Dr. Julie Harper has a very personal reason for finding her way into dermatology. She was an acne sufferer as a teenager. But once under the care of a dermatologist, her quality of life greatly improved and she became inspired to offer that same relief to others. Today, she is director of the Dermatology and Skin Care Center of Birmingham, as well as a Clinical Associate Professor of Dermatology at the University of Alabama in Birmingham.
An expert in rosacea as well as acne, Dr. Harper is a founding director of the American Acne and Rosacea Society. She has extensively written and spoken on acne and rosacea. Some of her writings can be found in journals including Practical Dermatology, Advances in Dermatology and Cecil’s Review of General Internal Medicine 8th edition.
Read on to share her thoughts on acne and anti-aging treatments, as well as some great at-home tips for clear skin.
Tell us a bit about your background. Why did you choose dermatology as your specialty?
I was an acne sufferer as a teenager. While acne is not life-threatening, it can be life-altering. I would spend hours trying to conceal and cover my acne and I did not want to be seen without makeup. Once I was under the care of a dermatologist, my acne and my overall quality of life greatly improved. I thought it would be really gratifying to help people in that same way. By the way, I was right! Whether it is acne, rosacea, eczema, or aging, improving the overall health of a person’s skin is very rewarding.
What’s happening in the area of adult acne treatment?
First of all, I think we are seeing more adult acne, particularly in women. We do have some recent evidence that one of our topical acne medications (Aczone) actually tends to work better in women than in men. It is a topical agent that is FDA-approved to treat acne. Importantly, it is well-tolerated and can be applied under makeup. It does not bleach or stain clothing or other fabrics. Topical retinoids are still an important treatment option for adult acne. Adult females may benefit from hormonal therapies, including oral contraceptive pills and/or spironolactone.
Are there any triggers for adult acne/rosacea that people may not even be aware of?
It’s easier to come up with a list of triggers for rosacea than acne. Rosacea may be exacerbated by sunlight, hot beverages or soups, emotional distress, spicy foods and even hot showers. Keep in mind anything that causes vasodilation ( this is a mechanism of cooling in response to a thermal stimulus) can exacerbate rosacea. While rosacea is centered around small blood vessels in the face, acne is centered around the hair follicle or pore. Acne can certainly be aggravated by stress. The role of diet in acne continues to be controversial. There is some evidence that a high gylcemic load diet may contribute to acne. More studies are needed before this theory is confirmed.
What are some of your at-home secrets and tips for healthy skin?
Don’t ever skip sunscreen!!!! Not even one day!!! Other than that, take it easy on your skin. Don’t overscrub. If you love to exfoliate, pick a gentle product and exfoliate once or twice a week. Find a moisturizer that you like and use it regularly. Look for ingredients like petrolatum, dimethicone, and glycerin.
Are you noticing any trends among the requested treatments by your patients?
People want to look natural. Gone are the days of looking “frozen” or of over-filled lips (thank goodness!!). Botox and filler treatments should make people look rested and more youthful. If someone compliments your Botox or filler, then your doctor did not do a good job!
What’s new in the area of anti-aging treatments? Do you find any new treatments particularly exciting?
I can’t talk about anti-aging without talking about sunscreen and topical retinoids. Don’t waste your money on expensive anti-aging treatments if you are going to tan or smoke. Ultraviolet damage and cigarette smoking promote aging of the skin. On the other hand, everyone who is interested in anti-aging skin care should be on a topical retinoid. From a procedural standpoint, I love Botox and filler. While many of the fillers are FDA-approved to treat the nasolabial folds (the parentheses around the mouth), the trend is to volumize the face in other locations (i.e. the “apple” of the cheek, the temples, the chin).