shutterstock 328775612

In the early twentieth century, unsuccessful federal court cases and continued adverse consequences of unsafe food, drugs, and cosmetics quickly illustrated the inadequacies of the [Pure Food and Drug Act of 1906](https://www.fda.gov/about-fda/fdas-evolving-regulatory-powers/part-i-1906-food-and-drugs-act-and-its-enforcement). As we discussed in [part I of this series](https://aedit.com/aedition/early-history-of-us-food-drug-cosmetic-regulation-fda), the law did provide some safety standards and labeling accuracy, but it also required that the government prove a manufacturer intended to defraud with its labeling — a nearly impossible burden to meet.

The law also had no power to regulate cosmetics, medical devices, or advertising, nor did it create any standards for food safety. Among the tricks and bad practices used by manufacturers: 

- Glass bottles that only appeared to be full
- False-bottomed boxes
- Misleading and fraudulent advertising claims
- Inadequate record keeping for prescription drugs
- A lack of safety testing for new drugs and cosmetics

Consumer advocacy groups and the publication of books like Arthur Kallet and F.J. Schlink's *100,000,000 Guinea Pigs: Dangers of Everyday Food, Drugs and Cosmetics* (1933) raised awareness of the law’s shortcomings, but the offenses continued.

## **The American Chamber of Horrors**
In 1933, the chief education officer (Ruth deForest Lamb) and chief inspector (George Larrick) of the [United States Food and Drug Administration (FDA)](https://www.fda.gov/home) assembled a collection of misleading and dangerous products to illustrate the inadequacies of the current laws and to advocate for broadened regulatory powers. The exhibit gained notoriety when Eleanor Roosevelt toured it with a reporter, who dubbed the collection the “Chamber of Horrors.”

Included in the exhibit (which was a sensation at the Chicago World’s Fair) were a variety of packaging tricks, advertising swindles, and products that didn’t work or, worse, were hazardous and toxic. Some of the highlights:

- **Lash Lure**: The toxic aniline eyebrow and eyelash dye that caused serious infections, blindness, even death among salon-goers.
- **Banbar**: A blend of alcohol, water, and horsetail (a weed) flavored with peppermint purported to treat diabetes that actually killed those who relied on it instead of insulin.
- **Bred-Spred**: A line of enticingly packaged ‘jams’ that contained artificial colors and flavors, pectin, and hayseeds but no fruit.
- **Koremlu**: Billed as a harmless hair removal cream, this toxic concoction contained thallium acetate and caused systemic hair loss and neurological damage.

## **The Elixir of Sulfanilamide Disaster**
As a result of mounting evidence and pressure, a bill to revise and expand the Pure Food and Drug Act of 1906 was introduced before Congress in 1933. But passage of the bill was stalled for years as politicians, advocacy groups, and lobbyists debated. In 1937, a Tennessee manufacturer created what was believed to be a red raspberry-flavored liquid version of sulfanilamide, a true ‘wonder drug’ that had proven to be safe and effective (in powder form) to treat strep infections. After the elixir was tested for flavor, appearance, and fragrance, it was shipped to doctors and pharmacies across the country.

[Elixir Sulfanilamide](https://www.fda.gov/files/about%20fda/published/The-Sulfanilamide-Disaster.pdf) killed 107 people, many of them children, because the sweet liquid was, in fact, a solution of the powdered drug and diethylene glycol — a chemical commonly used as antifreeze and documented at the time to be a deadly poison, though the manufacturer hadn’t bothered to check.

The combined efforts of the FDA, physicians, and media saved countless more deaths. But, due to the limitations of the 1906 law, the FDA was only able to prosecute the S.E. Massengill Co. because it had mislabeled its product an “elixir” (which must contain alcohol) instead of a “solution.” The fact that the formula contained a deadly poison was not legally actionable. 

## **Finally: The Food, Drug & Cosmetics Act of 1938**
The Elixir Sulfanilamide disaster provided the final incentive Congress needed to act. In 1938, the [Food, Drug, and Cosmetics Act](https://www.fda.gov/about-fda/fdas-evolving-regulatory-powers/part-ii-1938-food-drug-cosmetic-act#:~:text=FDR%20signed%20the%20Food%2C%20Drug,adequate%20directions%20for%20safe%20use.) was passed, making it illegal to market unsafe drugs, cosmetics, and devices, establishing food safety standards, and requiring that a drug be proven safe prior to marketing. Factory inspections and court injunctions were also added to the FDA's arsenal. 

In the ensuing decades, court cases and congressional acts bolstered the original FD&C Act. The highlights:

- **Wheeler-Lea Act (1938)**: Empowered the Federal Trade Commission (FTC) to regulate drug, device, and cosmetic advertising.
- **“The Black Book” (1949)**: A guide to evaluate the safety of chemical food additives that was updated in 1982 to include color additives and is now known as “The Red Book.”
- **Durham-Humphrey Amendment (1951)**: Defined what drugs require a prescription from a licensed practitioner
- **Miller Pesticide Amendment (1954)**: Established procedures for setting safe pesticide limits on agricultural products (this is now handled by the Environmental Protection Agency).
- **Food Additives Amendment (1958)**: Prohibited use of cancer-causing substances and required new food additives to be proven safe prior to marketing.
- **Color Additive Amendment (1960)**: Prohibited use of cancer-causing color chemicals in food, drugs, and cosmetics, and required manufacturers to first establish safety before use.
- **Kefauver-Harris Drug Amendments (1962)**: Required manufacturers of new drugs to prove effectiveness to the FDA.
- **Federal Anti-Tampering Act (1983)**: Passed in response to cyanide poisoning from tainted Tylenol, it made it a crime to tamper with packaged consumer goods.
- **Nutrition Labeling and Education Act (1990)**: Required all foods to have standardized labeling.
- **Family Smoking Prevention and Tobacco Control Act (2009)**: Gave the FDA authority to regulate tobacco products.
- **Drug Quality and Security Act (2013)**: Passed in response to a deadly meningitis outbreak in 2012 originating from a compounding pharmacy, it required greater oversight and electronic prescription drug tracing.

## **Drugs vs. Cosmetics, According to the FDA**
After generations of federal oversight, most people today are familiar with the FDA. From lettuce recalls to Botox® approval, the agency affects our lives on a daily basis. But, in spite of its notoriety, many Americans aren’t clear about how the FDA regulates cosmetics and beauty products in this country. “If you ask 10 different people, then you will get 10 different answers,” says cosmetic chemist [Ni’Kita Wilson](https://www.nikitawilsonbeauty.com/).

Here’s where the definitions spelled out in the FD&C Act become important:

- **Drugs**: “Articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease” and “articles (other than food) intended to affect the structure or any function of the body of man or other animals.” (e.g. oral contraceptives and the active ingredients in [sunscreen](https://aedit.com/aedition/how-to-apply-sunscreen-and-not-miss-a-spot))
- **Cosmetics**: “Articles intended to be rubbed, poured, sprinkled, or sprayed on, introduced into, or otherwise applied to the human body… for cleansing, beautifying, promoting attractiveness, or altering the appearance.” (e.g. moisturizer, lipstick, hair color)

Some products meet the definition of both a drug and a cosmetic. These include things like [dandruff shampoo](https://aedit.com/aedition/best-hair-care-products-by-texture-color) (shampoo is a cosmetic but controlling dandruff alters bodily function like a drug) and most [toothpaste](https://aedit.com/aedition/best-natural-oral-care-toothpaste-mouthwash-brands) (tooth cleanser is a cosmetic but added fluoride is a drug).

So, how does the FDA influence the creation of skincare and makeup? “When we're developing [acne](https://aedit.com/aedition/best-skincare-ingredients-to-treat-acne-blackheads-whiteheads), sunscreen, or other over-the-counter products, we have to adhere to the ‘rules of engagement’ outlined in the monograph ‘rule book’ for that category,” Wilson explains. “I have to be careful with the benefit claims of each product that I develop to ensure that I am not misleading the consumer to think that my cosmetic product has drug benefits.” For example, there are certain colorants that she can’t use on the lip or eye area as per the FDA. “They definitely have a say in how things are done,” she notes.

## **The Difference Between FDA Approval & FDA Regulation**
The FD&C Act and ensuing laws gave the FDA the power to regulate food, drugs, cosmetics, and medical devices. 

- **FDA Regulation**: Implies the agency legally oversees those industries — setting rules, guidelines, and standards and enforcing compliance with relevant laws. 
- **FDA Approval**: Signifies a product has been proven safe and effective through research and clinical trials prior to its market release.

Drugs (both prescription and over-the-counter) must either obtain FDA approval or meet strict standards called ‘monographs’ prior to being marketed. With the exception of color additives, cosmetic products and ingredients do not need FDA approval, nor do they need to be registered with the FDA like drugs and drug manufacturers do.

Falsely claiming that a product is “FDA approved” may be a federal offense. Here’s a rundown of what the U.S. Food and Drug Administration does and does not approve:

### **The FDA Does Approve:**
- New drugs and biologics (like vaccines and blood products)
- Medical devices (via a tiered clearance system)
- Human cells and tissues (through a risk-based approach)
- Food additives
- Color additives used in FDA-regulated products 
- Animal food additives and drugs

### **The FDA Does Not Approve:**
- Companies
- Compounded drugs
- Tobacco products
- Cosmetics
- Medical foods
- Infant formula
- Dietary supplements
- Food labels/nutrition facts
- Structure-function claims (like “calcium builds strong bones”)

## **FDA Recall vs. FDA Withdrawal**
So, what happens when a product is deemed unsafe, contaminated, or questionable? In cases of minor violations that wouldn’t involve legal action, the FDA requests a so-called ‘market withdrawal.’ The company isn’t in trouble per se, but they’re being asked to remove the product from distribution until the correction is made.

On the other hand, the FDA recalls a product when there’s a clear legal violation. Goods are removed from distribution and consumers are advised to either return or dispose of the product. Recalls are divided into three categories: 

1. **Class 1**: Product could cause serious harm or death
2. **Class 2**: Product can cause temporary or reversible health consequences
3. **Class 3**: Not likely to cause harm but still a violation

It’s estimated that over 4,000 drugs and devices are recalled each year.

## **The Push for Cosmetic Regulation**
The FD&C Act of 1938 does not require cosmetics manufacturers to register (it’s voluntary), and they are not obligated to follow [Good Manufacturing Practices (GMPs)](https://ispe.org/initiatives/regulatory-resources/gmp/what-is-gmp) the way drug companies are. Under current law, the FDA has no authority to recall cosmetics — the agency can only request that a manufacturer voluntarily recall a product. If a cosmetic manufacturer is making claims reserved for drugs or if their ingredients are found to mimic drugs, then the FDA can step in, as they’ve done with several [lash serum](https://aedit.com/aedition/eyelash-growth-serum-benefits-safety-results) makers over the past decade.

The need for cosmetic regulation came to a head in 2019 with the revelation that Johnson & Johnson concealed for decades that the talc in their baby powder could be contaminated with asbestos. The problem arose again with tween accessories giant Claire’s when it refused to recall several makeup products that independently tested positive for asbestos. Instead, it opted to withdraw the items from shelves while reassuring the public that its makeup is safe. 

Currently, Congress is considering two bills that would expand the FDA’s authority over cosmetics. The [Cosmetics Safety Enhancement Act of 2019](https://www.congress.gov/bill/116th-congress/house-bill/5279/text) would require manufacturers to establish product safety and report adverse effects, while empowering the FDA to conduct its own cosmetic safety testing. The [Safe Cosmetics and Personal Care Products Act](https://www.congress.gov/bill/116th-congress/house-bill/4296?q=%7B%22search%22%3A%5B%22increasing+accountability+at+VA%22%5D%7D&s=1&r=2) would require that all ingredients (including the notoriously-vague [‘fragrance’](https://aedit.com/aedition/fragrance-free-beauty-skincare-for-sensitive-skin)) be detailed on labels and would ban all toxic ingredients.

## **Safety & Efficacy**
Given that many consumer goods are not expressly approved prior to marketing, we’re generally left to trust that the manufacturers are following good practices and that the market will weed out those who aren’t. After all, it’s in a company’s best interest to meet its claims.

However, there are plenty of examples of dangerous products being marketed and widely used before the FDA stepped in (hello, [tobacco](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health)). So, how skeptical should we be before purchasing? “In general, I would presume a large majority of the products to be safe,” Wilson says. “[Read the ingredient label](https://aedit.com/aedition/category/read-the-label) to see if the product contains ingredients that don't raise any red flags.”

If you’re not sure about an ingredient, do some research. “[Paula's Choice](https://www.paulaschoice.com/ingredient-dictionary) has a helpful ingredient dictionary based on relevant studies,” Wilson suggests. Another tip? Keep your sources varied. “Read all types of information — not just those stating that everything is toxic,” she cautions.

What about ‘green,’ ‘clean,’ ‘vegan,’ or ‘organic’ beauty products? [We’ve talked about green beauty recently](https://aedit.com/aedition/what-clean-green-natural-mean-for-beauty-makeup-skincare-products), but in terms of FDA regulation, these terms are simply buzzwords. “The only term that has a true meaning tied to it is ‘organic,’ which is attached to the USDA,” Wilson explains. “The FDA does not recognize any of the others. They are just marketing terms and are no indication of the product’s safety profile or if it's better than another product.”

## **The Takeaway**
While the FDA has certainly made the consumer landscape — including the beauty business — safer and more efficacious, it’s still up to us to do our homework before making cosmetics and personal care choices. With consumers demanding more transparency than ever from brands and manufacturers, it seems like only a matter of time before the laws evolve again. 

AEDITION complexion perfection-min

Beauty Collection | The AEDITION

Beauty

In this two-part series, we’re examining the history of the FDA, and the people, products, and events that contributed to the past and present of American food, drug, and cosmetic policy.

The Modern History Of FDA Food, Drug, And Cosmetic Regulation In The United States

The Ultimate Guide To U.S. Food, Drug, And Cosmetic Regulation, Part II

shutterstock 1286780089

Whether we’re strolling through Sephora, standing in line at the pharmacy, or tackling an online Target run, we tend to take for granted that the items in our basket — from [makeup](https://aedit.com/aedition/category/makeup) and personal care products to prescription and over-the-counter medications — are safe and effective. The same holds true for the cosmetic treatments and plastic surgery procedures recommended to us by medical professionals.

Thanks in large part to consumer protection laws and regulations in the United States, this is (mostly) a fair assumption. But that wasn’t always the case. In this two-part series, we are looking closely at the [U.S. Food and Drug Administration (FDA)](https://www.fda.gov/home): the people, products, and events contributing to the past, present, and future of American food, drug, and cosmetic policy. 

## **Land of the Free, Home of the Huckster**
It’s almost inconceivable for us to imagine a world without Starbucks and [self care](https://aedit.com/aedition/category/self-care). But back in the early years of the founding fathers, most Americans rarely bathed. They grew what they ate and had limited methods of food preservation. ‘Basics’ like soap and tooth powder weren’t widespread until the mid-nineteenth century.

Because the accepted standards of ‘medical care’ (hello, bloodletting?) were so scary, many Americans did not trust traditional doctors. This created the opportunity for the rise of patent medicines: concoctions that purported to alleviate or cure any number of ailments with little or no scientific basis.

So-called quack remedies hawked by traveling ‘snake oil’ salesmen (named for the supposedly exotic ingredients in their formulas) had equal potential to cure or kill. Enterprising patent medicine entrepreneurs were among the first American marketers to employ advertising tactics like testimonials and celebrity endorsements to convince the unsuspecting public.

## **The Earliest Days of U.S. Food & Drug Policy**
In 1813, the fledgling federal government passed the [Vaccine Act](https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2018.304348) to ensure a central, reliable supply of smallpox vaccine existed to combat one of the world's deadliest diseases. It was the first law passed by Congress that addressed the health of Americans. Nine years later, the law was repealed after a vaccine mixup resulted in several deaths. The incident stoked Americans’ distrust of traditional medicine.

A group of physicians met in Washington in 1820 to address the scary reality that many ‘medicines’ of the time were deadlier than the ailment they were meant to cure. Together they developed the [U.S. Pharmacopeia](https://www.usp.org/) — the first set of guidelines for medicine quality. Following these standards was, however, not obligatory.

## **Welcome to the Jungle**
By the mid-1800s, the Industrial Revolution began changing the consumer landscape. Factories mass produced food, clothing, and household items that could be shipped via the new railroads that were crisscrossing the country. Goods that were previously available only to the wealthy and elite became more readily available.

But, without any oversight, food and drug contamination was rampant. Consumers had no way of knowing whether the canned beef stew they bought was really even beef or, worse, if eating it would lead to a deadly case of food poisoning. In 1906, Upton Sinclair published *The Jungle*, a shocking exposé of the appalling conditions of meatpackers in Chicago. His descriptions of tainted, rotten meat fueled public outrage over the unscrupulous practices of food industry manufacturers. 

## **Is the Cure Worse Than the Disease?**
Even if a food, drug, or cosmetic manufacturer had no ill intent, the lack of research and scrutiny allowed plenty of unsafe products to flourish into the early twentieth century. Cocaine toothache tablets and heroin cough syrup (say what?) were just two of the remedies marketed to treat *children*.

With the amount of information now available at our fingertips, it’s hard to imagine falling victim to sensational medical claims and false advertising. Here’s a look at some of the popular (and dangerous!) turn-of-the-century quack medicines and devices that misled unsuspecting consumers:

### **Vapo-Cresolene**
[Vapo-Cresolene](https://www.nursing.virginia.edu/news/flashback-cresolene/) was touted as a cure for respiratory conditions ranging from sneezing to asthma and whooping cough. In reality, it was vaporized coal tar. The packaging instructed users to heat the tar in an enclosed room throughout the night, which led to poisoning in children from inhaling the toxic fumes. Vapo-Cresolene was one of the many ways companies sought to profit from the waste products of burgeoning industries. 

### **Mrs. Winslow’s Soothing Syrup**
First introduced in 1849 and widely marketed in the U.S. and U.K. as a cure-all for fussy babies, [Mrs. Winslow’s Soothing Syrup](https://www.woodlibrarymuseum.org/museum/item/529/mrs.-winslow's-soothing-syrup) was mostly a mix of morphine and alcohol. According to the company’s advertising lore — meant to gain a mother’s trust — “Mrs. Winslow” was allegedly a nurse who developed the formula. The suggested dosage of six to 10 drops for infants lulled them to sleep, but it’s estimated that thousands never woke up. Because there were no labeling requirements, mothers had no way of knowing that one teaspoon of syrup (recommended three to four times daily for babies six months and up) contained a lethal dose of morphine.

### **Liquozone**
Billed to the public as “liquid oxygen,” [Liquozone](https://www.sciencehistory.org/distillations/a-killer-of-a-cure) was a mixture of water and sulphuric and sulphurous acids, with traces of hydrochloric or hydrobromic acid. It’s inventor capitalized on the public’s ignorance and the widespread, mistaken belief that ozone gas has a purifying effect. Taking advantage of emerging germ theory, the manufacturer touted the liquid’s supposed antibacterial qualities, curing everything from ‘bowel troubles’ to cancer. The company was eventually discredited in court, though potentially dangerous ozone ‘purification’ devices are still being marketed today.

## **The Pure Food and Drug Act**
Public outcries over the widespread sickening and death of consumers, combined with the sensation caused by *The Jungle*, led the government to take action. In 1862, President Abraham Lincoln created the [Bureau of Chemistry](https://www.fda.gov/about-fda/history-fdas-fight-consumer-protection-and-public-health/history-fdas-internal-organization) under the [Department of Agriculture (USDA)](https://www.usda.gov/). In 1880, its chief chemist, Peter Collier, advocated for a federal food and drug law. Though the bill was defeated, more than 100 food and drug bills were introduced in Congress over the next quarter century.

Collier’s successor, Dr. Harvey W. Wiley, continued to campaign for legislation. He is known as the “Father of the [Pure Food and Drugs Act](https://www.fda.gov/about-fda/fdas-evolving-regulatory-powers/part-i-1906-food-and-drugs-act-and-its-enforcement),” which passed Congress in 1906 and was signed into law by President Theodore Roosevelt. According to the FDA, the law “prohibits interstate commerce in misbranded and adulterated foods, drinks and drugs.” The [Meat Inspection Act](https://www.fsis.usda.gov/wps/wcm/connect/fsis-content/fsis-questionable-content/celebrating-100-years-of-fmia/overview/ct_index) was passed the same day. In 1907, the USDA issued a list of seven chemical colors considered suitable for use in foods. Notably absent from the law, however, were provisions for drug and cosmetics safety. 

## **Early Challenges to the PFDA**
Patent medicine manufacturers were quick to contest the new regulations (and expose loopholes) of the Pure Food and Drug Act. After the government seized large quantities of a useless ‘remedy’ called Johnson's Mild Combination Treatment for Cancer, the Supreme Court ruled in favor of the manufacturer in [U.S. v. Johnson (1911)](https://supreme.justia.com/cases/federal/us/221/488/). The court declared that the act “does not prohibit false therapeutic claims but only false and misleading statements about the ingredients or identity of a drug.”

In response, Congress enacted the [Sherley Amendment in 1912](https://www.jstor.org/stable/4573181?seq=1#metadata_info_tab_contents), which made it illegal to label medicines with false therapeutic claims but stipulated that there must be an intent to defraud in order to convict (which proved to be very difficult to accomplish in court). In 1913, the [Gould Amendment](https://www.fda.gov/files/A-Century-of-Ensuring-Safe-Foods-and-Cosmetics.pdf) required food packages to be clearly labeled “in terms of weight, measure, or numerical count” on the outside. The following year, the [Harrison Narcotic Act](https://www.naabt.org/documents/Harrison_Narcotics_Tax_Act_1914.pdf) began requiring prescriptions and record keeping for narcotics.

Also in 1914, the Supreme Court ruled on food additives, deciding that the government must show that a chemical additive caused harm before the substance could be banned. In other words, just because a food contained a hazardous chemical, didn’t mean it was illegal. Because there were no codified safety standards, the government had to prove all over again — in every case — that a substance was hazardous.

## **The Takeaway**
These early steps toward regulating food, drugs, and cosmetics in America were crucial in the quest to protect people from the hazards of tainted and dangerous goods. Fortunately for U.S. consumers, it was only the beginning. Stay tuned for our [second installment of this story](https://aedit.com/aedition/modern-history-of-us-food-drug-cosmetic-regulation-fda), where we’ll explore the modern FDA — from its Great Depression-era origins to its relevance today.

The Early History Of FDA Food, Drug, And Cosmetic Regulation In The United States

The Ultimate Guide To U.S. Food, Drug, And Cosmetic Regulation, Part I

jan-kopriva-aQCClWOS9dY-unsplash

Questions and concerns over the realities of recovering from [breast augmentation](https://aedit.com/procedure/breast-augmentation-with-implants) feature prominently into pre-operative conversations and research. From the celebrities and influencers who have publicly documented their recovery to friends or loved ones who may have had the procedure themselves, it’s easy to be overwhelmed with information. If you are considering having a breast surgery, chances are you will have been looking through [stories of the recovery process](https://aedit.com/aedition/what-its-really-like-to-get-breast-implants), before and after photos, and will have been wondering what to expect.

To give you a clearer picture of what [recovery](https://aedit.com/aedition/category/recovery) is actually like, we’re breaking down what can be expected from the healing process. As with any procedure, recovery and results will look different for everyone and plastic surgeons have their own recommendations for giving patients the best possible outcome. Here, we offer some honest insight into what it’s really like to [recover from breast augmentation](https://aedit.com/aedition/how-long-does-it-takes-to-recover-from-cosmetic-surgery-procedures).

## **The First 48 Hours After Breast Augmentation**
Generally speaking, breast augmentation surgery takes two to three hours and surgeons allow patients to go home the same day. Because [general anesthesia](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia) is involved, patients will need someone to transport them home after the procedure, and it can be helpful to have a caretaker around for the first few days. Providers may offer (for an additional fee) or be able to recommend [at-home nursing services](https://aedit.com/aedition/plastic-surgery-recovery-nursing-concierge) to help with post-op care. 

As the grogginess from the anesthesia wears off, patients will likely experience some discomfort and start adjusting to their new body. “The first 48 hours after a breast augmentation, patients can expect swelling, soreness, and a feeling of ‘heaviness,’ as the weight of the implants on the chest is a new sensation,” explains [Umbareen Mahmood, MD,](https://aedit.com/provider/umbareen-mahmood-md-23) a board certified plastic and reconstructive surgeon in New York City. 

How the breast augmentation is performed will impact the recovery process.“The level of discomfort after breast augmentation depends largely on the surgical technique performed,” says [Lauren Chmielewski, MD](https://aedit.com/provider/lauren-chmielewski-md-143), a New York City-based board certified plastic and reconstructive surgeon. “The location of the scar, the method of dissecting the pocket, and where the implant is placed can all affect the level of soreness after surgery.” To better understand what you can expect, she recommends discussing it with your surgeon preoperatively.

### **Removing Sutures**
The surgery technique will also play a role in the number of incisions, where they are located, and how they are closed. “I use surgical tape (steri-strips) and have patients wear a surgical bra or non-underwire sports bra,” Dr. Mahmood explains, adding she allows for showering within 24 hours after surgery. The steri-strips usually fall off by the time a patient reaches the one-month post-op mark, at which point Dr. Mahmood advises her patients to begin using scar cream to [minimize any visible scarring](https://aedit.com/aedition/minimizing-scars-after-surgery) in the long run. 

## **Pain Management After Breast Augmentation**
Your surgical team will do its best to make sure you are as comfortable as possible throughout the recovery process, and the work actually begins in the operating room. “Utilizing key steps during the surgery helps the patient to have a rapid recovery post-operatively,” Dr. Mahmood shares. “Techniques like meticulously controlling any bleeding in the OR, gentle handling of the tissue — especially the pectoralis muscle — and injecting local anesthetic set patients up for a smoother postoperative course.” 

Similarly, Dr. Chmielewski says pain is generally managed by a “multi-modal” approach. “I typically use long-acting nerve blocks to decrease pain medication requirements immediately after surgery,” she shares. Oral pain medication is used as needed, and Dr. Mahmood says most patients don’t need it after the initial 48 hours.

While the amount of [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) and [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) depends on the patient and surgical technique, it is a natural part of the healing process. “The majority of the swelling and bruising should resolve in two weeks,” Dr. Chmielewski says. “Taking homeopathic supplements such as arnica and bromelain can reduce the amount and extent.” Residual swelling can linger for four to six weeks, she adds.

## **Resuming Normal Activities After Breast Augmentation** 
Patients who undergo breast augmentation surgery are usually women who are active, so the need to take things easy for a few weeks can be one of the more challenging parts of the post-op process. “Many of my patients are busy professional women and/or moms who have a lot on their plate,” Dr. Mahmood shares. “I advise them to get everything in order prior to their surgery so they don't have to worry about it post-op.” 

Both experts emphasize the importance of keeping within the prescribed levels of activity after surgery to avoid having to endure a longer recovery. It’s important, for instance, to avoid movement that involves the chest or arms. “Patients are advised to refrain from heavy lifting and be aware of pushing or pulling maneuvers, which can make the pectoralis muscle feel sore,” Dr. Mahmood says. That is particularly pertinent if the implant is placed under the muscle. Stocking up on groceries prior to surgery (more on that below), so you don’t have to worry about carrying heavy milk cartons or water jugs can be beneficial in making the initial days of recovery more comfortable, she notes.

While it’s important to take it easy, [don’t turn into a couch potato](https://aedit.com/aedition/sleeping-better-after-cosmetic-surgery-aesthetic-procedures). “I encourage patients to practice a range of motion activities after surgery, which helps prevent tightness in the shoulders and arms,” Dr. Mahmood explains. Be sure to confirm with your provider what types of movements are safe to avoid any complications. In the first few days post-op, simply walking around your home a few times a day will help boost the healing process. Many patients are cleared to return to work within the first week, though it could be up to six weeks before you [resume your normal exercise routine](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures).

## **Final Results After Breast Augmentation**
By six weeks post-op, you’ll likely be able to start shopping for your new wardrobe. Dr. Chmielewski says one of the most common questions she hears from patients is about when they can buy new bras and tops. “As the swelling subsides, the breasts will continue to change in shape and size,” she explains. “I have my patients wait six weeks (or when cleared by me) before purchasing new clothes.” 

Seeing the true final result can take a bit more time though, particularly if the implants are placed behind the muscle. Most patients can expect the final results to show in three to six months time. 

## **Preparing for Breast Augmentation Recovery** 
As you’ve probably gleaned at this point, taking the time to prepare for your recovery is crucial to making sure things go as smoothly as possible. “Pick up your [supplements](https://aedit.com/aedition/vitamins-supplements-to-avoid-before-cosmetic-surgery) and [prescriptions](https://aedit.com/aedition/opioid-crisis-plastic-surgery-recovery-pain-management) ahead of time and have them ready to go for the car ride home,” Dr. Chmielewski says. “Arrange for help if you have small children or pets that depend on you for the first week after surgery.” 

A [healthy, well-balanced diet](https://aedit.com/aedition/meal-plans-diet-before-after-cosmetic-surgery) is key to recovering well, and she recommends stocking up on low-sodium meals ahead of time. “You may not feel like cooking after surgery and having healthy, pre-made meals to eat will save you from salty takeout,” Dr. Chmielewski says. As she explains, salt causes fluid retention and can worsen and prolong post-operative swelling. 

At the end of the day, any errands or chores you can take care of ahead of time will help you in the long run. “Things like cleaning the house, making sure you have groceries, and having comfortable clothes to wear — like zip-up tops — can be very beneficial in making the initial days of recovery comfortable,” Dr. Mahmood concludes.

AEDITION rejuvenators-min

Medical Aesthetics Collection | The AEDITION

Aesthetics

You’ve asked questions, looked at pictures, and read stories, but what can you really expect from the breast augmentation recovery process? We’ve got you covered.

A Guide To Breast Augmentation Recovery And Healing

Expectation vs. Reality: Recovering From Breast Augmentation

shutterstock 1365204119

Questions and concerns over the realities of recovering from a [rhytidectomy (a.k.a. facelift)](https://aedit.com/aedition/category/facelift) feature prominently into pre-operative conversations and research with surgeons, friends, family, social media, and the internet at large in the run-up to a procedure. If you are considering having a facelift, chances are you will have been looking through [stories of the recovery process](https://aedit.com/aedition/what-its-really-like-to-have-a-facelift), before and after photos, and will have been wondering what to expect. 

To give you a clearer picture of what [recovery](https://aedit.com/aedition/how-long-does-it-takes-to-recover-from-cosmetic-surgery-procedures) is actually like, we’re breaking down what can be expected from the healing process. As with any procedure, recovery and results will look different for everyone and plastic surgeons have their own recommendations for giving patients the best possible outcome. Here, we offer some honest insight into what it’s really like to recover from a facelift. 

## **The First 48 Hours After a Facelift Are Key**
Whether you go home the same day (with the help of a caretaker) or stay overnight for observation is up to your surgeon, but you can expect to have bandages and drains in the immediate aftermath of a facelift. “After the surgery, you will be wrapped in a large head dressing for compression, and most surgeons place two small drains to help remove any extra fluid,” says [Melissa Doft, MD](https://doftplasticsurgery.com/), a double board certified plastic and reconstructive surgeon in New York City. 

It should come as no surprise that swelling, bruising, and discomfort are common in the aftermath of the procedure. Your surgeon will prescribe [pain medication](https://aedit.com/aedition/opioid-crisis-plastic-surgery-recovery-pain-management) to help ease any aches, which is just one piece of the post-op protocol. “It is important to ice your face during the first 48 hours to help reduce swelling and bruising,” she says. “It is also important to make sure that you are comfortable.” 

Ensuring comfort isn’t just for a more enjoyable recovery experience, it’s important for your health. “One of the most common complications after a facelift is a hematoma or blood collection,” Dr. Doft explains. “They often occur when your blood pressure rises and this is usually due to discomfort or pain.” As a result, your surgeon may require you to have a [private-duty nurse](https://aedit.com/aedition/plastic-surgery-recovery-nursing-concierge) monitor your blood pressure overnight. After that first night, the dressings and drains (which are very small and do not hurt to take out) will be removed. 

### **Removing Sutures**
Dressings and drains aren’t the only things that need to come out after surgery. Depending on the surgeon and type of facelift procedure, incisions will be closed with staples, stitches, or a combination of both. While it depends on the individual case and patient, Dr. Doft says sutures around the ears are typically removed five to seven days post-op, while the stitches in the scalp come out after 10 to 14 says. 

## **Pain Management After a Facelift**
The level of post-operative discomfort varies from person to person, but Dr. Doft notes that a facelift is not a particularly painful procedure over all. “The operation is not very painful, but it is a little uncomfortable being wrapped and staying propped up on pillows,” she shares. Valium can be helpful to manage this. You will likely have prescription pain medication to take for the first few days. After that, you should be able to switch to over-the-counter painkillers taken at regular intervals until you feel comfortable enough to take them as needed. “Pain is managed with pain medication like Tylenol, Celebrex, or Vicodin,” Dr. Doft says.

When it comes to areas of pain, Dr. Doft explains that tightness around the neck is the most common complaint she hears during recovery. “Many patients find that their neck feels tight initially, but the tightness will decrease over the first two weeks,” she says. Additionally, the ears may prove to be pesky. “They also find that their ears are sore during the first few days,” she notes. “I usually inject a long-acting numbing medicine during the operation to help decrease any discomfort.” 

In addition to icing and sticking to your prescribed medication plan, there are some steps you can take to help reduce discomfort: 

- **Don’t Be Shy**: Ask friends or family for help with any tasks that feel like they are too much for you in the aftermath of surgery. 
- **Sleep Smart**: Keep yourself propped up, even while you’re [sleeping](https://aedit.com/aedition/sleeping-better-after-cosmetic-surgery-aesthetic-procedures), to help with swelling and bruising.
- **Stay Active**: While you shouldn’t over exert yourself, make sure you [keep on moving](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures) within the limits set by your surgeon.

All of these factors will help with the swelling (more on that below), which, in turn, will keep you more comfortable. 

### **Post-Op Swelling** 
Swelling is usually the main source of discomfort after a facelift, and the amount of swelling you experience will depend on how your body reacts to and heals from the procedure. Swelling often peaks three or four days post-op. You may find the swelling causes sensations of tingling, numbness, or tightness. As we mentioned, don’t resort to bed rest. Instead, relax in a seated position and take regular walks around your living space.

While some patients opt not to look at mirrors for the first week to avoid looking at the worst point of the recovery process, it is important to monitor how things are going. If you notice swelling is a lot worse on one side of your face or if you are finding it difficult to breathe, you should get in touch with your surgeon right away. 

### **Post-Op Bruising** 
In order to thwart swelling and bruising, Dr. Doft recommends this pre-op protocol for her patients: “I always suggest that they take arnica and bromelain before and after the surgery,” she says. “I find that the combination is helpful in reducing bruising and swelling.” The duo isn’t meant to replace regular icing for the first 48 hours but rather to complement it. 

When it comes to [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox), most resolve in the first seven to 10 days. The specific areas that bruise will depend on the type of facelift you have, and your general predisposition to bruising. Certain [medications, vitamins, and supplements](https://aedit.com/aedition/vitamins-supplements-to-avoid-before-cosmetic-surgery) can make bruising worse, and you will likely be advised to stop taking them in the lead up to surgery. Some patients may experience bruising around their eyes, even though the area isn’t directly treated. It is generally due to the delicate area being disturbed during the procedure and will heal along the same timeline as the rest of your bruising. If you have a black eye that persists, follow up with your surgeon. 

## **Resuming Normal Activities After a Facelift**
After the initial 48 hours of downtime, you will likely be able to get up and move around more. It’s important to [remain active](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures) (within reason). While surgeons may allow for light housework so long as you are feeling well enough, you should avoid heavy lifting and bending over for at least a week. At the end of the first week, you can plan to wear makeup again as desired.

At two weeks post-op, you’ll likely be comfortable enough to return to work and mix with friends and family again — particularly if you can adjust your hairstyle to cover any scarring. You may have lingering swelling for four to six weeks after the procedure, but it shouldn’t hinder your ability to go about your daily life. Most remaining activities can be resumed at one month post-op, Dr. Doft says.

## **Final Results After a Facelift**
So, how long until you enjoy the final results of your facelift? “Most of the swelling will be gone after six weeks but you will continue to notice improvements for a year,” Dr. Doft says. Between three and six months, you should have a pretty good idea of what your outcome will be. It’s important to note that it often takes facelift patients several months to get used to seeing themselves with their new look, so [be patient](https://aedit.com/aedition/treatment-for-post-plastic-surgery-depression-blues-during-recovery) with yourself.

Any [scarring](https://aedit.com/aedition/minimizing-scars-after-surgery) will fade over the course of 12 months, at which point you can also decide if there are any other treatments or procedures you would like to consider to enhance the results. Generally speaking, you can expect the results from a facelift to last anywhere from a few years to more than decade, depending on the technique. Less invasive S-lifts (also known as [mini-facelifts](https://aedit.com/procedure/minifacelift)) average two to five years, while a full facelift can last 10 to 15 years.

You’ve asked questions, looked at pictures, and read stories, but what can you really expect from the facelift recovery process? We’ve got you covered.

A Guide To Facelift Recovery And Healing

Expectation vs. Reality: Recovering From A Facelift

shutterstock 635554727

If you are considering cosmetic surgery, chances are you have become accustomed to the price ranges that we list in our [procedure guides](https://aedit.com/procedures). Often, these ranges can be quite large and are caveated with a note that costs depend on location and provider. But regardless of where you decide to have your procedure, the price can be broken down into distinct categories. To help you to understand what you’re really looking at on your cosmetic surgery invoice, we’ve put together a general breakdown.

## **The Cost of Cosmetic Procedures**
As we mentioned, most of the information you will find about cosmetic surgery costs is either based on national averages or a range as opposed to a fixed fee. Because most cosmetic procedures are considered ‘elective’ (i.e. not medically necessary), they are [not usually covered by insurance](https://aedit.com/aedition/insurance-coverage-for-plastic-surgery-cosmetic-procedures) and require patients to pay out of pocket. Once you start consulting with aesthetic providers, they will be able to give you more specifics about the amount you will end up paying. 

With that in mind, below are the three main factors that make up the cost of a cosmetic procedure:

### **1. Surgical Fee**
Your surgery invoice will, first and foremost, include a surgical fee, which is what your provider takes home. This fee is set by the surgeon and covers costs incurred to perform the procedure and run their medical office, including insurance, staff, rent, and other expenses. This fee can vary depending on your surgeon’s [experience and expertise](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology), as well as the size of their practice and its geographical location.

### **2. Anesthesia Fee**
Similarly, the anesthesia fee is what the anesthesiologist gets paid and tends to only be a factor if general anesthesia is involved. It can vary based on their experience, the procedure, and the [type of anesthesia administered](https://aedit.com/aedition/everything-you-need-to-know-about-anesthesia), but it is generally agreed upon before surgery by the anesthesiologist or facility and the surgeon.

### **3. Facility Fee**
The facility fee is a fixed fee that is set by the hospital or clinic where a procedure is taking place. It includes the cost of nursing care, drugs, medical materials, and procedure-specific items (think: implants) that will be used before, during, and after your treatment. 

It should be noted that the [first time you meet](https://aedit.com/aedition/questions-to-ask-your-doctor-during-plastic-surgery-consultation) with an aesthetic provider, you may pay a consultation fee. Providers set their own consultation fee, and, if a patient chooses to move forward with the procedure, the fee will be applied toward the total cost of it. 

If you have questions or concerns about the cost of a procedure, patients should feel free to have an open dialogue with their provider. They may be able to present different treatment options at varying price points. While not always the case, patients who choose to [combine procedures](https://aedit.com/aedition/best-surgical-and-non-surgical-cosmetic-procedures-to-combine) (think: a facelift and blepharoplasty or tummy tuck and liposuction) sometimes save a bit of money, in addition to maximizing recovery time and enhancing results.

## **Additional Costs to Consider**
Aside from the fees outlined above that relate directly to the procedure itself, there are additional expenses to consider before undergoing a cosmetic treatment or procedure. There are often preoperative and postoperative costs not captured in the surgical, anesthesia, and facility fees. These, too, vary by procedure type, but fall into the following categories: 

### **Pre-Operative Care**
Cosmetic surgery patients who will be placed under general anesthesia will likely be required to [seek clearance](https://aedit.com/aedition/why-you-should-lose-weight-before-plastic-surgery) from their primary care physician prior to surgery. This can include a chest x-ray, EKG, and basic blood work. These tests are carried out to spot any pre-existing conditions that would make the procedure more risky. There may be separate fees involved for each of these workups, so it’s worth inquiring about what tests will be required before you schedule your procedure. That way, you can price them out and budget accordingly.

### **Travel Expenses**
If you are considering having a procedure with a provider who is not located nearby, you will want to explore the [cost of traveling](https://aedit.com/aedition/safety-risks-of-medical-tourism-traveling-abroad-for-plastic-surgery) (both transportation and accommodations) to and from the facility. In addition to arriving in plenty of time before procedure day, you may need to stay close for days or weeks after the procedure to monitor healing. Depending on the procedure and downtime involved, you may also need to bring someone with you.

### **Recovery Care**
Follow-up appointments and post-operative care may be needed in the days and weeks following a procedure. It can include pain management, removing sutures, and changing dressings, and it’s worth checking what is or is not included in your initial quote to avoid any unexpected fees. Additionally, you may want to invest in pillows, garments, or other items to make your [recovery more comfortable,](https://aedit.com/aedition/preparing-for-a-smooth-recovery-from-plastic-surgery) all of which come at an additional cost.

While [recovering](https://aedit.com/aedition/category/recovery) under the watchful eye of medical professionals is usually unnecessary (though some procedures may require overnight observation), many providers offer concierge services. For a separate fee, you may be able to stay in a recovery center or receive regular nursing care for the first few days of healing. Even if you choose to forgo additional care, be sure to consider the financial impact of your downtime and recovery. Depending on the procedure, you may need to take time off from work, arrange child care, and/or have a friend or loved one stay with you. 

## **The Takeaway**
When it comes to the cost of cosmetic surgery, the only constant is that there aren't many. While patients can expect to pay surgical, anesthesia, and facility fees, just how much those will be depends on the procedure, provider, and location. Additionally, there are several costs (pre- and post-op care, travel expenses, etc.) that are not captured by those fees but should be considered. Consulting with your provider will ensure you receive the best treatment plan for your needs.

To help you to understand what you’re really looking at on your cosmetic surgery invoice, we’ve got a breakdown.

How Much Cosmetic Surgery Costs

What You’re Actually Paying For When You Get Cosmetic Surgery

shutterstock 1083859292

Let’s be real: Acne is the great equalizer. Like it or not, most of us have — at some point or another — dealt with it. Whether it’s cystic, adolescence-related, or the hormonal acne that can affect us well into our twenties, thirties, and forties, just about everyone has a relationship with acne that ranges from casual to decades-long. 

Fortunately, there is much that can be done to heal and even prevent active breakouts, so long as you know what kind of acne you are treating. Here, a guide to the different types of acne that can crop up on the face and body alongside direct-from-the-dermatologist tips on how to address it from an ingredient, product, and prescription perspective. 

## **1. Comedones**
While ‘comedone’ is the technical term, you most likely know this type of non-inflammatory acne as ‘blackheads’ and ‘whiteheads.’ As such, there are two types of comedones:
 
1. **Closed Comedones** (a.k.a. whiteheads): Non-inflammatory lesions that form when the pore closes on top of a buildup of sebum and dead skin cells, resulting in a small — usually white — bump.
2. **Open Comedones** (a.k.a. blackheads): Non-inflammatory lesions that occur when the pore remains open despite being clogged with excess oil and dead skin cells, causing a dark-colored spot on the surface of the skin.

“They are variations of congested pores filled with compacted dead skin cells, primarily keratin proteins and sebum,” says [Jessica Weiser, MD](https://www.weiserskin.com/), a board certified dermatologist and founder of Weiser Skin in New York City. “Open comedones are true blackheads — clogged pores with dilated openings at the skin surface — whereas closed comedones have the same compacted keratin plug, but a thin layer of skin typically obstructs the follicle opening.”

As Connecticut-based board certified dermatologist [Mona Gohara, MD](https://dermatologyofct.com/about/our-providers/mona-gohara-m-d/), explains, comedonal acne often affects teenagers due to increased oil production. “This is typical around puberty,” she says. But adults can deal with blackheads and whiteheads, too. “They can also form from skincare that is too occlusive, hair products, and friction from clothing that is too tight,” Dr. Gohara adds. 

### **Recommended Treatments for Comedones** 

- Vitamin A derivatives (think: retinol and retinoids)
- Alpha Hydroxy Acids (i.e. glycolic acid)
- Beta Hydroxy Acids (read: salicylic acid)
- Azelaic Acid
- Benzoyl Peroxide

One thing all our experts agree on? Comedonal acne is best treated with topical [vitamin A derivatives](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare), like prescription retinoids and over-the-counter retinols. “I think of [topical retinoids] as pipe cleaners for your skin,” says [Joshua Zeichner, MD](http://www.zeichnerdermatology.com/), a board certified dermatologist and director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. “At the same time, they help reduce inflammation.” 

Dr. Gohara, for one, is a fan of over-the-counter [Differin](https://www.target.com/p/differin-adapalene-gel-0-1-acne-treatment-15g/-/A-51346324) and prescription Retin-A and Tazorac. [Altreno](https://www.altreno.com/) is another prescription-strength option that is specifically formulated for sensitive skin. While many vitamin A derivatives can be irritating, Altreno “contains hydrating ingredients that reduce potential irritation,” Dr. Zeichner says. On the OTC retinol front, Dr. Weiser recommends [Skin Better AlphaRet Overnight Cream](https://skinbetter.com/products/rejuvenate-alpharet-overnight-cream/), [Allies of Skin 1A Retinal + Peptides Overnight Mask](https://www.dermstore.com/product_1A+Retinal+Peptides+Overnight+Mask_73733.htm), and [SkinCeuticals Retinol 1.0](https://www.dermstore.com/product_Retinol+10+Maximum+Strength+Refining+Night+Cream_4505.htm). 

If retinoids and retinol are not for you, most exfoliating ingredients should do the trick. Since this type of acne is primarily due to blockage of the follicle, New York City-based board certified dermatologist [Sejal Shah, MD](https://aedit.com/provider/sejal-shah-md-17984), generally recommends using products featuring ingredients that increase cell turnover like hydroxy acids and azelaic acid. She likes [La Roche Posay Effaclar Medicated Gel Face Cleanser](https://www.target.com/p/la-roche-posay-effaclar-medicated-gel-face-cleanser-for-acne-prone-skin-6-76-fl-oz/-/A-16452472) and [Nip + Fab Salicylic Fix Pads](https://www.nipandfab.com/us/skincare/range/teen-skin-fix-salicylic-acid/teen-skin-salicylic-acid-day-pads). Benzoyl peroxide is another good option, says Dr. Gohara, adding that non-comedogenic products are a must for those prone to comedonal acne. “It should say that on the label,” she shares. 
 
If you’re looking for [cleaner formulas](https://aedit.com/aedition/what-clean-green-natural-mean-for-beauty-makeup-skincare-products) that are just as effective at eradicating non-inflammatory acne, try the [Orveda Cleansing Bamboo & Enzymatic Water](https://orveda.com/us/cleansing-bamboo-enzymatic-water) to remove makeup. The [Susanne Kaufmann Tonic Clarifying](https://skinbiologique.com/products/susanne-kaufmann-tonic-clarifying), meanwhile, is a great pick to refresh the complexion and reduce inflammation. To finish off this clean routine, apply the [African Botanics Neroli Infused Marula Oil](https://credobeauty.com/products/african-botanics-neroli-infused-marula-oil) morning and night to balance oily skin. 
 
## **2. Hormonal Acne**
Not just for teenagers, hormonal acne can stay with women well into their late thirties and forties, Dr. Gohara says. Unlike the superficial nature of non-inflammatory comedones, Dr. Weiser explains that hormonal acne is often “deep, painful cystic papules or nodules” that appear on the jaw, chin, and neck. “Hormonal breakouts are triggered by internal hormones levels including androgens (testosterone) and cortisol (stress hormone) levels,” she notes, which means oral contraceptives can both cause *and* treat it.

### **Recommended Treatments for Hormonal Acne**

- Oral medications like Sprionolactone and Accutane
- Oral Contraceptives
- Blue Light Therapy
- Chemical Peels
- Laser Treatments

There isn’t all that much that can be done at home to treat hormonal acne because the lesions occur deep beneath the surface of the skin and very rarely ever come to the surface, Dr. Weiser says. “Warm compresses can be helpful at reducing swelling,” she explains. “But these lesions are more likely to rupture under the skin surface, further worsening the inflammation and swelling and risking a larger and more serious skin infection.”
 
While OTC products tend to not work for this type of acne, there are prescription oral medications that offer some relief. “Prescription treatments that internally control hormones — such as [spironolactone](https://aedit.com/procedure/spironolactone-for-acne-treatment) and certain types of oral contraceptives — are generally the most effective ways to control this hormonally-driven acne,” Dr. Weisner says. Isotretinoin (a.k.a. [Accutane](https://aedit.com/procedure/spironolactone-for-acne-treatment)) is another option.

When it comes to in-office procedures, [blue light therapy](https://aedit.com/aedition/everything-you-need-to-know-about-the-benefits-of-light-therapy), [chemical peels, and laser treatments](https://aedit.com/aedition/chemical-peel-vs-laser-treatment-what-is-best-for-your-skin) can all be effective in treating hormonal acne.
 
## **3. Body Acne**
Typically caused by friction (often from athletic gear) and not changing out of clothing after working out, Dr. Gohara says that body acne is most common on the chest, shoulders, and back. Appearing in the form of non-inflammatory comedones and inflammatory pustules and papules, body breakouts can impact men and women of all ages. “While body acne is quite common in puberty and teens, it can also afflict adult men and women, especially those who naturally sweat excessively or exercise intensely,” Dr. Weiser says. She adds that it’s important to cleanse skin immediately after sweating to prevent sebum, bacteria, and debris from sitting on the surface of the skin for prolonged periods.

### **Recommended Treatments for Body Acne**

- Topical Salicylic Acid and Benzoyl Peroxide 
- Oral medications

The treatments that body acne responds to depends on the type of lesions, Dr. Shah notes. “If mild or mild-moderate, it may respond to topical treatments,” she says. “But more moderate to severe body acne may require oral medication.”
 
To treat mild to moderate body acne, Dr. Gohara recommends body washes formulated with benzoyl peroxide or salicylic acid body washes, like the [CeraVe SA Body Wash](https://www.amazon.com/CeraVe-Salicylic-Ounce-Fragrance-Exfoliate/dp/B077TWXCQV). In addition to BHA-spiked washes, Dr. Weiser says to look for a combination of products that contain antimicrobial ingredients and retinol to control oil glands. She likes [Murad Acne Control Body Wash](https://www.murad.com/product/acne-body-wash/) and [ZO Skin Health Oil Control Acne Pads](https://zoskinhealth.com/products/getting-skin-ready/acne-treatment-pads).
 
## **4. Nodules or Cystic Acne**
Cysts refer to swollen, red pimples that manifest as both small pustules (a pus-filled whitehead) at the skin surface and deeper lesions beneath the skin. Inflammatory acne occurs as a result of bacteria (usually Propionibacterium acnes, known as P. acnes) in the lesions that triggers the body to form an immune reaction. “These lesions often still begin as clogged pores due to excess oil production that become secondarily infected with bacteria,” Dr. Weiser says. Those who deal with cystic acne and nodules are typically predisposed to it. Dr. Gohara says that this type of acne is hormonal and “often this is a genetic factor.”

### **Recommended Treatments for Cystic Acne**

- Topical products with Benzoyl Peroxide, Retinoids, Sulfur, and Hydroxy Acids
- Oral medications like Sprionolactone and Accutane 
- Steroid Injections

Due to the severity of this acne, cysts and nodules generally require combination therapy, as medications and topical treatments alone are usually not effective. “It may be helpful to use topical benzoyl peroxide products, such as [PanOxyl Acne Foaming Wash](https://www.target.com/p/panoxyl-acne-foaming-wash-with-10-benzoyl-peroxide-5-5oz/-/A-14984165), retinoids, or hydroxy acids,” Dr. Shah says. “But often this type of acne responds better to oral medications — spironolactone in women and isotretinoin.”

Dr. Weiser notes that treatment of inflammatory acne involves antimicrobial therapy to address the bacterial component and treatment of the underlying oil production and congestion. “Look for products that contain antibacterial sulfur and probiotics, in addition to prescription-strength antibacterial topical medications,” she says. Her picks include [111Skin 3 Phase Anti Blemish Booster](https://www.spacenk.com/us/en_US/skincare/treatment/blemish-acne-treatment/3-phase-anti-blemish-booster-MUK300051736.html) and [Eminence Clear Skin Probiotic Mask](https://eminenceorganics.com/us/product/clear-skin-probiotic-masque). 
 
For acutely inflamed lesions, Dr. Shah says that steroid injections can also be helpful.

## **The Takeaway**
Whether you are dealing with acne on the face or body, there is much that can be done to speed up the healing process and — with regular maintenance — prevent it from recurring. Topical retinoids, hydroxy acids, and benzoyl peroxide can be used to effectively treat non-inflammatory comedonal acne (think: blackheads and whiteheads). When it comes to treating inflammatory hormonal, body, and cystic acne, a combination of topical skincare (OTC and prescription), oral medication, and professional procedures may be needed. Consulting with a board certified dermatologist will ensure you receive the best treatment regimen for your acne.


AEDITION minimalists-min

Wellness Collection | The AEDITION

Wellness

A guide to the different types of acne that can crop up on the face and body — and direct-from-the-dermatologist tips on how to treat and prevent it.

How To Treat Hormonal Acne, Body Acne, Cystic Acne, Whiteheads, Blackheads

How To Treat The Most Common Types Of Face And Body Acne

shutterstock 1087180529

At this point, you probably know you need to be wearing sunscreen, right? You may buy a bottle of it at the beginning of the summer (i.e. now) and plan to diligently apply it every time you’re at the beach or the pool. You may even be one of those people who wears sunscreen every day (kudos to you!) no matter if you’re heading to the shore or just going for a walk in your neighborhood. 

But for many people, knowing you should wear sunscreen and actually wearing it are two different things. In fact, a [recent study by the American Academy of Dermatology (AAD) found](https://www.aad.org/news/2020-04-28-sun-protection-important-survey) that while 76 percent of Americans understood the importance of sunscreen, only 40 percent actually wear it on a regular basis. Furthermore, nearly 40 percent of respondents in a recent survey by Neutrogena admitted that they’ve been more focused on health-related acts like handwashing during the COVID-19 pandemic than sunscreen application. As a result, 20 percent said they are applying sunscreen less often than usual.

Putting on sunscreen at all is the first step, but how and where you apply it are the next. In a [2017 study published in the Journal of the American Academy of Dermatology](https://www.jaad.org/article/S0190-96221601506-1/abstract), only one third of people applied sunscreen on *all* exposed skin. Despite the AAD’s insistence that sunscreen only works when applied properly, there is ongoing confusion among most people about how to do it. 

If you’ve ever had a gnarly sunburn on the back of your knees or a strip of blistering red on your scalp, you know that a cursory rub of sunblock is not going to cut it. There are plenty of places even the most diligent sunscreen users often forget, and leaving those spots exposed increases the risk of [sun damage](https://aedit.com/aedition/cosmetic-procedures-treatments-to-correct-sun-damage) even if you think you’re covered. We spoke to top dermatologists to find out what these places are, how to avoid missing them, and the best way to apply sunscreen from head to toe.

## **The Most Common Places People Forget To Apply Sunscreen**
Sun damage can happen any place there is exposed skin that’s not protected by sunscreen or some other form of sun protection. In fact, “the most common places for non-melanoma skin cancers are the face, chest, and arms — places where the sun exposure is the highest,” says [Adriana Lombardi, MD](https://aedit.com/provider/adriana-lombardi-md-12670), a board certified dermatologist and founder of Advanced Laser and Skin Cancer Center in New Jersey. When applying sunscreen, most people look to those places first for the same reason (i.e. they’re exposed). But there are plenty of other places people tend to forget, including:

### **1. Ears**
Even when applying sunscreen to the face, it’s common to forget to apply it on your ears, too. When hair is cut short or pulled back or if you’re wearing a baseball cap, the ears are especially exposed and at high-risk for sunburn if they're not protected.

### **2. Lips**
The lips are a common place to find skin cancer because even if “you put sunscreen on your face, you rarely put it on your lips,” says [Morgan Rabach, MD](https://aedit.com/provider/morgan-rabach-md-17913), a board certified dermatologist and co-founder of LM Medical in New York City. “It’s an easy place to miss.” Using a lip balm with SPF (the [Colorescience Sunforgettable Total Protection Color Balm SPF 50](https://www.colorescience.com/products/sunforgettable-total-protection-color-balm-spf-50) has a subtle tint, while the [Burt's Bees All-Weather SPF 15 Moisturizing Lip Balm](https://www.burtsbees.com/product/all-weather-spf-15-moisturizing-lip-balm/VM-792850900103.html) is a good sheer option) regularly can help protect the sensitive lip area from burning. Added bonus? It will help reduce the chance of visible signs of aging (think: fine lines), too.

### **3. Scalp**
Both Dr. Lombardi and Dr. Rabach say they regularly see sunburns on the scalp — especially along the part or in patients with thinning hair. To apply sunscreen to your scalp without messing up your ‘do, Dr. Rabach suggests using a mineral sunscreen with a brush applicator (we’re fans of the [Supergoop Poof Part Powder](https://supergoop.com/products/poof-part-powder)) to cover any exposed skin. “If you have thinning hair or a large part, use regular sunscreen,” she adds. Another option is to wear a hat with UPF protection (more on that below!).

### **4. Tops of Hands and Feet**
During sandal season, feet are exposed to sun much more regularly, but people still forget to apply sunscreen to them, Dr. Rabach says. The same goes for hands, which are regularly exposed to sun without protection. Hand creams with SPF — like the [Deborah Lippmann Rich Girl Broad Spectrum SPF 25 Hand Cream](https://www.sephora.com/product/rich-girl-broad-spectrum-spf-25-h-cream-P381213) — tend to be great, non-greasy options.

### **5. Back**
In men, the most common place to find melanoma is on the back, Dr. Lombardi shares. Not only is your back hard to reach on your own, but it’s “more difficult to see to monitor for changing moles,” she says. That means not only is asking someone else to apply sunscreen on your back important, but getting regular [skin checks both at home](https://aedit.com/aedition/how-to-conduct-at-home-self-examination-skin-cancer-screenings) and [with your dermatologist](https://aedit.com/aedition/dermatologist-skin-cancer-screenings-mole-checks) is as well.

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### **6. Back of the Legs**
Dr. Lombardi notes that the back of the legs is the most common place to see melanoma in women. Exposed legs — especially in sunny months like summer — means that applying sunscreen on both the front and back of legs daily is essential.

### **7. Around Waistbands and Under Straps**
“Sometimes you’ll have sunscreen on your chest or back, but there will be a line around the band where you haven’t applied it,” Dr. Rabach warns. The same goes for straps of any kind, which tend to move around as you move throughout the day. She recommends tucking your fingers at least an inch below waistbands and straps when applying sunscreen for maximum protection.
 
## **How to Apply Sunscreen Properly**
As you can probably tell by now, correctly applying sunscreen can go a long way towards properly covering these tricky areas to prevent potential sun damage or skin cancer. [According to AAD guidelines](https://www.aad.org/public/everyday-care/sun-protection/sunscreen/how-to-apply-sunscreen), you should always use a sunscreen with a minimum of SPF 30 and reapply it every two hours (rain or shine!). But there is more you can do to make sure you’re protected.
 
### **Put It On Inside**
“When going to the beach or engaging in activities that have higher than usual exposure to the sun, I recommend applying sunscreen all over before leaving the house,” Dr. Lombardi says. Putting it on inside ensures that you get more complete coverage and that you can also tell more easily if you’ve missed a spot.
 
“Putting on sunscreen in front of a mirror is really helpful,” Dr. Rabach adds, as it allows you to make sure you’re covering hard-to-reach places. Make sure you’re applying sunscreen underneath all elastic bands or straps — or, better yet, apply it to your body *before* putting on your swimsuit. “Have a system,” she says. “Go top to bottom or bottom to top and have someone help you with your back.”
 
### **What Kind of Sunscreen You Use Matters**
While all dermatologists agree that sunscreen is essential, they differ on what kind is best. “I always recommend mineral-based sunscreens, as they physically block the skin from the sun,” Dr. Lombardi says. Dr. Rabach, however, says that usually people prefer chemical sunscreens for their bodies because they’re often easier to apply to large areas. Be sure to keep in mind, however, that “chemical sunscreens are going to take 20 to 30 minutes before they even start working,” she says, which is all the more reason to apply them before you go out. “If you’re applying [chemical] sunscreen outside at the beach or the pool, you basically have 30 minutes of exposure before it starts working,” Dr. Rabach says.
 
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### **Spray vs. Lotion**
“Spray sunscreens are easier to apply on the body and on children,” says [Samer Jaber, MD](https://aedit.com/provider/samer-jaber-md-3882), a board certified dermatologist and founder of Washington Square Dermatology in New York City. “But people often underapply them or miss spots.” He says that if you’re going to use a spray sunscreen, make sure to go over the same spot multiple times to make sure you applied enough. And, even if you’re using a spray sunscreen, you should still rub it into your skin to ensure adequate coverage.
 
However, spray sunscreens may pose more risk than just inadequate coverage. “There is a lot of data that shows [spray sunscreens] are really bad when you breathe them in,” Dr. Rabach says. “As soon as you smell the sunscreen, you’re breathing it in.” If you’re using a spray sunscreen, don’t do it in an enclosed area and never put it on your face. “Instead spray it on your hands first and then rub it on your face,” Dr. Jaber suggests. 

### **Try Sun-Protective Clothing**
If you’re especially worried about missing spots, consider wearing specially designed sun protective clothing when outside. “It’s much easier to wear clothing than to remember to reapply sunscreen every two ours when you’re out and about,” Dr. Jaber says. Not only does it remove the need to reapply, but it also could offer better protection than sunscreen in general. “There is a common misconception that, by applying sunscreen, you’re blocking 100 percent of UV rays, but even with the highest SPF that’s not true,” he says. Using physical protection like hats, sunglasses, clothing, and even umbrellas with an ultraviolet protection factor (UPF) is more effective.
 
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### **Boost With Supplements**
“Although not a substitute for sunscreen, some supplements protect skin from the inside out,” Dr. Lombardi says. “In patients that are more at risk of skin cancer or that may have extensive sun damage, I recommend using [Heliocare](https://www.heliocare.com/?utm_source=google&utm_medium=cpc&utm_campaign=intent&gclid=CjwKCAjwh472BRAGEiwAvHVfGvRCU6C3WoZRLqAxpHtArwDOUwbFadhMt5AQY_tJYbq0usBmmL9UmhoCttEQAvD_BwE) in addition to sunblock to give them extra photo protection.” She also recommends [Sunisdin Softgel Capsules](https://www.isdin.com/us/softgel-capsules-SunIsdin_capsules.html?cgid=all-products) — antioxidant supplements that can make the skin more resilient against the sun. But remember: These supplements do not replace sunscreen, so you still need to apply and reapply sunblock.
 
## **The Takeaway**
Wearing sunscreen regularly is the first step in fighting against sun damage and skin cancer, but you also need to apply it properly. Every time you apply sunscreen, remember these commonly missed areas and make sure to cover them effectively. Whether you change the type of sunscreen you’re using or opt for sun protective clothing, making sure you’re completely covered can make all the difference. 

From the most common spots people miss to how to stay adequately protected from head to toe, The AEDITION spoke to board certified dermatologists about the best way to apply sunscreen.

How To Apply Sunscreen And Not Miss A Spot

A Definitive Guide To Applying Sunscreen

roberto-delgado-webb-washV-MnHRA-unsplash

Skin cancer is the most commonly diagnosed form of cancer in the United States — but even the sobering statistics don’t tell the full story. [According to the American Cancer Society](https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf), the actual number of the two most common types of skin cancer (i.e. non-melanoma basal cell and squamous cell) are difficult to estimate because cases are not required to be reported to cancer registries. 

Invasive melanoma, meanwhile, accounts for just about one percent of skin cancer cases, but it is responsible for the majority of skin cancer deaths. Melanoma most often affects non-Hispanic whites, but skin cancer does not discriminate. The [Skin Cancer Foundation reports](https://www.skincancer.org/skin-cancer-information/skin-cancer-facts/) that one in five Americans will develop skin cancer by the age of 70.

Even so, there is so much that can be done to combat the disease. Early detection is key, and the [American Cancer Society says](https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2020/cancer-facts-and-figures-2020.pdf) that many of the more than five million skin cancer cases diagnosed each year could be prevented with safe sun habits and regular screenings. That’s why we’re here to help. You may have already seen our [guide to professional skin cancer screenings with a dermatologist](https://aedit.com/aedition/dermatologist-skin-cancer-screenings-mole-checks), and at-home skin checks are an equally important part of the skin cancer prevention process.

So, how often should you be checking for changes to your skin and what is the most efficient way to do so? The AEDITION asks the experts.

## **How Often You Should Conduct At-Home Skin Cancer Screenings**
A [study published in the May 2018 issue of JAMA Dermatology](https://jamanetwork.com/journals/jamadermatology/fullarticle/2678687) found that patients who routinely perform self skin examinations — coupled with regular whole-body physician skin checks — are more likely to be diagnosed with thinner (read: less dangerous) melanoma. Additionally, those patients have a better prognosis and survival rate. 

It should come as no surprise then that the [Skin Cancer Foundation recommends](https://www.skincancer.org/early-detection/self-exams/) monthly at-home skin checks. “I recommend patients examine themselves at home once a month, so that they can get to know their body,” says [Samer Jaber, MD](https://aedit.com/provider/samer-jaber-md-3882), a board certified dermatologist and founder of [Washington Square Dermatology](http://www.washingtonsqderm.com/) in New York City. “It helps them catch something quickly if it changes.” 

## **What to Look For During At-Home Skin Cancer Screenings**
In order to know what to look for during a self-exam, you need to understand the characteristics of skin cancer. “There are three most common forms of skin cancer,” says [Julie Russak, MD](https://aedit.com/provider/julie-russak-md-4645), a board certified dermatologist and founder of [Russak Dermatology Clinic](http://www.russakdermatology.com/) in New York City. “Ane it’s important to know the early signs for all of them.” Here’s what to be on the lookout for:

- **Basal Cell Carcinoma (BCC)**: The most common form of skin cancer, BCC can present as a non-healing pimple that is often pearly in appearance. “If you notice a sore that is not healing for longer than usual — up to three weeks — pay attention to it,” Dr. Russak says.
- **Squamous Cell Carcinoma (SCC)**: The second most common form of skin cancer, SCC often presents as a red, dry patch. Dr. Russak refers to it as an “eczema-like” effect on “sun damaged skin” and adds that it can also have a scab and bleed on its own.
- **Melanoma**: As mentioned above, melanoma is the deadliest form of skin cancer due to its ability to spread, and it typically presents as an irregular mole or birthmark.

In the case of melanoma, the [ABCDE rule of skin cancer](https://www.skincancer.org/skin-cancer-information/melanoma/melanoma-warning-signs-and-images/) should be considered during skin checks (both professional and at-home). “A mole that is growing asymmetrically, has border irregularities, or is changing in size or color, can indicate the development of skin cancer,” Dr. Russak says. The ABCDEs include: 

- **A – Asymmetry**: Growth is asymmetrical
- **B – Border**: Rough or jagged edges
- **C – Color**: Various shades of brown, tan, black, red, white, or blue
- **D – Diameter**: Larger than six millimeters (think: a pencil eraser)
- **E – Evolving**: Changing, growing, bleeding, etc.

At the end of the day, self-exams are all about monitoring the body for changes — whether it’s the evolution of an existing spot or the advent of a new one. “Patients should look for anything that has changed, grown larger, become darker, or doesn’t heal,” says [Cheryl Karcher, MD](https://aedit.com/provider/cheryl-karcher-md-4323), a board certified dermatologist and co-founder of [Center Aesthetic & Dermatology](https://www.centeraesthetic.com/) in New York City. 

Dr. Jaber agrees, encouraging patients to keep an eye out for the so-called [ugly duckling](https://www.skincancer.org/skin-cancer-information/melanoma/melanoma-warning-signs-and-images/). “The most important thing to look out for is if a spot on the body is changing, itching, burning, bleeding, or looks different from the others,” he says. “This is called the ‘ugly duckling’ sign.”
 
## **How to Conduct At-Home Skin Cancer Screenings**
Now that you know what to look for, it’s time to learn how to conduct a self-examination. While you’ll ultimately need to find a process that works best for you, our experts have a few tips ensuring your check is both simple and effective.

“I like to do it systematically — starting at the head and ending with the toes,” Dr. Karcher shares. Needless to say, a mirror (or two!) will be required, and it might also be useful to have a hair dryer on hand. Dr. Russak suggests setting up in a well-lit room with a hair dryer, full-length mirror, and hand-held mirror. From there, she examines the skin in six distinct sections:

1. **Face & Neck**: “Start with examining the front of your face and sides of the face and neck in the mirror,” she says. 
2. **Scalp**: Next, she recommends using a hair dryer (on the ‘cool’ setting) to blow strands out of the way and reveal the scalp.
3. **Arms & Hands**: From there, “examine your arms and hands — looking in between each finger and paying attention to the nails,” she explains. It is best to do this with bare (read: not polished) fingernails. 
4. **Front Body**: “Examine the front of the body, lifting each breast to see underneath them, too,” Dr. Russak explains.  
5. **Back Body**: Using the hand-held mirror, inspect the back of your neck, shoulders,  and upper back. Reposition the mirror to see your lower back and buttocks.
6. **Legs & Feet**: Last but not least, “make sure to inspect the back of the legs and look at the soles of the feet, in between the toes, and at the toenails,” she notes. 

Since self-examining certain parts of the body can be challenging, Dr. Jaber recommends calling in reinforcements as needed. “Looking at your back, neck, and scalp can be difficult, but it can be done by having a loved one take a look,” he says. When it comes to the scalp, don’t be shy about asking your hairstylist for help. “Anybody who goes to the hairdresser on a regular basis should always ask them if they see anything new,” Dr. Karcher says.

### **Don’t Forget To Check These Body Parts**
While following Dr. Russak’s head-to-toe technique covers a lot of ground, there are certain body parts that are often overlooked. The fingers and toes (including under the nails) can be hiding places for skin cancer, as are the bottoms of the feet. The scalp is also easy to forget, and people are encouraged to examine the genital area as well. “Make sure to be thorough when you do a self skin exam,” Dr. Jaber emphasizes.

## **What to Do If You Find a Suspicious Spot**
If you find a spot that you feel is suspicious, the directive is simple: call your dermatologist ASAP. “I always tell my patients that I would rather see them and tell them that it's nothing, instead of them waiting and letting it turn into something,” Dr. Russak shares. While at-home checks are an essential part of early detection, nothing beats an exam with a well-trained eye. “If you see a spot that looks different, has changed, stands out, isn’t healing, or is itching, burning, or bleeding, see a dermatologist,” Dr. Jaber says. “They can evaluate it in person.”

## **The Takeaway**
Performed at-home and in dermatologist offices, skin cancer screenings — quite literally — save lives, but skin cancer prevention involves a lot more than examining the skin. Practicing safe sun habits (like the ones below) is the first-line of defense:

- Use an [SPF of at least 30](https://aedit.com/aedition/what-you-need-to-know-about-sunscreen) with UVA/UVB protection daily (yes, even if it’s cloudy!)
- Reapply SPF every two hours and immediately after swimming
- Stay in the shade between 10am and 4pm
- Wear a wide-brim hat to shade your face and polarized sunglasses to protect your eyes
- Avoid indoor tanning

No matter your age or [skin tone](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types), it is important to remember that it is never too late to protect yourself from the sun and take a more proactive approach to your health and safety.

Self-exams are an important part of the skin cancer prevention process. So, how often should you be checking for changes to your skin and what is the most efficient way to do so? The AEDITION asked the experts.

How To Conduct At-Home Self Examination Skin Cancer Screenings

How To Conduct An At-Home Skin Cancer Screening

shutterstock 1568859367

Do you know your Fitzpatrick skin type? While you may not be familiar with the term, chances are you’re pretty in tune with the concept of the Fitzpatrick Skin Phototype. The scale classifies a person’s skin tone based on how likely they are to burn. With [Skin Cancer Awareness Month](https://www.skincancer.org/get-involved/skin-cancer-awareness-month/) upon us and summertime just around the corner, it’s time to learn how you measure up and how dermatologists use a patient’s score to help determine everything from skincare regimens to sun-prevention methods. 
 
## **What Is the Fitzpatrick Skin Phototype?**
In 1975, Thomas B. Fitzpatrick, MD, a dermatologist and chairman of the department of dermatology at Harvard Medical School, was experimenting with a treatment for psoriasis that involved exposing test subjects to UVA rays. Dr. Fitzpatrick (a.k.a. the “father of modern academic dermatology”) initially used hair and eye color to determine the recommended amount of UVA exposure to give participants (all of whom were white). But when dark-haired, brown-eyed patients ended up sunburned, Dr. Fitzpatrick realized that he needed to base his treatment on more than just hair or eye color. Instead, he needed to consider how the subjects’ skin responded to the sun.

He began asking patients to describe what happened to their skin after sun exposure when they didn’t have any sun protection. Based on their answers, he created four categories to classify patients’ tendencies to burn (erythema) versus tan (induce pigmentation) — providing an estimation of the amount of melanin present in skin cells. It didn’t take long for the phototype to be widely adopted for clinical use as a useful predictor of skin cancer. A decade later, two more categories were added to encompass a larger spectrum of skin tones.
 
## **How to Determine Your Fitzpatrick Skin Type**
Consulting a [board certified dermatologist](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) is the most effective and accurate way to determine your Fitzpatrick skin type, especially for those with darker skin tones. While a sunburn may show up as redness on pale skin, it may manifest as tenderness on darker skin. Similarly, those with paler skin tend to associate ‘tanning’ with skin darkening, but those with darker skin don’t necessarily think of it the same way.

Whether it is you or a dermatologist attempting to determine your classification, below are the characteristics associated with each Fitzpatrick skin type (and a few celebs that fit the bill):
 
### **Type I**: 
- Light (pale white) skin 
- Light blue or green eyes 
- Red or blonde hair
- Always burns, never tans 
- e.g. Emma Stone and Prince Harry

### **Type II**: 
- White (fair) skin 
- Blue or green eyes 
- Blonde hair
- Burns easily, tans poorly 
- e.g. Gwyneth Paltrow and Justin Timberlake

### **Type III**: 
- Medium (white to olive) skin 
- Hazel or light brown eyes
- Dark blonde or light brown hair
- Burns mildly, tan gradually 
- e.g. Kendall Jenner and Nick Jonas

### **Type IV**: 
- Olive (moderate brown) skin
- Dark brown eyes
- Dark brown hair
- Burns minimally, tans easily 
- e.g. Sofia Vergara and Mario Lopez

### **Type V**: 
- Brown (dark brown) skin
- Dark brown to black eyes
- Dark brown to black hair
- Tans easily, rarely burns 
- e.g. Beyonce and John Legend

### **Type VI**: 
- Black (very dark brown to black) skin
- Brown/black eyes
- Black hair
- Never burns, tans easily 
- e.g. Lupita Nyong’o and Daniel Kaluuya

## **How Dermatologists Use the Fitzpatrick Scale**
“It is very much an inherent part of the dermatologic physical exam,” says [Nikhil Dhingra, MD](https://aedit.com/provider/nikhil-dhingra-md-17376), a board certified dermatologist at Spring Street Dermatology in New York City, of the Fitzpatrick scale. As such, dermatologists use the diagnostic tool in several ways:  

1. **To Assess Skin Cancer Risk**: “Type I skin, for example, is the fairest and at the highest risk for most skin cancers, while a type IV or VI might come in with a rare subtype of melanoma in locations like under the foot,” Dr. Dhingra explains.
2. **To Determine In-Office Procedures**: “Many laser treatments are totally inappropriate and unsafe once you enter the territory of skin types III to VI,” he says. “This dichotomy highlights the imbalance in the technologies available on the market when it comes to treating a diverse patient base.”
3. **To Evaluate Medical Conditions**: “Understanding skin types and what a rash or medical condition can look like when shaded with pigment is another critical use of the Fitzpatrick system for most dermatologists,” Dr. Dhingra shares. As he explains it, a rash that looks one way on a type VI patient could look very different than it would on a type I. 

More than just a collection of color swatches, the Fitzpatrick scale helps to inform proper patient  care. “It’s important to recognize these differences, so your patients get the correct diagnosis and treatment,” Dr. Dhingra says.
 
## **The Relationship Between Fitzpatrick Types and Skincare**
It’s important to see the Fitzpatrick scale as a spectrum that can inform how the skin generally behaves. “The fairest of skin types is going to be high-risk for skin cancers and  prone to sunburns, freckling, and conditions like rosacea,” Dr. Dhingra says. “Type VI skin patients, on the other hand, are going to be more prone to issues of pigmentation, while patients in the middle groups will have varying features of each extreme.” With that in mind, here’s how the phototype can inform your professional and at-home skincare routines: 

### **At-Home Skincare**
[Morgan Rabach, MD](https://aedit.com/provider/morgan-rabach-md-17913), a board certified dermatologist and co-founder of LM Medical in Manhattan, says she considers a patient's skin concern (think: aging or oiliness) and Fitzpatrick score when making product recommendations. “Types I to III often have red tones to their skin and may benefit more from ingredients like sulfur or niacinamide to reduce redness,” she says. “Type III to VI have more chances of hyperpigmentation, so certain [alpha and beta hydroxy acids](https://aedit.com/aedition/guide-to-topical-alpha-hydroxy-acids-in-skincare) and bleaching agents like hydroquinone may be helpful.” 

There are, however, a few active ingredients that almost all her patients can benefit from. She is a fan of antioxidants and sunscreen in the morning and [retinol](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare) and more nourishing moisturizers at night. Dr. Dhingra agrees that antioxidants like [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare) have a universal appeal. “My recommendations include the [Isdin Isdinceuticals Flavo-C Serum](https://www.isdin.com/us/anti-oxidant-serum-isdinceutics_flavo_c.html?cgid=ampules-and-serums) and [La Roche Posay Redermic C Vitamin C Lotion](https://www.laroche-posay.us/face-and-body-skin-care/face-products/face-moisturizer/redermic-c-vitamin-c-lotion-3337872413704.html),” he says.
 
### **In-office Treatments**
Your Fitzpatrick score is critical when considering any professional cosmetic treatment or procedure. “It’s important for patients to seek out a board certified dermatologist for proper treatment, especially if you belong to a Fitzpatrick III to VI category,” Dr. Dhingra says. “You have a higher risk of burning and pigmentary issues, if an inappropriate treatment is done in the wrong hands.”

While it is important to consult with a board certified dermatologist before undergoing any cosmetic procedure, there are few rules that tend to hold true. “Fitzpatrick skin types I to III are the ideal skin types for [laser hair removal](https://aedit.com/procedure/laser-hair-removal),” Dr. Rabach shares. “The higher melanin content in skin types above a III creates a risk of the laser changing the skin color and causing blistering.” Similarly, she recommends skin types IV and above stay away from [microdermabrasion](https://aedit.com/procedure/crystal-microdermabrasion) and [chemical peels](https://aedit.com/procedure/tca-peel). “They are more likely to cause hyperpigmentation,” she says.
 
### **Sun Protection**
People with less melanin (types I, II, and III) are more susceptible to the aging effects of UV rays —  though sun damage affects the entire scale to some extent. Dr. Dhingra recommends all patients use a daily moisturizer with an SPF of 30 to 45 (yes, that’s even meant to be used on days you are working from home or cooped up inside!). He likes the [EltaMD UV Clear Tinted Broad Spectrum SPF 46](https://eltamd.com/product/eltamd-uv-clear-tinted-broad-spectrum-spf-46/) for types III to VI skin, and the non-tinted [EltaMD UV Daily Broad-Spectrum SPF 40](https://eltamd.com/product/uv-daily-broad-spectrum-spf-40/) for types I and II. 

Generally speaking, those on the fairer end of the spectrum need to be extra cautious when venturing out into the sun: “Think UV clothing, hats, and umbrellas,” he suggests, adding that those on the darker end of the spectrum — namely, types IV to VI skin — should be mindful of sunlight exacerbating preexisting pigmentary concerns (i.e. melasma and hyperpigmentation from acne).
 
### **Skin Cancer Risk**
Research has shown that the lower your Fitzpatrick score, the higher your risk of skin cancer. But that doesn’t mean types IV through VI are in the clear. “All skin types can get skin cancer,” Dr. Rabach warns. “Therefore, all skin types should see a board certified dermatologist for skin checks.”
 
## **The Takeaway**
While analyzing your Fitzpatrick skin score online can be useful and fun (think: Am I a Sofia or a Beyoncé?), nothing beats the advice of a board certified dermatologist — particularly if you fall into categories III and above, as more than half the United States population does. 

“Having trained in New York City — and as a type IV skin type myself — I’m particularly comfortable having preselected a list of products and treatments for our skin of color community,” Dr. Dhingra says. “This can mean recommending a certain acne cream that I also find helpful for also combatting the resultant hyperpigmentation. Lighter skin types, conversely, are often betrayed by their fairer skin when it comes to things like rosiness of the cheeks, so I may err for a milder routine as not to flare up the redness.”

Needless to say, there is a lot of nuance to the skin that goes far beyond the Fitzpatrick scale. Before you start surfing celebrity social media accounts in search of your next skincare routine, make an appointment for your yearly skin cancer screening and, while you’re there, ask your dermatologist to determine your Fitzpatrick score.

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It’s time to learn where you fall on the scale and understand how dermatologists use a patient’s score to help determine everything from skincare regimens to sun-prevention methods.

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