Seven things
What actually helps, in order of how much
Sun protection, which is the only genuinely preventive thing on this list
Broad spectrum, at least SPF 30, on the face, ears, neck and backs of the hands every morning, all year, whatever your skin tone — the risk is lower on darker skin but it is not zero, and the cancers that do occur are found later precisely because everybody assumes it is. Reapply outdoors. We will not tell you which one to buy: the best sunscreen is the one you will actually put on every day, and price has almost nothing to do with how well it works.
Moisturiser is a treatment, not a luxury, and the amount is the point
For anybody with eczema or dry skin, an ordinary bland emollient used generously and often does more than any expensive product used sparingly. The usual failure is quantity: an adult with widespread eczema needs roughly 500 grams a week, and almost nobody uses a tenth of that. Thicker is better on drier skin, and the best time is within three minutes of getting out of a shower.
Four products, not eleven
Most people arrive using a shelf and getting nothing from it, because the actives cancel one another out and the irritation caused by one gets blamed on another. A gentle cleanser, a moisturiser, a sunscreen and — if there is an actual reason for it — one active ingredient will do more than a routine three times the size. We will happily tell you to stop buying things.
Introduce one thing at a time, slowly
A new active goes on twice a week for a fortnight before it goes on nightly. Nearly every case of somebody deciding a product does not agree with them is a case of starting it daily from the first day. And if you are patch tested, bring everything you use in the actual bottles rather than from memory.
Finish the course, and use enough of it
The commonest reason a treatment here appears to have failed is that it was used for three days out of a prescribed fourteen, or spread far too thinly out of a reasonable fear of it. If a plan says twice a day for two weeks, it means that, and if the reason it stopped early was worry, telephone us rather than guessing — that is a two-minute conversation and it saves an appointment.
Do not scrub, strip or steam an inflamed face
Acne is not dirt and rosacea is not a hygiene failure. Hot water, physical scrubs, astringents and long steam make both worse, and a great deal of what people believe is a stubborn condition is a treatable condition plus six weeks of aggressive washing. Lukewarm water, twice a day, and leave it alone in between.
Look at your own skin once a month, in a mirror, with the lights on
Front, back, both sides with arms raised, forearms, palms, between the toes and the soles, and the scalp with a hairdryer and a hand mirror. You are looking for anything new, anything changing and anything that behaves differently from all your other marks. Photograph anything you are keeping an eye on, with something for scale — for your own comparison over time, which is the one genuinely useful thing a photograph does in this field.
We claim nobody else's approval, and we name nobody's product. Dermatology is regulated in New York State, every physician here is licensed, and the practice is inspected like any other medical office. What we will not do is decorate this website with the seal of a board, a college or an academy as though somebody outside this building has personally vouched for the care you are about to receive. Nobody outside this practice has reviewed it. So instead of a wall of logos, these pages tell you plainly who will examine you, what they will do, what they will not do, what it costs, what can go wrong and how often. Ask us about any of it before you book.
Bring the bottles, not the names
The single most useful thing you can put in a bag before an appointment is everything you have been putting on your skin.
Not a list — the actual containers. The strength printed on a tube is frequently the answer to why something has not worked, and nobody remembers it accurately. Half the long-running dermatitis in this practice is explained by a product somebody brought in, and a meaningful share of stubborn acne and rosacea is explained by the four things on the shelf that are cancelling each other out.
This matters more if you use anything bought abroad or online, particularly anything sold for lightening skin. Products outside regulated channels have repeatedly been found to contain mercury or potent steroids, and the steroid-containing ones cause a rebound darkening worse than the problem they were bought for. Bring the container rather than the name.
Questions
Skincare — the questions we are asked most
Which products do you recommend?
We will tell you what kind of thing to buy — a bland emollient ointment, a gentle non-foaming cleanser, a broad-spectrum sunscreen you will actually wear — and we will not name a brand. Price correlates poorly with effectiveness in this category, and a practice that names products is either guessing on your behalf or has a reason to.
Is expensive skincare better?
Very rarely, and for the things that matter here almost never. The most useful products in dermatology are an unglamorous moisturiser used in large quantities and a sunscreen you are willing to put on every morning. Most of what makes an expensive product expensive is not in the part that works.
How long before a new product should work?
Twelve weeks for anything treating acne or pigmentation, because that is how long skin takes to turn over and how long inflammation takes to settle. A fortnight tells you whether you tolerate it, not whether it works.
My skin stings when I put anything on it. What does that mean?
Usually that the barrier is damaged — most often by over-washing, over-exfoliating or too many actives at once. Occasionally it means a genuine contact allergy, and if it is confined to where a specific product goes, that is worth patch testing. Stop everything except a bland moisturiser for a fortnight and see.
This page is not medical advice, and it is not a diagnosis. Nothing on this website is medical advice for you in particular, and it is not a diagnosis. These pages describe conditions in general terms so that you arrive knowing what the questions are — they cannot tell you which condition you have, because that requires somebody to look at your skin, feel it, ask you a hundred questions and frequently take a sample of it. Two conditions on this website can look identical in a photograph and need opposite treatments. If something on your skin is new, changing, painful or not healing, the useful next step is an appointment rather than more reading.
A named diagnosis and a written plan you leave holding
Book an appointment
Pick a physician and a time from the calendar — it shows only the hours each of them genuinely has free. A new patient appointment is thirty minutes, a full skin examination forty-five, and you leave with a named diagnosis written down. If something on your skin has changed, telephone instead and say that word: it is triaged differently.