Whenever I begin working with a new patient, I take a comprehensive health history which includes the question, "Do you have any skin problems?" I'm particularly concerned about such conditions as psoriasis, eczema, and skin cancer.

So many of my new patients will tell me, "I have dry skin." But a few tell me their skin is excessively oily. Here’s what you can do if your skin is dry – or even too oily.

Even though they're not diseases, extremely dry or excessively oily skin can pose problems. Diet, environment, and soaps can all add to your skin problems. With so many skin-care products available, it's easy to choose the wrong kind for your particular type of skin. Especially when advertisements proclaim their products are the answer to your skin problems. When you know which ingredients will minimize overly dry or very oily skin, you can often find inexpensive products that work well.

Revitalizing Dry Skin

The number-one remedy for dry skin is to drink enough water or other liquids, which don't contain dehydrating caffeine or sugar, throughout the day – even if it means looking for restrooms more often.

Get sufficient quantities of the right kind of oils. Essential fatty acids (EFAs), such as the omega-3 and omega-6 fats found in flax oil, raw walnuts, fatty fish, evening primrose oil, and borage seed oil do more than help control weight and support your immune system. They keep your skin healthy and moist. If you're not eating enough foods high in EFAs every day, or taking them in supplements, you may be contributing to your dry skin. Don't rely on applying oils topically. Take one teaspoon of flax oil, or two capsules of flax, borage, or evening primrose oil, twice a day. Add two to four capsules of fish oil daily, except on days when you eat oily fish, like salmon.

Your skin needs vitamin A to repair and make healthy skin. Red, yellow, and dark green leafy vegetables contain carotenoids, used to make vitamin A. Include several good portions of these foods every day. Supplement your diet with 15,000-25,000 mg of carotenoids – or 5,000-10,000 of vitamin A in your multivitamin. Make sure you get enough vitamin C, which is needed to make the skin protein collagen. Take 1,000-2,000 mg a day and eat citrus, kiwis, spinach, kale, and strawberries, which are  all high in vitamin C.

Avoid products with ingredients that dry the skin, like acetone, alcohol, benzoyl peroxide, camphor, citrus, sodium laurel sulfate, eucalyptus, menthol, and mint. Some of them may be "natural" and smell good, but they have drying effects. Use fragrance-free skin cleansers instead of soaps.

Avoid long, hot showers or baths since these dry your skin as well. Use a moisturizer after bathing with some of the following ingredients: urea, glycolic acid, lactic acid, or alpha-hydroxy acid.

Use a good sunscreen with SPF-25 or more containing zinc oxide, titanium dioxide, or avobenzone daily. Only these ingredients protect against both UVA and UVB radiation.

TIP: Use a sunscreen/moisturizer combination to give your skin double benefits.

To remove dead skin, dry brush your body with a loofah sponge every day. Use a softer brush for your face to avoid bruising delicate skin.

When Skin is Too Oily

While dry skin is more prevalent, you may have inherited oily skin. When the oil glands in skin, called sebaceous glands, make too much oil (or sebum), your skin becomes oily. The nice result is that your skin remains moist and you're likely to have fewer wrinkles. But too much oil can plug up your pores and cause them to stretch and break, resulting in acne. Or you can have shiny, oily patches that are unsightly areas for dirt to collect.

Begin with your diet, eating plenty of whole grains, nuts, seeds, beans, and yeast, which are high in vitamin B2. A vitamin B2 (riboflavin) deficiency can contribute to oily skin. Next, look at the skin-care products you're using.

Natural Cleansers For Oily Skin

If you have oily skin, use only facial cleansers with alcohol-free toners. Alcohol is drying, but it could dry your skin too much and backfire on you, causing more oil to be secreted. If you use a moisturizer, use very small amounts of one that is oil-free. In fact, all of your cosmetics should be free from oil. Here are a few natural products you can use for cleansing:

• Gently cleanse your skin with apple-cider vinegar and water (1:1 ratio).

• Cleanse your face with a strong, cool, sage tea. Make it ahead of time and store it in your refrigerator. If you don't grow sage and can't find sage tea, you can get Female Sage Tea by Traditional Medicinals, Inc. from Natural Resources (800-747-0390).

• Rub a slice of raw potato on your face and rinse with cool water.

• Add three to five drops of any of the following essential oils (found in natural food stores) to your favorite cleanser or shampoo: lemon, orange, peppermint, rosemary, tea tree, jasmine, or geranium.

Finding the Best Skin-Care Products

The best products for your skin are always the ones that are most appropriate for your particular skin type. These may or may not be products sold in natural food stores. To understand your skin's particular needs can be as confusing as finding the right vitamins. So I'd like to suggest you get a copy of The Beauty Bible, by Paula Begoun, (Beginning Press, Seattle, WA, 1997; 800-831-4088). It's a good start in educating yourself on many ingredients found in cosmetics and skin-care products. For more detailed information, her gigantic book, Don't Go to the Cosmetics Counter Without Me (2001) talks specifically about many, but not all, popular brands of cosmetics.

One Final Note: Try These Good Moisturizers

Avocado, canola oil, evening primrose oil, hazelnuts, kukui nuts, olives, safflower oil, soy oil, sunflower oil, and herbs such as comfrey, calendula, and aloe vera are soothing, effective moisturizers. Find or make products with some of these ingredients. For instance, take half a ripe avocado, mash it, and put the paste on your face for half an hour, covering it with a hot, moist towel. Rinse it off with warm water, then seal your pores with cool water. Or you can use Système 41 products, which contain many of these ingredients.