Oily Skin and Blemishes Q&A with Dr. Rivers


Thank you for all of your questions following our last Q&A with Dr. Rivers.  As always, if you have anymore inquiries please email us at

  1. What are the best ways to deal with excessively oily skin?

    In this situation it is important to use a gentle cleanser and a mild AHA (alpha hydroxyl acid) or BHA (beta hydroxyl acid) wash or peel. This will help to reduce some of the oil and should help to improve acne as well. Should the skin become too dry, then one needs to reduce the number of products being applied to the skin and simply use a gentle cleanser in conjunction with a moisturizer.

  2. What kind of beauty products should one use to avoid bad skin?

    People should avoid products that may be occlusive to the skin or applied too thickly as these factors may clog pores and predispose people to acne.  If someone has dry or sensitive skin, drying or peeling agents may be harmful to the skin.   That said, if the skin can tolerate products in general, one should consider using compounds that contain gentle exfoliants (AHA, BHA), antioxidants (vitamins C and E), and topical vitamin A derived ingredients (retinol, tretinoin).  Further, there is some clinical evidence to support the use of topical growth factors and plant derived ingredients such as beta-thujaplicin in beauty products.  Evidence for other ingredients such as topical hyaluronic acid and stem cells is very limited.  For skin lightening kojic acid, azelaic acid, and retinoids are some ingredients to look for in these types of products.  Finally, using a moisturizer with a sunscreen or a sunscreen alone will be very helpful to keeping the skin looking young and to help avoid the development of brown marks on the face.

  3. Do you have any tips for patients with sudden skin care emergencies and an event less than 24 hours away? 

    Hot compresses and topical hydrocortisone that you can buy over the counter at the drug store.

  4. What do you do in the office for those patients with this timeline and a blemish, under eye circles, or loss of radiance?  

    Blemish:  inject with a corticosteroid. 

    Under eye circles: makeup,  sometimes a dermal filler like  juvederm or restylane.  

    Loss of radiance: microdermabrasion.

  5. Is there anything you tell them to do at home to avoid an office visit? 

    Don’t pick or squeeze deep cysts – you can make it worse.

  6. What if they have a few more days, would you change the approach to the problem?

    For blemishes, I would recommend a combination of a topical antibiotic with a topical retinoid  ( vitamin A derivative)

  7. Are natural products healthier and advisable instead of the non-natural ones?

    There is very little evidence to suggest that “natural” products are healthier for the skin.  In fact, many “natural” products contain chemicals that are not clearly indicated to the consumer.  Remember that every water containing product (creams and lotions) needs to have a preservative system to prevent contamination by viruses, bacteria and fungi.