How to care for all skin types

I'm Lisa Birnbach for howdini.com. How do you wash your face? And how often? Do you know what products your skin needs, and which to avoid? Dermatologist, Dr. Nicholas Perricone, whose latest book is called, Ageless Face, Ageless Mind, is here to answer these and other questions that amount to skin care 101 for women. Thank you Dr. Perricone.

Thank you.

What's the best way to figure out what your skin type is?

Well, I'm not a traditional dermatologist in terms of skin type. Everybody has skin types. Well, there are skin types that categorized in different terms of amount of pigment. So skin type 1 is always burns, never tans. And you go through that. And then there are other skin types, you know. And people say, well, I'm oily, or a dry, or I'm sensitive. I look at skin types in terms of inflammation.

Now inflammation is an invisible process, most of the time, on the skin. But I found that the traditional view of skin is probably not correct. For example, you probably have the impression-- and many derms do too-- that people with more pigment in their skin, have Italian-Spanish background, are less sensitive than a lighter-skinned person.

You, yeah, I'm less sensitive to sun exposure, but actually more sensitive. And, for example, African-American skin, extremely sensitive to things that create inflammation. So if they have an acne lesion, they get a tremendous dark, we call it, post-inflammatory hyperpigmentation. They also tend to have lumpy scars, called hypertrophic or keloid scars, because of an exaggerated inflammatory response. So I break you down into skin type in terms of how you react to insult and then how much inflammation you produce.

Is washing your face with soap and water really the worst thing you can do for your skin, or not so bad?

Well, you should be using a non-irritating, almost like a non-detergent, type of soap because anything that's going to create inflammation is going to accelerate the aging process. So, when you cleanse your face, you want to use something that we would call, a so-called, mild non-detergent. And that can be something as simple as a bar soap that is non-detergent. There are many liquid soaps out there that are non-detergent and have that non-detergent activity.

What I do with my cleansers that I've created is to add anti-inflammatories to them, like alpha-lipoic acid, vitamin C ester, DMAE. So we're going to get a cleansing process and adding an anti-inflammatory to the skin at the same time.

What about a daily regimen for oily skin? What do you recommend for that?

Well, a good daily regimen for oily skin is the fact that you want to regulate your oil production. And I've found that, if you regulate and then you treat for inflammation, you can regulate the oil production very nicely. So what I recommend is cleansing twice a day with a soap that actually includes an anti-inflammatory. Then I recommend using something with alpha-lipoic acid on it topically.

Alpha-lipoic acid, by changing the levels of inflammation in the sebaceous gland, at the oil gland, regulates that very, very nicely. I see patients do very well. The big mistake is they're using drying agents and get a rebound reaction because it causes inflammation.

Well, so for dry skin or combo?

OK, dry skin is really not just dry skin. There's underlying inflammation in dry skin, so you want to treat the inflammation too. So I've worked on a topical we call Face Finishing Moisturizer that contains some incredible emollients that are natural to skin but DMAE and naturally anti-inflammatory. And so, if you treat the inflammation first, the dryness resolves much more quickly.

I actually did a study looking at extreme dry skin on old people in their lower legs in the winter, which happens quite often. We call it asteatotic dermatitis. And I used a traditional emollient, or a moisturizer, on one leg. And then added powerful anti-inflammatories so the same emollients. We had the same base. And the leg that was getting the anti-inflammatory emollient, the dry skin resolved in 50% of the time as the other leg being treated. So treat the inflammation first.

Sensitive skin, the same?

Sensitive skin's kind of a loose word that we use. You know, 80% of the women I talk to say they have sensitive skin. I don't know exactly what that means. But, certainly, you want to avoid anything that causes inflammation. And if you believe you're there, then stick with something that's simple, not a lot of ingredients, no fragrance. And then you have to find the right thing for you.

I think the last person who told us what our skin was, whether it's somebody at a department store or somebody, a friend, that's what we believe. Don't you? I think there's a lot of mis-information out there.

I think it's a lot of suggestion. Yeah, we carry that with us. But you've got to start using your own ability to observe. And you'll get to know yourself better than anybody.

Well, thank you, so much for being here.

My pleasure.

For howdini.com, Lisa Birnbach.