Being sequestered at home has become the new excuse to explore any hidden talents. Aside from tapping into your inner Marie Kondo, some of you are well on your way to earning an honorary doctorate as an expert wine sommelier, courtesy of your nightly (filtered) Zoom parties. Despite whatever new interests are occupying your time and attention, a variety of factors—constant cohabitation in small quarters, the state of the economy, the unforeseen future—can worry us all. No matter how many Peloton classes you force yourself to get dressed for, the agita of isolation can manifest emotionally and physically. 

What we are going through right now as a collective community is what health professionals call chronic stress. Unlike acute stress, which is immediate, (think: stepping on a piece of glass), chronic stress is long-term and can ultimately cause more harm. To help aid us in all of the tools we need to successfully manage stress—when it affects our skin and our emotions—during this unique time, we’ve turned to Dr. Ava Shamban. The Harvard-educated, board certified renowned dermatologist (Nicole Kidman, and the Deschanel and Arquette sisters are all fans) has spoken with us from a safe social distance about the viable tools and options to help manage what challenges come our way. Below, she discusses the essential steps for achieving clear skin and a clear mind. 

Let’s discuss our sanity. Our mental health is tested during these stressful times. We’re used to seeing people face to face. Zoom parties are not the same as touching and speaking directly to our friends and loved ones. What are some doctorly tips for getting rid of the blues?

In situations where we are confronted with new and confusing information every day, without a structure defined by work or a typical schedule, it’s important to establish a schedule and maintain your sense of order. Try to eat actual meals at the same time, set bedtime, and time to wake up at the same times. Set an alarm. Keeping your circadian rhythm is key to managing overall wellness. 

Load up on immune-boosting foods, such as berries, nuts and leafy greens, to nourish yourself inside and out. Make sure you block out screens and all blue lights for a specific period every single day. Don't seclude or isolate, especially on days you are feeling particularly down, stressed, or looking less than your best. Those times are actually key for social connecting. Again, fresh air daily is key—specifically, giving your system a break from the circulating air from the home heating and cooling units. Make sure you implement a new schedule for yourself that includes not only projects but self-care time. And put on some makeup and clothes you didn't sleep in for yourself. It's an instant pick-me-up. Looking better always leads to feeling better.

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An at-home exercise routine or outdoors walking will help as does meditation. Try to schedule a group social hour and find happy ways to release the pent-up energy and anxiety we all have inside. 

In addition to vitamin D, are there certain vitamins we need to increase while nestled at home?

Quercetin, a super potent antioxidant that can help boost your immunity.  Vitamin C is a super immune booster, as is vitamin E which is a powerful antioxidant that helps the body fight off infection. Magnesium is a super important mineral, key to boosting your immune system. Run a bath before bed, which will relax the entire nervous system—and add mineral salts to replenish the magnesium we are lacking. It’s best delivered trans-dermally. 

For a wide variety of reasons, the honeymoon period of spending days home inevitably turns into a stress for many. It can also begin to take its toll on our skin in the form of breakouts. What does a stress flare-up look like on the skin, and how can you best get rid of it effectively home? 

If your acne is flaring, here are a few options. Firstly, at this time, it’s easy to schedule a telederm appointment. This is simply an appointment over FaceTime or Zoom with your dermatologist, who can address your concerns. It’s become quite common now, as the alternatives are sparse. I’d say that in almost all cases, your board-certified dermatologist will be able to determine what you have going on and what you need. You could need a prescription to treat the flare. Otherwise, an over-the-counter cocktail of salicylic acid, benzoyl peroxide and glycolic acid used twice a day to put out the flame can greatly help. La Roche Posay has a 3-Step Acne Treatment System that works really well. It’s easy to purchase online right now and has a triple threat of all of the necessary ingredients. I also have a great acne buster, the Dr. Ava Gly/Sal 5-2 pads that treat acne with a mix of effective glycolic acid and salicylic acid. The pads also help brighten the skin and help exfoliate. If you have eczema flaring from stress, a facial oil can help soothe the flare-up. Also, some calming ingredients to help stop rashes and itches I recommend are chamomile, aloe calendula cream, green tea and niacinamide. These all help.  

What about an effective DIY cleansing treatment to tackle stressed-out, flared-up skin?

Yes, I have an easy anti-bacterial, hydrating DIY cleanser that I often recommend for my patients to make when on sets or in remote locations. You take one cup of grapes (with seeds), one tablespoon of honey, one tablespoon of olive oil, half a teaspoon of baking soda and five tablespoons of milk. First blend the grapes, honey and olive oil together. Make sure the grapes are mashed, but the seeds are still textured. Then add in the baking soda and milk; stir until no white powder is visible. Seal in jar and refrigerate. Then wash hands and apply on skin for two minutes. Don’t forget to keep the mixture refrigerated.

Let’s talk skin health and the role the immune system plays for skin to stay clean and safe. What are your recommendations while we’re confined to our homes to protect and strengthen our immune system? 

It’s important to note that our skin is a major first responder of the immune system, preventing at the most basic entry level would-be foreign invaders—from bacteria to viruses, fungi to splinters—and mounting an immunological defense. The barrier function of the skin is best supported by moisturizing it, so that the cells can lie down flat and not lift up like dried-up roof tiles with spaces in-between for the pathogens or bacteria and other invaders. If you really want to go top of the line, I recommend Alastin Transform Body Treatment. The ingredients are superior, it gets rid of any crepe-like surfaces, it firms effectively, and it protects. Another all-around great moisturizer that is more reasonable but still works effectively is CeraVe Daily Moisturizing Lotion. It works really well with simple, hydrating ingredients. Remember, quarantining at home is like a deserted island in more ways than one. The stale air and the dry heat deplete our skin of moisture, so hydrating is key. If the amount of moisture in the air is less than in the room, the room's air will literally suck out the water from your skin. It is like a vacuum evaporating the water daily contributing to looking and feeling dehydrated, dull and lackluster. If at all possible, if you can get something online delivered, a house plant like a fern or palm in your living areas and bedroom can help significantly. Again, I know it’s an odd time to get a house plant, but if you can safely get one in your house while you’re confined, it’s a great idea. 

Another important tip is not to forget to open your windows. Humidifiers can also help. If you just want a simple, cool, clean humidifier, nothing fancy is needed—any will do the trick. It makes a huge difference to rehydrate and refresh not only your skin, but also to restore and elevate your mood. We have indoor pollutants in dust, cleaning solutions and chemicals, and all types of indoor lights and screens are potentially damaging on us while we’re home, too. 

Consistent handwashing is at its peak. Aside from an epidemiologist, a dermatologist’s hand-washing technique breakdown is probably the most reliable. What the best proper hand-washing technique is in your opinion?

There is a wonderful step-by-step visual aid from the World Health Organization you can access. It calls for 20 seconds of washing, top and bottom of hands and interlocking fingers. Really rub or scrub off those bugs. Pump or bar soap will do, but don’t leave the bar soap sitting in water (bacteria's favorite playground). And make sure you dry your hands carefully. If you can, use a microfiber anti-microbial towel to dry, or at least ramp up your wash cycle with all hand towels and wash cloths. Take off your rings so soap doesn’t get trapped under them and better yet, give them a rest while sheltering at home, so no bacteria sticks to you on the metal.

Soap vs. Hand Sanitizer? What is better? Why?

Soap is much better because it has two molecules—water loving and lipid-loving molecules. It attaches to any foreign bacteria or virus it helps to disengage it first. That said, the actual hand-scrubbing motion lifts the virus off the hands and the water takes it away.

Dry, cracked hands are inevitable right now. Is there a scrub you love or even a brush to slough off the dead skin that’s combating dry hands effectively? It seems as if everything is working topically, but dryness still comes back under the surface.

Personally, I don’t think a scrub is really necessary. It will most likely irritate the skin further. I think it’s better to use a thick lipid-based moisturizer such as the La Roche-Posay Lipikar healing balm. Also use that to rub your cuticles and nails so they get super hydrated. 

Anything specific we should do for our hands when going to bed?

Very simple: load up on tona of moisturizer and put hands into cotton (or even wool or cashmere gloves) to sleep in.  You will see a huge difference in just one night. 

Given everything you mentioned, how many times a day do we need to be applying moisturizer? 

As often as possible, but at least three times a day. Apply a moisturizer at nighttime on damp skin, post bath for the highest absorption and efficiency. 

While we are advised to wipe down and disinfect thoroughly what comes inside the house, hand sanitizer and wipes are really scarce now. What can we make that is available to sanitize that’s easy?

First, to protect your hands, before anything, it’s important that you should use gloves when you’re cleaning and disinfecting. You can make a DIY bleach solution using a tablespoon or two in a quart of water—which is every bit as effective as those wipes, which will fill up our landfills.