How Did Wrinkles Become the Enemy?

 How Did Wrinkles Become the Enemy?

By Dr. Chau Phan, Pharmacist and owner of Pleasant Care Pharmacy

It occurred to me, as I was doing research for my book, Age Gracefully: Make the Right Decisions for Your Skin, that the skin care products I compound at Pleasant Care Pharmacy might just be part of the answer to the question posed in the title of this article. In other words, by helping you slow the development of wrinkles on your skin, I might be contributing to wrinkles’ bad name in our culture. So I began to think about how (and when) wrinkles acquired that bad name.

After all, what did wrinkles ever do to make us view them with such suspicion? Well, for one thing, they seem towrinkle 1
appear out of nowhere. In the midst of our busy lives, we look in the mirror one morning and there it is, a creaseline that didn’t occur because we slept wrong on our pillow. Our reaction? Panic. “When did that happen? And, oh no, there’s another one…and another!”

Now before you ask, “What are you suggesting – that we stop smiling?” let me remind you that frowning – over time – also causes wrinkles.

As I explain in my book, here’s how wrinkles happen:

  1. The muscles in your face start to atrophy naturally over time. They weaken or disappear in places.
  2. The lack of muscle mass behind the skin causes the skin to appear less tight, and wrinkles develop where the muscles used to be.
  3. As the three layers of the skin – the epidermis, the dermis and the hypodermis – get thinner, they are less able to provide the barrier your body requires. Reduced skin thickness causes wrinkles.
  4. Over time, the dermis layer of our skin loses collagen and elastin, and with that loss comes a reduction in elasticity, strength and resistance, creating wrinkles.
  5. Also over time, our bodies begin to lose more water than we take in, making it more of a challenge to stay hydrated. It also becomes harder for water to enter our cells. Our skin is not a high priority in comparison to our vital organs, so the signs of dehydration will show first on our skin.

Notice how many times in the previous paragraphs I used the expression “over time”. To me, that expression has positive, as well as negative, connotations. As I explain in my book, over time, we have control over many of the extrinsic factors that contribute to the occurrence of wrinkles.

To prevent wrinkles, we must stop the loss of muscle mass and the thinning of the skin, as well as maintain the integrity of the skin’s collagen and elastin with lifestyle changes that include avoidance of:

  • Secondhand smoke (as well as avoiding/eliminating smoking as a habit yourself)
  • UV radiation
  • Pollution
  • Alcohol consumption (or at least reducing it)
  • Repetitive facial muscle movements, such as frowning and squinting
  • Stress (or, again, at least reducing it)

At the same time, we can embrace: sleep drink eat well

• Hydrating with appropriate water intake
• Eating foods high in protein to maintain muscle mass
• Getting enough sleep
• Exercising our forehead and eyes
• Using protection against wrinkles, such as sunscreen and lip balm


Chapter four of my book includes details about these lifestyle changes if you want to learn more.

In the meantime, to get back to the original question posed in this article, maybe the answer lies in our making a friend out of those wrinkles – even as we do what we can to avoid them. After all, don’t we as women want to be taken seriously? With age comes wisdom, right? You’ve heard that expression “She has grown comfortable in her own skin.”

Yes, let’s make friends with those wrinkles we can’t avoid. They are a badge that shows the world we’ve been here long enough to know a thing or two.

If you would like more information about Pleasant Care Pharmacy or about my skincare products, you can contact me at or call me at 510.200.9984.

How to Apply Eczema Cream


How to Apply the Creams That Protect Skin from Eczema Flare-Ups

By Dr. Chau Phan, Pharmacist and owner of Pleasant Care Pharmacy

I hope you have had a chance to see my video demonstration. I believe the video is informative for parents of children who have eczema, as well as for adults who have this skin ailment. The order of the steps is especially important, both for prevention of flare-ups and healing of affected areas.

I thought it would be helpful to capture in this article the sequence of steps for applying cream to skin affected by eczema so that you can refer to it any time for a refresher.

Sequence of steps for treating skin affected by eczema
As you have seen in my video demonstration, you need to follow a certain order as you apply skin care products to eczema-affected skin. Following these seven simple steps will help you maximize the healing and protective powers of the creams and ointments.

1. Have ready three essential products: A moisturizer designed for eczema sufferers, a steroid cream (topical corticosteroid) and petroleum jelly.
2. Take a quick shower in water that is neither too hot nor too cold or soak in a tub of water for 10 to 20 minutes (using cream directly afterwards will seal in wetness).
3. Apply the moisturizing cream all over the body, especially to areas that are potential targets for flare-ups.
4. If an area is red, apply the steroid cream on top of the moisturizer. Side note: If skin is cracked, apply polysporin ointment instead of steroid cream.
5. If the area is simply dry and not red, just apply the moisturizer to it.
6. Look for areas that may be newly red (behind the knees, inside the elbows, and behind the ears are places to look, especially during times of weather change).
7. Use petroleum jelly as a sealant for the moisturizing and steroid creams.

Following these steps twice a day will become a skin-saving routine that will help skin to heal and feel better.

Important reminders about the sequence to follow
The shower or tub soak needs to be short, and you should not use any soaps that dry the skin. Applying the creams and petroleum jelly directly afterwards will seal in the moisture left on the skin from the shower or bath. If soaking is the preferred mode, you can include a few drops of oil in the water.

Especially for adults who are uncomfortable with the feel of Vaseline on their skin, the protective cream can be sufficient. The reason for the application of petroleum jelly is that it forms a protective cover for the creams.

Keeping a container of the moisturizer with you throughout the day and applying it as necessary is also a good idea. For babies, apply petroleum jelly throughout the day on eczema areas if there’s still dryness, in addition to the twice-a-day moisturizing routine.

You might also want to watch the video demo again to review the process in action.

If you would like more information about Pleasant Care Pharmacy or about my skincare products, you can contact me at or on Or you can call me at 510.200.9984.

How to Counter the Effects of Stress on Eczema

How to Counter the Effects of Stress on Eczema

By Dr. Chau Phan, Pharmacist and owner of Pleasant Care Pharmacy

As you read in my January 6, 2017 article about protecting your skin from eczema in the 4 seasons of the New Year, one of the triggers for an eczema flare-up is stress.

You have probably heard many recommendations for how to avoid stress, especially as we move into a new year. Keeping stress at bay includes:

• Meditating to set your day up for success and to clear your head when stress-inducing things happen during the day
• Exercising regularly to release pent-up “fight or flight” adrenaline
• Listening to music that relaxes you and / or focuses your attention on the task at hand
• Eating a healthy diet rich with anti-oxidants
• Limiting your intake of alcohol
• Pre-planning your day, week, month, year

You’re probably thinking that the last recommendation in that bullet list belongs under the category of “Life is what happens when you’re planning something else.” But there is something to be said for having a plan in place so that you are better prepared to handle the unexpected. The plan is your “I got this” armor to help you respond rather than react to the stressors.

Which brings me to my first point: Why does stress cause eczema flare-ups?

What’s going on when you’re stressed that causes a flare-up?
When you’re tense, your body reacts by trying to protect you. Our bodies are hard-wired to react to stimuli that our minds have been trained to see as reasons to run away from danger or stay and duke it out with the enemy.

Our bodies take their cues from the mind and will often go into a heightened “flight” state – even when that is not called for. To get ready to run away, our body produces lots of epinephrine, and norepinephrine. This in turn makes our heart beat faster, our muscles tense in readiness to run, our sweat glands to go into overdrive and our mind to be on high alert.

A study called “Association of stress with symptoms of atopic dermatitis,” shows that besides from producing epinephrine and norepinephrine, stress causes an increase in itchiness for people with eczema. This in turn will cause more eczema flare-ups.

How pre-planning helps you avoid stress
With a new year (calendar year, school year, fiscal year in business) come all kinds of tips and hints for using planning to keep you on track – especially when the unexpected happens. Smart phones and tablets have alerts you can program to remind you to schedule time to plan the day or week. And if you haven’t put a plan in place for the whole year yet, you can use the start of the Chinese New Year (January 28, 2017) to do that!

Some people feel that the end of one day or week is the time to prepare for the next. Others want to do so at the beginning of a new day or week. Whatever you feel comfortable doing is what you will get into the habit of doing. Five minutes of focused attention on scheduling the to-do’s is all it takes. Once those are in place in among the other planned-for happenings (meetings, events, appointments), you can tell your mind to shut off the anxiety so that you can truly concentrate. And when the interruption happens (crisis or otherwise), you can see how to fit it into what you have to do (and what you can put off to another day / week so that you can deal with the interruption).

The scheduling devices we use today are also great for planning for the known stressors in our lives. For example, you might have a presentation to give in February. Have you pre-planned time to develop it, have it reviewed by a person (or persons) whose judgment you trust, and “dry-run” it in front of an audience who can help you finesse it?
And how about those emails? What if, as part of your planning, you scheduled in short spurts of email checks, say, four times a day? Digital devices have functionality that is the equivalent of a sign on the back of your chair that says, “I am working on deadline; I promise to check with you later.” That will work for “shutting off” email until your next check-in.

Texting and phone calls, on the other hand, may need more old-fashioned methods of dealing with their ability to derail your concentration. Remember: Not every text message or call needs to be answered right now. Use your laptop or tablet for focused work and put the digital device somewhere else (or on “mute”) until you are done with the task that requires your undivided attention.

Less stress, fewer eczema flare-ups
Some people can even get stressed just thinking about how stress can cause their eczema to act up. You can see how this can create an almost constant loop of stress to itchiness to flare-up to stress to more itchiness to…So, how about, in this New Year, you give planning a try to break the cycle? The trick is to give your mind “time off for good behavior” by creating that pre-planning armor I talked about earlier.

Plans for the day, the week, the month and the year help you feel prepared…for just about anything. You can use the power of that feeling to help you respond, rather than react, to those inevitable stressors. You got this, right?

If you would like more information about Pleasant Care Pharmacy or about my skincare products, you can contact me at or on Or you can call me at 510.200.9984.


Protecting Your Skin from Eczema in the 4 Seasons of the New Year

Protecting Your Skin from Eczema in the 4 Seasons of the New Year

By Dr. Chau Phan, Pharmacist and owner of Pleasant Care Pharmacy

Happy New Year! Before I talk about some of the things eczema sufferers can anticipate and prepare for in the seasons of the coming year, I thought I’d explain a little about why we at Pleasant Care Pharmacy focus on eczema as our skin care topic for the month of January…even though October is Eczema Month in the United States.

We believe the New Year is an opportunity to look ahead to the calendar year just beginning and to prepare for it – for all of us, but especially for those who want to avoid eczema flare-ups. The actions you can take in every season of the year to protect yourself from flare-ups have to do with that word “triggers”. And each season has its own triggers. I think the old expression applies, “Forewarned is forearmed!”

You probably know that eczema usually comes about as the result of an over-reaction by your body’s immune system to an outside source. The way you first discover that your body has this reaction is that your skin begins to itch, change color and texture and / or a rash appears.

Once you have your eczema under control with the help of skin creams, such as those we compound here at Pleasant Care Pharmacy, you and your immune system are back in partnership with each other in keeping you safe from the bad bacteria that can make you sick. From that point on, you understand the importance of preventing “flare-ups” by taking precautions. This article talks about what you can do in each season of the year to prevent those flare-ups.

Winter’s triggers to eczema flare-ups 
In this coldest of the four seasons, overly dry or wet skin is an issue (and a primary way that eczema symptoms can recur). So, here are some things you can watch out for:

Exposure to extremes of heat and cold. Dropping temperatures and an increase in precipitation bring with them challenges to your skin as you exercise and go into and out of heated buildings. As an eczema sufferer, you know that it is important to keep your skin dry – but not overly so. You must also protect against wetness, especially in areas of your body that are covered, not allowing the moisture to evaporate. The following list includes ways to protect yourself from high heat or cold.

• Defend your skin against temperature extremes by app
lying protective cream as you go about your day (hint: keep a container of cream in your gym bag). You can also apply an ointment, such as petroleum jelly, on top of the cream layer to prevent water evaporation.
• Wear layers of clothes that keep out moisture and maintain an even balance of warmth and coolness against your body and eliminate the layers as temperatures warm up or when you’re inside (hint: the bottom layer should be lightweight, moisture repellent and quick drying to prevent over-sweating; 100 percent cotton is best for eczema skin).

• Keep your thermostat at no more than 72 degrees and no less than 68 when you are inside during the day (hint: our body temperature decreases as we near the end of the day, but avoid the temptation to raise the thermostat as you head off to bed; 65 degrees is the recommended sleeping temperature).
• Consider using a humidifier in your home to increase the moisture in the air as your heating system is keeping you warm.

Protection against germs without causing damage due to dryness. Winter means a rise in flu, the common cold and pneumonia. Here are some ways to minimize your exposure to viruses and bacteria that can cause these illnesses without risking an eczema flare-up or infection.

• Keep your hands away from your face as much as possible and wash them to eliminate contaminants.
• Use hand soaps that don’t dry out your skin and avoid using alcohol-based hand cleaners (hint: it’s best to use moisturizing soaps that protect against dryness and don’t kill off the good bacteria).
• Be vigilant in applying the protective skin cream that prevents flare-ups and, once a flare-up starts, keep it from getting infected.

Winter allergens to be mindful of. Eczema sufferers know that allergens can be a source of irritation to your skin and are usually vigilant about the allergens of spring and summer. You may need a reminder, though, that the cold months have their allergens as well. Avoid wearing wool next to your skin and guard against indoor allergens sent out into the air by your furnace, such as mold spores, pet dander, insect parts, and dust mites, by changing the filter in your heating unit.

The eczema triggers of spring
With spring comes an increase in outdoor activity for most people. Besides guarding against allergic reactions to pollen and pet dander (remember that furry animals are shedding their winter coats), the following tips will help prepare you for this season:

• As you exercise (and temperatures are rising), watch for sweating in sensitive areas such as behind the knees or on the inside of the elbows.
• Be sure to stay hydrated, especially as your activity level increases.
• Protect your skin from the sun’s harmful rays with a wide-brimmed hat, sunglasses, long-sleeved, loose-fitting clothes and sunscreen protection of SPF 30.
• If you can, choose to exercise outside in the early morning or early evening to avoid the heat and high sun of midday.

Summer’s contributions to eczema flare-ups
Avoid sudden transitions from really high heat to overly air-conditioned indoor environments.
• In your home, remember to control the amount of humidity you are exposed to (50 percent is just about perfect).

Last, but not least, the triggers to watch out for in fall

Autumn features allergic reactions to ragweed (highest counts for this pollen are between August and the first frost) and mold spores. Even though you’d like to forego air-conditioning and open the windows, try to keep them closed in the morning.

Other things you can do to fight off autumn’s allergens include:

• Using an air-purifying system to eliminate air-borne irritants
• Putting dust mite covers on your pillows, mattress and box springs
• Spending time by the ocean for relief from ragweed allergies

Fall is, of course, “back-to-school” time and the entryway to the holidays, and that means increased stress, a potential eczema trigger. As the lazy days of summer give way to academic demands and holiday preparations, consider using scheduling tools to organize your time more efficiently. Some things you might want to do (or avoid doing) to handle stress:

• Meditating just 10 minutes a day
• Keeping your alcohol intake to a minimum (or eliminating alcohol altogether)
• Getting enough sleep
• Looking for ways to help the less fortunate, but also…
• …making time for you

As the song by The Byrds in the 1960s said, “To everything…there is a season and a time for every purpose…” My hope is that you will find these tips helpful in keeping your eczema from recurring at any time of the year.

If you would like more information about Pleasant Care Pharmacy or about my skincare products, you can contact me at or on Or you can call me at 510.200.9984.