Maintaining Healthy Skin

The skin serves numerous functions - detoxifying, protecting, regulating - but the primary protective or barrier function is the most obvious. The top layer of skin cells has the most important function in maintaining the effectiveness of the barrier. Here the individual cells overlie each other and are tightly packed, preventing bacteria from entering and maintaining the water-holding properties of the skin.
Fatty substances (lipids) are secreted by the cells during the course of their journey from the base layer of the skin to the top. These lipid molecules join up and form a tough connecting network, in effect acting as the mortar between the bricks of a wall.

The cell wall barriers are simply layers of fats that surround the watery contents. Therefore, the communication mechanisms must operate through these fatty cell walls. In fact, many of the substances that are involved in this communication process are various fats since it is easiest for fats to move within the fatty layers that comprise the cell walls. Despite its bad reputation, proper fats and cellular fats are of major importance in our body’s biochemistry and physiology.

Damage to the skin barrier can result from a combination of genetic predisposion and exposure to sensitizing chemicals and other substances. That is why avoiding irritants is as important as using products that help. In skin care, the most common irritants are usually perfumes and preservatives.

Fatty substances control the majority of our body’s physiology through receptors that activate many important genes. Likewise, our skin barrier is comprised of a supporting structure of collagen, a protein that contains fats that serve a critical function. These fats prevent the excess loss of water through our skin and prevent the cells of our body from becoming dehydrated and dying.

A major sign of a defective skin is the dryness that results from excessive water loss. This water can not be applied topically but must be ingested. To prevent the excessive water loss and the resulting dry skin, we must repair the skin barrier. We find that the skin composition in individuals with dry skin is due to an improper mixture of the skin fats. This is commonly due to a deficiency in our diet of the correct fats, those contained in natural olive oils, avocados, and healthy nuts, etc. On a nutritional basis, we can provide these necessary fats through the skin sometimes through topical treatments containing natural butters or oils, like Shea, olive and cocoa butter. The epidermis is not a usual means to acquire nutrition but it can absorb enough fatty substances to correct the fat imbalances that are the cause of the defect in the skin’s barrier function and thus correct the dry, itchy skin or sensitive skin problem. Try to be aware of chemical preservatives in any topical products you do use.

Although many products today are labeled “fragrance free,” that is really a misnomer. Nearly all products contain some fragrance to mask their chemical odor; so-called fragrance-free products may just contain fewer chemicals than others. What’s more, the fragrances used in many products (even pricey perfumes) are commonly synthetic. For sensitive individuals, this chemical brew can be a problem To make matters worse, many natural fragrances are now extracted using harsh solvents rather than old-fashioned distillation methods, in which fewer chemicals come into contact with the essential oil of the flower. Unless you can determine the extraction method used, be cautious. This is one reason many individuals react negatively to the essential oils used in aromatherapy massages and related products – many are of a synthetic, chemical composition.

According to several studies, various preservatives including formaldehyde, parabens, and others commonly used in skin, hair, and beauty products can also provoke allergic reactions. Although the preservatives are needed to maintain product shelf life and only minute amounts are present in any given product, many products contain these same chemicals, including skin care products, makeup, medications, antiperspirants, toothpaste, and foods. Many of these products are used on a daily basis, causing a higher reaction rate. As a result, the overall exposure to these harmful ingredients is higher than would occur if only a single product were used. Studies show that massage therapists have more contact dermatitis – or skin inflammation - due to exposure to these extracts.

Until recently, few studies investigated the cumulative impact of repeated exposures to preservatives in a variety of products and ingredients. For the majority of people, these product preservatives are an additional benefit, not a problem. But, as the chemical compositions increase, so do the allergic reactions.
If you suffer from sensitive, allergic skin or severe dry skin, you may be among those who will have a problem or reaction to these chemical-laden products. In this case, it is your role as an informed consumer to carefully read labels for all products that come into contact with your skin - internally or externally- to assure that they don’t contain the listed ingredients that you must avoid. Your skin barrier does a lot to protect you naturally, help it out when you can and feed it nourishing chemical-free products whenever you can.

Proper care of your skin

Those who have never had skin issues or were blessed to even have beautiful skin for most of the lives, are now desperate to address the skin wrinkles and many run to the dermatologist feeling a lot of regret. Although genes certainly play a role in one’s skin condition, decades of neglect, or even mistreatment of their skin is most frequently the source of their skin problems.  Many say that if they knew then what they know now, they would have done things very differently and taken better care of their skin.
There are numerous explanations for unhealthy skin but the main causes tend to be an unhealthy diet, an ineffectual cleansing routine, and poor lifestyle choices.

“Is it too late to save my bad skin? I never paid much attention to my skin because I never had any skin problems. I never bothered with skin care products because I didn’t need to. Now I’m seeing wrinkles and spots forming, I guess it’s just too late to anything about it.” If this sounds like you, you may want to keep reading.Never fear, because there is still much that you can do to help your skin. If you are lost in sea of product choices, you can still be assured cosmetic dermatology can offer many alternative treatments.

Not surprisingly, many adults rarely consult a dermatologist that is until AFTER the signs of aging have appeared. Wrinkles, of course, are the chief complaint. Your skin may feel  rough to the touch, and even sore, especially in drying environmental  conditions such as on an airplane or in a low-humidity environment like the desert or high-altitude cities. In the winter, when indoor heating is used, your skin gets even more dehydrated, making the wrinkles look worse. Your skin may catch on rough clothing. You may also notice wrinkles on your neck or others parts of your body.

Poor Diet
Your skin is a living, breathing organ of the body and it needs proper nourishment and hydration to look and feel its best. When your skin is deprived of the necessary vitamins, minerals, and nutrients that it needs it is unable to functional at optimal levels and the structure slowly begins to break down. This breakdown results in dry skin, blemishes, discoloration, wrinkles, and premature ageing.

In order to avoid this breakdown you need to feed your skin a varied mix of important nutrients each day. Ingesting sufficient amounts of vitamin A, a nutrient that can be found in citrus fruits and orange vegetables, can help you avoid dry skin and blemishes. Eating foods rich in the vitamin B group like brewer’s yeast or breads, or taking a vitamin B group supplement, can help you ward of skin discoloration, dry skin, dermatitis, shallow skin, and premature ageing.

To help discourage wrinkles, pale skin, sun damage, blemishes, and other unhealthy skin symptoms, nutrients like calcium, protein, iodine, niacin, folic acid, iron, and copper are very important to a healthy diet. Get these effective skin helpers by enjoying foods like mild, eggs, cheese, chicken, fish, leafy vegetables, fruits, and grains.

Poor Hygiene
Another common cause of unhealthy skin is poor hygiene. Whether this involves the failure to clean your skin often enough or the use of an ineffective cleansing routine, built-up dirt and grime can lead to blemishes, premature ageing, shallowness, dry skin, and wrinkles.

When your skin is not properly cleaned on a regular basis, dirt, pollution and other harmful substances are allowed to build up on your skin and clog the pores. Clogged pores result in breakouts, dry skin, and the reduction of cell renewal.

To get the most out of your cleansing routine make sure that you wash your skin twice a day, everyday. Also, make sure that you are using an effective cleanser like a soap that is specially formulated for deep cleansing. Make sure that you use gentle pressure when cleaning the skin, do not scrub or pull on the skin since this can result in tiny tears that are susceptible to irritation and infection. Finally, always follow your cleansing routine with a hydrating moisturizer that also contains a sunscreen in order to hydrate your skin and protect it from sun damage.

Bad Lifestyle Habits
Even if you enjoy a healthy diet and pay special attention to your skin care regime you can still be sabotaging the health of your skin by indulging in unhealthy habits. Habits like sun tanning, smoking, choosing fizzy drinks or sodas over water, and wearing heavy makeup can lead to the development of unhealthy skin. Avoid excessive sun exposure, always wear sunscreen with an SPF (sun protection factor) of at least 15, stop smoking and avoid those who smoke, drink plenty of water, and choose light cosmetics if you want your skin to stay young and healthy looking for years to come.

Laser Hair Removal

Temporary hair removal is accomplished with conventional treatments such as shaving, waxing and epilation. Another method is the use of selective photolysis, which is light energy that is produced by the laser, and is targeted at the pigment in hair. This causes destruction of hair follicles while sparing surrounding structures (i.e., the skin).

Long lasting hair removal can be achieved with the use of several available lasers. Total temporary hair removal, which lasts for several months, can be done in almost all patients. However, total permanent laser hair removal is not commonly done. Stable permanent hair removal may be possible in some cases and usually requires multiple treatment sessions.

FAQ

1. Is laser hair removal painful?

Laser hair removal can be mild to moderately uncomfortable. Each individual hair follicle is surrounded by nerve endings. While some patients may be able to tolerate the procedure without the use of an anesthetic, others may find the application of an anesthetic cream (such as EMLA) helpful. A generous layer of anesthetic cream is applied for 30-60 minutes before the procedure and can provide adequate relief from discomfort during the procedure.

2. How many treatments are necessary?

For satisfactory, long-lasting hair removal most patients require three to six treatments. The interval between treatments varies between 4 and 12 weeks, and will depend on your hair color, the type of laser used, and the location treated.

3. What are the complications?
   - Pigment alteration: Postinflammatory hyperpigmentation or darkening of the skin next to the treated area has been reported in 5% of patients and is sometimes seen in darker skinned individuals. Strict sun avoidance is recommended. Hypopigmentation, or lightening of the surrounding skin, has also been reported. These adverse effects are usually temporary. Alteration in underlying pigments is also a risk, especially when Q-switched lasers are used.
   - Infection: Bacterial infections are rare and occur when the superficial skin is injured. Antibiotic treatment may be prescribed, but generally good wound care is sufficient to prevent infection. If you have had prior episodes of cold sores or herpes simplex infections, you may develop a recurrent episode after a laser treatment. If you have a history of herpes simplex infections, your doctor should prescribe appropriate antiviral medication prior to laser hair removal to prevent a recurrent herpes episode.
   - Scarring may rarely occur and generally follows an infection or superficial skin injury.

Fortunately, the complications of laser hair removal are rare if it’s done by an experienced and skilled physician. You should expect a certain degree of pain, swelling and redness around the hair follicle after each treatment session. These symptoms resolve over the following 24 hours and include:

Who is a candidate for Laser Hair Removal?

Almost anybody who has undesirable hair is a candidate for laser hair removal. However certain conditions may complicate treatment. Laser hair removal achieves the best results with light-skinned, dark-haired individuals. Lasers with longer wavelengths are generally useful for darker-skinned patients.

Caution must be exercised in certain situations:

• The presence of an active bacterial or viral infection prevents treatment until the condition resolves.
• A history of hypertrophic scarring or keloid formation requires less aggressive laser treatments in order to avoid any complications.
• The presence of a suntan makes laser hair removal less effective and increases the likelihood of scarring or skin injury.
• If you have psoriasis or vitiligo, you should be warned about the possibility of causing more lesions in the treated areas.
• Most dermatologists recommend waiting 1 year after taking isotretinoin (Accutane®) before doing laser hair removal because of atypical scarring that has been associated with use of this drug during treatment.

Where?

Laser hair removal can be performed on virtually any hair bearing part of your body including your arms, legs, bikini area, back, etc.

Objectives of Therapy

1. The primary objective is safe and effective hair removal.
2. Total permanent hair removal, while desirable, is not always possible.
3. Total temporary hair removal lasting several months is a reasonable expectation.
4. Some permanent hair reduction in treated areas is possible, especially after multiple treatments.

Preoperative Care

1. You should strictly avoid sun tanning and artificial tanning products.
2. You should avoid waxing, plucking or electrolysis of any areas to be treated for at least 6 weeks before your laser treatment.
3. The use of shaving and depilatory creams is allowed.
4. If you have darker skin, you should consider a bleaching cream or skin lightening regimen.
5. You should shave the treatment areas within 24 hours prior to treatment.
6. Anesthetic cream can be applied 30-60 minutes prior to treatment
7. You should remove cosmetics prior to treatment.

Postoperative Changes

1. You will see redness and swelling around the treated hair follicles immediately following treatment.
2. Blisters and crusting are rare, though more commonly seen in darker skinned individuals.
3. Several days after treatment, hair may be extruded from the follicle.

Postoperative Care

1. Immediately following treatment, cold compresses can be applied to the skin surface
2. Emollients and/or topical corticosteroid creams can be used to keep areas moist and reduce redness and swelling.
3. Blisters and crusting are treated with antibiotic ointment and daily soaks.
4. You should strictly avoid the sun in order to prevent pigmentary changes.

Lasers used for Hair Removal

Laser energy, through the principle of selective photothermolysis (a process that involves selective absorption of an intense light pulse at wavelengths that are absorbed by the hair follicles, but not by the surrounding tissue), targets the pigment in the hair follicle. This causes destruction of hair follicles while sparing surrounding structures (i.e., the skin). Growing hair is more sensitive to destruction than resting hairs. Many of the lasers listed below utilize epidermal or skin cooling techniques. The effect of cooling the surface of the skin serves to minimize discomfort during treatment while increasing the effectiveness of the laser treatments.

1. Ruby Laser (694 nm, normal mode)
   - All patients will see a growth delay of their hair. Some patients will see a permanent reduction in hair growth.
   - This laser is more effective for dark hair. Blonde and gray hairs are more resistant.
   - White hairs do not respond to treatment
   - Epilaser® (Palomar) and Epitouch® (Sharplan) are examples of ruby lasers
2. Alexandrite Laser (755 nm, normal mode)
   - All patients will see a growth delay of their hair. Some will see a permanent reduction in hair growth.
   - It is effective for dark hair. Blonde and gray hairs are more resistant.
   - White hairs do not respond to treatment
   - It is potentially safer for darker skin than the ruby laser
   - Rapid repetition rates of the laser will reduce treatment time
   - Apogee® (Cynosure) uses a cooling gel on the skin
   - Gentlase® (Candela) uses dynamic cooling spray
3. Pulsed Diode Laser (800nm)
   - Patients with thick or coarse hair will see a delay in hair growth. Some patients will see a permanent reduction in hair growth.
   - It is effective for dark hair. It is not effective for fine hair.
   - Potentially, it is safer for darker skin types
   - LightSheer® (Coherent) uses contact cooling
4. Intense Pulsed Light Source (500-1200 nm)
   - It is effective for dark hair, both fine and coarse
   - It is potentially useful for darker skin types
   - Epilight® (ESC) uses cooling gel
5. Nd:YAG Laser (1064 nm, Q-switched)
   - Permanent hair removal has not been demonstrated
   - It can temporarily remove light hairs
   - It is potentially safe for all skin types, and causes the least epidermal damage of all treatments.
   - Carbon suspension is applied to skin in some treatments
   - There is a lower risk of epidermal damage
   - Short operative times are required
   - It causes the least discomfort of all laser hair removal treatments

Healthy Diet Helps Dry Skin

There are lots of things you can do with your diet and supplements that can help your dry skin. To combat dry skin, your body needs fats to build fat-rich cells that hold on to moisture. Saturated, monounsaturated and omega-3 fats are key components in the cell membranes . Vegetarians (who eat eggs and dairy products but not meat) eat about one-third less saturated fat than the average meat eater. Vegans (who eat no animal products of any kind) only receive about one half as much saturated fat as the average meat-eating American. As a result, they obtain from their diet much less cholesterol than omnivores.

Although cholesterol has received a bad name due to concerns about its connection with cardiovascular illness, recent studies show that it does have benefits, particularly for some post menopausal women. Cholesterol is needed for key body functions within the cellular membranes that impact the skin. For example, studies show that cholesterol-lowering drugs can lead to dry skin, while decreased levels of essential fatty acids have been associated with dry skin, dry hair, and brittle nails. If you have these symptoms and you are a vegetarian you may want to speak to your doctor to see if you may suffer from an essential fatty acid deficiency.

The best way to assure you get a healthy diet of skin-enhancing  fats is by eating a wide variety of whole plant foods. You can get fats from nuts, seeds, olives and avocados Use olive oil, replete with monosaturated fat, for cooking and salad dressings. Coconut oil is also an excellent alternative for it retains its stability at high temperatures. Try to avoid processed  foods and deep-fried foods that are rich in trans fats and omega-6 polyunsaturated fats. These fats contribute to the production of free radicals, the by-products of oxidation, which is a skin aging process that antioxidant vegetables help tame. Although for many years polyunsaturated vegetable oils, like canola, corn, safflower, and soy were recommended, canola oil is actually unstable when heated and the processed used to stabilize it turns a certain percentage of the oil into a trans fat.

Eating the undesirable fats found in these oils (as well in trans-fat containing foods such as margarine, most baked goods, fried foods, processed foods and sweets )may increase both wrinkling and the risk of developing skin and other cancers including melanoma. Vegetarians can eat eggs and dairy to obtain saturated fats while vegans can obtain them from coconut oil.

Fish oils are good sources of omega-3 polyunsaturated fatty acids which can increase the lipid content of your cells. They can be obtained from fish like salmon, as well as supplements with Omega-3 or Cod Liver Oil capsules. Omega-3s help your skin by providing essential fats needed for cellular integrity while they also prevent inflammation which can lead to the formation of dark spots in pigmented skin types.
Antioxidants are helpful in fighting free radicals - renegade oxygen molecules that cause cellular aging and wrinkles.

Also look for products that contain ingredients that help your skin retain moisture, such as essential fatty acids along with ingredients like lecithin to strengthens kin cell membranes. Look for products that are also third party tested to ensure they are free of environmental toxins. It is important in purchasing essential fats to ensure that you find a pure, well-tested source, free of environmental contaminants.

Several studies have suggested that it is better to get antioxidants through natural food sources instead of supplements, but if this is not possible or additional vitamin intake is needed, supplements can be a valuable help.

SUPPLEMENTS
The following oral supplements that contain the below nutrients can all be helpful to your skin:

Selenium is a powerful antioxidant mineral. Selenium. Some scientific evidence suggests that consumption of selenium may reduce the risk of certain forms of cancer. However, FDA has determined that this evidence is limited and not conclusive. Vitamins A, C, E, B5, alpha lipoic acid, and grape seed extract,  Ester-C , CoQro, lutein, as well as zinc, selenium, copper, and lycopene. Take these supplements according to the manufacturer’s directions.

Taking glucosamine supplements increases hyaluronic acid production. Hyaluronic acid (also called Hyaluronan) is a component of connective tissue whose function is to cushion and lubricate.  Vitamin C can be especially beneficial,  although it is tough to get ample quantities from supplements, every little bit helps. Be cautious of a laxative effect from vitamin C. take small doses at first then build gradually to endure to reaction has occurred. Buffered vitamin C is also available for those with sensitive digestive tracks. Complementing your daily skin care regimen with skin supportive supplements can boost the benefits to your skin.

Sun Safety for Skiers

Higher altitude means increased levels of harmful UV exposure compared to sea level areas. UV exposure increases 8-10 percent with every 1,000 feet above sea level.  At an altitude of 9-10,000 feet, UV may be 45-50 percent more intense than at sea level. In addition, snow reflects about 80 percent of the UV light from the sun, meaning that you are often hit by the same rays twice. This only contributes to the problem, further increasing the risk for skin cancer.

The combination of higher altitude and ultraviolet (UV) rays reflected by the snow puts skiers and snowboarders at an increased risk of sun damage and ultimately, skin cancer. More than 90 percent of all skin cancers are caused by sun exposure. It’s easy to associate winter with frostbite and windburn, but most people are unaware that UV rays can be even more damaging on the slopes than on the beach,it’s important to take proper precautions while on the slopes.

Both snow and strong wind can wear away sunscreen and reduce its effectiveness, so you have to take extra precautions. To protect your skin from the bitter cold, heavy winds and winter sun, follow these important sun protection tips:
•    Use a broad-spectrum sunscreen with an SPF of 15 or higher whenever you spend time outdoors. Apply 30 minutes before hitting the slopes.Be aware that the sun’s reflection off the snow is strong even on cloudy days.
•    Apply sunscreen liberally and evenly to all exposed skin - most skiers and snowboarders do not use enough sunscreen and therefore do not get the maximum protection.
•    Use a more moisturizing sunscreen. Winter conditions can be particularly harsh on the skin.
•    Be sure to cover often-missed spots: lips, ears, around eyes, neck, underside of chin, scalp and hands.
•    Always wear a lip balm with an SPF 15 or higher. Lips are even more sensitive than most parts of the skin.
•    Reapply at least every two hours, and more often after sweating or exposure to wind and snow.
•    Carry a travel-sized sunscreen and lip balm with you on the slopes. Reapply on the chairlift, especially after a long, snow-blown run.

Cover up.
•    Wear items like ski masks, which will cover most of the skin, leaving very little exposed to the wind and sun.
•    UV-blocking sunglasses or goggles that offer 100% UV protection and have wraparound or large frames protect your eyelids and the sensitive skin around your eyes, common sites for skin cancer and sun-induced aging. The sun’s rays and glare can impair your vision, so it’s important to wear sunglasses or goggles to clearly see the terrain. Plus, it will increase your enjoyment and performance while skiing.
Be mindful of time spent in the sun, regardless of the season.
•    Keep track of the time you spend in full sunlight. If possible, ski early in the morning and later on in the day, before 10AM and after 4PM. This helps avoid long lines and decreases the amount of time spent outdoors in the most intense hours of sunlight.
•    If you are on the slopes for most of the day, take a few breaks indoors to reapply sunscreen.
•    Drink plenty of water to avoid dehydration from the sun.
Enjoy the winter season, but be sure to take care of your skin to avoid the damage the cold season can cause. The first organization in the U.S committed to educating the public and medical professionals about sun safety, The Skin Cancer Foundation is still the only global organization solely devoted to the prevention, detection and treatment of skin cancer. The mission of the Foundation is to decrease the incidence of skin cancer through public and professional education and research.