Skin and Hair Archive

Ask the doctors

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Q. I was recently diagnosed with eczema. Is this condition treatable without the use of steroids? I'd like to avoid using them if I can.

A. Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition. Some people with eczema have mild dryness or itchiness, while others experience more severe symptoms, such a scaly rash or skin that cracks and oozes. Eczema is more common in childhood, affecting up to 20% of children, but it also affects adults. The good news is it's not contagious, and in some cases, it's possible to manage the condition without using steroids.

Dermatologists tell us what ingredients to look for in a skin serum to treat a variety of skin conditions.

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As you get older, you might start to look a little more intently at the rows of lotions and potions at the drugstore and the beauty counter. You may wonder which ones can really help your skin look more like it used to — minus the wrinkles, dark spots, and other signs of aging.

One word that's showing up on labels a lot these days is "serum" — typically on products that promise to brighten and smooth your skin and help roll back the clock. These little glass bottles contain a host of impressive-sounding ingredients such as hyaluronic acid, niacinamide, and L-ascorbic acid. But do they really work?

The right combination of components is essential to get the results you hope to see.

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Serums can be used to treat a wide range of conditions, including brown spots, wrinkles, and dry or acne-prone skin. Below are the ingredients that Harvard dermatologists Dr. Abigail Waldman and Dr. Maryam M. Asgari recommend for various skin conditions.

Problem: Dry or sagging skin

If your skin is dry, tight, and flaky, look for serums that contain vitamin E, niacinamide, and glycolic acid. Also look for ceramides, which are fatty molecules that help hold the skin together and keep moisture from escaping. Other good options are serums that contain hyaluronic acid, or those with collagen peptides, epidermal growth factors, or stem cells.

A good moisturizer is one of the foundations of an effective skin care regimen for dry, older skin. Moisturizers can soothe dry skin and make wrinkles less noticeable, even though the effect is temporary. But with so many to choose from, how do you decide?

Petroleum jelly is one of the most effective moisturizers, especially when used right after bathing to seal in moisture. It is also one of the least expensive. But many people dislike using it on their faces because it looks and feels greasy. Instead, creams and lotions that contain some water are a better choice for a facial moisturizer. Many of these creams and lotions are humectants, an oil-free class of moisturizer that binds water to skin, so the smoothing, softening effects may last longer.

In the journals

A prescription cream called 5-fluorouracil (5-FU, sold as Adrucil and other brands) may help people reduce their risk for squamous cell carcinoma (SCC), according to a study published in the Jan. 3, 2017, JAMA Dermatology. SCC, the second most common cancer in the United States, strikes twice as many men as women.

Researchers recruited 932 people, 98% of whom were men, with an average age of 71. Each had experienced at least two skin cancers — SCC, basal cell carcinoma (BCC, the most common skin cancer), or both — on their face or ears within the past five years. They were randomly assigned to receive either the 5-FU cream or a placebo cream. Everyone applied a thin layer twice a day to their face and ears for up to four weeks. Over the course of a year, the 5-FU group had a 75% lower incidence of SCC compared with the placebo group. They also had a 11% lower incidence of BCC, but this difference was not statistically significant. It's not known why 5-FU helped prevent SCC but not BCC, according to the researchers.

Symptoms of dry skin, eczema, contact dermatitis, and psoriasis can overlap.

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It's easy to overlook dry skin during the winter, when indoor heating and dry air pull moisture from the skin. But sometimes it's tough to tell if dry skin is a consequence of the season or a sign of a serious condition. "I see a fair number of people who come in with psoriasis or eczema and had just assumed it was dry skin," says Dr. Jason Frangos, a dermatologist at Harvard-affiliated Brigham and Women's Hospital.

Why does skin dry out?

It's not just winter conditions that lead to dry skin; it's also a change in our skin's top layer, or epidermis. This layer is normally thick with naturally occurring fats and oils that act as a barrier to help retain moisture and prevent irritants from entering the skin.