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Monthly Archives: November 2016

The Dry Skin Diet for Healthy Skin

If you have dry skin, you know that lotions and moisturizers help. But can certain dietary choices combat dry, itchy, scaly skin?

“The most important part of the skin barrier is lipids, including phospholipids, free fatty acids, cholesterol, and ceramides,” says Amy Newburger, MD, an attending physician in the Dermatology Department at St. Luke’s Roosevelt Medical Center. “Skin without enough fat in it has a protein predominance and is kind of like a mess made just of twigs with no glue between them.” Water easily escapes through a barrier without lipids, allowing skin to become dehydrated.

Polyunsaturated fatty acids are necessary for the production of intercellular lipids — the “glue” between the “twigs” in the stratum corneum, or surface of the skin. They also have an anti-inflammatory effect on irritated skin. Two types of fatty acids that are “essential” — that is, they must be obtained through the diet — are omega-3s, and omega-6s.

Foods that are high in omega-3 fatty acids include fatty fish like salmon, herring, mackerel, anchovies, and sardines, as well as flaxseed oil, some types of eggs, and grass-fed beef. Evening primrose oil and borage seed oil, which are high in omega-6s, help hydrate the skin and prevent water from evaporating, says Leslie Baumann, director of the University of Miami Cosmetic Medicine and Research Institute. “If you don’t like fish or are pregnant and can’t eat it, omega-3 supplements are a good option.” Most Americans get enough omega-6s through their diet because they’re contained in corn and safflower oils.

While anecdotal success of fatty acids for alleviating dry skin has not been conclusively bolstered by research, several studies have shown significant positive effects: In a 2006 study of 50 patients with atopic dermatitis, 96 percent of those given capsules of evening primrose oil for five months showed notable reduction in intensity, itching, and dryness of the skin. In another study, of 29 elderly patients, borage seed oil supplements taken in pill form helped reduce water loss from the skin by 10.8 percent. And in a study of 118 infants with high risk of developing atopic dermatitis, those who were given borage seed oil and went on to develop the condition experienced a lower severity of the disorder than those in a placebo group. On the other hand, a 2006 meta-analysis of 22 studies that tested the effects of essential fatty acid supplementation found that no significant benefit was conferred on people with atopic dematitis by plant and fish oil supplements. More studies must be conducted before conclusions can be reached.

Vitamins and Minerals for Dry Skin

“Vitamin C is necessary for the function of the enzyme that causes collagen to form,” says Dr. Newburger, “and collagen acts as a sponge for moisture.”

Newburger adds that copper and zinc are also necessary. Together, vitamin C, zinc, and copper keep collagen denser, which in turn allows for plump, hydrated skin. “Any good multivitamin with trace minerals in it contains zinc and copper,” says Newburger. Zinc has also been found to have anti-inflammatory effects, which is vital for maintaining smooth skin.

Caffeine, Alcohol, and Dry Skin

While consuming caffeine is unlikely to dehydrate you, it does make the blood vessels constrict, which is why it’s used in eye creams (to reduce puffiness). “Long term, this means a reduced amount of blood flow and nutrients though the tissues,” warns Newburger. “And if you don’t have healthy circulation, you won’t have age-appropriate cell turnover.”

In the case of alcohol, Michele Murphy, a registered dietitian at NewYork Presbyterian–Weill Cornell Medical Center, explains that although it’s a diuretic, you’d need to be severely dehydrated to experience any noticeable changes. “The average person having a glass of wine with dinner every night and maintaining adequate fluid intake is unlikely to see any real difference,” she says. Contrary to popular belief, drinking large amounts of water does not affect skin. “The water we drink that’s processed internally isn’t going to impact the external look or feel of the skin,” Murphy says. Instead, it’s the skin’s outer layer that is essential for keeping moisture in.

Don’t Overdo It

If you’re already eating a balanced diet with sufficient fats, adding more fats or taking supplements is not necessarily a quick fix for dry skin. “If you’re deficient in fat or certain vitamins, it does have the potential to affect the look or feel of your skin,” says Murphy. “But supplementing beyond what the body needs has not been shown to improve skin.”

Tips to Choosing the Right Skin Care for You

Selecting skin-care products can be a daunting task, what with all the choices filling pharmacy aisles. You’ll find dozens of over-the-counter products with such labels as “maximum strength,” “clinical strength,” and “original prescription strength” — plus seemingly identical products that are available only by prescription. What do all these labels mean, and how do you know which product is the best one for you? Here are some answers.

How Much Active Ingredient?

The active ingredient in an over-the-counter product is often the same as the one found in its prescription counterpart, but at a lower dosage. Over-the-counter dandruff shampoo contains a lower dosage of the active ingredient ketoconazole (1 percent), while the prescription-strength versions contain 2 percent. Inhydrocortisone anti-itch cream, the maximum over-the-counter dosage is 1 percent, while prescription-strength creams contain 2.5 percent. According to U.S. Food and Drug Administration (FDA) regulations, once a product’s active ingredient reaches a certain percentage — such as 1.5 percent for hydrocortisone, or 2 percent for salicylic acid in acne treatments — it requires a prescription from a doctor.

Sometimes It’s Just a Marketing Strategy

Because the FDA does not closely regulate over-the-counter skin-care products, a company can label a product “maximum strength” or “clinical strength” for any reason it sees fit — and the label is no guarantee that the product will actually be any stronger than others on the market. The best way to find out whether you are really getting the “maximum” strength of an ingredient is to check the ingredients label, says Robyn Gmyrek, MD, assistant clinical professor of dermatology at Columbia University College of Physicians and Surgeons. “Compare the label with other products on the shelf,” says Dr. Gmyrek, and check the percentage of the active ingredient in each product.

Although an increase in the active ingredient in a product of 1 percent may not seem as though it would significantly affect the strength, it can, says dermatologist Doris Day, MD, director of Day Cosmetic, Laser and Comprehensive Dermatology in New York City and a professor at NYU Medical School. For this reason, it’s best to test a new skin-care product by applying a dime-sized amount on your forearm, to see if it causes a reaction.

Prescription Products Must Be Approved by the FDA

For the FDA to approve a product’s switch from over-the-counter to prescription-strength status, regulations require a company to show that even a slight increase in the amount of active ingredient (for example, 1 percent) “changes the structure or function of the skin.” All prescription products are reviewed by the FDA and have gone through numerous clinical trials, says Debra Jaliman, MD, a New York City dermatologist. The FDA also decides what dosage level constitutes a prescription. Some OTC products may be labeled “original prescription strength,” which means a prescription from a doctor was once required, but the product is now available without one.

Finding the Right Product for You

How do you know which product to try? Stronger dosages can have harsher effects on your skin, so it’s generally safer to start with a lower dosage. Try the basic OTC product for a minimum of two weeks to gauge the results, then move on to a maximum- or clinical-strength product, if necessary, or request a prescription, says Dr. Day. For acne, you should expect to wait a little longer — from four to six weeks — to see results. And if any product irritates your skin or makes symptoms worse, see your doctor immediately.

Skin and Beauty Glossary

Acne conglobata: Type of acne in which interconnected nodules are located beneath the surface of the skin.

Acne mechanica: Acne caused by exposure to heat, covered skin, pressure, or repetitive friction.

Acne vulgaris: The most common type of acne, associated with blackheads, whiteheads, papules, and pustules, commonly referred to as pimples or zits.

Actinic keratoses: Precancerous growths that can appear red, thick, and rough; usually found on sun-damaged skin.

Age spots: Flat, brownish patches on the skin caused by sun exposure and perhaps aging; also known as “liver spots.”

Alopecia: Unusual hair loss, most often on the scalp.

Alpha hydroxy acids (AHAs): Exfoliating ingredients derived from fruit and milk sugars and used to help reduce the appearance of wrinkles and age spots.

Antioxidants: Vitamins A (including beta carotene), C, and E, thought to repair and protect skin cells by neutralizing damaging free radicals.

Atopic: When an antibody present in the skin makes someone more likely to experience allergic reactions.

Basal cell carcinoma: Type of skin cancer that forms at the base of the epidermis of the skin and usually does not spread to other parts of the body; associated with long-term overexposure to the sun.

Benzoyl peroxide: Topical acne treatment that kills acne-causing bacteria.

Blackhead: A clogged pore usually filled with hardened oil and dead skin cells; the tip is visible at the pore opening.

Blepharoplasty: Cosmetic procedure to remove excess fat and skin from around the eyes.

Chemical peel: Chemical solution applied to the skin to remove damaged outer layers.

Dermabrasion: Procedure in which a rotating brush is used to abrade, or remove, the outer surface of the skin.

Dermatitis: Inflammation of the skin.

Dermis: The middle layer of the skin.

Eczema: Inflammatory response in the skin that can lead to redness, itching, and scaling.

Epidermis: The outer layer of the skin.

Exfoliate: To slough off the outer layer of skin cells.

Follicle: A shaft in the skin through which hair grows.

Isotretinoin (Accutane and other brand names): Oral vitamin A-based medication used to treat severe acne.

Laser resurfacing: Laser procedure to remove signs of aging, including fine lines, wrinkles, and age spots.

Melanin: A chemical in the body that gives skin and hair their unique color.

Melanoma: Life-threatening form of skin cancer that usually develops in an existing mole.

Mole: Pigmented skin lesion also known as a nevus.

Noncomedogenic: A product not likely to clog pores and cause acne lesions.

Papule: Acne lesion that appears as a small, red bump on the skin.

Photo-aging: Skin damage that results from prolonged overexposure to the sun.

Phototherapy: Artificial ultraviolet (UV) radiation treatment for some skin diseases.

Plaque: Raised, but relatively flat, patch of skin.

Psoriasis: Skin condition characterized by red, raised, scaly patches.

Pustule: Inflamed acne lesion containing pus.

Retinoids: Derivatives of vitamin A used to treat a variety of skin conditions.

Rosacea: Skin condition characterized by prominent spider veins and sometimes swelling.

Sclerotherapy: Treatment that reduces the appearance of varicose veins and spider veins by injecting them with a special solution.

Sebaceous glands: Oil-producing glands in the skin that are attached to hair follicles.

Seborrheic dermatitis: Scalp condition associated with itching and flakiness (dandruff) that can also occur on the face.

Skin biopsy: Diagnostic procedure in which a portion of the skin is removed for examination in a laboratory.

Spider veins: Small reddish or purplish sunburst-shaped veins under the skin.

Squamous cell carcinoma: Type of skin cancer that forms in outer layers of the skin, capable of spreading to other parts of the body, and associated with long-term overexposure to the sun.

Subcutis: The layer of fat beneath the skin.

Telogen effluvium: Hair loss that is temporary, often related to stress, illness, or recent childbirth.

Topical: A product applied on the skin.

Tretinoin: Topical retinoid used to treat acne by unclogging pores; also used to lessen signs of photo-aging.

Ultraviolet light: The sun’s UVA and UVB rays that can cause both skin damage and skin cancers.

Urticaria: Raised reddish, itchy areas, also called hives.

Varicose veins: Large blood vessels that appear as blue bulges beneath the skin; may be associated with swelling, pain, and other symptoms.

Whitehead: Closed acne lesion caused by a clogged hair follicle.

A Guide to Natural Skin Care Products

In today’s world of eco-conscious living, being good to the environment is a high priority, whether you’re buying light bulbs or a cream for dry skin and wrinkles. And cosmetics companies take advantage of that by offering natural skin care products with ingredients that are touted as being better for your skin and environmentally friendly.

“Natural skin care is more of a marketing term than a scientific one,” says Dee Anna Glaser, MD, a dermatologist and professor of dermatology at St. Louis University and president of the Cosmetic Surgery Foundation.

“Products that have botanical ingredients that come from plants or nature — think honey or beeswax — tend to be labeled as natural,”’ says Dr. Glaser. They may or may not have the same ingredients that other products do. And you can find them everywhere, from drugstores to department store makeup counters to boutiques and even at dermatologists’ and plastic surgeons’ offices. In fact, so-called natural skin care products are so ubiquitous that it’s hard to tell whether they’re any better for you than other products.

“‘Natural’ really doesn’t tell you anything,” Glaser says. “It’s a way of marketing [a product] to make you feel good about its use when people are trying to be green and think environmentally.”

In some cases, natural skin care products may be the way to go, but not always. “Poison ivy is natural, but that doesn’t mean you want to rub it against your skin,” Glaser says.

The Benefits of Natural Skin Care Products

There are some ingredients in natural products that are soothing and calming to the skin, even if your skin is sensitive. Glaser notes the benefits of these ingredients:

  • Soy. Products that contain soy can soothe the skin while fading dark discolorations.
  • Feverfew. This herb can calm irritated, dry skin that’s prone to eczema.
  • Antioxidants. Vitamins C and E have real benefits for the skin. They scavenge for free radicals, which damage cell DNA, leading to wrinkles and skin aging. Unfortunately, many over-the-counter products don’t have a high enough concentration of antioxidants for them to be effective. But you can buy products such as CE Ferulic (which contains vitamins C and E) and Revaléskin (made from coffeeBerry extract) from a dermatologist or a plastic surgeon, Glazer says.

Natural Skin Care Concerns

Sometimes natural skin care products aren’t the best choice when you’re shopping for a moisturizer for dry skin or a cream to treat your wrinkles, Glaser says. Among the drawbacks are:

  • Sensitive skin irritation. Your skin type should dictate the type of products you can use, Glaser says. Someone with rosacea or sensitive skin — and about half of all women think they have sensitive skin — can be irritated by alpha hydroxy acid and glycolic acid, which are natural ingredients.
  • Allergic reaction. Allergens in natural skin care products can cause problems for some people.
  • Breakouts. Someone who’s acne-prone may not be able to tolerate natural lotions that contain oils because they may clog pores and lead to breakouts.
  • High cost. You can find expensive traditional and natural skin care products, but in general, natural skin care products tend to be a bit more costly. An oil-free traditional face cleanser is about $5 for 5.5 ounces, while a natural cleanser that contains bark, chamomile, rosemary, and echinacea costs about $9 for 6 ounces at the drugstore.

What to Look For in Natural Skin Care Products

The key to choosing natural skin care products is to choose wisely. When you’re shopping for skin care and you’re considering natural products, keep these things in mind:

  • The fewer ingredients, the better. When you’re buying any type of skin care product, including natural products, look for one with few ingredients, Glaser says. Natural skin care products tend to have extra ingredients added to them, but the more that’s in it, the more likely it is to cause irritation or an allergic reaction, she says.
  • Big brands tend to be better. Big companies such as Neutrogena, Dove, Oil of Olay, Aveeno, Cetaphil, and others test their products before putting them out on the market, so they’re unlikely to cause skin problems, notes Glaser.
  • Try retinol or retinoids. Retinol, sold over the counter in various products, and retinoids, which are available by prescription as tretinoin (Vesanoid) and tazarotene (Avage, Tazorac), are derivatives of vitamin A that help reduce wrinkles. They’re natural products that really work, Glaser says.

The bottom line is that you should choose products that work for your skin, gives you results, and have the feel and fragrance that you enjoy.