You Asked, we answered

I'm still getting acne, now what?
Acne is the most common skin condition in the world and over 90% of guys will have some form of acne during their life. Men have more oil glands in their facial skin, thicker beard hairs, and higher levels of testosterone than women, making them more prone to severe acne. Men often feel that acne gives them less credibility in social and professional interactions. Some simple, at-home tips can go a long way. First, never squeeze an acne pus bump or pimple because whatever stuff comes out, a greater amount actually goes down into the skin and enzymes are released, causing scars. Next, go gentle on the skin—don’t rub or scrub the face and wash it gently with your fingertips. We like Cetaphil brand cleanser because it cleanses the skin without irritating it, which is known to provoke acne. Also, use an over-the-counter benzoyl peroxide gel (like Neutrogena on the spot acne gel) once per day. This should help clear individual pimples up quickly. Just remember that it can bleach any fabric, including collared shirts, towels and pillow cases. We recommend not putting it below the jaw line because it can bleach the collar of button-up shirts. These steps will help, but prescription medications are often needed to control what’s left. At Vorteil, we treat acne using a combination of medical, procedural and light-based therapies that are tailored to the individual client. Preventing new acne and treating acne scars requires specialized knowledge of the skin of men that only a dermatologist should manage.

Vorteil’s Bottom Line: Don’t worry, acne is extremely common and there are simple and effective treatments to get your face back to normal.
My face is always red, what's going on?
Facial redness can be caused by many different things, rosacea probably being the most common cause of redness in men with lighter complexions. Rosacea seems to be due to overactive nerves and blood vessels in the skin that are activated by five main factors: stress, sunlight, smoking, alcohol, and hot showers. Avoiding the “big five” factors will go a long way toward improving facial redness. Specifically, wear a zinc oxide sunscreen every day on your face (don’t worry, it won’t irritate your skin), go luke-warm over steaming hot showers (if this is too much to ask, at the very least, don’t continue cranking up the hot water while you’re in it), ease stress by getting some exercise, and go easy on the alcohol and tobacco. Over time, the redness may have occurred so often that it is now permanent, which means the blood vessels in the skin are permanently dilated and enlarged. The larger blood vessels can be noticed as small bluish red lines on the face and result in increased blood flow, which shows up as redness. Both the redness and small blood vessels can be treated successfully with lasers and other methods. Considering that lasers are defined as the practice of medicine (and not a “spa” treatment) and have risks, make sure the one treating you is a dermatologist with specific knowledge of men’s skin.

Vorteil’s Bottom Line: Facial redness can be improved with lifestyle modification. If you need more help, don’t hesitate to contact Vorteil.
I think I am starting to notice some hair loss, what should I
Male pattern balding is extremely common, affecting most men at some point in their lives. It is caused by a combination of the genes you inherited and the hormones your body produces after puberty. Although there is no known cure, don’t panic! There are a few simple things you can do to try to keep what you have and possibly re-grow some hair. First, buy some anti-dandruff shampoo. Vorteil recommends Head and Shoulders Active Sport for men. It contains zinc pyrithione, which has been shown to block the message that tells the hair follicles to shrink and die. Next, buy Rogaine 5% foam at Costco (it is least expensive there). The foam is easy to use and doesn’t leave your hair greasy. It is much less likely to cause an allergic reaction compared to the liquid as well. Using it once a day will help, but twice a day may give a slightly better result. Rogaine mostly increases the caliber and thickness of the hair, although it can grow some hair too. Third, take some biotin. Although a biotin deficiency is very rare in the US, biotin can act like a fertilizer for your hair, providing it with a critical nutrient for hair growth. 2,500 micrograms per day is sufficient for this purpose. These tactics are a great place to start, however, Vorteil has other methods to combat hair loss, such as prescription medications, hair restoration surgery and other inside tips that require a more tailored approach to a given man’s medical and hair loss history.

Vorteil’s Bottom Line: Hair loss is inevitable for most men, so take action before it’s too late. Follow this simple regimen for 6 to 12 months. If you don’t see any improvement and need some more help, don’t hesitate to contact Vorteil for more answers.
Are sunscreens safe?
Sunscreens are classified as over-the-counter drugs and are carefully regulated for safety by the federal government. Sunscreen ingredients are classified into two main groups: inorganic (containing zinc oxide and titanium dioxide) and organic (all other). Both types protect against skin aging and skin cancer. Oxybenzone, an organic sunscreen, has received a lot of press in the media regarding its potential for hormonal disruption, primarily based on a study in rats. A recent human study showed that it would take 277 years of daily application of sunscreen containing oxybenzone to reach the level found in the rat study. Furthermore, after 40 years of use in the US, there has not been one published study showing harm to humans. Zinc oxide and titanium dioxide do not enter the body through the skin because the particles are too large; they are completely safe. In addition, these ingredients tend to be less irritating to the skin and eyes after sweating or water sports. For these reasons, and the fact that they offer better sun protection, Vorteil only uses zinc oxide and titanium dioxide in its sunscreen products.

Vorteil’s Bottom Line: Don’t believe the hype; sunscreens are safe and are the single most important thing you can do to prevent skin aging.
What does it mean when a skin care product has 'anti-aging' on the
This is a frequent question among men because of the widespread use of this phrase on over-the-counter skin care products for men, like Jack Black, Lab Series, and Anthony Logistics. First, because of the new US Food and Drug Administration’s (FDA) rules on sunscreen that were passed in 2012, any product containing sunscreen can claim “anti-aging”. This is accurate, because sunscreens that block ultra violet A (UVA) light protect the collagen in the skin from being degraded and, therefore, help minimize skin aging. However, don’t be misled into thinking that the serum peptides, ginger root or jojoba oil in the product is anti-aging. In fact, by FDA definition, any product (besides sunscreen) that is sold over-the-counter cannot alter the structure and function of the skin. If it did, it would have to go through the FDA’s rigorous testing to get approval and validate its claims, which none of them have. This is evident in product promotional items that say the product “alters the appearance of the skin”, which is different than “alters the skin”. In fact, if you splashed water on your face and took a photograph, it would alter the appearance of the skin. This subtle wording allows companies to use this misleading phrase to a man’s disadvantage.

Vorteil’s Bottom Line: Sunscreen is anti-aging, so wear it daily. All the other ingredients on over-the-counter products are just marketing hype.
The dark circles under my eyes are bothering me, mostly because people tell me 'you look tired today'. Please help.
Dark circles under the eyes are extremely common among men. According to a recent article in Dermatologic Surgery, dark circles are caused by more than one thing, the most important being heredity/genetics, accumulation of fluid, and loss of collagen in the area of skin beneath the eye, which creates a shadow effect. Although we can’t do anything about our genetics, we can improve the appearance of under eye circles by focusing on the other two. First, avoid excessive alcohol and salt, which can lead to puffiness around the eye that can contribute to dark circles. Next, try an over-the-counter allergy pill, like Zyrtec or Claritin, once or twice per day (such as morning and night). This blocks histamine, which is a proven mediator of fluid leakage that results in swelling around the eyes. Loss of collagen in the skin creates a “hollow” appearance around the eyes. This loss of tissue casts a shadow that can cause under eye dark circles to worsen. Because no over-the-counter cream has been scientifically proven to increase collagen in the skin, your best bet is a pharmaceutical grade, prescription cream containing retinoic acid (not retinol, retinal or retinaldehyde). Retinoic acid, through double-blind, placebo controlled trials, has been proven to increase collagen in the skin and prevent its breakdown. Soft tissue fillers containing hyaluronic acid can also replace lost collagen and minimize the shadow effect. More advanced treatment, like eye surgery (blepharoplasty) or laser procedures, are required in some cases if the above tactics don’t help.

Vorteil’s Bottom Line: Dark circles are caused by many factors that each need to be treated to optimize the appearance of the eye area.
I'm starting to get hair in my ears, what do I do? Please help.
Ear hair is much more common in men than women and is challenging to treat. According to the latest dermatology literature, laser hair removal doesn’t work due to the size of the hair and the nooks and crannies in the ear it hides in. Plucking (also known as epilation) is very painful in this area and usually results in red bumps a few days later. Depilatories (such as Nair for Men) are too toxic to put in the ears. Although far from perfect, electric shavers specifically for ear hair (such as the Phillips Norelco Precision Nose and Ear Trimmer) can trim the hair without nicking the skin. The goal is to trim (not shave) the hair to the point where it is not noticeable. That’s why the screen on the trimmer prevents the blade from touching the skin, which is a good thing.

Vorteil’s Bottom Line: For ear hairs, an electric trimmer is your best bet.
I get razor bumps on my neck and face when I shave, what should I do?
Razor bumps (also known as pseudofolliculitis barbae or sycosis barbae in dermatology jargon) are much more common in men than women due to a man’s larger caliber hair and thicker skin. According to a study in the Journal of the American Academy of Dermatology, it occurs in 45-83% of men. After shaving, the sharp edge of the hair shaft re-enters the skin, typically within a day or two. This creates an inflammatory reaction to the hair shaft, and the shape, direction and nature of its growth determine how severe the bumps are. Although the beard area is most prone to this, other hair-bearing areas of a man (scalp, arm pits, pubic area, chest, back) can get razor bumps after shaving, tweezing or waxing. Although not shaving for 2 months can cure it, this is not very practical for most men. Since reducing the closeness of a shave is key, the next best alternative is to use an electric clippers (such as Braun, Norelco, Remington) and shave hair to a minimum of 1 millimeter (basically stubble). Electric clippers have a protective gap between the blade and the comb, thereby preventing an extremely close shave. For those men where stubble is unacceptable, make sure you are shaving correctly. First, wash your face with a benzoyl peroxide 10% wash (Oxy, Clean and Clear brands, available at Target or Walmart) before shaving to reduce the bacteria on the skin. Second, use a high quality, single blade razor and shave immediately after a luke-warm shower, which softens the hair and prevents a sharp edge after shaving. Use shave gel (not foam), because gels absorb more water and tends to soften the hair more. During the shave, don’t pull the skin taut or press hard on the razor when stroking, and also shave with the grain (ie: in the direction of hair growth), not against it. There are more advanced treatments for razor bumps, including prescription gels and laser procedures to help if the above techniques don’t cut it.

Vorteil’s Bottom Line: Razor bumps are very common in men who require a close shave. Good shaving technique can help, but many men require more advanced treatments.
I work in sales and need to look my best. What should I focus on?
Your face says it all, so start there. It doesn’t matter if you drive a Ferrari or wear a Prada suit, if your face looks tired and your skin looks weathered, people will notice that first. Your skin, your forehead wrinkles, and even the lines between your eyebrows tell the world what you’re feeling. However, as we age, these expressions may not deliver the messages accurately. Your friends think you look mad or sad, but you feel great. First, take frown lines. Whether the issue is horizontal wrinkles across your forehead or vertical lines between your eyebrows, injections of Botox can completely erase years off your face and make you look less tired and angry. Another great area for Botox treatment is the “crow’s feet”, the lines that radiate from the eyes when we smile. A lot of guys are—in fact, using Botox to their advantage because 363,000 procedures were performed in the US on men in 2011 alone. Brown spots on the face are another common concern for men in sales or professional occupations who spend time interacting with clients. These spots can be faded with pharmaceutical grade retinoic acid creams, chemexfoliation procedures, and lasers.

Vorteil’s Bottom Line: The condition of your face is the first thing people notice about you. Skip the cars and designer clothes to focus on it. You will reap the rewards.
The heels on my feet are cracking and are calloused. Can you help?
Almost every man has thick, calloused heels. This is mostly due to excessive walking and running in old or poorly fit shoes. Flip-flops, not wearing socks, and going barefoot can also cause heels to crack and fissure. The primary cause of calluses is that the skin is dehydrated from constant friction. To correct this, first try and get better fitting shoes and correct the issues just described, as the callouses will definitely return if you don’t. Next, head to the local pharmacy or Target and pick up some urea 20% cream. Urea is a natural humectant that prevents water from evaporating from the skin. It also causes the water binding sites on the keratin (the major protein in skin) to open up and bind more water. This leads to less dehydration and softer heels. You can also put a piece of saran wrap over the cream for a few hours after applying it for extra penetration into the thick callus. If this doesn’t work, head to your dermatologist for a prescription strength version of urea

Vorteil’s Bottom Line: Heel callouses can be cured with these simple steps. If you need more help, don’t hesitate to contact Vorteil.

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Male Dermatologist. Serving Dana Point, San Clemente, San Juan Capistrano, Ladera Ranch, Aliso Viejo, Laguna Beach, Laguna Hills, Laguna Woods, Tustin, Rancho Santa
33971 Selva Rd. | Dana Point, C.A. 92629 | Tel:949-276-2600 | Fax:949-276-2601