September 22, 2017

Understanding skin care basics

Woman applying face cream in mirror

The average person uses nine personal care products on a daily basis, while at least 25 percent of women use 15 or more. There are hundreds of thousands of skin-care products on the market with new ones being introduced all the time.

Along with the wide range of price points can leave a person feeling overwhelmed just trying to decide on a body soap.

UW Health dermatologist Dr. Apple Bodemer knows just how confusing it can all be, but she said that it doesn’t have to be. To start, she has a very simple philosophy: “Beauty starts on the inside.”

She adds that the better you take care of your body, the better you will look and feel, “That healthy glow really does come from inside,” she said.

There is no secret formula — despite what marketers might suggest. Drinking plenty of water, a diet rich in plant-based foods, regular moderate exercise, getting good quality sleep, having positive friendships, making time for hobbies and enjoying life — all of those things doctors are constantly telling us really do make a difference.

Four basic categories of skin care products

No matter how much you take care of the inside, the largest organ of the body — your skin — does need some TLC as well. To help maintain its health and appearance, Bodemer said there are four basic categories of over-the-counter skin care products we can use:

  • Cleansers

  • Moisturizers

  • Sunscreens

  • “Anti-aging”


When it comes to using cleansers, there are a few basic rules:

  • Cleanse no more than twice a day

  • Use warm water and a gentle cleanser

  • Avoid abrasive cleansing devices and scrubs

“Rubbing your fingers gently in a circular motion is all you really need to achieve clean skin,” said Bodemer. “It is important to avoid over-cleansing or cleansing too harshly.”

Cleansers that are too strong or abrasive can affect the health of the skin and result in dryness, irritation and inflammation, which in turn can result in flares of chronic skin conditions such as eczema and psoriasis. Unless otherwise recommended by your physician, it’s also best avoid harsh antibacterial cleansers. Instead, look for gentle cleansers, particularly those that promote having a pH closer to normal skin.


Like cleansers, Bodemer recommends a few basic rules for moisturizing:

  • Liberally apply thick creams, ointments or oils, especially after bathing while the skin is still slightly damp

  • Use something that you scoop out of a tub or squeeze out of a tube — not from a pump

Bodemer said most moisturizers don’t actually add moisture to the skin, but instead help draw moisture from deeper tissues and help prevent the loss of moisture from the surface, which is why the thicker the moisturizer, the better. She offers a caution about lotion.

“Lotions are essentially a Band-Aid," she said. "While they feel good at first, they have high water content and in the long run contribute to more evaporation of moisture from the skin, which we are trying to avoid.”

When shopping for a moisturizer, Bodemer recommends ones that contain the following ingredients:

Ingredients that slow down evaporation (also called occlusive):

  • Petrolatum

  • Beeswax

  • Lanolin

  • Various oils, such coconut oil

  • Dimethicone

  • Shea butter

  • Cocoa butter

Ingredients that that help attract water to the skin (also called humectants):

  • Lactic acid

  • Urea (ureic acid)

  • Glycerin

  • Propylene glycol

  • Alpha hydroxy acids

  • Panthenol

Bodemer, whose training includes integrative dermatology, also recommends “food-grade” oils including coconut, apricot kernel, almond, avocado and sesame oils and shea butter.

“I am a huge fan of food-grade oils. Apricot kernel oil is my favorite facial moisturizer. It is the lightest of the oils and is absorbed quickly. I find it works really well even for people who have oily skin or acne,” she said.

Among the benefits of food-grade oils is that they are easy to find, unlikely to cause allergic reactions, don’t contain preservative and have anti-inflammatory and anti-oxidant qualities. Although she does add a caution about shea butter.

“Shea butter comes from the shea nut. They have a very low protein content, and while the protein present in shea does not appear to trigger allergic reactions, if someone has a tree nut allergy, I would watch carefully for reactions,” she said.


Most people are already familiar with the basic rules of sun protection: Wear clothing and wide-brimmed hats that protect the skin, minimize exposure to the midday sun (between 10 a.m and 4 p.m.), wear sunglasses and, of course, wear a sunscreen with an SPF 30 or higher rating.

“I especially like sunscreens that contain the physical blockers — zinc oxide or titanium dioxide,” said Bodemer. But she also stresses that sunscreens are imperfect and are only part of a UV protection plan. That’s where the clothes, hat, sunglasses and staying out of the midday sun come into play. When you do use sunscreen remember to use it appropriately, which means:

  • Apply it early: 15-20 minutes before the UV exposure

  • Use enough: About a nickel-sized dollop for the face alone, about a palm full for face and body

  • Re-apply every 2 hours or after getting wet

It’s easy to think that the higher the SPF the better the protection, but really the number is just an estimate of how much time you can be in the sun before experiencing a burn. Regardless of the SPF, sunscreen wears off after about 2 hours, so it does need to be re-applied.

Types of sunscreen

When it comes to sunscreen there are two types: Physical and chemical blockers. The physical blockers are zinc oxide and titanium dioxide. These are often better tolerated by individuals with sensitive skin. Bodemer explains that the mineral-based sunscreens often leave a white/gray residue on the skin, but that can be avoided by looking for ones labeled micronized or nano-particle.

Chemical blockers commonly found in sunscreens include homosalate, octisalate (octylmethoxycinnamate), octinoxate, oxybenzone, octocrylene, avobenzone and meroxyl. Some of these can cause allergic reactions, which is why Bodemer recommends avoiding products containing oxybenzone and octinoxate. On the other hand, if you are going to use a sunscreen with chemical blockers, Bodemer suggests looking for avobenzone and meroxy, because both have a lower likelihood for causing allergic skin reactions.

Anti-aging products

Bodemer said one of the best ways you can keep skin looking and feeling great is to avoid exposure to UV radiation.

“Most of the skin changes we associate with aging are not necessarily factors of simply getting old, but actually induced and accelerated by UV radiation, so doing whatever you can to minimize this will give you a huge advantage — both for skin health and appearance,” she said.

If you decide to incorporate anti-aging into your skin-care regimen, Bodemer suggests two basic rules:

  • Know what issues you are hoping to address and have realistic expectations

  • Be willing to use the product or products regularly for at least several months to see a benefit

Over-the-counter anti-aging products are primarily focused on minimizing wrinkles and brown spots or blotchy skin. Because this class of products is not classified as drugs, they do not have to prove effectiveness, and do not have to identify concentrations of ingredients on the product labels. Bodemer warns that many of these types of products can cause irritation and should be used cautiously in people with sensitive skin.

She notes there are some ingredients that may have some anti-aging benefit, including:

  • Retinol: Helps increase cell turnover (or exfoliates the skin), stimulates collagen and elastin, helps fade dark spots

  • Vitamin C: Can help minimize photo damage (must be stored in an air-tight dark container)

  • Hydroxy acids (alpha-, beta- and poly-): Gently exfoliate the skin — removing upper layer of dead skin and stimulating the growth of a smoother more evenly pigmented skin layer

  • Coenzyme Q: Might reduce fine lines and wrinkles and have some UV damage protection

  • Tea extracts (black, white or green): Have potent anti-oxidant and anti-inflammatory properties

  • Grapeseed extract: Anti-oxidant and anti-inflammatory

  • Nicatinamide (B3): Anti-oxidant, helps reduce water loss from skin and might improve elasticity

  • Ingredients that help lighten brown spots:

    • Hydroquinone

    • Kojic acid, from Japanese mushrooms

    • Arbutin, from bearberry, mulberry, blueberry, cranberry, wheat, pear

    • Azelaic acid, from grains

    • Vitamin C


If you’ve been in the market for anti-aging products, no doubt you’ve wondered whether that small tube is truly worth more than $100. Bodemer said that expensive products aren’t necessarily better.

What you could notice is that the look, smell or even feel of the product might be different, but a higher-end product might not actually work any better than a more moderately priced one.

“Basic, good quality skin care products are readily available and don’t have to break your budget," Bodemer said. "If you want to treat yourself to something that makes you feel special, go right ahead — just know what you are paying for.”