I have an acne problem and have been to several dermatologists and so far they have not helped me. Their medicines and suggestions have caused me great pain, irritation and lots of money. Do you think facials may help my condition or can you suggest another dermatologist who knows what he is doing?

Acne can be controlled in about 75 per cent of the acne sufferers, but skin treatments or the application of topical products do not necessarily get “rid of it.” You may have to do some of your own homework to determine the cause of your acne. There are about a dozen or more causes: heredity, adolescent acne, sunbathing, medication, overuse of cleansing agents or just scrubbing or washing the skin too much, use of dandruff shampoos, coal tar shampoo, exposure to insecticides, food allergies or sensitivities, digestion problems (which can include constipation) etc. Interview some skin care specialists or estheticians and dermatologists until you feel comfortable with their routines or advice. You may have to try a few procedures until you find the right combination for your skin; there is no single treatment program for everyone. Some estheticians and dermatologists do work together to give a better all-round treatment.

A treatment will improve the appearance and increase the natural function of the skin. A good skin treatment involves a light surface cleaning, a deep cleansing which will help liquefy or soften the sebum and remove impurities that may be trapped in the skin. There may be a light surface peeling or exfoliant to get rid of the keratinized waste and dead skin cells so that the skin can more easily absorb the following penetrating serums. You may receive a warm misting vapor (not hot steam) to moisturize and relax the tissues and to prepare the skin for extraction of blackheads, clogged pores etc. After the extraction, there might be an application of a serum, which is usually a concentration of ingredients that have a nourishing, healing, anti-bacterial, strengthening or calming effect on the skin. Depending upon the skin, there may be some massage to drain the lymph areas in the face and then the mask to finish off the treatment. It will help the skin get rid of the surface clogging.

Both my parents have varicose veins and it is very likely that I will have them too. Now, in the summer heat, they are aching. I have read your articles on scleratherapy-vein injection, but what else can I do to prevent further damage?

Veins transport the blood back to the heart (deoxygenated blood) and lungs from the body to be re-oxygenated. They have valves along their length that act like locks on a canal to prevent backflow. The movement of the blood is helped by muscular contraction as the walls have no muscular layer and can exert little pressure on the blood flow. The valves open to allow the blood to flow upward, then close to prevent back seepage. If the valves have been weakened they may collapse, the blood then begins collecting in the vein, stretching the walls out of shape. Most varicose veins occur on the surface of the legs because the deeper veins have more support. If you have a job that requires you to stand for long periods of time, try to take a break any chance you can to sit down and put up your legs. Most doctors agree that exercise, especially walking or swimming, is very beneficial for the circulation. A balanced diet, proper weight control and lots of water does help. Wear support hosiery, avoid crossing your legs while sitting and don’t wear any tight constricting clothing. Varicose veins are a complex problem, but fortunately there is much you can do to prevent the condition. If you already have them, preventative measures can ease the discomfort.

My doctor said that some soaps can cause sunburn. Is this true and which ones?

The chemicals in some deodorant, anti-bacterial or highly perfumed soaps can react with the sun to cause bad sunburns or pigmentary stains. This does not happen with all people nor with all deodorant soaps, but to prevent a reaction, change to a very mild, non-deodorant unscented mild soap when you are planning to spend time in the sun. Is rinsing your face with cold water to close the pores a good idea?

I believe that using temperature extremes (hot or cold) on the face causes too much stress on the skin. It vasodilates or constricts the blood vessels and in time causes them to become weakened. A cold water rinse can cause the skin to contract too much over a period of years and this could make pore openings widen. It could also temporarily cause blood vessels to contract, allowing very few nutrients to reach skin cells. The oil or sebum in the follicles may temporarily solidify, making the cleansing and the balancing of the pH of the skin more difficult. Use lukewarm water to wash and rinse the face.

Do non-alcoholic toners take off cleansers as well as the astringents do?

Most toners are designed to stimulate, cool, soothe and restore the pH of the skin (acid mantle) which was disturbed by a cleansing product. When the pH is restored, your treatment cream, moisturizer or night cream will act on the skin much faster. The differences among the toners, exfoliants, clarifying lotions, fresheners or astringents lie in the amount of alcohol in them. Other ingredients may differ according to fragrance, soothing or calming, or strengthening qualities. When cleansers were thick creams to be tissued off, you needed an astringent to dissolve the cream in the pores. Today, cleansers are used with water and a sponge or facecloth.

All mascaras that I have tried seem to make my lashes clump together. What should I use?

When you are applying mascara, apply color evenly with one stroke of the wand. Let the mascara dry between applications. A lash comb may help to separate the lashes.