Fountain of youth


Ok, ok, so maybe it’s not the actual “fountain of youth”, but recent research has highlighted that daily sunscreen use can slow the signs of aging. For reals. The recent Annals of Internal Medicine study demonstrated that study participants (adults younger than 55) who used sunscreen daily showed no detectable increase in skin aging after 4.5 years. As another plug for daily sunscreen use, the study showed that skin aging from baseline to the end of the trial was 24% less in the daily sunscreen group compared to a group of adults using sunscreen at their discretion. As with most data, additional research should be done to further investigate results, but in the meantime if you are looking to maintain those youthful good looks, try adding sunscreen or moisturizer with sunscreen into your daily routine and make it a habit.
See you in the shade!

Still smelling like a rose ……

“Happiness radiates like the fragrance from a flower, and draws all good things toward you.” -Maharishi Mahesh Yogi

While I am pretty sure that this quote is not referring to my homemade deodorant experiment (day 11), the happiness radiating from my armpits, which literally do smell like a flower, is at least not driving anyone away from me (can I get woot! woot!).

Over the last week and a half, I have been pretty physically active so I can really put my concoction to the test. As I mentioned in an earlier post I have kick-boxed, kettle-belled, and added in some cycling to see how this stuff works.  Despite not being an anti-perspirant per se, I haven’t experienced being more sweaty than usual. A side note is in order here: I am a serious sweater when I work out. Those gals you see whose hair is in place at the end of a workout who look amazing and rejuvenated at the end of a work-out….yeah, I’m the other one. Hair barely contained by the ponytail, all wild and unruly and looking like I need to be rejuvenated, that’s me. So now that we have that established, you can imagine that I have literally given my deodorant a workout.

So now to down to business. I have read lots of recipes online and I applaud, appreciate and thank everyone out there who has shared their versions of homemade deodorant. Many people use coconut oil accompanied by baking soda, cornstarch or arrowroot powder, plus or minus essential oils. Great sites to check for a recipe using coconut oil are: Passionate homemaking and A Sonoma Garden.

Although I enjoy the smell and taste of coconut, my husband is not a big fan, so if I want to draw him towards me with my fragrance,  I need to use another base ingredient.  I have made 2 different versions of deodorant using shea butter accompanied by a variety of other butters. The first version is on the drier side and has a tendency to be more lumpy or crumbly upon application. Of course being my first attempt making the stuff, I didn’t write down the exact ingredients but here are the basics:

1st recipe

1st recipe

3 Tbsp organic Shea butter

1  Tbsp Kokum butter

1 Tbsp Illipe butter

3 Tbsp Pure baking soda (you don’t want any aluminum in it)

2 Tbsp Arrowroot powder or cornstarch

1 1/2 Tbsp beeswax granules

Essential oils (optional): lavender,rosemary, peppermint, lemon, tea tree oil: these are examples of oils with stronger scents for odor control and tea tree oil is also proposed to have anti-bacterial properties. The exact amounts can vary depending on your preference but to overcome the stronger natural scent of shea butter 25-40 drops is recommended.

  1. Melt the beeswax in a double boiler (glass bowl in pot of boiling water) or microwave
  2. Add butters and powders, followed by your essential oils and mix it all together
  3. While mixture still warm pour into your container (as this version is a little drier in consistency, I put it in a glass jar and apply with my fingers)
  4. Let mixture cool and it will firm up

The second recipe results in a softer more spreadable product and I used a traditional deodorant container to pour the mixture in at the end. You can either purchase these containers online or empty out and clean one that you already have.

This recipe is an adaptation of one I found at Our life simplified (great site, check it out)

2nd recipe

2nd recipe

2 Tbsp Shea butter

1 Tbsp Pumpkin butter

1 Tbsp Beeswax granules

2 Tbsp Arrowroot powder or cornstarch

2 Tbsp pure Baking soda

2 Tbsp Sweet almond oil

1/8 tsp (1 capsule) Vitamin E oil

Essential oils (optional): again I forgot to measure how much I used, but I combined lavender, sandalwood, sweet orange, and a smidge of eucalyptus

  1. Melt beeswax as above
  2. Add butters, sweet almond oil and Vitamin E oil (puncture hole in capsule and squeeze oil out)
  3. Add arrowroot powder or cornstarch and baking soda and essential oils and mix all together
  4. While mixture warm pour into your container and then let it cool and firm up

May you all radiate happiness with your ambrosial smelling underarms and draw all good things toward you! Enjoy!

By the hair of my chinny chin chin….

My dog Beaudi. He graciously agreed to be the model.

My dog Beaudi. He graciously agreed to be the model.

As a kid, hearing about  hair on your chinny chin chin was an amusing part of a fairy tale. As an adult female, having hair on your chinny chin chin is no laughing matter, right ladies? And not to leave the guys out …..having rogue earlobe hairs and feeling like a sasquatch may not be your thing, so the good news is that over the last few decades the options for hair removal have expanded and improved.

There are numerous methods available for hair removal, some of which are very temporary and some of which have the potential to permanently reduce hair growth. Notice I didn’t say permanently remove hair. I am a New Yorker to my core, despite living on the West Coast for many years,  I’m gonna tell it like it is…if it sounds too good to be true, it most likely is…so I’m not going to try to convince you otherwise.  As a dermatologist it is my job to provide facts, details and opinions so that my patients can make informed decisions. So even though this site is not intended to treat, diagnose or cure any disease or ailment, and as readers you are not patients, I am committed to providing clear, concise (well maybe not that concise, I am known to ramble a bit) explanations of issues in hopes of being helpful.

So let’s start with the basics of hair. I am sure many of you have tweezed, shaved, waxed, threaded,  sugared or “been lasered” only to be befuddled by the fact that some hairs stay gone and others rear their wiry heads way too soon. This is due to the fact that hair grows in three phases: the actively growing phase (anagen), which comprises about 80-90% of hairs. On the scalp this phase lasts about 2-6 years, whereas on the arms, legs, eyelashes, and eyebrows the phase is only about 30-45 days which helps explain why hair in these areas is much shorter than the scalp. The next phase or  transitional phase known as catagen comprises 3% of all hairs at any time. This phase lasts for about 2-3 weeks. The last phase is the resting  phase (telogen) which comprises 10-15% of hairs and last approximately 100 days. It is during the telogen phase when “shedding” occurs and about 25-100 telogen hairs are shed each day. The kicker is that hairs are not in sync with each other and while some hairs are growing, others are transitioning or falling out.  Moreover, it’s only when hairs are in anagen (growing hairs) that they are responsive to removal modalities (i.e. electrolysis, laser).

Now that we have the basics down, how do you choose the best hair removal method? There are several factors to consider: convenience, pain threshold (a very subjective factor), cost, goal for temporary vs. more long-lasting results and anatomic location. Most of these factors are intimately intertwined.

For instance, shaving is very convenient as you can do it yourself, in your home, cost is lower (although the cost of razor blades these days is nutty), pain is minimal but the results are very temporary as you have to shave every few days because you are only trimming the hair not removing it.

Waxing/threading/sugaring: convenient as the service is readily available and it’s quick, cost is relatively low, can be done on most if not all external anatomic locations. The downside is that it can be painful and the results usually only last about 3-6 weeks. With repeated treatments the hair follicles may be disrupted/ damaged  which may lead to permanent hair loss (but most likely patchy at best).

Electrolysis: So how does it work? An electric current is applied with a very fine needle-shaped electrode, or metal probe into each hair follicle to destroy the root. The pros are that this method has a good track record for permanent hair reduction and in some cases permanent removal. Since it targets the follicle itself, this method can be used on most skin types. The cons are that it can be painful, requires many treatments (can be upwards of 15-30)  and can be expensive. Also operator dependent so results can vary.

Laser: Laser hair removal is one of the most commonly performed cosmetic procedures in the U.S. A beam of  highly concentrated light penetrates into hair follicles. It is the pigment in the follicles that absorbs the light and this destroys the hair.  The technology of lasers has advanced so that patients of color can safely have laser performed without damaging skin tone. As with other methods, only the anagen follicles are targeted so treatments need to be repeated every 6-8 weeks to capture more and more of the anagen follicles until the desired level of hair reduction is achieved.

The pros are that laser can be done relatively quickly depending on the site treated and the results are long-lasting. Treatments literally can take as little as 5 minutes! The cons are cost, number of treatments required (usually 6-12) depending on body part treated and pain. I can attest to the fact that current lasers are way less painful than lasers used in 2008 even, and that is saying a lot because I am a big wimp. Risks of treatment other than pain , include swelling at treatment site, burns (go to someone with expertise and experience, and have a test spot done first: settings can be adjusted to avoid this). Although with the advances in technology this does not happen as often, but lightening or darkening of the skin in the treated area can occur.  The other issue with lasers are that they are best used on course hair: legs, back, bikini, underarm, men’s beards. Although they are used for women’s facial hair, the light colored, peach fuzz found on women’s cheeks, chins and lips is unlikely to respond as well. Lasers target a color and the lighter the hair the less there is to target.

Topical therapy: A serendipitous discovery of hair loss was noted when using an anti-malarial drug (eflornithine). The medicine is formulated under the trade name Vaniqua which is a prescription cream used to reduce facial hair growth in women. The mode of action is to block the enzyme that leads to hair growth. This ” blockage” is gradual and can take up to six months to take effect, during which time other hair removal methods would need to be continued. It’s a twice daily application and the downside is that once you stop using it…the hair growth is no longer blocked and hair will eventually return.

So as you can see there are many options…this is a good thing. The best expected outcome is permanent hair reduction and in some cases permanent hair removal may occur. Now don’t get me wrong, I’m a glass half full kind of a girl (and if the wine is really good, fill her up’) but when it comes to issues in medicine I am a realist, and I hope armed with this information you will be too so that you can decide which if any of these modalities might work for you and you will not be disappointed with the result. If none of these float your boat, au natural is beautiful too!

Smelling like a rose, or at least like lavender and rosemary


What’s in a name? That which we call a rose by any other name would smell as sweet. -William Shakespeare

Roses. They conjure up so many images. Images of love, romance, beauty. It’s amazing really that a simple flower can conjure up complex emotions; the promise of new beginnings or the celebration of established relationships and reminders to cherish all that we already have with the well-known saying of, “take time to smell the roses.” Sound advice which I am trying to follow in my new digs.  Same with blossom where you are planted. That’s a good one too. Easier said then done of course, but I am working on it!

I have roses on the brain because last night my sweet husband brought home not one, but two dozen roses for me (see pics above) because he thought I sounded a little, shall we say, blue. I can’t even recall what was going on at the time that would have provoked his assumption, but honestly it was a welcome surprise and reminds me of how lucky I truly am…literally I am smelling the roses.

This quote and recent turn of events brings me to the whole point of this post actually, which is the smell of roses. The smell of things in general for that matter, including your armpits which is a great topic. What a segway right? I just dove right in there huh? You bet I did. So now let’s dive right into that topic. Smelly armpits! I know, not exactly glamorous or what you want to read about while sipping a glass of wine or drinking your morning coffee, but let’s be honest, we all have the ability to excel in this department. Some are higher achievers than others (those who shall not be named), but we are all participants in this club.

So, my new journey into reading labels has not been limited to food ingredient lists. I have been reading cosmetic and medicinal labels as well. After nearly 15 years of practicing medicine, I am opening my eyes and my mind to not just accepting what’s on the shelves and the teachings of my mentors. There is a lot of “stuff” on the shelves, even marketed as “natural” that I can’t even pronounce or understand. How is that good for you? So, as a result of this discovery as a skin professional, I feel it is my obligation to make a change. I have been researching what other people have tried, reading about natural alternatives and experimenting with my own recipes.

As a dermatologist, I am trained to be an expert of the skin. Most of my career has been focused on diagnosis and management of skin cancer (especially melanoma) both clinically and histologically but at the moment, I am retraining myself in many ways and for now I am retraining to be an expert on the health and smell of armpits. Mine and yours if you are game.
I am on day 5 of my new “deodorant” and I am smelling like a proverbial rose if you will. With a blend of shea butter, pumpkin butter, a few other butters, corn starch, baking soda, and an essential oil blend of lavender and rosemary I have kickboxed, kettle belled and pilateed (don’t know if that’s a word but just roll with it) without knocking out my classmates with stink. My husband ( I did mention he was a saint didn’t I), even stuck his nose right in my armpit to test the power of my concoction and he didn’t flinch. I smelled like lavender and rosemary!
The current deodorant version is predominantly a solid, so I will be working on the formula to make application a bit more user-friendly over the next few weeks and will keep you posted with the specifics in case you want to experiment on your own.

So what’s in a name? These days it’s hard to know when reading labels of food and personal hygiene products, but when you make it yourself there is no question. It can be simple, easy and you can come up smelling like roses….or at least like lavender and rosemary in my case. More to come, I promise….

Skin cancer and Sun-safety basics


My daughter at 6 months

We are in the midst of a skin cancer epidemic.  Skin cancer is by far the most common malignant neoplasm.  In fact there are more than twice as many skin cancers each year in this country as all other forms of cancer combined. The most common type of skin cancer is basal cell carcinoma , and the second most common type is squamous cell carcinoma. It is estimated that one out of every five Americans will develop skin cancer at some point in their life.  Ultraviolet radiation (UVR) is the cause of the vast majority of the nearly 3.7 million skin cancers which are diagnosed in the US annually. UVR is also responsible for up to 90 percent of the visible changes commonly attributed to aging, including wrinkles, sagging skin and brown spots.

Malignant melanoma, the deadliest form of skin cancer, is also an increasingly important public health problem in the United States and worldwide. The incidence of melanoma has increased 3.1% annually during the past 20 years, which translates to an incidence that is increasing faster than that of any other cancer in the United States. Melanoma is not just a disease of the elderly; it is the second and third most common cancer of women and men in their 20’s respectively.  It is the most common deadly skin cancer of women between the ages of 20 and 35.  Someone dies every hour in this country from melanoma. The current lifetime risk of an American developing invasive melanoma is 1 in 59.  This rate is alarming when contrasted with the 1 in 1500 lifetime risk for Americans born in 1935.   The increased incidence of skin cancer appears to be multi-factorial. Sun exposure, both recreational and occupational, changing patterns of dress favoring more skin exposure, ozone depletion and increased life expectancy are likely contributing factors. Additional risk factors including family and personal history of skin cancer, immunosuppression, and carcinogens may also influence developing and dying from skin cancer. People at highest risk include those individuals with light skin and eyes, an inability to tan, freckle easily and have a large number of typical or atypical moles.  Of all these risk factors, sun exposure, is the only established modifiable cause of skin cancer.

The skin is the most exposed organ to environmental ultraviolet radiation (UVR) and to its related effects. The sun emits UVR waves that range from 200 to 400nm. Solar radiation that reaches the earth’s surface comprises approximately 95% UVA (320-420nm) and 5% UVB (290-320nm) rays.  UVB is largely responsible for sunburn, while UVA rays, which penetrate the skin more deeply, are associated with wrinkling, sagging, leathering and discoloration; these changes are also referred to as the effects of photoaging. UVA rays are relatively constant throughout the day and the year. They also can penetrate through window glass, so you are at risk of exposure even when indoors and in your car.  UVB rays, in contrast, have greater intensity in summer than in winter, at midday than in morning or late afternoon, and in places closer to the equator and at high altitudes. It’s important to be aware that certain surfaces reflect the sun’s UV rays, allowing them to hit your skin and eyes twice. Not only does water reflect an extra 10 percent of UV light ; UVR can penetrate water to a depth of 60cm resulting  in significantly increased exposure.

It is well established that there is a strong causal relationship between UV exposure and the development of melanoma and non-melanoma skin cancer (basal and squamous cell carcinoma). Children spend a lot of time outdoors and there is compelling evidence that childhood is an especially vulnerable time for the damaging (carcinogenic) effects of the sun.  The negative effects of UV radiation are accumulated during an entire lifetime and the risk of skin cancer increases with age. It is estimated that approximately 25 percent of our total sun exposure is acquired by age 18, and men over age 40, who spend the most time outdoors, get the highest annual doses of UV rays.   There is epidemiologic evidence supporting the causal relationship between sun exposure and skin cancer which includes a higher incidence of malignant melanoma in persons with a history of sunburns during childhood and adolescence; increased frequency of skin cancers with higher sun-exposure history; heightened risk of melanoma for those with increased childhood sun-exposure history; and relationship between sun exposure and increasing number of nevi, which may predispose to melanoma. The anatomic areas that skin cancer develops on appear to be somewhat related to the average amounts of UV exposure to those sites. For example, melanoma tends to be found more frequently on the legs in women, and the back in men. However, there is a trend toward increasing rates of melanoma on the trunk of women, due in part to clothing styles with increased skin exposure, opportunities for leisure activities in sunny areas and indoor tanning.

With increased life expectancies, and spending more leisure time outdoors, preventing ongoing accumulation of sun damage needs to be incorporated as an important part of a healthy lifestyle. Just as we try to limit our children’s exposure to other known carcinogens such as cigarette smoke, we should do everything we can to minimize their exposure to the ultraviolet radiation from the sun.

With the incidence of skin cancer on the rise, now is the time to take action against the ONE AND ONLY modifiable risk factor : excessive sun exposure. The purpose of sun-safety behavior is not to avoid outdoor activities, but rather to protect the skin from the detrimental sun effects. There are important steps you can take to decrease your risk of skin cancer without compromising the fun, or the competitive edge of any sport in which you may be competing.

Sun safety requires implementing a comprehensive set of sun safe behaviors, because no behavior alone will provide sufficient sun protection. While complete sun avoidance is not realistic, seeking shade when possible and capitalizing on the fluctuation of the intensity of UVB rays, by exercising outdoors in the early morning and late afternoon/early evening is recommended. The UVA rays will remain intense throughout the day, therefore the detrimental effects of the sun still exists at these times as does the risk of sunburn.  Additional sun protective measures include use of sunscreen. Sunscreens are chemical agents that help prevent the sun’s UV radiation from reaching the skin.  As UV radiation is comprised of both UVB (sunburn) and UVA (photoaging) rays it is important to use a product that protects against both types of rays, designated as “Broad spectrum.”  Sunscreens are designated by their SPF –Sun Protection Factor- which is a measure of a sunscreen’s ability to prevent UVB from damaging the skin. An example of how this works is as follows: If it takes 20 minutes for your unprotected skin to begin turning red, using an SPF 15 sunscreen should prevent reddening 15 times longer which is about 5 hours. It is estimated that sunscreens with SPF 15 block approximately 93 percent of all incoming UVB rays. SPF 30 blocks approximately 97 percent; and SPF 50 blocks approximately 98 percent.  Although these may seem like minor differences; for those individuals who are sunlight sensitive or who have a history of skin cancer, these extra percentages will make a difference. It is also important to note that no sunscreen can block 100 percent of UVB rays, and we do not currently have an established metric to calculate protection against UVA rays. So while “reddening” of the skin is an indication of your reaction to UVB rays, there is no immediate telltale sign of the UVA damage you may be accumulating.

Although moisturizers and after-shaves with SPF15 or higher may be sufficient for everyday activities where you spend a few minutes intermittently in the sun, stronger water-resistant sunscreens are required for aquatic sports participants as well as the spectators spending hours outdoors.  Currently in the US, many of the sunscreens available combine different active chemical sunscreen ingredients in order to provide broad-spectrum protection. Typically, at least three ingredients are combined to achieve this goal including PABA derivatives, salicylates, and/or cinnamates for UVB absorption; benzophenones (for example Oxybenzone and sulisobenzone) for shorter-wavelength UVA protection; and avobenzone (Parson 1789), ecamsule (Mexoryl), titanium dioxide, or zinc oxide for the remaining UVA spectrum. For individuals with sensitive skin, sunscreens composed of only titanium dioxide and zinc oxide are available. These latter ingredients are referred to as “physical blockers” as they function by reflecting the UV rays rather than absorbing and subsequently dispersing them like  “chemical blockers”  such as Parsol 1789, (which can irritate the skin in some individuals) .  The level of protection against UV rays is comparable between the physical and chemical blockers. To ensure that you get the full SPF of a sunscreen, however, you must apply a sufficient amount, which is 1 ounce-about a shot glass full.  Most people only apply half to a quarter of this amount, which translates to a lower SPF on the body than advertised on the sunscreen label. A good example for a long day in the sun that lasts hypothetically 8 hours would require the use of 4 ounces of sunscreen, or half of an 8 ounce bottle for just one person. Another significant factor in ensuring sun protection is when sunscreen is applied. Sunscreens should be applied 30 minutes prior to sun exposure to allow the ingredients to fully bind to the skin. Despite sunscreens being labeled as “water-resistant” and “waterproof”, they are only effective up to two hours and therefore require reapplication of the same amount every two hours. Sunscreens should also be reapplied immediately after swimming and toweling off.

We know that sunscreen alone cannot fully protect you from the damaging UV rays and risk of skin cancer. Although reapplication of sunscreen every two hours is recommended, it is not always feasible. Therefore, there are additional sun safe practices that should be adopted. Clothing is the single most effective form of sun protection as it is our first line of defense against the sun’s damaging ultraviolet rays.  Wearing sunglasses and wide-brimmed hats with at least a 3 inch brim will help protect your eyes, head and neck is prudent. For the rest of your body, there are several factors to consider when choosing the ideal attire for sun safety, and one of these is UPF, which stands for Ultraviolet Protection Factor. UPF measures the amount of UV radiation that penetrates the fabric and reaches your skin.  For example, a fabric with a rating of UPF50 will only allow 1/50th of the sun’s UV rays to pass through which means the fabric will significantly reduce your skin’s exposure to harmful UV radiation because only 2 percent of the UV rays will get through. When choosing clothing for every day wear, heavier weight and tightly woven or closely knitted fabrics (corduroy,denim,wool) , as well as synthetic  and semi-synthetic fabrics (such as polyester and rayon) offer the greatest sun protection . Dark and bright colors offer greater UVR protection than whites or pastels. A good rule to remember is that if you hold up fabric to the light and you can see through it, then UV radiation can penetrate it …as well as your skin. Also when clothing gets wet or excessively stretched, the UPF will go down. On a positive note, there are easy ways to increase the UPF of everyday by washing your clothing with a laundry additive such as Rit Sun GuardTM. This product has the active ingredient TinosorbTM which increases clothes sun protective abilities for up to 20 washings. It changes your everyday white cotton shirt from a UPF of 7 to 30.

For aquatic activities, choosing swim suits and rashguards that have been specially treated with chemical UV absorbers, known as colorless dyes are preferable. There are currently national criteria as well as international standards for UPF testing; a UPF label may state that the item meets the standards of the American Society for Testing and Materials and/or the AS/NZS Standard. In addition, choosing swimsuits with the greatest body coverage is paramount to protecting the skin from the harmful UV rays, especially during long practices and endurance events where reapplication of sunscreen is not feasible. Swimsuits with full back coverage and leg coverage either to the knee or ankle will help ensure more comprehensive protection. If such swimsuits are not readily available, wearing a rashguard over your swimsuit will be a useful substitute.

Key points:

  1. Sun safety should be incorporated into your everyday life as the sun’s harmful UV rays are present 365 days a year
  2. Wear broad spectrum sunscreen everyday: for daily activities a moisturizer or after-shave lotion with SPF15 or higher is sufficient; but for aquatic activities or prolonged outdoor exposure choose SPF 30 or higher; apply 30 minutes prior to exposure and reapply every 2 hours
  3. Wear sunglasses, a wide-brimmed hat (brim at least 3 inches) and choose clothing that is tightly woven, closely knit and dark or bright-colored. UPF labeled clothing is available or you can increase your own clothing’s UPF by using a product like Rit Sun GuardTM
  4. Seek the shade, but be aware that sunlight may reflect off surfaces like concrete ,water and sand and can reach you beneath an umbrella or tree
  5.  Avoid activities during peek sun exposure  hours between 10am and 4pm
  6. Healthy habits are best learned at a young age, therefore practicing sun safety for your children should be a priority. Damage from UV rays occurs with each unprotected exposure and accumulates over the course of a lifetime, therefore people of all ages need to be safe in the sun to minimize their risks of melanoma and non-melanoma skin cancer.


This post is a modification of an article I wrote for a publication for FINA, the international governing board for all competitive aquatic sports.

Many of the facts used in this post were obtained from the Skin Cancer Foundation website: