Skincare 911

It's something everyone fears: Waking up on the day before or day of a big event such as a wedding, reunion, business interview, or first date with an unsightly skincare emergency. Have you ever cancelled a first date because a cold sore erupted? What about cystic acne on your chin that appears the day before an important meeting? While neither of these is "life threatening" conditions, they sometimes feel that way.

Dr. Rebecca Baxt, a Manhattan/New Jersey board certified dermatologist, says there are solutions and she shares her expertise on what can be done to minimize various conditions that might put a blemish on your special day. Remember to consult with your doctor about the pros and cons of each of these solutions to help make the best personal decision for you.

Cold Sores and Allergic Reations

Problem: Cold Sore
Dr. Baxt offers cortisone injections to patients who want to look better faster. "Very diluted cortisone into the cold sore, this can bring the inflammation down quite rapidly," she says. If you are afraid of needles, call your doctor and ask him/her to call in a prescription for Valtrex, Famvir, or Acylovir. Dr. Baxt says, "You can pick up Abreva, an over-the-counter medication. If you can't make it to the pharmacy, you can try some old-fashioned remedies: Visine will help take the red out. You can also use a cold compress and Tylenol or ibuprofen."

Problem: Allergic Reaction
The first thing you need to do is stop eating or using whatever is causing the allergic reaction. If the reaction happens a few days before an important event or meeting, Dr. Baxt recommends using hydrocortisone cream twice a day and taking Allegra, Claritin or Zyrtec, which are longer acting and less sedating than Benadryl. You can also use a whole-milk compress for 10 minutes twice a day.

For allergic reactions that occur the day of your special event, use the hydrocortisone cream and then a hypoallergenic cover-up. The opposite of red is green, so apply green tinted concealer on the red area. The combination will create a flesh-toned hue. A good quality tinted moisturizer naturally has green/yellow undertones and also provides moisture to dry skin. But allergic reactions should be taken seriously. "If this type of reaction is something you have never experienced before, go immediately to your dermatologist," says Dr. Baxt.

Cystic Acne and Puffy Eyes

Problem: Cystic Acne Breakout
Some people attempt to deal with cystic acne themselves by using a lancet or small knife to extract the clogged pore, but the results can cause permanent damage. "Cutting open a cyst is extremely risky. You not only run the risk of getting an infection, but you also run the risk of scarring, as in a permanent skin indentation or protrusion," says Dr. Baxt.

And what if you cut open a cyst but can't squeeze out the root clog? You don't know where the root is or how deep it resides inside your skin. You can't even be 100 percent confident that you will be able to completely remove the hardened plug of the cyst. If any remnants of the clog remain, the cyst is likely to get re-inflamed and come back even worse.

A steroid shot is an option often used by models and actors. One option often used by actors. Dr. Baxt clarifies, "when we discuss treating acne with cortisone or 'steroid' shots, we are referring to the process of gently placing a very dilute quantity of a 'glucocorticoid' steroid into the cyst. Glucocorticoids are a class of steroid molecules that are naturally produced by our bodies and have numerous functions including the regulation of human metabolism, immunity, and inflammation. They have very potent anti-inflammatory effects so they are often used to treat inflammatory diseases in medicine. Within one or two days of injection into a cyst, the steroid will shrink the inflammation producing relief of pain and almost immediate cosmetic improvement."

Problem: Puffy Eyes
"A cool compress or cooled cucumber slices applied for 5 to 10 minutes can constrict blood and lymph vessels," says Dr. Baxt. "You can also use cool tea bags, which contain tannins that will help reduce swelling. And since puffy eyes can be caused by a high salt diet or alcohol, try to cut out both before an important occasion."

Sunburn

Problem: Sunburn
Take a cool bath or shower. Set the water to a cool temperature that's just below lukewarm, and relax for 10 to 20 minutes. The temperature will ease the pain, and the water will lessen your skin's irritation. Repeat as often as you need to. Avoid using soap, bath oils, or other detergents as you bathe as they can further irritate your skin.

If you have blisters forming on your skin, take a bath instead of showering. The pressure from the shower might pop your blisters. When you get out, don't rub your skin dry with a towel. Instead, let yourself air dry, or pat the towel over your skin in small, gentle movements. Apply cold compresses to your skin. If you're not in a situation where you can bathe, or you'd just prefer not to, you can instead apply cold, wet compresses to your skin. Dampen a washcloth or other piece of fabric with cold water, and lay it over the affected area for 20 to 30 minutes. Re-wet it as often as you need to.

Apply aloe vera to burned skin. Using the pads of your fingers, gently apply the aloe to your sunburn. Don't "rub it in" all the way, as you might with a regular lotion. Leave a thin layer on top of the burn - this helps prevent the skin from drying out and becoming more irritated. Reapply as often as necessary.

Treat inflammation with cortisone cream (optional). Cortisone creams contain a small dose of steroids that can work to reduce inflammation to your sunburn. Wear loose cotton clothing over sunburned areas. Baggy T-shirts and loose cotton pajama pants are ideal things to wear while you're recovering from sunburn. If you can't wear that, at least try to make sure your garments are cotton (which allows your skin to breathe) and as loose as possible. Drink plenty of water. Sunburns can be dehydrating so it's important to counterbalance this by drinking a lot of water while you recover. Aim for 8 glasses containing 8 oz. of water each day.

Apply unscented moisturizer to your skin as it starts to heal. When you no longer have open blisters, or the redness of the sunburn has subsided a bit, treat your damaged skin to some tender loving care. Liberally apply a creamy, unscented moisturizer to sunburned areas over the next few days or weeks to prevent peeling and irritation.

Too Much Filler

Dr. Baxt suggests doing fillers no sooner than 1 month before a big event to allow time for healing and touch ups. One of the reasons Dr. Baxt leans toward hyaluronic acid fillers such as Restylane, Juvederm and Perlane is because they are easily reversed with Hyaluronidase. This product dissolves and degrades the Restylane, Juvederm or Perlane so as to reverse the results of the initial injection. It's a great insurance policy when choosing a practitioner.

Most patients find the immediate results of soft tissue filler treatments very satisfying. If an undesirable result occurs, your treatment provider should be able to discuss and carry out all of the treatment options. Removing the effects of a filler treatment can be difficult. This is why any filler treatment needs to be done carefully, conservatively and only by very experienced and Board Certified Specialists.

According to Dr. Baxt, Hyaluronic Acid based dermal fillers have the additional safety of being partially or completely reversed with time or with the injection of a commercially available enzyme known as Hyaluronidase.
Before picking up the syringe, good dermatologists and plastic surgeons will evaluate your skin quality and texture; tissue tone and thickness; cheek and lip volume; bone structure; and how your face looks when animated and how it looks when still.

Whether you choose a conservative option for your immediate skincare needs or decide to engage the assistance of a trained professional, it's important to remember that our skin is our largest organ and should be taken care of not only for those momentous occasions in our lives, but every day.

Want more skincare tips from Dr. Baxt?
Skincare 101 and 5 Myths Exposed
Jet-Setting Your Way to Healthier Skin

Rebecca Baxt, M.D., MBA, FAAD is a Board Certified Dermatologist specializing in both cosmetic and general dermatology for adults and children. She is a fellow of the American Academy of Dermatology, a member of the American Society for Dermatologic Surgery, New Jersey State Medical Society, Bergen County Medical Society, and the Dermatological Society of Greater New York, as well as the American Medical Association.