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Why does dry skin happen?
The best way to visualize dry skin, formally known as xerosis cutis, is to think about your skin as not smooth like a wall but more like a cobblestone street. When our skin becomes dry the mortar that holds our skin cells together starts to break down. This leaves the skin with a cracked porcelain-like appearance. This process also makes the skin more vulnerable to environmental stresses because the barrier the skin forms is simply not intact.
The most common triggers for dry skin are :
Cold air: colder temperatures result in less moisture in the air. The moisture in our skin evaporates faster leaving it feeling dry and scaly.
Age: as we get older our skin starts to thin. This makes it less able to hold onto moisture leaving it more vulnerable to dryness.
Medications: retinoids, blood pressure medications, and cholesterol-lowering medications are the most common. Retinoids such as isotretinoin, tretinoin, and retinol can dry the skin by causing it to exfoliate. Blood pressure medications, diuretics, in particular, work by pulling fluid out of our body to lower our blood pressure. Inevitably the skin will dry as well. Cholesterol is found in the skin and the bloodstream. Many people on cholesterol-lowering medications will note dry skin as a result of this loss.
Sun exposure: The sun can thin the skin further and break down collagen and elastic fibers in the skin that can hold moisture. This results in less of an ability to hold onto moisture. It can also trigger further evaporation of moisture from the skin.
Exposure to irritating chemicals: most common examples here are sodium laureth sulfate in soaps and cleansers or bleach solutions. These products can directly break down the skin causing it to dry excessively.
Hot showers and space heaters: hot showers can strip the skin of natural oils and result in excess dryness.
Hypothyroidism and other hormonal imbalances such as estrogen: a low-functioning thyroid is known to cause excessively dry skin
Genetic disorders: some people lack certain proteins in the skin that are needed to keep the skin intact. Ichthyosis is a disorder that causes the skin to have a fish-like scale from excessive dryness.
What is a BB cream—and how does it differ from a foundation, concealer, or moisturizer?
BB stands for a few different things. The most common is ‘beauty balm’, however, I have seen some refer to BB as blemish balm as well. BB creams are multitasking products that have a moisturizer, foundation, and sunblock all in one product. They eliminate the need to use 3 different products as these are all in one. The goal of these products is to minimize the number of products needed in your routine.
There is a learning curve here because most of us are so used to using several products to address different concerns. It’s important to understand that if you are using a BB cream then there is no need for a separate foundation or a separate moisturizer or separate sunscreen. The patients I have that developed clogged pores or acne after using these products were usually because they didn’t realize that there was no need to use other products! By putting on an extra foundation in addition to the BB cream, for example, you may be putting too much on your skin! Many people consider BB creams as their base and still add more foundation on top. This really shouldn’t be necessary. If you need added coverage for specific spots or blemishes, however, you may still need a concealer. Although the foundation in a BB cream will provide a nice base, you may find an added concealer may be necessary for specific blemishes.
How should a patient suffering from dry skin choose the best BB cream for his/her skin?
To choose the right BB cream if you deal with dry skin focus on products that have ingredients that really target dry skin in particular. Looking for ceramides, glycerin, squalene, Hyaluronic Acid or hyaluronate, botanical oils, and other hydrating ingredients is key. Try to avoid products that have buzzwords such as anti-aging, ageless, or age-defying or for acne-prone skin. These products sometimes have ingredients designed to minimize the appearance of wrinkles or other ingredients to exfoliate the skin - some of these may be irritating to those with dry skin. Also, look for sulfate-free products to avoid excess irritation.
Recommendations for BB Creams
My number one recommended product is Bare Minerals Complexion Rescue (my shade is desert 6.5!). Even though it’s not marketed as a BB cream, it technically is one. It combines sunscreen, moisture, and tint in one product. It has nice coverage even if you choose not to use an added concealer. It has a broad range of tints for most consumers. For sunscreen, it uses titanium, a mineral-based sunscreen. I love this because I prefer to avoid chemical sunscreens.
Bobbi Brown BB Cream: This product has a nice range of tints and provides solid coverage while still feeling lightweight. It’s hydrating and gives a nice dewy youthful look to the skin. It contains a number of hydrating ingredients including squalene, urea, and glycerin. It also contains titanium as one of its sunscreen ingredients although it does also contain chemical sunscreens in addition.
Kiehl's BB cream: this product is hydrating and also uses titanium as its sunscreen for broad-spectrum coverage.
What is the difference between a BB and a CC cream?
BB and CC cream designations are purely marketing terms that companies generated to create a buzz to market their multitasking products. Technically BB creams (thought to stand for "Beauty Balm") were meant to provide lightweight sheer coverage with added hydration. This is basically a tinted moisturizer with sunscreen. Any differences beyond this designation vary widely from company to company with no one standardized definition. Some may add additional lightening agents for spots, while others may focus on mineral sunscreen additives. There is no regulation of the way this term is used so it is not as simple as recommending a product in this category.
CC cream was meant to stand for "color correcting” - slightly heavier than a BB cream but not quite as thick as a foundation. Still would likely have an SPF. May have added coverage for mature skin in terms of discoloration, textural irregularities, fine lines, and wrinkles. As a Dermatologist, I find that consumers are so confused by these designations that I have had patients come in with a bag of products that comprise their routine that includes a moisturizer, a foundation, then a BB or CC cream, then a concealer then an SPF containing product on top of that! They could have likely gotten away with just one of those products but the aisles at beauty stores convince them they need one of everything.
If a BB or CC cream offers SPF 45 coverage how does it compare to a tinted sunscreen with SPF 45? Do both products offer the same sun protection?
Yes, both products would offer the same sun protection value. The process for FDA approval of the use of the SPF labeling is standardized regardless of the type of product. For example, a cream vs a lotion vs a powder vs a spray - if they all list the same SPF value then they all provide the same sun protection value. The only caveat is that SPF only refers to the amount of UVB blocked by the product. UVB is responsible for sunburns (think sunBurns) and likely plays a larger role in the risk for skin cancer. The amount of UVA blocked is not indicated by SPF value. UVA is responsible for prematurely Aging the skin. This is thought to play an indirect role in skin cancer risk simply because part of aging the skin is thinning the skin which makes it more prone to sunburns. The only way to distinguish between products with regards to full sun protection value (UVA and UVB) is to look at the ingredient label to determine which active ingredients are responsible for providing the SPF value and see if they also provide UVA coverage. A lot of work and shows how poor the SPF rating system is from a consumer perspective.