By Kathryn Leverette

The debate has always been heated among skin care specialists and dermatologists as to the risks and benefits of scrubbing one’s countenance and body parts. The dangers of creating microscopic tears in the skin are very real, especially if a scrub contains granules with irregular edges, like crushed walnut shells or apricot pits, or if too much pressure is used with any method of exfoliation, including alcohol, witch hazel or astringent with cotton and microdermabrasion.

Washcloths vs. Scrubs vs. Astringent/Cotton vs. Buffing Pads: There are pitfalls to every method of “epidermabrasion” and skin tampering, especially on skin Black, thin, post-operative or sensitive skin.

Who’s at Risk: Sensitive and thin-skinned individuals, People of Color, post-operative skin (laser, deep dermabrasion and medical peels) and those using Magic Shave or other hair removal chemicals, Retin-A, Accutane, benzoyl peroxide, BHA (salicylic acid), glycolic acid and other AHAs and sun-sensitive skin. Because many active ingredients, medical procedures and professional treatments can cause superficial flaking and/or peeling, the temptation to speed up the process by scouring off their dead skin cells can be irresistible.

Abrading and tampering with the skin manually (scrubs, buffing pads, rubbing with a washcloth or towel, rubbing, picking, scratching, patting, using alcohol and cotton, scraping the skin while shaving, being shaved or removing shaving powders, microdermabrasion, “dermaplaning” with a blade, and/or using too much pressure for any reason) can “over-process” the skin. This allows “active” home and professional products and UV rays to penetrate into irritated skin, worsening the inflammation, which can turn mild flaking into excessive scaling and prolonged irritation which “activates” the melanocytes in the basal layer of the skin (the cells that provide your natural coloration). This situation incites a dramatic increase in pigmentation problems, especially if exposed to sunlight, rubbing, scrubbing, picking, or product overuse. Repeated manipulation, friction and skin tampering can slow down the healing process, introduce bacteria, incite secondary infection, and cause epidermal cells on and around blemishes to thicken, darken, and get larger as the body struggles to defend itself from the constant assault.

Unwelcome Results: Side effects include temporary redness, burning, excessive and prolonged scaling, increased sun-sensitivity, a thick build-up dead skin cells, severe pigmentation problems and an uneven skin tone, especially on the neck and cheeks. Symptoms can last anywhere from a few days to several months.

Warning to People of Color: Abrasion caused by overzealous manual exfoliation (scrubbing too often, scraping the skin, using too much pressure, picking, scratching, skin tampering, rubbing with a towel) by any means or method, exposure to sun and lack of adequate water intake (dehydration), can leave unsightly and hard-to-remove hyperpigmentation in its wake, especially on the neck. You can’t scrub the “black” off your neck, or someone else’s neck! And, you can’t scrub, scrape or pick off thickened dead skin cells. They just get worse.

Better Yet: Use your products exactly as directed. To combat flaking, try sulfur mask (mild, non-mechanical exfoliant that will “passively” dissolve dead skin cells. Apply a generous coat and allow it to remain on the skin for up to 10 minutes, without letting the mask dry out. It should be showered or rinsed off with warm water and gentle pressure from fingertips only. Ask us about other methods to help remove dead skin cells without trauma.

Safer Scrubs: Scrubs containing finely-ground meal (like cornmeal), papaya enzyme creams, man-made jojoba beads, fine polyethylene granules, soaps containing powdered exfoliants, and tiny marble spheres have a smooth, uniform surface, won’t tear delicate skin. However, overuse and/or applying too much pressure with the gentlest exfoliant can still cause problems!

Experienced skin care professionals can perform lactic acid peels or gentle enzymes formulated for sensitive skin if you need to exfoliate. Gentle exfoliants designed for home use on sensitive skin are safe bets and can safely boost skin-smoothing results if used as directed.                                                                                                 
      

©2001, 2002, 2003, 2004, 2006 Kathryn Leverette and Urban Skin Solutions, Inc.

Does KP look different on People of Color?   Yes. On many black, Hispanic, Asian and dark or olive-skinned people, KP resembles thousands of tiny blackheads and dark blemishes blanketing the skin.

What parts of the body are affected?  The backs of the arms, the shoulders, the front and sides of the upper legs, the calves, the buttocks and occasionally on the cheeks of small children, though its not limited to those areas.

What causes KP?   Though KP has been blamed on everything from shaving to tight jeans to dry skin, keratosis pilaris is a chronic, genetic condition caused by hyperkeratosis, the build-up of dead skin cells that cover the follicle opening. 
           
Is there a cure for KP?  No. Though KP can be controlled, the can bumps return shortly after abandoning treatment. While there is no lasting “cure”, consistent home management can keep those bumpy symptoms in check, lessening the risk of hyperpigmentation.

What can I do to treat my KP?  Gentle, twice daily use of natural bristle body brush with an alpha hydroxy acid, sulfur or benzoyl acne soap or cleanser can sometimes solve the problem. Keratolytic topicals like sulfur/resorcinol lotion, benzoyl peroxide (BPO), glycolic or lactic acid gel or lotion, potent Retin-A® can all be highly effective with regular use. Since 1989 most health insurance carriers won’t cover Retin-A® prescriptions for adult patients over 26 years of age; the large amount of Retin-A® needed to keep keratosis pilaris under long-term control make its use financially prohibitive.

My KP seems to improve when I get a lot of sun. Why?  Sun exposure causes mild burning and subsequent peeling (similar to BPO, Retin-A®, AHA, BHA, etc.) that temporarily exfoliates KP bumps. But, the sun also darkens bumps on People of Color and causes premature aging, the destruction of skin texture, unsightly sun spots (keratoses), sagging of the skin and skin cancer.

How do I use these exfoliating products?  Since keratosis pilaris most frequently affects the non-sensitive areas of the upper arms, thighs and buttocks, topical exfoliating products may be used daily in the absence of skin irritation. Product potency and the daily application schedule should be evaluated and varied according to individual skin sensitivity of those areas and other affected body parts.

What if my KP is red in appearance?  Some light-skinned KP sufferers get a non-inflamed form of “red” KP characterized by thousands of tiny rough red bumps. Others have an inflamed KP condition that resembles active acne and larger lesions, often caused by picking. Cleansers and topicals containing benzoyl peroxide (BPO) and/or sulfur, which are both anti-bacterial exfoliants, work well on all red and/or inflamed KP. Keep in mind that it bleaches fabric and must not be worn if one expects to perspire or be exposed to the sun. It works best when worn on the affected area at bedtime, followed by clean white T-shirts and/or pajamas.

What if the KP is bumpy but not inflamed?  Alpha hydroxy acid (glycolic or lactic) lotions or gels (10% to 15%) can be applied sparingly once or twice day, and rubbed thoroughly into the skin until all traces have been absorbed. Unlike benzoyl peroxide, alpha hydroxy acid (AHA) won’t discolor fabric. For non-inflammatory and post-inflammatory cases, alpha hydroxy acid lotions and gels can be applied sparingly in the absence of irritation.

What if my KP bumps are much darker than my skin tone?  Sometimes, KP looks like a sprinkling of blackheads, especially on People of Color. Formulations containing alpha hydroxy acid (glycolic or lactic) formulated with lighteners and brighteners along with bleaching soaps can work wonders on KP that is a much darker brown than the surrounding skin. Hydroquinone (HQ) must be allergy patch-tested for three days prior to use unless you have used skin lighteners containing HQ without adverse reactions in the past. Body exfoliants containing AHA and formulated with hydroquinone and skin brighteners are designed specifically for use on hyperpigmented skin if direct sun is avoided and full-spectrum sunscreen is used religiously.

How do skin lighteners fade the spots caused by KP?  These products work three ways. First, alpha hydroxy acid softens and exfoliates the buildup of keratin (dead skin cells) that buries the hair follicle. Next, it acts as a “vehicle” to carry skin lighteners and brighteners deeper into the follicles. Last, skin lighteners help inhibit the over-production of dark melanin coloration in the basal layer of the epidermis, but need a vehicle with a small particle size to penetrate deep enough to be effective.  Lighteners and brighteners include hydroquinone, kojic acid, mandelic acid, arbutin, bearberry extract, mulberry extract, azelaic acid, licorice root extract, l-ascorbic acid, vitamin K, lemon and lime extract, and others. These ingredients perform best when formulated with a “penetrant” (like AHAs and retinoids) that allows these melanin-suppressors to penetrate the follicle.

Can I go into the sun after the KP clears up and my spots fade?  If your skin is exposed to any direct sun at all, it is important to apply full-spectrum sunscreen hourly. Try to make every effort to avoid the sun whenever possible. This is especially important if any discoloration is present, or if your skin blemishes have a tendency to over-darken. Previously hyperpigmented skin can darken faster than the surrounding skin, even after the spots have faded and the KP is under control. Keep in mind that a variety of health problems and medications can make your skin extremely sun sensitive and total sun avoidance is advisable.

What are the side effects of these treatment products?  The side effects of the treatment for keratosis pilaris can include temporary dryness, mild peeling and itching and the presence of superficial darker patches of dead skin cells. These symptoms subside as the skin gets used to exfoliating lotions and gels, and if they are used exactly as directed. Overuse will worsen or prolong these symptoms.

Can scrubbing help my KP?  Gentle exfoliation in the absence of irritation can help keep the KP-affected skin smooth. Excessive pressure, rough scrubbing and picking are taboo. They increase the risk of uncomfortable side effects, irritation, sun sensitivity and dark discoloration.

Are any treatments available to boost my efforts?  Professional glycolic and lactic acid peels, the absence of irritation, can be useful in boosting stubborn cases.

Can I stop treatment after I clear up?  No. Keratosis pilaris is a chronic genetic condition with no permanent cure. Home maintenance must be continued permanently to prevent the bumpy or symptoms from recurring.

© 2003 Kathryn Leverette, Solutions Center, Kathryn Leverette, Inc. ]]> http://www.forestnatives.com/2010/01/keratosis-pilaris/feed/ 0 http://www.forestnatives.com/2010/01/fungus-among-us/ http://www.forestnatives.com/2010/01/fungus-among-us/#comments Sat, 30 Jan 2010 23:24:43 +0000 Kat http://www.forestnatives.com/?p=63 Tinea Versicolor Fungal Infection by Kathryn Khadija Leverette

The non-contagious fungal rash of Tinea versicolor is a chronic, asymptomatic superficial infection characterized by light scaly, macular patches. These patches range in color from light pink to deep tan. Although the name suggests a variety of colors, the hue of all patches is about the same in any [...]]]> Tinea Versicolor Fungal Infection
by Kathryn Khadija Leverette

The non-contagious fungal rash of Tinea versicolor is a chronic, asymptomatic superficial infection characterized by light scaly, macular patches. These patches range in color from light pink to deep tan. Although the name suggests a variety of colors, the hue of all patches is about the same in any one individual.

The areas involved are usually restricted to between the chin and the waist, on the trunk and arms, sometimes to the wrist. Facial involvement is rare except in blacks. The rash may be mildly itchy, especially during times of perspiration, but most people are bothered most by its unsightliness. Involved untreated areas are usually hypopigmented patches that appear significantly lighter than the surrounding skin. A simple wood’s light exam intensifies pigmentary changes and allows the extent and margins to be readily observed, with the infected areas always appearing orange in fluorescence.

Tinea versicolor is caused by the organism Pityrosporum orbicular.  It is seen mostly in young adults living in temperate climates and accounts for about five percent of all fungal infections. The fine scales of tinea versicolor are teeming with “hype” and “spores”.
Factors predisposing a clinical infection include:

• pregnancy
• genetic predisposition
• underlying disease
• patients taking systemic steroids
• a warm and humid climate
• an active lifestyle that includes exercise, perspiration and occlusive workout wear

Tinea versicolor can infect people for years because of inconsistent treatment and re-infection. Tinea versicolor is unique because it produces hypopigmented lesions that lack skin color. The fungus itself produces a form of azelaic acid, which may interfere with melanin production in the affected areas, and may be cytotoxic to the melanocytes that produce brown skin cells.

Tinea versicolor may be treated in a variety of ways, some of which may prove successful if used diligently for a prolonged period of time. The problem is that most topical methods used in the past are messy, tedious, frustrating and time-consuming. People often give up, and choose to “live with it” rather than undergo the often unsuccessful, standard medical treatment.

In the past, evening application of the following anti-fungal preparations have been prescribed follow an exfoliating bath. Though infection can be cleared up, re-infection is common, and pigmentary changes can sometimes take months to resolve.

The most common medically-prescribed treatment products include:

• Dandruff preparations: Zinc pyrithione, selenium sulfide suspension, sodium hyposulfite 25%, or Tinver Lotion (25% sodium thiosulfate, 1% salicylic acid, 10% alcohol) applied to lesions twice a day for fourteen days.
• Anti-fungal creams: Lamisil (terbinafine), Lotrimin (clotrimazole), Monistat-Derm (miconazole), Halotex (holoprogin), Tinactin (tolnaftate) and Nizoral (ketoconazole) preparations applied to lesions twice a day for fourteen days.
• Topical retinoids: Applied twice a day for two weeks can exfoliate tinea versicolor
  spores and help to resolve the pigmentary changes, but is prohibitively expensive since many  insurance companies will not cover the use of Retin-A® and similar topicals for this purpose.
• Oral anti-fungals: Systemic anti-fungal drugs (Lamisil and Nizoral) promise up to a 90 percent “temporary” cure rate. These potent broad-spectrum anti-fungal agents are useful in the treatment of most stubborn fungal infections. However, intermittent use of oral anti-fungals to control a chronic fungal infection is potentially dangerous because it can lead to liver toxicity. Because of this risk, they should be utilized as a last resort in the most serious, treatment-resistant cases only. And even then, re-infection can occur.

Effective alternative approach:

Urban Skin Solutions recommends

This routine should be performed twice daily and immediately after perspiring, longterm to prevent reoccurrence in those prone to tinea versicolor. Avoid wearing occlusive clothing like spandex, nylon jogging suits, and clothing made from silk and synthetic materials.

Similar problems can affect women on the chin, sideburns, neck, chest, abdomen, legs and in the bikini area from tweezing, waxing, shaving and sometimes even depilatories. The sensations experienced by the razor bump (ingrown hair) sufferer are constant itching, tingling, burning, soreness, swelling and sometimes real pain. Symptoms can be mildly annoying and localized for some, and severe and extensive for others.
Pseudofolliculitis barbae is a chronic condition that can persist as long as the individual shaves, waxes, threads, and/or tweezes. Obviously, the problem can be dealt with by just allowing the hair to grow out. As the hair grows longer, it simply pops out the follicular opening and new “bumping up” ceases because the individual has stopped shaving, waxing or tweezing. This option, however, is not always practical due to the pressure of one’s employer, lifestyle, beauty and grooming customs.

Strict grooming regulations have been historically imposed by law enforcement agencies, fire departments, parcel delivery services and the military. These and other industries have traditionally insisted on the clean shaven look, and this has caused suffering and disfigurement to thousands of black men. In recent years, consciousness has gradually increased and some rules are slowly changing. Some branches of the military, most notably the Navy, are allowing extremely bump-prone men to sport a short, neatly groomed beard.

For decades, viable solutions to this universal problem eluded the medical, esthetic and drug store markets, and continue to do so, on a wide-scale basis. Most physicians have relied, unsuccessfully, on topical steroids, retinoid creams and systematic antibiotics.

Over-the-counter and mailorder systems have utilized single edge blades, weak cortisone creams, bromelain enzymes, abrasive scrubs and alcohol-based salicylic acid solutions. While these methods can help improve the condition, they rarely offer longterm relief. As a result, this all too common skin disorder presents a wide open arena for knowledgeable esthetic practitioners, who can dispense exfoliating, calming and antibacterial professional products and have the skill to release ingrown hairs safely in a clinical skin care setting.

Shaving Habits: We instruct our clients to shave in the direction of hair growth with a single edge disposable blade like the PFB Bump Fighter. Examine the shaving area and determine which areas are less �bumped up� than others. Carefully imitate the shaving method and direction you use in the clearest areas, and repeat the same process on the entire shaving area. Do not repeatedly go over the same area in a back and forth motion in an effort to get a closer shave. Unscented shaving creams, mild shaving soaps and gels containing benzoyl peroxide or alpha or beta hydroxy acids work well with single-edge disposable blades. The blade should be used no more than once or twice.

If the preferred shaving method involves an electric razor, we prefer the traditional barber�s trimmer, called a T-edger or liner, which gives a close, more precise shave that the larger clippers. An example of this compact trimmer is the Wahl, designed for black men who shave, but Oster, Andes and other trimmers work equally well. Professional disinfectant spray (Clippercide or Oster) must be used before and after shaving to disinfect and lubricate the blades.

We include wives, mothers and girlfriends in the consultation. They are often the ones who wield the sewing needles and tweezers, or observe the picking, unhooking, tweezing and other types of skin tampering habits at home. Picking and tampering with the skin of introduces secondary bacteria and leads to inflammation, delayed healing, scarring and larger, thickened dark spots. Tweezing and waxing trap recently removed hairs deep below the skin line, setting them up to become trapped again and again as they re-grow.

Avoid rotary shavers that cut beard hair at too many different angles, seriously compounding the problem. The skin should never be stretched to obtain a closer shave. When the skin bounces back, newly shaved hair will be situated, and later trapped below the skin line. The same principal applies to twin, triple and five-blade razors; the first blade stretches the skin, while the second (third, fourth and fifth) blade shaves way too close.

Depilatory creams and shaving powders should be discouraged once one of our anti-bacterial, keratolytic topicals is applied nightly in the bump prone area without irritation. Use of depilatories leads to dark hyperpigmentation of the lower face and neck, sometimes called “shadowing”, caused by chemical irritation and subsequent sun exposure. Melanin-suppressing skin lighteners should be introduced gradually in the absence of irritation and allergy. During the day, greaseless anti-inflammatory creams and oil-free full-spectrum sunscreens are vital to correcting and discouraging beard discoloration.

Electrolysis: Those with chronic “trouble spots” (often on the neck or cheeks, usually where tweezing was performed repeatedly) might want to explore the “blend method” of electrolysis for their problem areas. The electrologist should be skilled and experienced in the treatment of black, bump-prone clients with curved, often scarred, hair follicles. The curved follicle, healing process, risk of scarring and hyperpigmentation, as well as inflammatory reaction to the temporary “trauma” of electrolysis can differ radically from other races.

Laser hair removal has become increasingly popular in recent years to gradually and permanently reduce hair on the face and body. It is important that candidates do their homework to steer clear of the risks related to lasers, especially scarring and hyperpigmentation on darker skin tones.

Laser practitioners must:

(a) Use the safest, most appropriate laser for darker skin tones (the YAG Q-switched neodymium yttrium aluminum garnet laser that produces a 1064nm wavelength of laser light)

(b) Be well-trained in the use of that laser

(c) Disclose exactly what that laser can and cannot do for you

(d) Be experienced working with your ethnic skin type

(e) Be able to address pre-laser pain management, reduction of inflammation, melanin suppression (to control pigmentation), sun protection/avoidance, and be able to treat post-laser skin.
© 2005, 2006, 2009 Kathryn Khadija Leverette

Lower that thermostat! Keep the heat no higher than 70 degrees during the day and evening. If you get cold, layer your clothes and add a down comforter. Turn the heater OFF, or lower it to no higher than 55 degrees while you sleep. Turn on your car heater to warm up the car before you get in. Then turn it off. Wear warmer clothing and footwear. Your skin, scalp and sinuses will thank you.

Never stand, sit or sleep close to the heater, or stay too long in a hot shower just to “warm up”.

Hard water alert! If you live in a hard water area, your skin can become extremely dehydrated and develop a darker skin tone, and your hair will feel like straw. Install a good water-softening system or wash/rinse your face in spring or distilled water. Go online to www.therashower.com and purchase their inexpensive shower massage unit, which filters the chlorine and other drying chemicals. If you change the filter monthly, your shower will feel like soft rainwater and it will help soften your skin and hair dramatically. Try using a cool mist humidifier to help hydrate your skin, hair and sinuses while you sleep.

Increase your water intake. Start with drinking half your weight in ounces per day. Use mason jars instead of trying to count cups of water. When filled to the top, a mason jar holds 24 ounces of water. Did you know that herbal teas, flavored water and juices qualify as water intake? So, if you hate tap water, try bottled mineral water, Brita filtered water, sparkling water, fruit juice, fresh vegetable juice, Vitamin Water, Crystal Lite and herbal tea.

Not included as water intake: Club soda, soft drinks, energy drinks, diet soda, tonic water, Lipton, Gatorade, Propel, PowerAde, V-8, V-8 Fusion, tomato juice, milk, coffee, Earl Grey, black or green tea, orange pekoe tea and beverages labeled ‘iced tea’.

Triple your water intake if you live in a hard water area, you smoke or are exposed to any secondhand smoke, drink alcohol, sports drinks, energy drinks, coffee or tea, take diuretics, blood pressure or diabetic meds, antibiotics, cold or allergy meds, antidepressants, diet pills, sleep aids, anxiety meds, ADD meds or any medication that can cause “dry mouth”.

Know this: Lack of adequate water intake, interior heat, hard water, dry climate, smoking, secondhand smoke, long hot showers and baths, medication, dehydrating beverages and other factors can cause internal and external dehydration. If you’re tired, achy, stiff, run down, have trouble concentrating, and if your skin is feeling tight, flaky, itchy, wrinkled, getting irritated and blotchy, and you are developing a darker uneven skin tone, you might be clinically dehydrated!

No long hot showers! Showers and baths should be short and warm….never hot. Pat dry, don’t rub and leave your skin slightly moist. Mist with a hydrating toner. Seal in moisture with a rich body lotion, like one of our resurfacing skin brightening body lotions, which hydrate, lighten the skin tone and prevent ashy dead skin build-up. Ask about our special products for excessive dry skin, seborrhea, discoloration, itching, flaky scalp, scar tissue and eczema.

Don’t scrub off dead skin cells with a washcloth, buffing pad, harsh scrub or even with your fingers. This causes darkening, similar to a rug burn, and makes dead cells build up even more. Pat your skin dry after cleansing. Never rub with a towel. Ask about safe new methods to remove dead skin cells without traumatizing your skin.

Dry Skin Treatments:  Most of our professional peels, body treatments and facials can be customized to help shed dead skin cells and address dry, dehydrated or irritated skin. We can adjust our facials with a moisturizing additive and we can add moisturizers to most treatments, including our customized treatment masques, eye masques and power bleaching.

Use caution with clay masques! Try using clay masques every other day (instead of daily), apply to oily and bump prone areas only and never let them dry out. Apply a thicker coat of masque, wait just 5 to 7 minutes, and then remove it before it dries. Thin coats dry too fast, and leaving a clay masque on after it dries sucks the moisture right out of your skin. Ask us about using one of our hydrating or exfoliating peel/masques when your skin is dry.

Be consistent with home care and water intake and ask for help if you need it. Don’t discontinue your corrective products for longer than a day or two, even if you’re dry. You may need a more hydrating moisturizer and a different cleanser during the winter months, especially as you get older. We can adjust your home care regimen so potentially drying products are changed, or used less often, during the coldest months.

Request an appointment.  We’re here to help in the office, by phone and via email.      

Follow directions. Applying “active” skin care products too thick or too often can cause over-drying. Avoid over-dry areas like the smile lines, sides of the nose, and mouth as directed. Never apply moisturizer, lip balm, eye cream or other creamy products while wearing BPO, which migrates into dry areas causing irritation, dehydration and darkening. Sleeping in an over-heated room or near a heater while wearing BPO can do the same thing.

Seborrhea, an annoying hereditary skin and scalp condition, may need some special attention during the winter months. Seborrhea is a chronic on-and-off problem that’s often part of an “oily, sensitive skin profile” that worsens in cold weather and when you’re under stress.

Treat your seborrhea: Purchase a few white satin, silk or high-count cotton pillowcases, which are much less damaging to fragile, thinning hair than ordinary low-count cotton percale. Severe build-up, called hyperkeratosis, may mean you need a special shampoo, an exfoliating gel and a cream or ointment, which work together to dissolve stubborn dead skin cells and calm itching. Your thinning hair will begin to thicken and grow in. The itching, flaking, and dandruff-like symptoms will improve dramatically!

Warning: Don’t use a brush, scratch or rub your scalp if you’re experiencing any flaking, thinning, itching, dead skin build-up, inflamed sores or bumps of any kind. These conditions will only worsen.

Shampoo more often: Shampooing less leads to more build-up, hair loss and severe itching.

Seborrheic dermatitis: Don’t forget that seborrhea can also affect your face, causing redness, light blotches, flaking and inflammation. It’s easy to treat, so talk to us. We can help.                                                                    

So, drink more water, quit smoking, turn down the heat and avoid that heater, keep hard water away from your face, take shorter, less hot showers, and take better care of your skin and scalp!  

©2007 Kathryn Khadija Leverette, Urban Skin Solutions, Inc. and urbanskin.com 

Genetics:  Does a parent or other family member also have dark circles? Before you answer, were they smokers? Smoking also causes severe dark circles. Avoiding smoke, using non-drying skin brighteners formulated for the eye area, and wearing UV-protective eyewear will improve the appearance dramatically. In some cases, however, warm-toned, corrective camouflage cover cream may be necessary. Unfortunately, most cover creams tend to look dry, accentuating the appearance of under-eye wrinkles and dehydration. To solve this problem, increase your water intake and always hydrate the under-eye area with a good moisturizer ten minutes before applying cover cream. Blend the cover cream with a small amount of oil-free moisturizer on the back of your hand. Stipple (tap) this mixture gently around the eyes and blend into surrounding areas with the tip of a make-up wedge. Set with a light dusting of micro-milled loose powder. Full-coverage mineral make-up and the appropriate application technique can also camouflage this problem

Lack of sleep: Does one of the following scenarios describe you? Chronic lack of sleep? Longterm sleep disorder? Frequent air travel that includes crossing time zones? Graveyard-shift employment? Interrupted sleep during the day? All of these factors involve physical stress, causing chronic dark under-eye circles and other skin problems, especially acne. A consistent bedtime routine, improved sleep habits and seven uninterrupted hours of sleep will help relieve symptoms. Sleeping too little, then trying to catch up on the weekend, doesn’t work.

Dehydration:  Lack of adequate water intake impacts darker skin tones dramatically. Smoking, alcohol, coffee and tea consumption, medications, long hot showers, hard water and indoor heating significantly increase the body’s need to re-hydrate with water. Rule of thumb: Drink enough water to equal about half your weight in ounces. For every dehydrating beverage, drink a lot of extra water. Drink even more water if you take antibiotics, diuretics, antidepressants, meds for allergies, colds, blood pressure, diabetes or sleep, or any medication known to cause dehydration, dry mouth and/or excessive thirst.

Chemical irritation: Topical acne medications like benzoyl peroxide (BPO) can cause temporary darkening when applied too close to the eye area. Acne washes containing BPO, salicylic acid and glycolic acid shouldn’t be rinsed over the eyes. Moisturizers applied to the eye area simultaneously with BPO can cause them to migrate together, drying out the skin in the eye area and diluting its action elsewhere. Overuse and/or thick applications of retinoids and anti-aging eye creams can cause temporary darkening, dryness and itching. Rubbing can prolong the situation. Longterm use of fluorinated steroid creams may lead to darkening and broken capillaries.

Contact dermatitis:  Hyperpigmentation accompanied by itching and mild peeling can be caused by frosted eye shadows, contaminated mascara, scented skin care products, contact lens products, product overuse, retinoids, alpha hydroxy acids and D&C red dyes. Switch to hypoallergenic matte eye shadows and unscented, non-irritating skin care products. Avoid make-up products that contain red dyes. Replace your mascara every three months and never share. Apply a mild hydrocortisone cream a couple of times a day until the rash and itching disappears.

Wiping and rubbing: Tearing, rubbing, wiping and scratching increases darkening around the eye. Remove eye make-up gently with a non-drying product. Keep potentially-irritating cleansers away from the eyes. Always pat dry and don’t rub. Address your allergies and use caution with contact lenses. Wear UV-protective eyewear, even on overcast days. At night, wear lightly-tinted sunglasses to protect the eyes from debris, dust and pollutants, which can cause tearing and darkening of the eye area.

Contact lenses: Irritation from contact lenses can lead to tearing, rubbing, wiping, and dry eyes. Wiping and rubbing increase the darkening. Wear sunglasses during the day and tinted glasses in the evening because contact lens wearers are more vulnerable to the effects of debris, dust and pollutants in they eye. Replace contacts often, keep them clean, get regular check-ups and consider lasik surgery.

Chronic allergies: Out-of-control allergies cause dark circles, called ‘allergic shiners’ in both adults and children, and tend to run in families. Swelling, tearing, wiping, rubbing, blotting and scratching the orbital eye area contribute dramatically to dark circles. Old school antihistamines cause unpleasant side effects and daytime drowsiness, so allergy sufferers are often inconsistent with treatment. Explore and remove the irritants that trigger your allergies. Control attacks with non-drowsy antihistamines and steroid nasal sprays, which work on swollen nasal tissues without entering the bloodstream. Claritin and the generic versions (loratadine) are over-the-counter and Allegra is now available in generic form (fexofenadine). Daily use of some antihistamines can cause dehydration and sun sensitivity, leading to increased darkening around the eye. Increase your water intake, avoid direct sun, use sunblock and wear protective eyewear religiously.

Obesity and sudden weight gain:  Fat cells seem to boost the body’s production of estrogens, which causes the skin to become sensitive to the sun and darken as a result. Sun avoidance and daily use of sunblock and sunglasses are a must. Drugs often associated with obesity including diuretics, oral anti-diabetic drugs, some anti-depressants and blood pressure medications, can dramatically increase photosensitivity. Cutting back on salt and high sodium foods, reducing fats, carbohydrates and sweets, and exercising regularly will help reduce your bodyweight and water retention, and improve your blood pressure, self-esteem and general health.

Sun exposure: Failure to wear sunglasses during even short episodes of sun exposure (including rainy and overcast days) can cause the delicate tissues around the eye to darken dramatically.

Thyroid problems:  Modern medicine is doing a better job of diagnosing thyroid problems these days. Darkening in the orbital eye area, constant tearing, puffiness, fluid retention, disturbed sleep cycles and delayed healing are symptoms that often accompany thyroid disease. Rubbing and wiping the eyes can intensify the darkening.

Hormones and pregnancy:  All hormonal changes, imbalances and hormone medications cause sun-sensitivity leading to skin discoloration and other problems.

Medications: Hormone replacement, birth control pills, antibiotics, antihistamines, painkillers, diuretics, oral anti-diabetic drugs, Accutane, anti-depressants and blood pressure medications and many other prescription and non-prescription drugs can cause sun sensitivity that can lead to darkening. Some topical preparations, including skin lighteners and retinoids, can also cause severe photosensitivity.

Smoking:  If you smoke cigarettes, cigars, clove cigarettes, blunts or weed, and if you are exposed to even small amounts of secondhand smoke, dark circles are a common side effect, especially on darker skin. Only two or three cigarettes a day (or 30 minutes of secondhand smoke) can cause darkening in the eye area. Now you have another good reason to either quit smoking, or put a stop to your exposure to secondhand smoke.

Lighten up:  If the orbital eye area is darker than your face, skin brightening ‘cocktails’ are available that contain mild glycolic or lactic acid (fruit acidexfoliants that are also “vehicles” to the deeper tissues), dimethyl isosorbide (a gentle, deep-penetrating vehicle), retinoids (deep-penetrating vitamin A derivatives), hydroquinone (the only FDA-approved skin lightener, rarely used in eye creams), l-ascorbate (stable, absorbable vitamin C, which firms and brightens the skin), and the following melanin-suppressing brighteners: kojic acid dipalmitate, azelaic acid, vitamin K, mulberry, bearberry and licorice root extracts, l-arbutin, mandelic acid and citrus extracts.

These specialty products, formulated for the orbital eye area, contain just enough fruit acid and/or retinoid to help active melanin-suppressing brighteners penetrate better. They also gently exfoliate and repair delicate under-eye skin, which helps reduce fine lines and improve elasticity and texture. Ceramides and other moisture-building factors hydrate delicate eye-area skin, which lacks sebaceous (oil-producing) activity and tends to dry out first.

You must gradually wean the skin onto active eye care products, using caution to apply very sparingly and rub in well until all traces of the product have vanished into the skin. Follow directions and then use even less. More is definitely not better and may cause temporary darkening of the epidermal cells, a dry, parched appearance and peeling accompanied by itching and redness. Start out every second or third night if you aren’t using benzoyl peroxide (BPO). Practice sun avoidance when possible, apply full-spectrum sunscreen and wear UV-protective sunglasses.

© 2000, 2001, 2002, 2007 Kathryn Khadija Leverette and Urban Skin Solutions, Inc.