Summer Skincare Tips from Dr. Swann

Summer is here so what do you need to do differently?  Hot humid weather with plenty of sunny activities can make summertime skincare difficult.  It is also the most important season to protect your skin from damage.  We ask Dr. Swann what are the most useful tips we can use going into summer?

1. Know your skin type & minimize inflammation.  Inflammation leads to hyperpigmentation.  If you put it on your skin and it burns, avoid it.  Your skin is more open in the summertime humidity and is also turning over more rapidly due to sun exposure.  That means you can become more irritated by products, including cleansers, moisturizers, sunscreens and prescriptions.  Dr. Swann recommends letting up on your turnover products in the summer.  If you are using prescription tretinoin, maybe lighten up to a retinol-based regimen or even glycolic or salacylic acid in a cleanser.  Use sunscreens that don't have chemicals, which tend to be irritatnts.  Use a synthetic cleanser, such as cetaphil or dove, which doesn't cleanse as well, but doesn't stay on the skin.

2. Sunscreen as a Morning Habit.  Particularly in the summer, if you are just applying your sunscreen before you walk onto the first tee or while you are poolside or getting on the boat, you have already failed.  The first 30 min your sunscreen is important to let it bind to the skin.  If you are hot when you put it on, it doesn't bind well and you end up sweating it right off.  Put sunscreen on after you wash your face or shave in the morning.  Use a physical sunscreen without chemicals and reapply if you are going to have prolonged exposure.

3. Lighten your moisture.  If you are used to using a heavier night cream, consider lightening to a lotion.  For daytime, you may get away with serum and sunscreen instead of a dedicated lotion.  This will lead to fewer milia or follicular imperfections. 

4.  Treatments to get rid of summer damage.  Even with a great skin regimen, you can end up with discolorations leftover from sun damage after a season of summer fun.  Dr. Swann says there is no substitute for commitment to a great skin care regimen, but there are therapies that can target seasonal damage and get you back into shape faster.  "I think of skin care like working out.  You can't build a sculpted body in a couple of weeks.  But there are therapies like peels or laser treatments that can target specific issues in the skin."  Our team loves to combine a solid skin care regimen with a series of peels and even prescriptions if necessary to idealize your glow and get you back on track fast!  We are particularly excited about Swann Dermatology's Reveal Peel that works really well in conjunction with an HQ-based regimen to brighten and unify skin tones, removing the signs of summer quickly.  We sometimes combine this with a fractionated laser peel in the fall to really boost results. 

Our team believes in individualized skin care for best results and there is no cookie-cutter method that gets everyone their best regimen.  We know skin and are here to help you look great in your skin!

Mike Swann, MD

Moisturizer & Acne Prone Skin BY CYDNEY HERNDON

There are many things that can be said about the causes of acne. However, we will save that for another day. Today I want to explain the importance of moisturizer with acne prone skin. I know how acne clients feel generally because we hear it all the time. They HATE moisturizer! Why? Because most acne prone skin is oily, and when they apply moisturizer, they feel like their skin will become oiler.

In my opinion everyone needs a moisturizer! Luckily we have been blessed with MANY types of moisturizers in this world today. Oil free moisturizers may feel so much better on acne prone skin. But you may ask, why do we recommend moisturizer if someone already has oily skin?

When a person has acne, normally their oil production is greater than someone with normal skin type. This can be caused from hormones, genetics, stress and even diet related. So, why would putting more moisture on top of the skin help? By putting a moisturizer on top of your skin, it can trick your oil glands by sending signals to the oil producing glands telling them to slow down on production. So, the less oily the skin, the less break outs, and the greater your skin feels.

Moisturizer is also great because it helps protect the skin from cracks that come with drying. Moisturized skin is harder for bacteria to flourish which makes it less likely for papules or pustules to become inflamed. Without infection and inflammation, redness will be decreased along with pain that can come with certain acne.

We have several different moisturizers here at Swann Dermatology to fit any skin type from Skin Medica and Elta MD . We offer samples so a person can test different types and see which best fits their skin. Idealizing a regimen for your skin requires assessment of your skin type and a good understanding of how topical therapies work. Did we mention that WE KNOW SKIN? We would love to invite you in for a consult to talk about your skin.

Skincare Q&A with Jasmine

What is Retinol?

This is a question that I get several times a week from patients.  Derived from vitamin A, Retinol was originally used as an acne treatment.   In addition to the drastic improvement in acne, clinicians couldn't help but take notice of the cosmetic benefits that Retinol provides. Retinol is now used worldwide to soften fine lines, improve texture, and help unclog pores or blackheads. Retinol also has a significant antioxidant component that helps fight free radicals, thus decreasing your risk of aging.  

Retinol vs. Tretinoin?

Clients commonly ask which one is better, but the real answer is which is better for a particular skin type.  One way we type the skin is "sensitive" vs. "resistant".  The risk-to-benefit ratio of people with sensitive skin tends to favor retinol, particular blends of retinol.  Less sensitive skin can have better results with tretinoin, but often need to start their regimen with a very light dose.  We favor higher strengths of retinol with the exception of the toughest skin types.  The way you apply these products will optimize your benefits and minimize your irritation.

How Do I Apply It?

The secret to using retinol is all about the application process.  We typically recommend starting nightly applications on a consistent schedule of three nights per week. It takes only one pump (pea size) of Retinol to a dry clean face at night followed by a moisturizer to minimize the risk of irritation or dryness that is sometimes associated with this product.  We recommend continuing the schedule of 3 nights a week for 2 weeks, gradually increasing nightly applications.Our goal is to work up to Retinol application every night.

What Are The Risks?

The application process is important.  Patients must start using retinol gradually to decrease side effects of irritation, redness, and itchy skin.  It is also important to avoid the corners of your mouth, nose and eyes when applying Retinol.  A broad spectrum SPF application is imperative while using this product, due to increased sensitivity to UV Rays. Follow these rules, and we will have you loving your Retinol.

What Type of Retinol Is Right For Me?

I like the blend of retinols in Skin Medica Retinol Complex because I see excellent results.  We keep this available for purchase at Swann Dermatology.  We offer shipping to anyone out of town that wants in on the fun!  If you're ready for the next step in your skincare regimen, introduce Retinol.  You will not be disappointed.  I also invite you to send me an email with any questions you may have.  We love skin and want to help you love yours!   


2015 Sunscreen Treatise

I believe sun protection is essential in promoting skin health and there is tremendous misinformation and poor understanding by patients and doctors alike about sunscreen.  When I was in training, some doctors were advocating for patients to use sunscreen, but when I asked what they used they often weren’t using sunscreen themselves.  When I found out about sunscreens that dermatologists were recommending, most of these were because they had a high SPF rating to prevent sunburns, but I didn’t like the feeling on my skin.  Additionally, sunscreens can be irritating to sensitive skin types and some have questioned the safety of utilizing some of the chemicals in some sunscreens.  The science behind sunscreens is significant, so here is my treatise on sunscreen and my advice on choosing the best sunscreen for your skin and finally some of my favorite sunscreens:

Use a physical-based instead of a chemical-based sunscreen for the broadest protection. Chemical sunscreens (avobenzone, PABA, etc) work as resistors of certain wavelengths of ultraviolet radiation and in turn produce heat on the skin surface.  Physical sunscreens (zinc, titanium) work as mirrors on the skin, reflecting the light.  Old physical sunscreens were obvious because it was like paint on your skin, and we saw it used on people who were getting lots of sun (think white-coated noses of lifeguards and surfers).  Nanotechnology and cosmeceutical additives such as hyaluronic acid now make physical sunscreens very elegant and wearable.  I actually prefer the tinted sunscreens for the face, because in addition to blocking UVB and UVA, they block visible light, which is important in melasma and brown discolorations on the face.

SPF isn’t everything.  For a long time, we have been told that SPF30 blocks 97% of the suns rays and that anything higher than SPF30 doesn’t end up giving much additional protection.  Although technically true, this is very misleading.  (1) The SPF number rating only accounts for the erythema or redness protecting ability of the sunscreen from UV-B only.  UV-B is important in the development of common skin cancers like basal cell and squamous cell carcinoma.  Surprisingly, when a sunblock that says it is SPF 100 it doesn’t have to cover a bit of UV-A radiation and UV-A is important not only in the development of melanoma, but is even more important in the development of aging because it brings about brown discolorations wrinkles, loss of elasticity and blood vessels or redness in the skin.  (2) The SPF number rating is based on using 3-4 times the amount of sunscreen that most of us put on our skin.  It requires a tablespoon of sunscreen on your face & neck in order to achieve the actual SPF number rating that is on the label.  The truth is, when you put SPF 30 on your face, most people usually achieve SPF 3 to SPF 5 based on how much they apply.  Although I do not advocate for putting a whole tablespoon on your face and neck, higher SPF ratings than SPF30 will actually give you better protection because we aren’t applying it as thick as they do for SPF testing in the laboratory.  This also may help you understand why the sunscreen added to your makeup isn’t enough. 

“Broad Spectrum” can still legally be narrow

When a sunscreen says it is broad spectrum, it means in addition to the UV-B coverage (SPF) it also covers some UV-A rays.  But a minimum threshold amount of UV-A coverage is not required in order to use that term, allowing manufacturers to literally cover a small 5-10% of the UV-A wavelengths of light to make this claim.  Physical sunscreens cover broadly because they act by reflecting the UV-A rays as well.

A bit on Usage and Activities & Water-resistance

Most of us who love to be outside are active and busy and the last thing we want on our run or bike ride is a mix of sunscreen and sweat getting into our eyes.  Sunscreen needs to integrate with the skin in order for it to function correctly.  This is why labels recommend applying to the skin “at least 30 minutes before activity”.  We have all applied or reapplied sunscreen after we are already out and about, like after 9 holes of golf, only to find it immediately “sweats” off the skin.  I recommend applying a sunscreen to your face and neck everyday in the morning as a part of your routine when your skin is still cool.  For women it can be applied as a primer for makeup and for men as the last thing they do to their face after they shave.  For reapplying during activities, I recommend using spray-can sunscreens because they don’t have to be rubbed in completely and you can keep your hands from getting greasy.  Regarding “waterproof” and “water resistant”, I will just tell you that these are tested in a laboratory environment where sunscreen is on an arm and it is gently placed underwater for a set amount of time.  In the real world where kids are playing in a pool or we are sweating and wiping our forehead, some of the potency of the sunscreens is certainly hampered.  My recommendation is to reapply sunscreen every two hours during water activities, but that a daily application in the morning will minimize damage the most.

Help your skin fight the damage with antioxidants

Sunlight produces an array of damage that end up causing DNA mutations and cell injury with free radicals.  Antioxidants such as green tea, vitamin C, and vitamin E are utilized in your body’s natural defense against oxidative damage from radiation.  Applying antioxidants to the skin and also eating a health diet rich in antioxidants can help your body to repair damage the quickest. 

Visible-Light, Infrared-Light and Heat

New research shows that the visible light and infrared light are a big concern with regard to aging. These wavelengths penetrate deeper than ultraviolet light and are not only produced by the sun, but also by our computer monitors and other man-made sources.  A good tinted sunscreen can help protect your skin from the visible radiation and with Skin Medica’s SOL-IR technology we now can be protected from infrared rays.


These are my favorite sunscreens for your face:

EltaMD UV Physical Broad-Spectrum SPF 41.  Lightly tinted with a matte finish, this has been my go-to sunscreen for people who just need the best protection from skin cancer and also want an elegant formulation.  This is oil-free and good for sensitive skin types.  If you don’t wear makeup or you don’t want to look or feel like you have anything on your face, this is your sunscreen.  This is available in a 3oz tube for $29. 

EltaMD UV Clear Broad-Spectrum SPF 46.  This elegant formulation comes in tinted and white,  and has antioxidants and niacinamide (vitamin B3) to repair damage in the skin and calm and protect acne-prone or rosacea-prone skin.  This daily sunscreen also contains hyaluronic acid and lactic acid which gives a very silky and smooth quality which many women love as a makeup primer. This is available in a convenient 1.7oz pump for $29.

Skin Medica’s Total Defense + Repair Broad-Spectrum SPF34 Tinted SUPERscreen. Powered by SOL-IR™ Advanced Antioxidant Complex , thisproduct adds visible and unprecedented infrared coverage to an excellent physical-based sunscreen.  This is more than just an excellent sunscreen.  Without utilizing any other products, 91% of users said 8 weeks after starting this product, they saw improvement in their skin’s overall health and overall appearance and 90% said they saw improvement in skin firmness, tightness, and elasticity. For minimalists who want a single product to give them proven anti-aging benefits in addition to the most advanced protection, this is the best and is available in a 2.3oz airless pump for $65.

A Guide to Aging Gracefully

Combating wrinkles and aging skin starts with prevention. Many young people overlook skincare because aging skin seems years away, but it’s not. Once your twenties come along, you may look in the mirror and think, “Is that a wrinkle?!”

While prevention is key, don’t panic! It’s important to know which products to use so you don’t waste money on expensive products that are formulated for older, dryer skin. “Many people think all skincare products are the same, but they are not. Young people who are just beginning to use age preventing products may blindly buy products that are actually for older skin. While these products are great for the right skin type, they can actually cause irritation and acne in younger skin. It’s important to ask a dermatologist or do your research before buying products,” says Dr. Michael Swann.

While getting older is a wonderful thing and shouldn’t be feared, there are things you can do to have healthy and vibrant skin. While you can’t control genetics, you can control what you do to and put in your body. Through a healthy lifestyle and the right skincare regimen, you can have the skin you desire. Starting with healthy, clean eating is key. Opt for fruits and vegetables and stay away from processed foods. It’s also important to stay away from cigarettes and tanning beds.

Along with a healthy lifestyle, there are great age-delaying products you can use to prevent wrinkles. Here’s the list:

1.    Sunscreen- Wearing sunscreen is one of the best things you can do. It’s important to use a broad-spectrum sunscreen—not just UVB protection, because UVA rays are more responsible for collagen breakdown than UVB. UVA rays even penetrate through windows, so your skin needs protection even indoors. Make sure you reapply sunscreen throughout the day and wear it all year around. 

We Recommend: Elta MD UV Daily Broad-Spectrum SPF 40 Moisturizing Facial Sunscreen, $29, Sold at Swann Dermatology

2.    Retinol- Retinol is a great product if you want smooth, clear skin. It stimulates collagen and can treat acne. Retinol can increase the skin’s sensitivity, so it is best used at night. 

 We Recommend: SkinMedica Retinol Complex 0.25, $60, Sold at Swann Dermatology

3.    Antioxidants- Antioxidants like C and E reduce oxidative damage (pollution from the environment) that can break down collagen. They also can enhance skin’s brightness. 

We Recommend: SkinMedica Vitamin C+E Complex, $98, Sold at Swann Dermatology

4.    Eye Cream- Eye creams can reduce the appearance of fine lines, wrinkles and dark circles around the eyes. 

We Recommend: SkinMedica TNS Illuminating Eye Cream, $88, Sold at Swann Dermatology

5.    Exfoliator- Exfoliating helps maintain a healthy complexion. You can use gentle scrubs or cleansers that have exfoliators in them. They will improve the appearance of skin texture, tone, and smoothness.  

We Recommend: SkinMedica AHA/BHA Exfoliating Cleanser, $46, Sold at Swann Dermatology