8 Things Your Dermatologist Wants to Tell You
What she wants to tell you: "You could be spending too much time at the nail salon."
"Patients often come into the office complaining of an itchy red rash on their eyelids," says Melanie Grossman, MD, a dermatologist based in Manhattan. "And they assume it's from their makeup or cleanser." This condition, called eyelid dermatitis, is also caused by irritants in the air—the most likely culprit being the chemicals from nail polish, polish remover and other products wafting around in the nail salon, Grossman says.
How to help her—and you: If it becomes a recurring problem, consider limiting manicures to once every two weeks (and maybe find a salon with better ventilation).
What she wants to tell you: "Off-label uses of (certain) drugs are fine."
Patients don't realize that many common prescription drugs can do double duty. "Antihistamines work for some people with rosacea," says Debra Jaliman, MD, a Manhattan-based dermatologist and the author of Skin Rules. "I've also used Aczone, a prescription acne medication, for keratosis pilaris—better known as those little-bumps-on-the-arm." And then there's Botox, which Jaliman says can be a lifesaver for people who suffer from excessive sweating or migraines. Other creative uses: It can prevent a new scar from stretching and can even act like a temporary nose job. "An injection at the tip of the nose can give a bit of a lift," says Jaliman, "subtly changing your profile."
How to help her—and you: Ask! Bring up a related segment you saw on TV or an article you read (like this one).
What she wants to tell you: "Actually, benzoyl peroxide doesn't turn pimples into scabs."
"People definitely lie about picking their skin," says Jaliman. "But we can always tell, because we'll see the scabs, the scratch marks or the small depressions caused by fingernails."
How to help her—and you: Be honest. Your dermatologist may suggest deterrents—like hiding your magnifying mirror or dimming the bathroom lights—or, if it’s serious, she may refer you to a psychiatrist who can get to the bottom of the issue. "We're here to help," Jaliman says.
What she wants to tell you: "You don't really need to see me for one of these..."
A facial. Your dermatologist isn't the only person who can squeeze, massage and smooth your skin while you relax in an easy chair. It's perfectly fine to see an aesthetician for one, says Jennifer L. MacGregor, MD, a board certified dermatologist at Union Square Laser Dermatology in New York City. In fact, some derms don't even offer facials.
How to help her—and you: If facials are your thing, treat yourself to one at your local medical spa (the aesthetician at a medical spa is more likely to have been trained by a dermatologist or to work with one than one who works out of a salon). Always ask to see proof of their training as well as their state license, which should be hanging on the wall. Keep in mind that there isn't much research about the long-term benefits of facials, save for the relaxed glow that comes from lounging in a chair and being tended to and moisturized for an hour. But for many of us, that's enough.
Next: The best way to get the most out of your appointment...
What she wants to tell you: "But only—and I mean only—see me for..."
Lasers and needles. (Or you might end up like these people.) "Clinicians can take a weekend course in injecting Botox or fillers or learning a laser, and then hang a certificate on their wall," says Whitney Bowe, MD, a clinical assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai Medical Center in New York. "But that doesn't mean they have adequate training in facial anatomy, nor does it mean they know what to do in the case of an emergency or complication."
How to help her—and you: Look for someone who's board-certified in dermatology and has graduated from a dermatology residency program. If you're interested in laser procedures, Bowe recommends finding a dermatologist who has multiple lasers on hand. Why? Some lasers that work well for lighter skin can burn the pigment in darker skin, leading to scars. "If he has only one or two lasers in the office, he might not be able to offer you the best option for your skin."
What she wants to tell you: "Book your mole scan before you show up, please."
"I offer skin checks to all of my patients," says MacGregor. She'll drop everything to look at a suspicious spot and will always make time for body scans. In fact, she'll add (and subtract) services and discuss whatever issues you want to talk about—from the dark patch on your cheek to the mole on your lower back. But this means that when you come in for a Botox injection and a skin check and then decide as your doctor is walking out the door that you're also interested in addressing your under-eye puffiness, she's going to do whatever she can to accommodate you. If every patient took this approach, wait times would get out of control.
How to help her—and you: Mention all the treatments you'd like done (including lasers, injectables and full-body scans for moles, freckles and other discolorations) when you call to make an appointment.
What she wants to tell you: "We're not here to judge you... unless you show up with a tan."
"Part of my job is to make people feel good about themselves; so pointing out a flaw that a patient hasn't noticed is doing exactly the opposite," says Bowe. "The one exception is if a patient is clearly getting too much sun and putting herself at risk for skin cancer. Then I'll point out that the sun exposure can result in old, wrinkled, unsightly skin. Sometimes beauty can be a greater motivator than fear."
How to help her—and you: Save her the lecture (and save yourself the dressing-down) and see her before your vacation, so that you can ask her for waterproof sunscreen recommendations (and maybe even score a sample).
What she wants to tell you: "We don't always practice what we preach."
"I used to take my dog outside in the morning without putting on sunscreen first," Jaliman admits. "It would only be for about five minutes, and I'd put it on after I came back." Jaliman was eventually reminded of something she always told her patients: Sun damage is cumulative. "I noticed I was getting freckles on my face, and I needed to laser them off." Now she doesn't even step out of the house without sunscreen—not even for the doggie's bathroom break. And her freckles have never come back.
How to help her—and you: Learn from her advice—as well as from her mistakes (because it's unlikely you have a laser machine at home to cover up yours).
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