Dr. Beleznay sat down with Practical Dermatology® and DermTube.com to discuss treatment and skincare recommendations for patients with acne and rosacea. Watch her interviews at DermTube.com. Ahead are some of Dr. Beleznay’s top skincare tips for her patients.
When patients present to the office, Dr. Beleznay says first and foremost, you must consider what brings the patient to your office, what their concerns are, and get a good history of what they’ve tried before, what they’ve been using, any side effects they’ve had from any medications, and then complete a physical exam.
Beyond the treatments she prescribes for acne and rosacea patients, Dr. Beleznay emphasizes the need to discuss skincare with them at every visit.
With acne patients, she says it’s very important to dispel two skincare myths that many patients believe—that moisturizers and sunscreen are bad for their skin.
She counsels her patients that a moisturizer is often a good adjunct, especially when using topical prescriptions that can dry out the skin. In fact, she even tells patients who are using a topical retinoid and experiencing dry, red, irritated skin as a result, that that they may want to mix the retinoid in with a moisturizer.
Dr. Beleznay recommends that all acne patients use a moisturizer that’s fragrance-free and hypoallergenic. She tells her patients to read labels and make sure that they use products—including make up—that are non-comedegenic so it won’t clog their pores.
She also emphasizes the need for sunscreen for patients with acne. “There are many patients who are resistant to use sunscreen. They’re worried that sunscreen will clog their pores more, that it’s oily, and it causes acne. And then some patients actually think that the sun helps their acne and so they want to get as much exposure to the sun as they can,” she says. It’s important to explain to patients with acne that sunscreen can actually be really helpful, especially for patients who have post-inflammatory erythema or redenss and post-inflammatory hyperpigmentation. “We really want to prevent that from getting worse, that’s why I really emphasize that having a good sunscreen is very important for daily use,” she adds.
Skincare is a critical part of treating patients with rosacea, particulary subtypes one and two, Dr. Beleznay says. “So everyone who comes into my office with these types of rosacea, we discuss at length how we manage their skin. For these patients, the interesting thing is we know more about the pathogenesis of rosacea now. And, in fact, in addition to vascular hyper-reactivity, which causes the redness as well as a bit of an innate immune system reaction in that there’s a lot of inflammatory markers, we also know there’s a defect in the skin barrier. And so what that means is this is sort of causing the whole situation where patients come in and they say they’re burning, they’re stinging, they’re having pain, they can’t put anything on their face without discomfort and that relates...to the skin barrier defect. And so it’s really important, I think, to get them to use products that feel nice on their skin and that also contribute to helping to improve that skin barrier.”
Dr. Beleznay recommends fragrance-free or hypoallergenic products to her rosacea patients. And, like with acne, she recommends daily sunscreen use with a product that feels good on the skin, that doesn’t irritate.
She also cautions her patients to avoid using anything harsh on their skin, like toners, astringents, and exfoliating agents.