Holiday Skin 911: What to Do When a Skin-care Disaster Erupts Before a Holiday Party by Dr. Manish Shah

Waking up on the day before or day of a big holiday party with an unsightly skin-care emergency can stress anyone out. How many people have canceled an invitation because a cold sore erupted? How about cystic acne on your cheek that appears on New Year’s Eve? While neither of these is "life-threatening" conditions, for anyone wanting to look good for the in-laws, they might as well be. However, there are solutions. Here's what can be done to mitigate various conditions:

1. Problem: Cold Sore

Solution: I offer cortisone injections to patients who want to look better faster. "Very diluted cortisone into the cold sore, this can bring the inflammation down quite rapidly. If you are afraid of needles, call your doctor and ask him or her to call in a prescription for Valtrex, Famvir or Acyolovir. You can pick up Abreva, an over-the-counter medication. If you can't make it to the pharmacy, you can try some old-fashioned remedies: Visine will help take the red out. You can also use a cold compress and Tylenol or ibuprofen.

2. Problem: Allergic Reaction

Solution: The first thing you need to do is stop eating or using whatever is causing the allergic reaction. If the reaction happens a few days before an occasion, I recommend using hydrocortisone cream twice a day and taking Allegra, Claritin or Zyrtec, which are longer acting and less sedating than Benadryl. Try a whole-milk compress for 10 minutes twice a day. For allergic reactions, use the hydrocortisone cream and then cover up redness by canceling it out entirely. The opposite of red is green, so apply green tinted concealer on the red area. The combination will create a flesh-toned hue. A good-quality tinted moisturizer naturally has green/yellow undertones and also provides moisture to dry skin. If this type of reaction is something you have never experienced before, go immediately to your dermatologist.

3. Problem: Cystic Acne Breakout

There are some people who use a lancet or small knife to cut into a cyst and fish out the clogged part of the pore. Cutting open a cyst is extremely risky. You not only run the risk of getting an infection, but you also run the risk of scarring, as in a permanent skin indentation or protrusion. And what if you cut open a cyst but can't squeeze out the root clog? You don't know where the root is or how deep it resides inside your skin. You can't even be 100 percent confident that you will be able to completely remove the hardened plug of the cyst. If any remnants of the clog remain, the cyst is likely to get re-inflamed and come back even worse. It's also not exactly good to cut open skin and dig around and squeeze the wound. Doing so will only make a bloody mess, increase the chance of skin scarring, and prolong the time it takes the cyst to heal.

Solution: Here's a secret that many a supermodel or actress uses: steroid shots. When we discuss treating acne with cortisone or "steroid" shots, we are referring to the process of gently placing a very dilute quantity of a "glucocorticoid" steroid into the cyst. Glucocorticoids are a class of steroid molecules that are naturally produced by our bodies and have numerous functions including the regulation of human metabolism, immunity and inflammation. They have very potent anti-inflammatory effects, so they are often used to treat inflammatory diseases in medicine. They can be formulated as creams to treat skin rashes or as pills to treat systemic disease. They can also be injected directly into local areas of inflammation such as in arthritic joints and inflamed acne cysts. Within one or two days of injection into a cyst, the steroid will shrink the inflammation producing relief of pain and almost immediate cosmetic improvement.

4. Problem: Puffy Eyes

Solution: The key to reducing the puffiness of puffy eyes is having something cool applied to them. A cool compress or cooled cucumber slices applied for five to 10 minutes can constrict blood and lymph vessels. You can also use cool tea bags, which contain tannins that will help reduce swelling. And since puffy eyes can be caused by a high-salt diet or alcohol, try to cut out both before an important occasion.

5. Problem: Sunburn

Solution: Take a cool bath or shower. Set the water to a cool temperature that's just below lukewarm and relax for 10 to 20 minutes. The temperature will ease the pain, and the water will stop your skin from becoming as irritated. Repeat as often as you need to. Avoid using soap, bath oils or other detergents as you bathe – they'll irritate your skin and possibly make it even worse. If you have blisters forming on your skin, take a bath instead of showering. The pressure from the shower might pop your blisters. When you get out, don't rub your skin dry with a towel. Instead, let yourself air dry or pat the towel over your skin in small, gentle movements. 

Apply cold compresses to your skin. If you're not in a situation where you can bathe, or you'd just prefer not to, you can instead apply cold, wet compresses to your skin. Dampen a washcloth or other piece of fabric with cold water and lay it over the affected area for 20 to 30 minutes. Re-wet it as often as you need to. Apply aloe vera to burned skin. Using the pads of your fingers, gently apply the aloe to your sunburn. Don't "rub it in" all the way, as you might with a regular lotion. Leave it a bit goopy and moist on top of the burn – this helps prevent the skin from drying out and becoming more irritated. Reapply as often as necessary. Treat inflammation with cortisone cream (optional). Cortisone creams contain a small dose of steroids that can work to reduce inflammation to your sunburn.

6. Problem: Too Much Filler

Solution: Do fillers no sooner than one month before a big event to allow time for healing and touch ups. One of the reasons I lean toward hyaluronic acid fillers such as Restylane, Juvederm and Perlane is because they are easily reversed with hyaluronidase. This product dissolves and degrades the Restylane, Juvederm or Perlane so as to reverse the results of the initial injection. It's a great insurance policy when choosing a practitioner. Make sure yours has it at his or her disposal. 

Most patients find the immediate results of soft tissue filler treatments very satisfying. If an undesirable result occurs, your treatment provider should be able to discuss and carry out all of the treatment options. Removing the effects of a "filler" treatment can be difficult. This is why any filler treatment needs to be done carefully, conservatively and only by very experienced and board-certified specialists. Hyaluronic acid based dermal fillers have the additional benefit of being partially or completely reversed with time or with the injection of a commercially available enzyme known as hyaluronidase.

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