Читать книгу You: Being Beautiful: The Owner’s Manual to Inner and Outer Beauty - Michael Roizen F. - Страница 11
1 In the Flesh
ОглавлениеYOU Test: Tale of the Tape
To take your facial fingerprint, pull out a roll of Scotch tape. Make sure your face is clean (without makeup, sunscreen, moisturizer, or peanut butter for at least two hours). Place a piece of tape vertically on the middle of your forehead from your scalp to the area between your eyebrows. Move it to the outside corners of your eyes, across the apple of each cheek, and above your lip. Press gently in each spot, leave it for a few seconds, and carefully remove. Check the tape for lines and flakiness.
If your tape is completely smooth: You have the skin of a typical 30-year-old.
If you have flaky or dead cells but no lines: You have the skin of a typical 40-year-old.
If you have flaky cells and small lines: You have the skin of a typical 50-year-old.
The world glows all around us. There’s the celestial kind of glow—the stars, the moon, the sun. And there’s the artificial kind—the night-light inside the baby’s room and the neon lights outside the nightclub. But the most wonderful glow we can think of is the living, breathing kind—the kind that comes in the form of human skin.
We all know or have seen people who radiate—who have the kind of smooth, shiny, healthy, glowing skin that could light up Times Square. But you know what? We all have that potential. The problem is that many of us treat our skin like wrapping paper; it starts out looking pretty enough, but eventually we’re going to find a way to tear it up.
Now, this glow we’re talking about isn’t just the result of good genes. It’s also the result of making good choices to protect, heal, and clean your skin. We all have the ability to make those decisions. European cars “glow” more than American cars because the manufacturers use smaller drops of color that reflect more light than they refract. Your skin works the same way: If you ruin your reflection through a buildup of oil or dead skin, you lose the glow (and your full beauty potential).
Of course, it goes without saying that pornographic and beauty-product entrepreneurs aren’t the only people who know the value of skin. We all know the risks of exposing our bare skin to the sun, snake fangs, and camera phones. And we also know that the way our skin looks goes a long way toward determining how we feel about ourselves. If we don’t look beautiful, we don’t feel it. And if we feel beautiful inside, we reflect it in our skin. So if you have smooth skin that radiates, then you feel and look younger—and probably are younger on the inside, an important aspect of your overall well-being and health. But if you feel depressed and reclusive, you may have more wrinkles than a shar-pei or become spotted, dotted, and blemished. And that’s one of the reasons why you should read this chapter. Ultimately, your skin communicates messages about your youthfulness, your vibrancy, and your health. Face it: Skin sells.
FACTOID
We love exercise. But exercise for the face? That’s an idea whose time has not come. Exercising the facial muscles is a sure way to increase your wrinkles. The facial muscles pull on the skin to give you facial expressions. And the repetitive movements of the skin, over the years, combined with the normal thinning of the collagen and elastin of the dermis, will eventually crack the skin, causing wrinkling. Botox is the reverse of exercise; it paralyzes muscles and lessens wrinkles.
Safari Secrets:
Lessons from the animal kingdom
The reason why there are butterfly collectors and not moth collectors? The colors of moths are determined by scales that are shed, so they don’t keep their colors in the box, only in life—just like humans. The colors of a butterfly’s wings are never lost.
Your Skin: Let’s Flesh a Few Things Out
Funny, whenever we say something’s skin deep, we mean that it has about as much depth as a puddle. But that’s hardly the case with skin—it’s an amazing and complex organ that extends much deeper than the part we can actually see and touch. Your skin is the biggest and heaviest organ of your body, making up 15 percent of your body weight and covering 12 to 20 square feet. The composition: 70 percent water, 25 percent protein, and less than 5 percent fats. The obvious role of skin is to protect and to package. It protects our blood, organs, and bones from what’s outside, and it also packages our body neatly together so we’re not blobby organisms that leave trails of blood and bits of tissue everywhere we go.
And skin does more than serve as our anatomical casing. Skin also helps us with healing. How? Touching in that loving way reduces levels of the stress chemical cortisol and increases levels of the feel-good chemical oxytocin. And touching in that special way (massaging and caressing, not the touch of a slugger’s right hand) also stimulates the vagus nerve, which runs up to the brain to improve the health of our whole body.
So here’s how your skin works. While serving as an obvious barrier to the millions of chemicals and germs that want to invade your body, it also has a big sensory function. Deep in the skin, follicles grow hairs that can sense before your skin is actually touched. Eyelashes, for example, prompt the eyelid (through great nerve connections) to involuntarily close to protect the eye before you even know you’re in danger and to quickly flick off bugs before they bite.
Besides sprouting up hairs that sense things, your skin lubricates itself with oils we call sebum produced by sebaceous glands and also absorbs certain medications and hormones. But it can also absorb things, such as toxins, that you don’t necessarily want. And ultraviolet light can turn your own skin against itself by creating those much-talked-about damaging free radicals, not to mention changing your DNA (and usually not for the better).
Like many structures in your body (including your blood vessels), your skin has several components (see Figure 1.1).
FACTOID
We can generate as much as a gallon of sweat in two hours, so we don’t have to pant like a dog (dogs don’t sweat). Also, unlike dogs, most of us don’t shed our furry coat, but we do lose nine pounds of skin a year. That’s a lot of dust.
Epidermis: Serving as the body’s primary barrier against the outside world, the epidermis is less than a millimeter thick. Your skin is your raincoat, keeping your insides dry and letting you swim without swelling. Your epidermis is so well designed that only the right-size molecules can get through. The cool thing about your skin is that it renews itself every six to eight weeks. How? Dead cells from the epidermis continually slough off and are replaced by new ones from below (that’s one major way you get dust in your home—the sloughing off of skin). Your epidermis largely determines how fresh your skin looks—as well as how well it works in terms of absorbing and retaining moisture.
Dermis: The thickest of your skin layers, the dermis is what actually holds you together.* It’s your leather. The dermis is made up of cells called fibroblasts, which make collagen and elastin, proteins that give the dermis its strength and allow it to be stretched. Dotting the dermis are hair follicles, sweat glands, and sebaceous glands, which produce the oily sebum that lubricates your skin and hair. This sebum is really a mixed blessing; while it helps keep bacteria under control, it also attracts insects. Finally, the dermis contains tiny blood vessels (to nourish the skin) and lymph nodes (to protect it from toxins). Subcutaneous tissue: This innermost layer is made up primarily of fat and acts as a shock absorber and heat insulator for your body (many mammals, by the way, don’t have this because their fur does the same job).
Figure 1.1 Flesh Beating UV radiation damages the skin by weakening elastic collagen fibers and by preventing stem cells from rejuvenating the injured area. It also causes free radicals to damage the DNA, which can lead to cancer. UV-C is blocked by ozone, UV-B penetrates the epidermis, and UV-A goes even deeper to the dermis.
The Skinny: How Your Skin Works
Your skin can do more than get you arrested. It’s able to do many things—some good and some we’d rather live without.
IT SWEATS: In a way, our skin acts as our third kidney, detoxifying our bodies. When we exert ourselves, not only do we sweat to cool our bodies, we also increase blood flow, which releases toxins. Though it may not be so great on silk blouses and stair climbers, sweating is something you need to do regularly—not just because of the cardiovascular and fat-frying benefits of exercise, but also because of its body-cleansing function.
IT TANS AND BURNS: Exposure to sun causes an immediate release of stored melanin and stimulates the cells designed to protect you from too much sun, the melanocytes, to produce a protective pigment, melanin. But that process takes several days, by which time you have left the beach with Santa-suit-colored flesh. The sun, unbuffered by melanin, is your skin’s cancer-causing deep fryer.
FACTOID
If stretch marks make your skin look like a highway atlas, the answer isn’t to try to cover them up with creams or makeup. They actually could be a road map to something more serious that’s going on inside your body. First, you need to make sure that your adrenal gland isn’t making too many steroids (that could be a sign of Cushing’s disease). If the marks are less than a year old and still have a purplish hue, you can have them lasered to lighten them, but other than that, only surgery can remove them.
Stop the Burning
Some burns are preventable (sideburns and sunburns), some burns are accidental (darn curling iron!), and some burns are downright dumb (leave the fireworks to the pros, smart guy). No matter what the cause, you can take steps to soothe the pain—and prevent scarring or further damage. First, you’ll want to cool the burn with water or ice as soon as you can to reduce the prostaglandin response and limit the damage. Clean the area with water and a simple soap such as Ivory, Neutrogena, Dove, or Cetaphil to remove dirt and bacteria, and don’t pop any blisters that form. For the small blisters, apply a sterile moisturizer like bacitracin or Neosporin twice a day and leave them intact. They serve as the ideal sterile biologic dressing over the nascent skin that is quickly growing to cover the injured area. Scarring is always worse if the growth of this new skin is hindered. Cover blisters with a fine gauze like Vaseline gauze or Adaptic. The small blisters will dry up and flake off within two weeks.
Note: If the burn is on your hands, face, or genitals (we won’t ask) and is bigger than a nickel, it’s a good idea to let a doc look at it. She may want to treat it with an antibiotic cream called Silvadene that kills bacteria and keeps the wound moist.
IT WRINKLES: We all know that wrinkles generally don’t look all that good—not in dress shirts and not on your skin. In fact, one main indicator of body aging is wrinkles, especially vertical lines above the lips and between the eyes (each of these stereotypically means different things; cigarette smoking and inflammation in your blood vessels cause lip wrinkles, while vertical lines between eyes reflect stress). How do we get wrinkles? In a couple of ways, actually. Since skin is attached to the muscle beneath it, your skin creases when your muscles move. Over time, that creates a well-worn groove. It’s actually like a stress fracture—the repeated bending of skin over the underlying muscle creates inflammation and the collagen gets squeezed together. Young skin stretches and recoils over the muscle, but thinned, old skin loses this ability. And, like an overbent piece of cardboard, it eventually cracks. As we get older, the connections between the skin and underlying connective tissue stretch out, which can cause sagging of the skin. When that happens, gravity pulls down, and the sagging contributes to the formation of wrinkles (see Figure 1.2).
Figure 1.2 Fine Lines Many things can cause wrinkling, including cigarette smoking and sun exposure. Ultimately, it’s caused by thinned, damaged collagen and a loss of elastin fibers (think of it as a kind of stress fracture). When skin loses its elasticity, gravity pulls down on it, and the sagging causes even more wrinkles.
How Skin Ages
When it comes to skin, most of us can spot the good kind a mile away. That’s because we can instantly identify all the characteristics of healthy and beautiful skin—it’s well hydrated, tight and elastic, not overly oily, has clean pores, and all that. But here’s the big myth about skin—that you can stop your skin from aging. No matter what products you use or procedures you undergo, you can’t stop time from pulling, tugging, and tearing at your skin. What you can do, however, is slow it down considerably and encourage all of those things that make your skin appear and be healthier.
Skin aging can happen in the matrix between cells, within the dermis, or on the surface. Here’s how:
In the matrix: Skin aging happens when your collagen becomes damaged and loses its tight weave, and your elastin loses its zing. The fibroblasts (and their DNA) that produce both collagen and elastin are prone to damage from UV radiation, and as they falter, that DNA, which makes collagen and elastin, makes less and/or defective collagen or elastin. Also, glycosaminoglycans (say that three times fast) are large sugarlike molecules that plump up a bit and fill the skin when they bind with water. As you get older, they become more like an old sponge and don’t suck up water as efficiently. The decrease in water content means that the skin becomes like a bad keynote speaker—dull and dry. And those old glycosaminoglycans can link up with proteins and cause yellowing (or browning) of your skin (that’s called glycation, and though it happens to all of us, it’s especially visible in diabetics).
On the surface: Your skin secretes fat (the technical term is lipids). Fatty acids called ceramides help protect an outer layer of your skin called the stratum corneum, so that you have better skin hydration and are less susceptible to irritation. Think of these fatty acids as a coating on you, like the slimy coating fish have on them; they serve as an extra buffer layer between you and the outside world. Ceramide concentrations decrease with aging and with washing with fat emulsifiers like soap and alcohol—our mantra isn’t “use just water” if you touch people and dirty objects, but using just water helps save those ceramides to help you.
Thinner, duller, less vibrant is what you can expect from your skin as you age, but you can control how fast those changes occur in your skin.
FACTOID
Most of the day, gravity pulls your skin down (contributing to facial sagging and wrinkles). When you sleep faceup, gravity exerts a light stretching effect on your skin; when you sleep face pressed to the pillow, you’ll look puffier in the morning and develop sleep lines. There are other reasons for puffiness upon waking. Allergy to dust mites or dust mite poop is common, as are allergies to feather pillows and laundry detergent. These all cause repeated nighttime eyelid swelling. You can prevent leakage of mite poop protein or mites by covering your pillow with a 1-micron case that feels like a pillowcase or a latex cover that feels a bit plasticky; both work to decrease mite allergies and the subsequent puffiness.
In your 40s, your skin becomes thinner and more translucent so capillaries show through. And those capillaries increase in number as a response to years of inflammation from sun damage. Signs of photoaging—such as wrinkles, age spots, and uneven pigmentation—may show up, especially if your parents or you weren’t diligent about sun protection during childhood and in your 20s and 30s. Your skin will produce less oil naturally in your 40s, leading to increased dryness. Cell turnover also is slower, which can cause skin to appear dull.
In your typical 50s, you may experience a deepening of facial lines and wrinkles due to the loss of subcutaneous fat, moisture loss, and accumulated sun damage. As skin elasticity declines, skin may start to sag, especially around the jawline and eye area. If you are postmenopausal, the related drop in estrogen can make your skin thinner, dryer, and more easily irritated. Hydrating moisturizers will decrease water loss but can lead to unnecessary dependence on them (you’ll feel as though you always need them). Vitamin A and E creams increase the water content of the skin. Regular exfoliation is a good start, decreasing the thickness of the dry, rough epidermis (more details later).
Soap It Up
How does soap work? It emulsifies oils—that is, it makes oily substances float away in water. Soaps are all derived from fats—the type of fat used determines the qualities of the soap. In its simplest form, soap is fat mixed with lye. Modern soaps add a chemistry set to the mix, but the simplest soaps are really the best, since every added chemical increases the likelihood of skin irritation, called dermatitis, or allergic reactions to fragrances or preservatives (in the subtle form of puffy eyes or red hands).
We like solid soaps because they can be made with a minimum of ingredients. Liquids often add many chemicals and preservatives. The simplest type of soap is made of saponified olive oil, with a small amount of an essential oil such as lavender or peppermint to give it a nice fragrance. Examples of simple, low-chemical bar soaps are Kiss My Face Pure Olive Oil Soap and Plantlife Aromatherapy Soaps. To prevent the spread of bacteria between users, treat the soap bar as you would treat a toothbrush—don’t share.
For liquid soaps, we like Neutrogena and Cetaphil. Check the ingredients—fewer is generally better. You might try See the Dawn Purity facial cleanser, which contains glycerin, aloe vera, and lavender flower–scented water, or Garden of Eve Facial Cleansing Nectar, which contains glycerin, safflower oil, wax, sunflower oil, and water.
If you are typical and natural, in your 60s, 70s, 80s, and 90s, cell turnover and skin healing are even slower, and your skin may be very dry, as well. Mature skin may need special care, starting with hydrating moisturizers and regular exfoliation to encourage cell turnover.
Your Skin: What Else Can Go Wrong
As the primary part of your body exposed to external threats, your skin is not only your body’s greatest protector* but also extremely vulnerable to the outside world.
Of course, we’re most concerned with cancerous growths. Keep an eye out for precancerous growths by self-exam with the help of a partner (have your spouse or a close friend look at all the areas you can’t see and photograph your total skin surface), and have anything new or different evaluated by a dermatologist. You can even use your cell phone camera to record pictures that your dermatologist can use to compare yearly changes. Put a dime next to any growths that you photograph to provide an estimate of size. By the way, in case you think you’re safe just because you stay out of the sun, realize that skin-damaging ozone levels increase in the afternoon, which can affect skin whether it’s sunny or not. That underscores the point that you need to try to keep your skin healthy even if you have the best sun-protecting habits.
Keep Off
One of the tricks to using skin products is not only finding the ingredients that will help you but also avoiding the ones that may damage or irritate your skin. Some ingredients you should think about avoiding:
Imidazolidinyl urea and diazolidinyl urea. They’re used as preservatives to prevent bacterial growth (not fungi), but they’re also a relatively common cause of contact dermatitis.
Fragrances. They may smell good, but these little molecules are responsible for allergic reactions in as many as 14 percent of people. Most skin-care products don’t really need added fragrances, but some, like soap, simply smell like the fats they were made from without added fragrance.
Sodium lauryl sulfate. It’s common in shampoos and cleaners to create suds and is relatively safe, but longer contact time can cause irritation and dryness, because the detergent strips the skin of lipids.
Mineral oil. Used as a base in some products, it may interfere with perspiration.
MEA, TEA. They’re common pH stabilizers, but when they’re exposed to air, they form potentially irritating substances called nitrosamines. And they have a tendency to clog pores and create blackheads.
Toluene. This chemical solvent, which the EPA designates as hazardous waste, is found in fingernail polish. Toluene can cause headaches, irritated eyes, and memory loss. The website nottoopretty.com lists perfumes and cosmetics that contain toxic chemicals like toluene. They’re not going to kill you, but if you don’t feel good, it’s worth experimenting to see if beauty products could be the source of your general blahness.
DMAE. This common “instant face-lift” ingredient in wrinkle creams actually does its work by causing cell damage and swelling. Sure, the wrinkles will go away temporarily (they also will if you’re slapped in the face), but that doesn’t mean it’s good for you.
YOU Test
What’s Your Type?
All that time in front of the mirror, in the shower, and at the nude beach has likely given you some pretty good insight into what type of skin you have. But there’s more to skin intelligence than just knowing whether you’re happier exposing it or concealing it. Take this test to determine your skin type.
1 Does your skin look dull or flake like a snow globe?
2 Does your skin look like a bathroom floor with a shiny, slippery texture?
3 Does your skin feel itchy and taut like sausage casing?
4 Do you have pores that are enlarged like craters, or clogged pores, or acne?
5 Does your skin react to cosmetics containing alcohol, synthetics, fragrances, and artificial colors?
6 Does your skin appear consistently moist, vibrant, and plumper than a squishy cantaloupe?
7 Does your forehead, nose, or chin appear oilier than a fast-food kitchen, while the skin around your cheeks, eyes, and mouth is normal or dry?
If you answered yes to 1 or 3, you have DRY skin.
If you answered yes to 2 or 4, you have OILY skin.
If you answered yes to 5, you have SENSITIVE skin.
If you answered yes to 6, you have NORMAL skin.
If you answered yes to 7, you have COMBINATION skin.
Safari Secrets:
Lessons from the animal kingdom
UV radiation comes in many forms, and we can see only a small spectrum. Other animals see things that we don’t (and vice versa), which explains why they are attracted to apparently dull objects or have strange colors themselves. Some animals, including birds, reptiles, and insects such as bees, can see into the near ultraviolet. Many fruits, flowers, and seeds stand out more strongly from the background in ultraviolet wavelengths than in human color vision. Scorpions glow or take on a yellow to green color under UV illumination. Many birds have patterns in their plumage that are invisible at usual wavelengths but observable in ultraviolet, and the urine of some animals is much easier to spot with ultraviolet.
Following are some other health issues that have beauty implications. These are irritating conditions that can influence your appearance and self-confidence.
ACNE AND ROSACEA: While people often like to think that things like chocolate are responsible for pimples, there’s no proof that what pops up on your dessert plate influences what pops up on your nose the night before a big presentation. What we do know is that 80 percent of U.S. teens and 40 percent of U.S. adults complain of pimples. But in Papua, New Guinea, the figure is nearly 0 percent, so it’s a fair guess that something is going on with our lifestyle. One culprit is inadequate intake of omega-3 fatty acids (as opposed to saturated or trans fats or omega-6 fats from corn and soybean oils). Get adequate amounts of these good fats by consuming walnuts, avocados, freshly ground flaxseed, canola oil, fish oils, or DHA supplements from algae. Another culprit? Stress. In studies of college kids during exams, researchers found them to have many more bouts of acne while under pressure. Paradoxically, the steroid medication triamcinolone can be injected to calm a severe form of pimples called cystic acne, but there’s a cost—it also thins the skin, often leaving a depression months later. And don’t squeeze—you’ll damage the skin by increasing inflammation and risk spreading the infection. Instead, wash your face with a coarse washcloth and mild soap to break open any pimples. Salicylic acid, benzoyl peroxide, azelaic acid, and vitamin A creams or gels are all simple and effective methods for reducing acne. You can also try an ancient Chinese remedy—seabuchthorn oil, which has been used for a few millennia in China for a variety of medicinal benefits. More recently, the rich fatty acid mixture has been used topically as a natural treatment for acne and rosacea. Try the soap form.
For rosacea—a form of adult acne that’s a fairly common problem—certain antibiotics tend to work not only because they kill bacteria but because of their anti-inflammatory effect. Our recommendation: Ask your doc if an ointment that combines antibiotics and a low-potency steroid cream such as hydrocortisone is right for you. Lasers that target the visible capillaries can have a dramatic immediate effect, and daily topical vitamin C and twice daily topical niacin more subtly reduce the redness in about a month.
ECZEMA: If your skin’s looking as if you just did the hubba-hubba in a bed of mashed strawberries, it might be a case of the common skin condition eczema. This is a type of allergic reaction, and it’s easily treated with inexpensive skin moisturizers. It’s especially common during the winter, when the dry air causes little breaks in the skin, letting in chemicals that rake over your skin, particularly your hands. Treat your skin like an athlete working out in the heat—keep it hydrated. After your daily shower (don’t dry yourself first), immediately apply Vaseline or cream (Eucerin, Keri, Nivea) so the moisture is locked in—and the rash-irritating dryness is kept out. If you have stubborn eczema, you might use a moisturizer with lactic acid or a steroid or a prescription drug called tacrolimus. If all else fails, have an allergist get to the bottom of your problem—in many cases the culprit is the metal nickel or one of the preservatives or fragrances in skin care products.
FACTOID
African Americans and people with dark skin have natural SPF 16 UV protection, although dark skin blocks Vitamin D3 production even more. So darker-skinned people require 10 to 20 times the sun exposure length (which equates to about two hours of exposure) of lighter-skinned people to build up the same amount of vitamin D. While all humans have the same number of melanocytes (which produce melanin and determine skin color), those melanocytes produce different amounts of melanin. People who moved to northern climates needed more UVB rays to make vitamin D, so they produce less melanin. And over time that has gotten ingrained into the genome so northerners typically have less dark skin.
PSORIASIS: Signaled by dry, flaking skin, psoriasis is an autoimmune ailment that affects the life cycle of skin cells. Remember how we talked about new cells replacing older cells that slough off and how that process usually takes less than two months?* Well, in people with psoriasis, that process takes only a few weeks. Immune cells go out and attack healthy skin cells by mistake, as if they’re trying to heal a wound. The result: Cells build up fast and form thick scales that are dry, patchy, itchy, and sometimes painful. In essence, your body is fighting a chronic civil war and your skin is caught in the middle.
FACTOID
The skin around the eyes is only ½ millimeter thick compared to 2 millimeters elsewhere on average. As the day progresses, the body accumulates fluid (that’s why your ankles might swell as well), and this engorges the veins beneath the eyes and makes them bulge and appear blue through the thin skin. The muscles around the eye also tire as the evening progresses, so they begin to sag. Dark circles can be due to melanin pigment—you can have those peeled away or use pigment reducers for many months. For translucency of skin, when muscles or blood vessels under the skin become visible, only makeup will really work. For shadowing from fat, you’ll need an eyelid lift. Finally, if there are larger blood vessels, you can have them zapped with electrocautery. Sleep helps, too.
While there’s no cure for the disease, people can get some relief from the pain and discomfort. Topical agents and light therapy (exposing yourself to small amounts of UV light) that slow skin replication can help. And powerful agents such as Humira or Remicade that are used to prevent joint destruction and arthritis from autoimmune attack on cartilage seem to slow remodeling enough to make the skin and nails (see chapter 4) much better almost instantly. Also, mindfulness meditation and resistance exercises may help to calm the autoimmune process when it is not so severe as to cause joint damage.
ALLERGIES: People with sensitive skin (about 10 percent of the population) should avoid some of the fragrances, antioxidants, stabilizers, preservatives, and coloring agents that are found in skin care products and cosmetics. Sometimes less is more. While a skin cream might have one or two active ingredients, they all have a dozen or more inactive ingredients—that is, they are supposed to be inactive in making your skin healthy. But those inactive ingredients could be active against you and your skin.
Whatever the case, you can take steps not only to decrease the chances of getting these and other skin conditions, but also to improve the look and vibrancy of your skin, no matter what your age.
YOU Tips!
With just about anything—computers, cars, kids—you’ve got two choices: You can prevent a problem before it happens, or you can try to repair one if it does. Your skin’s no different.* Though many of us have skin that’s sustained a demolition derby’s worth of damage, that doesn’t mean you can’t treat those issues. And if you still have young, tight, healthy skin, you can also take steps to ensure it stays that way. The challenge is fighting through all the different products that purport to slather on the lotion of youth. We’ll help you separate the skin savers from the money wasters. And also check out our YOU Tool in a few pages on the perfect skin-cleaning steps. The simplest concept for skin care is to feed your skin with nutrients at night, when there is no UV light, and to protect it from UV and toxins during the day.
CHECK LABELS. Going to the beauty counter is like going to the supermarket—there are millions of products, and many times you have no idea which ones are healthy and which ones aren’t. Some offer double robbery: They both weigh down your skin and lighten your pocketbook. Look for products that list an “active ingredient” and a particular concentration. Vitamins and supplements in skin lotions, creams, and potions usually have to be in the 1 to 10 percent range to really do something for or to your skin. The formulations also need to be pH balanced, and the active ingredient must be able to penetrate the skin (vitamin A works at a much lower concentration). Your best bet is to try reputable brands, but even some of those use ingredients that could enter the skin only in a science fiction movie. So the bottom line is that you have to read the label and use only the scientifically proven ingredients that are discussed in this chapter. Remember that cosmetic products are just that—cosmetic. Products that make therapeutic claims must be scientifically proven to be safe and effective and are regulated as drugs by the FDA.
CREAM IT ON. There are hundreds of skin-care ingredients, including many with fancy names and expensive price tags. But there is very little science to most of them and no science to many of them. The list of ingredients that really can make a difference in the skin is small. The big ingredients (and their closely related derivatives) to know:
Vitamin A (retinoids)
Vitamin B3 (niacin or nicotinamide)
Vitamin B5 (pantothenic acid, panthenol)
Vitamin C
Viamin E
Alpha-hydroxy acids
Ubiquinone or coenzyme Q10 (small-molecule antioxidant)
Ferulic acid (small-molecule antioxidant)
These eight are examples of skin-care ingredients you can cream on with solid scientific backing.
It probably makes sense to steer clear of hexapeptides and collagen. However, smaller peptides are okay. Dr. Perry’s NightSkin (vitamins A and C, glycolic acid, licorice extract, an herbal skin lightener) and Dr. Perry’s DaySkin (zinc oxide–titanium dioxide sunblock, Vitamins B3, B5, and E) are examples of skin creams with a scientific basis. (Of course, we saw the science and recruited him to work with us.)
KNOW YOUR VITAMINS. You know you need to ingest them, but vitamins are also important as topical agents. These are three of our favorites for good skin health.
Vitamin A. Winning our vote for the most valuable skin care nutrient to be applied to the skin—not in a vitamin pill—is vitamin A. Without vitamin A (a “retinoid”), your skin, hair, and nails will be dry and you will be sickly. Vitamin A is found as retinoic acid (Retin-A), retinol (retinaldehyde), or retinyl propionate. Be careful of these if you’re potentially pregnant. All of these forms work, because your body can transform one into another. Retinoic acid decreases acne by knocking out bacteria and decreasing the thickness of the dead layer of skin and oils that plug pores—and this decreases visible pore size. Topical vitamin A increases the stretchy elastin fibers, the hearty structural collagen, and the natural moisturizer hyaluronic acid in the skin. It lessens the dark pigmentation in the skin and is the first-line drug for acne, rosacea, and seborrheic dermatitis. Retinoids are really the only thing you can put on your skin that can repair sun damage, giving you smoother, less wrinkled skin. Most important, retinoids decrease things called actinic keratoses that can become skin cancer. These drugs might even be able to help stretch marks. Light destroys vitamin A. Because of this, you’ll be wasting your money if you put it on your skin in the morning. Use it at night, when it can do the most good.
Vitamin C. Vitamin C is one of your skin’s main water-based antioxidants, although in your skin, vitamin E, because it is lipid soluble, gets the top honor. But you can buttress the vitamin C levels in your skin by 40 times by rubbing in at least a 10 percent concentration of L-ascorbic acid. In your skin and in your orange juice, vitamin C rapidly breaks down with exposure to UV light and oxygen (so remember to close the refrigerator door—and did that light really go out?). So use the vitamin C at night, when it can stimulate your collagen and elastic and help build up your skin. The vitamin C will last a long time in your skin or until it is inactivated by UV light.
Vitamin C protects against sunburn and sun-induced wrinkling. It knocks out those free radicals and inflammation after UV exposure, and it can decrease the rosy look of rosacea. Vitamin C also helps with those brown age spots. If you use it along with vitamin A, you’ll get a better effect than with either alone.
Vitamin E. The major lipid-soluble antioxidant in your skin hitches a ride to the stratum corneum, the dead upper layer of skin, with your natural oils, called sebum. Topical vitamin E needs to be in the form of DL-alpha-tocopherol to make a positive difference to your skin. Many skin creams contain a much more user-friendly form, called tocopherol acetate, but this doesn’t do the magic of alpha-tocopherol. In fact, tocopherol acetate may actually hurt your skin. Vitamin C, by the way, needs vitamin E like Bonnie needs Clyde. Vitamin C is water soluble and an effective scavenger of free radicals in the water-soluble parts of the skin, while vitamin E works on the lipid-soluble portion. But if all you have is vitamin C, the lipid part of the cell ages. The real vitamin E stuff (DL-alpha-tocopherol) enhances the effects of sunscreen, stops the immune system from getting blitzed, and slows wrinkle production. Because UV light degrades vitamin E (just as it does vitamin C), it should be applied along with sunblock and/or at night.
Other antioxidants. Different plants make different sunblocks to protect themselves from the blistering UV light. And each of these usually dark-colored antioxidants can give the skin their benefits. The problem is that many antioxidants have red, blue, or green pigments, unappealing in skin creams. And while these antioxidants may make sense and even may be proven in animals, very few studies have been done to show that they really work in humans. New antioxidants include ferulic acid, idebenone, ubiquinone (coenzyme Q10), alpha lipoic acid, and resveratrol and are already making their way into our friendly neighborhood counters.
EAT FOR SKIN. Perhaps the only food some people associate with skin is a little whipped cream on Saturday night (more on sex in Chapter 10), but a lot of foods or ingredients in foods can help protect it.
Eggs (yolks, unfortunately), legumes, avocados, soybeans, and nuts: All of these contain biotin, an essential chemical for fat and carbohydrate metabolism. A lack of biotin (caused by taking too many antibiotics or an inadequate diet) can lead to dry skin or dermatitis of the face or scalp. (A deficiency can also cause your hair and nails to become brittle and frail.)
Salmon: It contains astaxanthin, the carotenoid that gives salmon its pink color, which improves skin’s elasticity, and the good fat DHA-omega-3, which also makes your skin and hair look younger and healthier.
Green tea: Contains polyphenols that have free oxygen radical scavengers. These protect against photo damage and thicken the epidermis. It can be taken orally or topically. And it may help sunburn.
Pomegranates: In addition to thickening the epidermis and prolonging fibroblast life to produce more collagen and elastin, they contain phytonutrients that seem to accelerate wound healing.
Tomatoes: The nutrients in these reduce the chance that you will get a sunburn, so bulk up on tomatoes (with a little lipid such as a few walnuts beforehand—so the active ingredients are absorbed) before your annual summer vacation. It may be because of the lycopene they contain, but we really do not know the active ingredients for this effect, so enjoy the tomatoes rather than just a lycopene supplement.
ASK FOR A HAND. There are many benefits to massage—relaxation, the release of muscle tension, the chance to chat with strong-handed Sven. There’s also another: aromatherapy. Many people think aromatherapy has to do with smelling, but it’s really about allowing your body to absorb oils that can have a profound effect on your health. There’s an ongoing debate whether massage with aromas is superior to standard massage, but some evidence suggests you may experience more short-term benefits from a massage with scents. The scent with the most data supporting it: lemon. We recommend you use the scent in a variety of ways:
Spray it on a pillow a couple of hours before bed.
Take a foot bath with lemon in it. Some studies show that a foot bath with lemon as opposed to a foot bath without lemon helps promote relaxation.
Have (or give) a massage with lemon oil, or add it to your bathwater.
Rub your body with lemon oil to promote sleep and soothe skin burns.
Some other aromas and oils we suggest:
Tea tree oil for topical infection in some of our “dirtier” areas, such as the feet, armpits, or groin, or even the pilonidal cyst area just above the crack between the buttock cheeks in hairy people.
Rosemary, which can help improve mental alertness and function by reducing the effect of stress so you can focus.
Peppermint and lavender (we suspect these work, but we’re still waiting for good scientific studies to find out).
PUT THE FIRE OUT. Quickly treat burns from both sun and flames with ice water, as mentioned earlier, to slow down the rush of inflammatory cells that create blistering and further the collateral damage of the burn. Sap from the aloe leaf can also be very soothing. Most important, prevent infections in the damaged area (bacteria love dead and burned skin), since infection will worsen the scar. Staying out of the sun for six months after surgery will minimize the risk of brown pigmentation in the scar as it tries to protect itself from UV radiation. By the way, if a new burn hurts, that’s good. It means you didn’t fry the full thickness of the skin. A deep burn through the dermis kills the nerves so you don’t actually feel it. But an old wound that starts hurting is your body’s message for you to see a doctor.
SLEEP AND EXERCISE. They stimulate growth hormone, which promotes fibroblast health and allows more production of collagen and elastin to keep your skin taut. They also accelerate the production of epidermis. See more about exercise and our new band workout in YOU Tools.
OIL UP. We love olive oil, and whenever we find another use for this natural wonder, we get excited. Olive oil should find its way into makeup and skin creams, since it has been shown to decrease UVB damage to the skin. Extra-virgin olive oil seems to work better. (Like almost anything, olive oil can be a skin irritant in some people.) To make an olive oil bath, add ¼ cup olive oil along with a few drops of lavender or peppermint oil to the bathwater. In the winter or in low humidity, olive oil is the most natural of the moisturizers. Massage it into your skin, particularly the elbows, face, feet, and legs. Olive oil can also be used to moisturize the scalp and hair, the nails, and the lips.
CHECK IT. Treat your skin like a science experiment. Look at it. Inspect the pore size with a magnifying glass. See how much skin you can slough off with sandpaper (kidding on that one). Do it regularly—one of the ways to really assess skin health is to look at your skin often, to compare changes in things like pore size, oil, flakes, and wrinkles.
DON’T TRAP DIRT. Your skin needs to breathe for heat exchange and to get rid of toxins from the sebaceous glands. But your skin can’t breathe if it’s suffocated by a pancake-thick layer of makeup. While we’re not in a position to tell you to flush your cosmetics, we do believe that many women can be brainwashed to believe that makeup is absolutely necessary to improve their appearance. Healthy skin is nature’s ultimate cosmetic.
DROP THE FAT. High blood fat levels won’t just clog your arteries—they’ll clog your skin. Out-of-control levels of cholesterol and triglycerides can wreak havoc on your appearance. A hailstorm of yellow bumps, called xanthomas, results from high triglyceride levels. Scavenger cells clean up the fatty debris beneath the surface of the skin. Diets low in saturated and trans fats, blood sugar control, and LDL cholesterol–lowering and HDL cholesterol–raising medications are essential steps. Once blood fats are lowered, xanthomas can resolve, but this may take years. Adding niacin (300 mg or more twice a day—see your doc on these) and 162 mg of aspirin a day (with half a glass of warm water before and after to minimize stomach damage) will help reduce arterial inflammation and reduce the risk of wrinkles as well as erectile dysfunction.
CHECK FOR CO-Q10. Coenzyme Q10 helps prevent damage to lipids on the surface of the skin. It’s good to see Co-Q10 as an ingredient in skin products that you’re going to buy. But studies have shown that many products listing Co-Q10 as an ingredient either do not contain Co-Q10 or have less of it than advertised (a lot less—like 90 percent less). Check www.consumerlab.com or look for the USP-verified symbol on the bottle to ensure you are getting the ingredients for which you are paying. After 2011, the FDA will be monitoring to ensure that what is on the label is what is in the bottle, but you should start earlier than that.
LAY OFF THE BOOZE. Alcohol dehydrates the skin and increases the leakiness of capillaries, so more water moves from the bloodstream into soft tissues. Combined with the horizontal position during sleep, this results in facial puffiness, stretched skin, and faster wrinkle formation. While we’re knocking vices, cigarettes not only damage your arteries to contribute to the formation of wrinkles, but they’re also responsible for vertical lines above the lips. That’s partly because cigarettes deplete levels of a gas called nitric oxide from the inner lining cells of your small arteries (and large ones, too). That short-lived gas helps gives skin some of its flexibility, so cigarettes and saturated fats take away your skin’s flexibility and contribute to wrinkles. Combine that with decades of puckering your lips around those cancer sticks and you’ve got prune lips. So when you quit, you often look younger as the nitric oxide returns and the vertical lines decrease.
ENLIST THE PROS. Some say wrinkles look distinguished. Some say they make you look older than a French cathedral. If you fall into the category where you want wrinkles on your skin as much as you want them on your wedding dress, then you have several professional options, besides the do-it-yourself tactics we’ve outlined above.
Injectible fillers. These plump up the tissue to eliminate wrinkles. Collagen injections are being replaced by hyaluronic acid because it lasts longer and your body can attack your own collagen if you use a lot of that cow stuff—not a good situation. Hyaluronic acid physically plumps up the dermis, making wrinkles virtually disappear. How long these fillers last depends on their thickness and the exact chemicals they are made from. The thinner ones (for fine lines) hurt less but have a shorter duration, while the thicker ones (for big wrinkles) that act more like caulk are inserted deeper and last longer. On average, they last between six and twenty-four months.
Paralyzing agents such as Botox. Originally approved to eliminate excessive twitching of the eye muscles, Botox weakens muscles, smoothing the skin and diminishing wrinkles. A very low dose of botulism toxin is inserted directly into a muscle and deadens its nerves for an average of four months. It’s most often and best used for creases between or around the eyes and the forehead. Daring surgeons inject it around the mouth, sometimes creating the ultra-beautiful effect of drooling. Yes, people have died from Botox, but the doses that were used were at least ten times the cosmetic dose. Around the eyes, go ahead and talk to your doc about Botox if you don’t want to scowl.
TRY A PATTY FACIAL. Stimulating the lymph drainage of your face can cleanse toxins and reduce facial swelling. Best of all, it only takes one minute in the shower. With the water caressing your face, gently sweep your hands from your chin down to your neck. This rubs the large nymph nodes (which always swell when your throat hurts) and stimulates the large ducts to drain waste fluid from the face. Then move up as you pat your fingers from the middle of your face outward toward your ears. Start below the lips and move up to beneath the nose, then the bridge of the nose, under the eyes, and finally the forehead.
ERASE THE MARKS. Here’s what you can do about some of the spots, blemishes, and lines that may make you feel like jumping out of your skin.
What’s On Your Skin: Age Spots
What They Are: Flat, round, brownish spots that look like freckles. Benign age spots aren’t dangerous.
What You Can Do: If they bother you, see a dermatologist or plastic surgeon who can treat them with bleaching creams, laser therapy, or such procedures as chemical peels. Using sunscreen can prevent the development of more spots. Sun makes them darker so use sunscreen—at least an SPF 30 with three-to four-star UVA protection. Common skin cream ingredients such as vitamin C, vitamin A, glycolic acid, emblica, and licorice extract can lighten brown spots when used for months (more in Chapter 4), and so can niacin.
What’s On Your Skin: Stretch Marks
What They Are: These scarlike marks appear when the skin stretches beyond its elastic capability and the underlying connective tissue tears.
What You Can Do: They tend to diminish over time after the early redness subsides, but there’s no known nonsurgical treatment to eliminate the marks. Treatments such as laser therapy or Retin-A are not effective in diminishing the appearance of scars.
What’s On Your Skin: Varicose Veins
What They Are: When valves preventing backflow of blood returning to the heart become weakened (often because of pregnancy or weight gain), blood pools in the veins of the legs, causing them to bulge.
What You Can Do: You can reduce some of the symptoms (like pain and swelling) by elevating your legs to promote blood drainage to the heart and avoiding standing for long periods of time. Wearing compression stockings while standing can stall their development. Various kinds of surgery can also address varicose veins—either by removing them or by closing them off.
Step 1: WATCH WHAT YOU’RE WASHING
You have an acid mantle (like cellophane) that forms a protective layer on your skin to inhibit the growth of harmful bacteria and fungi. If it loses this acidity, the skin becomes more prone to damage and infection. How do you lose the acidity? By washing your face with ordinary soap. Most of the soaps we use are basic in nature, which counteracts the acidity, so you end up removing the mantle that seals in moisture. Now, we’re not trying to encourage that outdoor look or manly smell by not washing. Use pH-balanced soaps and cleansers; if they are gentle enough not to sting your eyes, chances are good they won’t harm your skin either. Your pores will look smaller if they’re kept free of oils and dirt. Ideally, you should wash your face twice daily, and you don’t need to spend more than a few seconds doing it. Excessive rubbing can aggravate eczema and acne. Skip the soaps with colors and fragrances, too. They just add residue and increase the chance of an allergic reaction.
Step 2: ADD ANTI-OXIS
If you read our tip on vitamins, you’ll know they can help improve the skin. Here’s a quick recap of why antioxidants help. Natural antioxidants inside the membranes of your cells (vitamin E is the most common in the skin) protect you against free oxygen radicals in the membrane and lipid portions of the cell. They’re especially important for protecting your skin, because they help thicken your epidermis while the sun quickly depletes levels of vitamin E. Your body will replenish its own vitamin E if you are eating smart, but adding some extra vitamin C (which protects the water-soluble portions of your cells) can help decrease the appearance of wrinkles and improve the formation of collagen and elastin.
Only certain types of vitamin C will penetrate the skin—one called L-ascorbic acid does this particularly well. To work, it must be in a concentration of at least 10 percent and must be kept acidic. So, you can’t just rub oranges on your face and expect it to work. L-ascorbic acid is oxidized by the sun, rendering it ineffective, so use it at night.
Topical application of niacinamide (niacin, vitamin B3) and pantothenic acid (vitamin B5) and other antioxidant vitamins (taken orally) are good for the skin. In fact, topical niacin helps prevent injury caused by the sun, and increases the level of certain fats and protein in the skin, which improves its barrier function, and it helps reduce the yellowing of skin that’s associated with glycation (the yellowing can disappear between 4 and 12 weeks of use).
Step 3: MOISTEN BEFORE USING
Typically, your skin soaks up moisture to keep itself young and vital, but it loses the ability to do that as you age. Most commercial face creams are oil-based and work by blocking the release of water from the skin. As people grow older, however, they cannot rely on oil-based preparations to block the release of moisture. That’s because aged skin loses the ability to attract moisture in the first place and becomes fundamentally dehydrated. But the vitamin A family, commonly called retinoids, can increase the actual water content of the skin without clogging the dead layer of cells. Retin-A contains retinoic acid and requires a prescription. Retinyl propionate, retinyl palmitate, and retinol (retinaldehyde) don’t require a prescription, and all are converted by your skin’s own enzymes into retinoic acid.
Healthy moisturizers don’t disturb the acid mantle of the skin or clog pores. We prefer natural moisturizers, such as squalene (made from olives), avocado oil, walnut butter, or cocoa butter, and ones that are proven to be hypoallergenic. Apply while you’re still damp from the shower to seal the moisture in, and remember, it’s especially important to moisturize when you’re flying, at high altitudes, or in dry climates.
Step 4: EXFOLIATE OFTEN
Which is better for your floor? Sweeping it clean every week or waiting for all the gunk to build up and then doing one big power wash a year? Exactly. You have several choices when deciding to do the same with your face:
Mop it clean daily or weekly with a light physical exfoliant or a chemical exfoliant. Don’t use physical exfoliants that have sharp edges, since they can damage healthy skin below. Apricot seeds are natural and work like an old-fashioned straw broom as opposed to the newfangled chemical beads, which are more symmetrical like a synthetic broom. We favor the latter but won’t report you to the authorities if you insist on going the old-fashioned way. Try some on the back of your hand to make sure it’s not too harsh.
Microdermabrasion is industrial-level exfoliation and can be repeated monthly for the best results in typical people. Microdermabrasion uses either aluminum oxide or salt crystals or, even better, embedded diamonds to exfoliate while the oils are sucked right out of those pores. See below for more about microdermabrasion.
Power-wash it with something stronger, like trichloroacetic acid, which takes off the top layer of skin (it looks so bad for a week that we recommend doing this once yearly around Halloween). This is most useful to lessen that annoying splotchy brown pigmentation. This requires a doc.
Every few years you can scrape it with a sandblaster or wire brush—that’s real dermabrasion and the recovery is not particularly pleasant, so new light lasers are being developed to do this without the downtime. Unfortunately, they’re so new we can’t recommend one yet.
While they all can be effective, it makes the most sense to us to exfoliate once a week to remove dead skin cells and stimulate growth of new ones. If you wear makeup or are exposed to a lot of dirt, exfoliating nightly is recommended (don’t do it at midday, which basically only removes your makeup). Also, for the women here, you produce more oil during your period so you’re susceptible to more acne, meaning you should use a lighter peel.
Use a loofah sponge for your body. The loofah mechanically removes the old layer of skin. (Turkish baths require loofahs, and folks don’t feel really clean unless they’ve had a vigorous rubdown.)
If you’re going to do it yourself, look for exfoliating products that contain acids compatible with your skin’s own natural acidity. Some options:
Alpha-hydroxy acid (usually listed as glycolic acid) works as an exfoliant by peeling off the top layer of dead skin and hydrating with moisturizer. Alpha-hydroxy acids (skin-rejuvenating fruit acids) have been around for about 20 years and make a marked improvement in skin quality by sloughing dead skin cells off the surface so that more youthful-appearing fresh cells become visible. Fine lines and wrinkles lessen and your skin takes on a fresher-looking tone.
Glycolic acid (less than 10 percent concentration is safest; docs use higher concentrations), which is derived from sugarcane, traps moisture in skin and releases dead cells. Use it sparingly at first to make sure it doesn’t cause skin irritation.
Hyaluronic acid is a large sugarlike molecule in the extracellular matrix that binds with water and provides volume and fullness for skin, making skin smooth and moist. Hyaluronic acid can’t penetrate the skin, however, so when you put it on your skin, it’s really just a moisturizer.
Apple cider vinegar also works as an exfoliant for the top layer of skin.
Step 5: PICK THE BLOCK
You’re supposed to get 20 minutes of sunlight a day—but only when it’s at low levels (a good rule to tell: your shadow should be longer than your height). This includes even on a cloudy day, which stops only 20 to 40 percent of UV radiation. Beyond that, you know the drill. You know it, you hear it, you see the ads with the baby’s butt on billboards. Wear sunscreen. Like punishment doled out in the principal’s office, sun protection is nonnegotiable—because it’s the most critical factor in keeping skin healthy. It’s best to make sunscreen a part of your daily regimen so you won’t get unexpected exposure (or get a sunburn). Use a great moisturizer that you love that also contains an SPF 30 sunscreen and affords the protection you need. If you’re going to be outside for sports, use a lotion with SPF 30 (for UVB) and a four-star rating (for UVA) and reapply every two hours.
Our recommendation: Always protect your face and the backs of your hands but allow your body to be exposed to some sun for a few minutes before you add sunscreen. A little redness in the skin signifies that vitamin D is being made. Here’s a helpful hint: zinc oxide and titanium dioxide sunscreens protect immediately, and newer versions of these sunscreens form a thin film rather than making you look as if you smeared crayon all over your face. All the rest of the sunscreens—called chemical or organic sunscreens (misnomers if we ever heard one)—take 20 minutes to absorb into your skin before protecting. So get those few minutes of sun and then apply the zinc.
You need to slather all sunscreens on thickly and apply them evenly, making sure not to miss any spots such as the back of the neck, the top of the ears, and any exposed scalp. Most of us don’t put on enough sunscreen, and if that’s the case with you, then you’re getting only half the effectiveness (if you’re putting on SPF 30, it’s more like SPF 15). You really need 1–2 ounces of sunscreen to cover your whole body.
Which product is the best? Look for ones that are hypoallergenic and noncomedogenic, because you don’t want to cause other skin damage while trying to protect from sun damage. But don’t put a lot of faith in those labels, since all creams can cause pimples and rashes. It’s really hit or miss. Also make sure that your sunscreen is water-resistant so it doesn’t end up in your eyes while the rest of the players on your team watch you drop the ball in painful anguish. Water resistant also means it will stay on your body past the first droplet of sweat when you are hot. But even if it says “water-resistant,” reapply it after swimming. By the way, hats and T-shirts don’t provide enough SPF protection. Hats provide an SPF of 10 at the most, and T-shirts only about SPF 5 (but sun-protective clothing with higher SPFs are available).
Ever wonder what the heck the SPF numbers truly mean? An SPF of 1 means that your skin covered in SPF 1 would turn red in about 20 minutes; SPF 2 would require 40 minutes, and so on. The most common reason for sunscreen failure is using inadequate amounts.
Step 6: HAVE A PRO SAVE YOUR FACE
While some cosmetic procedures may seem as unnecessary as gumball machines, there are a lot of advantages to getting regular facials or microdermabrasion. Microdermabrasion is really a facial without all the glitz. It simply exfoliates your skin and sucks the dirt out of your pores. If you can afford it, get a facial or microdermabrasion monthly to clear pores, which can be clogged by makeup. The massage part will also stimulate blood flow. These cleaning procedures must be followed by proper skin care at home twice a day—cleaning, antioxidant protection, hydrating, protecting against the sun, and exfoliating regularly.
FACTOID
Within 1,000 years of a population’s migration from one climate to another, its descendants have the correct color skin to protect them and maximize nutrients in their environment. If you chart the evolution of skin color of populations living in one area for 500 years, the curve perfectly correlates UV radiation with skin color. The only exception is the Inuit, who have dark skin and hair even though they inhabit northern climates; that’s because they eat lots of fatty fish, which provide vitamin D, so they don’t need it from the sun. Our ancestors began migrating from northern Africa 250,000 years ago, so there has been lots of time for our skin types to adapt to our climate.
It used to be that people would decorate their bodies with the big three—clothes, makeup, and facial hair. These days, bodily decoration has become infinitely more creative and colorful. With the prevalence of tattoos and piercings on the rise (24 percent of people between the ages of 18 and 50 have tats), it seems that everywhere you turn, you’re looking at a skull, rose, or some Asian symbol. Some of us scar our bodies and embed metal under our skin. We’re not telling you that you can’t look like a Ferengi from Star Trek, but if you do choose that alien look, we want you to stay safe.
Professional tattoos are applied with a sewing machine–type needle that drags ink into the mid to upper dermis as it penetrates. Some pigments contain iron oxides and some organic chemicals. Most inks/pigments are from nonsterile bottles, but some companies do make sterile pigments, which cost hundreds of times more than the nonsterile ones (which makes them hard to find). Here’s the lowdown on what you need to know if you decide to have yourself inked or pierced.
STAY STERILE. Your artist should wear sterile gloves and a surgical mask, and your skin should be cleaned with an antibacterial solution. We prefer Betadine, but most will just use alcohol. Betadine is better because it lasts longer and kills a wider variety of bugs. But it needs to be applied wet and allowed to dry to really work its wonders. Infections can occur because the barrier of the skin is broken during the procedure. (Tattooing and piercing are the only situations where the skin is intentionally penetrated by nonmedical people.) Because pigment is not sterile, bacteria and viruses can contaminate it, and infections can come to you from parts of the machine that can’t be sterilized (even though your artist may think the machine is spotless). HIV and hepatitis B and C can be transmitted through tattoos and take a long time to show up in blood tests, so you won’t be able to donate blood for a year after receiving a tattoo. People with tattoos are nine times more likely to contract hepatitis C than people who never get tattoos. Essentially, you’re having sex with your tattoo artist and everyone else he’s used the pigment on. If you wouldn’t have sex with these unknowns, don’t get tattooed with that old pigment.
THINK AHEAD. A letter on your cheek? Dots on your fingers? You might want to think twice or even three times about putting a tattoo on an area that is visible in normal clothing. What you do to your privates stays private, but your neck will be visible to every employer and customer for your entire life. Pick spots that can be concealed and are more amenable to future modification, such as upper legs, buttocks, and back. When the skin is thin, it’s more difficult and painful to remove or alter.
KEEP IT CLEAN. Treat your tattoo like a wound for the first week or so. Keep it clean by washing it with soap and water twice a day. Coat the area with bacitracin, Neosporin, or Vaseline. You’ll know when it’s healed; it’ll stop hurting. If it still hurts after five days, give your doc a call.
TAKING IT OFF. Maybe you’ve decided that Yosemite Sam on your forehead doesn’t go over all that well at job interviews. If the tattoo is small, you might consider having it cut out—one procedure and it’s done. You’ll be replacing the tattoo with a scar, however. If it’s larger, lasers might be the answer. Different lasers are used for the different colors in your tattoo. The laser heats up the pigment and explodes the cells that contain it. The pigment then disperses and other cells pick it up. Each treatment blurs the tattoo until it is hard to see. But there are many drawbacks to lasering; it takes many painful, expensive treatments and often leaves white scars behind.
For the time being, you’ve got a problem if you don’t like your tattoo because the pigments are permanent, but removable tattoos are around the corner. Within a few years biodegradable pigment sealed into tiny plastic capsules will be used. When the capsules are lasered, they break open, and the biodegradable tattoo disappears.
CHECK THE PIERCING TOOLS. Piercing instruments must be sterilized in autoclaves—medical-type machines that kill every little germ that can cause infections. The instruments shouldn’t be boiled, placed in hot glass beads, or dipped in some strange chemical. The piercing instrument should be wrapped in a bag with an indicator that tells you the proper temperature was reached to kill bacteria and viruses. And that’s not enough. The autoclave must be tested every week with live bacteria to make sure it’s really working.
Like a tattooer, your piercer should wash his hands and put on sterile gloves, and your skin should be cleaned with Betadine before any piercing. The Betadine should dry on your skin to a beautiful orange. The jewelry should also be sterilized before it is put into your body. Since stones will loosen in an autoclave, we recommend using only metal jewelry right after a piercing. You can bring your jewelry to your family doctor and ask her to sterilize it for you. After the piercing, keep the area clean with hydrogen peroxide on a Q-tip or washcloth. Then coat the area with bacitracin or Neosporin. Skip where they tell you to clean the area with alcohol. That will actually stall healing. It takes weeks to months for the piercing tract to heal. Until that time, don’t remove the jewelry for more than a few minutes.
BE SMART. Earlobes are a pretty safe area to pierce; that’s why 12-year-olds with an ice cube and a needle can usually pull this one off. We recommend that you draw an ink spot exactly where you want the piercing on one side, then measure the distance up from the bottom of the lobe and back from the cheek. This is the spot the piercing should go on the other side. If they come out crooked, just take the earrings out and wait a month to repierce. Other than the lobes and the belly button, you’re increasing your risk of trouble if you stray to other areas. Ear cartilage, for example, has poor blood supply and can’t fight germs if they get in. An infection here will leave you looking like a basset hound. In the eyebrow, there’s a nerve that supplies sensation to the forehead that might be speared with the piercing. You’ll remember the piercing every day because painful scar tissue, called a neuroma, can form here. Other areas such as the nose, labia, and nipples are definite danger zones when it comes to infection and other long-term issues, like breast-feeding. And the tongue? Make sure you have good dental insurance; you’ll need it as the piercing destroys your teeth by clanging against your precious enamel and gives your breath that sweet odor of trapped bacteria. Ugh.
Cosmetic Enhancement?
Queen Cleopatra of Egypt set the trend for thousands of years. A little green copper and black kohl around the eyes and some red iron ore on the cheeks and lips and, voilà, Madonna had nothing on her. Since then, most women (and a few men) older than 12 have practiced the fine art of makeup to hide wrinkles, look younger, and attract mates. Early cosmetics were made of toxic metals such as lead, arsenic, and mercury that ate away at the skin if they were used long enough. Safer cosmetics have been in use for the last 200 years. Even so, toxins such as lead keep cropping up in makeup.
While the FDA supervises the cosmetics industry, that control is with a very long leash. Most creams and cosmetics contain many ingredients, and any one of the ingredients can cause contact dermatitis, a type of allergic reaction. Fragrances are the main culprits, but preservatives, chemicals (such as p-phenylenediamine and glyceryl monothioglycolate), UV sunscreens, resins, and nail acrylates cause many allergic reactions. If you suffer an allergic reaction, you may need a dermatologist or an allergist to perform a patch test on you to determine the cause.
Some other dangers to be aware of:
In the Middle East, Asia, and Africa, kohl is still used as an eyeliner. More than half of these products contain lead. Users have been found to have high body lead levels, which can lead to nerve damage. Lead has also recently been found in lipsticks manufactured in China.
Powders improve facial color and also absorb oil. They are made of either talc (magnesium silicate) or zinc stearate with added magnesium carbonate (chalk). Since inhaled talc and titanium dioxide cause lung injuries that some scientists think eventually lead to cancer, it’s a good idea to avoid powders with them. The industry is beginning to respond by creating “green” cosmetics. Powder made from velvety smooth cornstarch can safely replace the minerals that are toxic to your lungs.
Because germs can contaminate mascara, preservatives must be used. Mascara is probably the most dangerous of cosmetics, with risks of bacterial and fungal eye infections and allergic reactions to the preservatives, all occurring close to the eye. The dyes can also permanently color the inside of the eyelid.
For a list of specific product recommendations, see www.realage.com, where we have enlisted the help of cosmetics specialist Paula Begoun.
