Dr. Rachel Herschenfeld's practice is based in Wellesley, Massachusetts. After graduating from Harvard Medical School, she completed residencies in Internal Medicine and Dermatology, then joined two other dermatologists to found Dermatology Partners, Inc. Dr. Herschenfeld is board certified in Dermatology, and is a Fellow of the American Academy of Dermatology. Dr. Herschenfeld performs cosmetic procedures including Botox, Restylane, collagen, Sculptra, and laser treatments for many conditions.
Dr. Rachael Herschenfeld is a practicing dermatologist. Her answers here should not replace medical advice. To submit a question, e-mail skincare@washingtonpost.com. We reserve the right to edit submitted questions for length and clarity and cannot guarantee that all questions will be answered.
I'm a female in my mid-twenties and recently started using an over-the-counter RetinA night cream. I love the results I've seen: smoother, clearer skin with more even skin tone. The problem is that, as the package warns, my skin is really susceptible to sunburn now. My usual SPF 15 moisturizer just isn't cutting it. Can you recommend a moisturizer with a higher SPF that won't break me out (thus eliminating the benefits I'm getting from Retin-A)?
- S.C.
- S.C.
Your over-the-counter cream probably contains retinol or retinaldehyde. Both of these compounds are relatives of tretinoin, the active ingredient in Retin A, which is only available by prescription in the U.S. All these compounds can make your skin a little more sensitive to the sun. I would recommend a facial moisturizer that is designed to be non-comedogenic (to avoid producing acne) and that has an SPF higher than 15. Examples include: Neutrogena Healthy Defense SPF 45, Aveeno Positively Radiant SPF 3, and Olay Complete Defense SPF 30.
I'm 39 years old and have noticed in the last two years that scars left after cuts or acne do not go away. I have a mark on my leg from a small cut over the summer, my arm has a large scar where three large whiteheads were. Is there anything I can do to help lessen the scars?
- B. P.
- B. P.
The best way to minimize scarring from acne is to treat the acne itself. I would recommend seeing a dermatologist to evaluate any active acne and to discuss a treatment regimen to prevent further breakouts. Such a regimen might include topical medications such as tretinoin and benzoyl peroxide as well as oral medications such as antibiotics. Scars that are already present will fade with time. It is also possible that you are developing pigmentation in areas that have been inflamed or injured. This is a good reason to use sunscreen, since sunlight can darken any pigmentation. It is also possible that creams that help fade pigmentation, such as those containing hydroquinone, tretinoin or glycolic acid, may be of benefit.
I am a 50-year-old breast cancer survivor who has been taking tamoxifen for 21 months. It resulted in such terrible wrinkles on my face that I succumbed to a very expensive, fragranced Natura Bisse cream, Diamond Extreme, which seemed to improve the wrinkles. I have very sensitive skin so I used the sample for a week before buying the jar. Then my face broke out with little red bumps that turned into cuts and it has not cleared up. I am curious as to whether tamoxifen could have caused the breakout. I am desperate to stop looking like I'm suddenly 90 years old and I am afraid of the pain associated with Botox. Any ideas?
- D. B.
- D. B.
Tamoxifen does not typically cause acne. It seems more likely that your skin reacted to the new face cream. I am not surprised that your wrinkles initially looked better, since moisturizers generally do make skin look smoother. You do not need to buy a very expensive moisturizer to get this effect. I would recommend trying a moisturizer designed for sensitive skin, such as Vanicream moisturizing cream or Cerave moisturizing cream or lotion. If you are determined to use the Natura Bisse cream again, I would recommend trying it on a small, inconspicuous area on your arm for two weeks before applying it to your face. Once your face rash has resolved, you should see a dermatologist to discuss an effective topical anti-aging regimen.
