Skin Republic

Dear Dr. Jen,

At what age should I start worrying about wrinkles?  I’m still in my early 30s and I noticed that the lines near my eyes have already begun to form.  Is it too early for me to be getting wrinkles?  Is this reversible?  What products can I use to prevent further damage?

Tin

Dear Tin,

It’s never too early to worry about wrinkles.  This means that even in our 20s we can already start using some preventive measures such as daily sunscreen and anti-ageing creams.  Glycolic acid based creams or serums are good supplements.  This is a mild skin-renewing, glow-achieving cream.  Tretinoin or retinol based creams are still the best for anti-ageing.  This can come in different concentrations 0.025 to 1.00%.  I usually start my patients on the lowest concentration and slowly build them to the higher ones.  There are those that are extremely sensitive and may take time to adjust to the cream.  A good moisturizer is also a must!

Generally, cosmetics and creams that will cause you to peel heavily are not advisable.  This renders the skin defenseless under the heat of the tropical sun and will eventually cause sun spots or melasma.   If your current medication is causing you to peel, it needs to be adjusted.  There should be no stinging, redness, pain, peeling or sensitivity observed. 

When doing outdoor or beach outings, make sure not to put on your tretinoin the night before as this will cause sun-sensitivity.  Consistent application of sunblock throughout the day should be followed.

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Dear Dr. Jen,

I got very itchy rashes in front of my elbows and my neck.  I think it became infected because it started to get swollen.  My helper has been applying amoxicillin powder on it but it has only helped a little.  It is very painful when I stretch my arms.  Please help me!

Sid

Dear Sid,

You may have had a case of eczema or contact dermatitis.  Whatever the initial rash was, infection can easily come into the picture because any breaks on the skin make it susceptible to bacteria.  Once bacteria have infiltrated the skin, you will usually need antibiotics.

A common practice performed locally is opening a capsule of antibiotics and crushing it into the wounds.  This might offer temporary relief as the dryness from the powdered antibiotic will alleviate the weeping.  However, oral antibiotics, for them to be effective, they have to pass through our digestive system and be activated for it to be delivered effectively to the skin and other organs involved.  If topical antibiotics must be used, it should be in the cream or ointment form.

If the infection is serious, you will need oral intake of antibiotics.  The milder forms can be healed with use of mupirocin or fucidic acid creams.  I would advise you to see a PDS dermatologist to get proper assessment.  Some patients may need to be admitted if their immune system or other diseases (like diabetes) are not controlled.  Also, if the infection has gone deeper into the muscles or blood, stronger antibiotics will surely be prescribed.