, our skin’s natural ability to fend off UV rays from the sun begins to deteriorate, and we see the development of age spots.

Currently, there are four different methods that have proven to be successful at removing age spots quickly and easily.

IPL Treatment

IPL, also known as photorejuvenation, stands for Intensed Pulsed Light. This treatment for age spots is a non-ablative which simply means it doesn’t damage the surface of the skin. With IPL, intense light is sent to the deeper layers of your skin (dermis) without touching the superficial layers (epidermis). This innovative method is good for removing age spots because it uses the pulsed light to stimulate new collagen growth while fading discoloration and evening your skin tone.

The only drawback about IPL is that it has to be performed by a trained medical professional. The procedure can be quite expensive, too. You’d have to have 4 to 6 IPL treatments to see real results. At $300 to 600 per session, you could easily end up spending $1200 to $2200 to reach your goals.

Laser Resurfacing

Laser resurfacing is still a fairly new procedure, but it’s relatively safe. Laser resurfacing is most popular as a procedure for minimizing fine lines, but it’s also effective as a treatment for age spots. This procedure must be performed in a doctor’s office because it call for some sedation. Laser resurfacing is a popular treatment many plastic surgeons offer to help with removing age spots and other deep blemishes.

Like IPL, laser resurfacing can be quite expensive. The national average for this procedure is nearly $3,000 but many doctors offer financing so patients can take advantage of monthly payments.

Bleaching Creams

Bleaching creams are great for bleaching large areas of discoloration. However, as a treatment for age spots, bleaching creams tend to bleach the areas surrounding the spots more than the spots themselves. You can either purchase bleaching creams from your dermatologist or get them over the counter at your local drug store. Some people say bleaching creams are slow at removing age spots while others swear by them. Either way you can see some results.

Home Chemical Peels

A home chemical peel is perhaps the most cost-efficient and effective treatment for age spots available. It works by removing layers of dead skin over a period of several days (usually less than a week) in order to reveal fresh, new skin that is both younger looking and more supple. Lighter chemical peels only penetrate one or two layers of skin while deeper peels can go as many as three or four layers deep.

Many home chemical peel kits provide dermatologist-quality results at a fraction of the cost. As a result, they tend to be one of the most sought after solutions for removing age spots. The average home chemical peel kit will cost you about $80 for a basic kit and $660 for a more advanced kit. This is significantly less than the $300 to $2000 you would pay to have the same treatment done in a dermatologist’s office.

Organic Face Masks at Home

SPA INDEX PAPAYA PUMPKIN FACIAL

If you have visited spas and resorts in exotic locales such as the Pacific Rim, Bali, Hawaii, and Tahiti, you’ve probably seen an esthetician select and mash fresh fruit in front of you for a fresh-on-the spot enzyme mask. It’s easy to recreate this mask at home — we’ve found a Balinese mask for you which will leave your face fresh and glowing.

2/3 cup fresh papaya, mashed
15 oz. can pure pumpkin
1 egg, beaten

1. Prepare the mask. Cut the papaya in half and scoop out the seeds. Scoop out the papaya fruit and mash it well to eliminate lumps in the mask. Beat the egg until it is frothy. Combine that with the papaya. Add the pumpkin to the egg/papaya mixture and whip together. You can also mix the ingredients in the blender or a food processor for an extra smooth mask.

2. Prepare your face. Wash with your daily cleanser and remove all residual makeup on your skin. Rinse with warm water. It’s very important to have clean skin to ensure you get maximum benefits from the facial.

3. Apply the Mask. Cover your entire face, being careful to avoid the immediate eye area. If you have sensitive skin, test the mixture on your hand before spreading it on your face. You’ll feel some tingling as the enzymes in the pumpkin go to work immediately — gently exfoliating your top layer of skin. It works like a scrub without being abrasive to your skin. Leave the mask on for 10 minutes.

4. Rinse Off Mask. After you’ve relaxed for ten minutes it’s time to rinse. The mask is fairly thick — head for the kitchen sink.

5. Apply Toner & Moisturizer.

LEMON FACIAL MASK

2 tablespoons sour cream
1 teaspoon finely ground oatmeal
1 teaspoon fresh lemon juice
1 drop lemon essential oil
Cucumber slices (optional)
Mix the sour cream, oatmeal, lemon juice and essential together in a bowl. To use, massage over clean face and neck skin and the rest for 10 minutes (with cucumber slices if you have them) over your eyes. Rinse well with warm water and follow with toner and moisturizer.

Always use Lemon Facial Mask immediately for best results — the lemon juice will cause the sour cream to curdle if it is not used quickly.

AVOCADO CARROT CREAM MASK

This mask combines avocados, which are rich in Vitamin E, with carrots, which are high in beta-carotene and antioxidants, and cream, which is high in calcium and protein.  These ingredients will rebuild skin collagen, improve tone and texture, and fade age spots.

1 avocado, mashed
1 carrot, cooked and mashed
1/2 cup heavy cream
1 egg, beaten
3 tablespoons honey

Combine all ingredients in a bowl until smooth.  Spread gently over your face and neck, and leave in place 10-15 minutes.  Rinse with cool water and follow with your favorite toner.

Avocado Dry Skin Masque
California Avocado Commission

Beat the yolk of an egg until it is light and frothy, then add the mashed pulp of a half avocado, blending it well (you may use a blender at this point). Cleanse your face thoroughly before using this masque (or any masque). Spread the avocado mixture over the face and neck evenly; relax on a slant board or bed for about 20 minutes. Remove with clear tepid water and a face cloth, followed by a rinse of cold water or a mild skin lotion. The result should be a marked improvement in skin texture, and all-around revitalizing.

Avocado Oily Skin Masque
California Avocado Commission

Put the white of an egg, a teaspoon of lemon juice, and the mashed pulp of a half avocado into a blender. In seconds, you should have a lovely green mixture. Wash your face and neck thoroughly, then apply masque evenly on those areas. Relax for 20 minutes; remove with tepid water and a face cloth. Follow with cold astringent or skin tonic.

ALMOND-MAYONNAISE SCRUB
Dry Skin Exfoliator

1/4 C. almonds
1/8 tsp. mayonnaise

Grind almonds in blender until they form fine almond meal. Whirl in mayonnaise.  Gentle rub scrub onto your face, and leave in place 10 minutes. Rinse. Use a toner thereafter.  Shelf Life: Refrigerate for 2-3 weeks.

Apple Cucumber Facial Mask
1/2 cucumber, peeled
1 egg white
1/2 teaspoon lemon juice
1/2 teaspoon lime juice
1/2 teaspoon apple mint leaves
1 drop lime essential oil
Combine all 5 ingredients in a food processor and process until smooth. Add the essential oil last and mix well. Refrigerate the mixture for 10 minutes.
Apply a layer to your clean face and neck area and leave it on for 20 minutes. Rinse well with warm water. Apple Cucumber Facial Mask is best when used immediately as the ingredients are perishable. The leftovers can be refrigerated in the coldest section of the refrigerator for up to 1-2 days but should be discarded after that

Apple Face & Neck Gelee
Yield: Approx. 2 applications
Ingredients:
4 teaspoons hot distilled water
1 teaspoon freshly juiced apple juice
1 teaspoon aloe vera gel
4 teaspoons vegetable glycerin
1 heaping teaspoon powdered pectin
Add the glycerin to the water/juice/gel combination and stir to fully incorporate.  Add the pectin while the liquid remains quite warm (if it cools, place it in the microwave or a double boiler to raise the temperature) and use a hand held electric mixer to blend, or stir vigorously to dissolve the pectin. Once the pectin has fully dissolved, a light gel will begin to form. This may take from 15 minutes to 1/2 hour. Once the gel sets, Apple Face & Neck Gelee is ready to use. Apply the gel in a layer to your clean, damp face and neck. Rest for 15 minutes. Rinse with warm water and follow with a light moisturizer if desired. Leftover product can be stored in the refrigerator for about a week. Enjoy!! The shelf life of this product is necessarily limited by the fresh apple juice. It should be used within a few days after it is made.

Comnbination Skin Health

Combination skin is characterized by a mixture of oiliness and dryness. Typically, the oily areas tend to be the T-zone, consisting of the forehead, nose and chin. The cheeks are normal to dry. The degrees of oiliness and dryness can vary. Pores may be larger in the oily areas - with pimples, blackheads and breakouts sometimes occurring - and dry areas may feel rough and irritated.

The “tissue test” can help you determine if you have combination skin. Take a tissue and hold/press it against your face. If there’s oil on the tissue where it touched your T-zone, but no oil where the tissue touched your cheeks, you most likely have combination skin.

Causes
Many factors can cause combination skin, including hormones, age, genetics, the way in which lipids are organized in our skin and even the weather. Hormonal changes can lead to changes in skin’s oiliness or dryness. Teens and young adults tend to have oilier skin, especially in the T-zone, but with age, hormones change and the oil production may decrease (but unfortunately, acne is still an issue for many adults). Also, hormones change due to menstruation and the birth control pill, which can make skin oilier in certain areas. Lipids also play a role in combination skin: These proteins affect skin’s softness and feel. When lipids aren’t evenly spread throughout the skin, certain areas will feel drier and rougher, while other areas may feel soft but oily or greasy. The organization of lipids in skin is due to genetics and hormones. Finally, weather can exacerbate combination skin. Dry cold weather can cause skin to dry out and become irritated. Conversely, hot humid weather can increase oil production. This can affect your T-zone as well as your cheeks.

Care Plan
Combination skin requires special care to balance the oily and dry areas of the face. Proper cleansing, treatment, moisturizing and sun protection are all necessary.

• Cleansing: People with combination skin often have difficulty finding a cleanser that works for their unique skin needs. Formulas designed for oily skin may leave combination skin too dry, especially in the cheeks, while formulas designed for dry skin may leave combination skin greasy, especially in the T-zone. It’s best to avoid products that are either too drying or too rich. Instead, use a foaming or gel cleanser to get rid of dirt and oil without causing irritation or dryness. A cleanser to try is one that removes excess oil and impurities while still being gentle and not drying out skin.
You should also exfoliate your skin regularly to remove dry, dead, rough skin cells. These cells may be particularly prominent on your cheeks. They can flake off and block pores, causing blemishes and blackheads. Try a product that might include papaya and pineapple juice, olive derivatives and Ginkgo Biloba

Treatments: Treatment products are another important skincare component, helping to balance your skin. One treatment to try is one which moisturizes dry areas but prevents excess oil, especially in the T-zone. This product also contains antioxidants to prevent aging. Another type of treatment is a mask, and you’ll find an array of products for every skin type. Some experts advise using a hydrating/moisturizing mask on dry areas (cheeks) and a deep-cleaning clay mask on oily areas (T-zone). While using two different masks is certainly an option, you can also use a mask specifically designed for combination skin. If you suffer from breakouts, which may occur around the T-zone, use acne treatment products with salicylic acid. For problem skin, try a blemish serum or a spot treatment.

Moisturize: Combination skin needs balance, and part of that balance means moisturizing your skin. Moisturizing is especially important for drier areas of the face, but your entire face needs moisture. Some experts suggest using separate moisturizers - a lightweight one for the T-zone and a deeper one for cheeks. You may choose to use separate moisturizers, but you can also use a single moisturizer designed for combination skin. Try a lotion which balances skin with witch hazel and aloe extract to help skin stay soft. Pay careful attention to dry areas, as they may require more frequent moisturizing than oily areas. Generally, experts recommend moisturizing dry areas twice a day and moisturizing oily areas once a day. Keep in mind that your individual skin has unique needs, so you might want to adjust your moisturizer - how often you use it, where you need it and how much you need.

Sun Protection: Like all other skin types, combination skin needs protection from the sun. UVA and UVB rays can damage skin, so use oil-free sunblock all over your face daily (and on any other exposed areas). Try an oil-free sunlotion or sunblock because it protects your skin from UV rays and won’t make skin greasy.

Natural Treatments
Natural treatments such as aromatherapy oils, home-made exfoliants and masks may help treat your combination skin. For example, try mixing essential oils like chamomile, lavender and ylang ylang (just a few drops) together with your oil-free moisturizer. These ingredients have antibacterial properties and may help to rid skin of dirt or bacteria. However, if your skin is sensitive or easily irritated, or if you’re pregnant, you shouldn’t use these essential oils.

Exfoliating treatments can be made at home by mixing and grinding nuts, seeds or oatmeal along with water. These will slough off dead, dry skin cells - especially common around the cheeks. You can add citrus peels from fruit - like orange or grapefruit - to the mix and apply it to the oily T-zone.
To make a mask for dry areas, use ingredients like yogurt, mashed bananas or avocados to moisturize. On oilier areas, try pureed strawberries and apples.

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