04.27.08
Posted in Rosacea Facts at 4:12 pm by Administrator
Sensitive skin, rosacea, adult acne—how can you tell where you fit?
A recent article in the New York Times by Camille Sweeney, “In a Perfect World, Rosacea Remains a Problem” suggests that rosacea has become “the new cellulite.” That is, the people who “just have rosy cheeks” shouldn’t worry. However, and this is where the rub comes in, anyone who has rosacea knows they are not dealing with a case of just rosy cheeks, which can, I agree, be very attractive.
We rosacea-sufferers are painfully aware that a full-blown rosacea flare-up– where the whole face is bright red or appears rashy– is not at all attractive. Roscaea can be an embarrassment or even, as in the case of the airline pilot Sweeney mentions in her story, interfere with job performance. The airline pilot in question had rhinophema, the condition that affects men more than women and presents as tissue thickening and redness in the nose area. It has so often been referred to jokingly as a wino’s nose that people take it for granted that folks thus afflicted are heavy drinkers. The pilot has to work hard to cover up his nose with cosmetics and zinc oxide because it does not signal a drinking problem in his case, but a condition that is very hard to treat, and for which there is no known cure. The stigma of “wino’s nose” could have serious repercussions for him given his profession.
It is estimated that rosacea sufferers total up to 14 million in the US alone, and the number is climbing. As a sufferer myself I do not dismiss it as a cosmetic concern like cellulite, but a very embarrassing and potentially debilitating disease. True, it is not life-threatening but it does qualify, nonetheless, as a serious skin condition, especially if you are at stage two which presents with rashes and/or broken capillaries, or stage three rhinophema.
It is also true, as Sweeney points out, that many people do not know they have rosacea. If the condition is limited to rosy cheeks it probably doesn’t merit an emergency trip to the dermatologist to get a diagnosis. However I suggest that if you have any of the following: overall redness, patches of redness, areas that look broken-out, painfully dry skin or rough, scaly areas, then it might be time to pay that dermatologist a visit.
Many people are diagnosed with rosacea. Many others suspect they may suffer from rosacea because they have many of the symptoms—permanent redness and/or small eruptions on the cheeks that are not pimples. Of course, it should go without saying that seeing your dermatologist is always the first step towards treating any skin condition. For example, a rash on the cheeks which looks like rosacea to you will suggest a host of differential diagnoses, some of which may have serious health consequences, to a specialist. It is crucial to rule out other medical problems before proceeding with treatment.
In addition, you need a specialist’s diagnosis before deciding on a treatment course. An error common to people acting on their own is to treat rosacea like a case of adult acne, understandable because they can have quite similar symptoms. However, rosacea-prone skin is sensitive and sulfer-containing topicals, astringents and alcohol routinely used to control acne can seriously aggravate a rosacea-type condition and create setbacks in controlling it. If you have a diagnosis of rosacea you will also want to avoid taking steroids like hydrocortisone. Steroids suppress inflammation so they may look like they are working at first, but it ‘s quite possible that a “rebound effect” could make matters worse down the road. With a rebound effect the rosacea symptoms return with a vengeance and are very difficult to control.
Another common source of confusion exists around differentiating sensitive skin from rosacea or rosacea-prone skin. From a strictly diagnostic point of view sensitive skin is characterized by an increased susceptibility to stinging, but is also characterized by other criteria such as: skin which tends to go red, skin of photo type I or II (very fair and fair), known allergy, a basic dermatological disease such as atopic dermatitis or psoriasis, known intolerances to cosmetic products, or the subjective feeling of a lack of oil and moisture content of the skin. As you can see, figuring out what category your skin falls into can be tricky, especially as categories can overlap. Here are some red flags, so to speak, that will help you distinguish between common skin conditions.
Rosacea: Rosacea is vascular instability aggravated by an underlying inflammatory condition which may or may not be chronic. While we do not know what causes rosacea we do know its identifying characteristics, and a primary one has to do with flushing episodes. Everyone is familiar with the sensation of blushing. The flushing may be triggered by UV exposure, exercise, certain foods, allergic reactions, emotional stress or heat, among other things. In normal skin flushing caused by capillary expansion recedes quickly–once the stressor is removed capillaries shrink, usually within minutes. With rosacea the capillaries expand and stay dilated for much longer periods of time. If you are still red after 10-15 minutes you may be dealing with rosacea.
Adult acne: adult acne looks much like teenage acne, with outbreaks of blackheads, whiteheads and pimples. Women are more prone to seeing outbreaks along the jawline and chin. Adults with acne tend to have skin that is dry and sensitive as opposed to oily, an indication that hormonal influences are at work. The formation of pus in the pimples distinguishes adult acne from roscea-type outbreaks that typically occur across the cheeks. Rosacea outbreaks look more like rashes, with little to no pus formation.
Sensitive skin: In humans with delicate, sensitive or vulnerable skin, a neurosensory phenomenon called “stinging” can be observed. This “delicate skin” differs fundamentally from “dry skin” characterized by thickened and hardened horny layers.
Typical reactions of “stinging” on delicate skin are reddening, tightening and burning of the skin and itching.
They can be caused by stimulating ambient conditions such as: massage and the action of surfactants and exfoliants, and the influence of weather like sun, cold, dryness and also damp heat, thermal radiation and UV radiation.
There is also the problem of topicals–a person who experiences “stinging effects” in contact with a topical application will with high probability experience it repeatedly on each further contact. However, it is a very individual matter, and people with sensitivity issues must monitor for themselves what works and what doesn’t with their particular skin. Interestingly, you may develop a sensitivity over time, so that a product you have used for years may suddenly cause a flare-up.
Crossover and multiple conditions are also common, which doesn’t help when you are looking to identify and treat your unique skin problems. However, there are some things all skin types should pay attention to.
1) UVB protection. Exposure to the ultraviolet component of solar rays in the range between 290 nm and 320nm, the UVB range, causes erythema (redness), simple sunburn or even burns of greater or lesser severity. Acneic, sensitive and rosacea skin types need daily UVB protection. Zinc oxide is anti-inflammatory and provides protection in the UVB range.
2) It has been proven that the UVA range between 320 and 400 nm damages the elastin and collagen fibres of connective tissue, which causes the skin to age prematurely. It can also cause numerous phototoxic and photo-allergic reactions, and the damaging influence of UVB radiation may be intensified by UVA radiation. Sensitive, mature and rosacea skin types especially require UVA protection daily and year round. Zinc oxide provides protection up to and even past the 400 nm range, and is the best non-allergenic ingredient available for protection against the longer wave-lengths of ultra-violet light.
3) UV radiation is also implicated in the formation of ionic species (free radicals), which are capable of intervening oxidatively in biochemical processes. To prevent these reactions additional antioxidants and/or free-radical scavengers should be incorporated into cosmetic or dermatological formulations. All skin types should look for anti-oxidants like Vit E, Vit C, alpha-lipoic acid, and Co-enzyme-Q (idebenone) in their topicals.
4) Sensitive, dry or problematic skin often starts with a compromised “permeable” barrier (the top layer of the epidermis, the stratum corneum, which retains moisture). Products having an occlusive action or lipid-substituting products which lower the TEWL (transepidermal water loss) are recommended for barrier regeneration. Sensitive, mature, rosacea and even acneic skin types should be aware that lipids are the skin’s first line of defense against invasion by bacteria, pollution and UV exposure. Your skin will be happier if you add oil to it rather than strip oil away—even If you have oily, blemish-prone skin!
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04.14.08
Posted in Facts About UV Protection, Skin Aging Facts at 10:34 pm by Administrator
The Future of Sun Protection
Sun protection has become a more complicated affair than simply smearing on the stuff made famous by a pig-tailed little girl. In fact, our then-adorable beach baby could probably be a poster model today, only now her leathery, wrinkled skin dotted with precancerous lesions would serve as a warning to us all of the long-term effects of too much sun-time. Being tan used to equate with being healthy, but this perception is gradually changing as we learn more about the long term effects of too much sun exposure. Especially for those who are interested in preserving our skins against the ravages of time any outdoor activity isn’t the same care-free pleasure it used to be. An overview of that day at the beach from the perspective of UV exposure will help us understand just why this is so.
Ultra Violet Light
The sun emits light at all different wavelengths in the electromagnetic spectrum, but the UV (ultraviolet) range is responsible for skin changes and aging.
Though some ultraviolet waves from the sun penetrate earth’s atmosphere, most of them, especially the short-length UVC rays, are blocked from entering by various gases like ozone. UV penetration fluctuates on a daily basis, with more ultraviolet waves getting through our atmosphere on some days than others. However, as the ozone layer thins we can count on more frequent and prolonged penetration of UVC rays.
The graph below describes the range we are talking about.
UV light
UVC—————-UVB———–UVA——-visible light
_________________________________________________
200-290 nm 290-320 nm 320-400nm 400-700nm
short waves/high energy <-------------> long waves/low energy
nm=nanometers (1 nanometer = 1 billionth of a meter)
The ABC’s of UV
UV C rays are the shortest, highest energy ultra violet light and are the closest to x rays on the scale (moving left). These are sterilizing rays that kill small organisms and are the most carcinogenic. Sunscreens provide no protection.
UV B rays are the burning rays, which penetrate to the epidermis and are present from 10 AM to 4PM. They are 1000 times stronger than UVA, stimulate melanin biosynthesis, and are linked to squamous cell carcinomas. They cause all the nasty symptoms of sunburn; edema, redness, and itching. They can also contribute to cataracts.
UVA, the long wave, low energy waves, are present from sunrise to sunset, enter the dermis and are 1000 times more prevalent than UVB rays. For low-energy waves they have a long list of inimical effects: they cross-link collagen and elastin, damage DNA, destroy langerhans cells and immune function, turn melanin darker and cause hyper, hypo-pigmentation and broken capillaries.
A good mnemonic is UVA = aging, UVB = burning and UVC = carcinoma
Aging Rays
Up until the present, more attention has been paid to the shorter wave-lengths, the UVB rays which measure from 290 to 320 nm. The reason for this is simply because their effects are rapidly obvious. When we are over-exposed we burn. Most sunscreens on the market concern themselves with protection in this range, and in fact, an SPF rating is an indication of how much protection you are getting, over a duration of time, from the burning rays. So an SPF rating of 2 would indicate that, if you can stay out in the sun for ten minutes without burning, you would be able to stay out for 20 minutes without burning wearing your SPF 2 protection. The testing for SPF is simply a matter of measuring duration of non-burning time on human skin, where the parameters are known.
This is a relatively easy test to perform, and one can understand why FDA requirements vis a vis testing are only concerned with UVB protection. However, an aging population has begun to pay attention to the UVA part of the spectrum, and for an overwhelmingly obvious reason. The UVA rays are the aging rays, responsible for hyperpigmentation, sun spots, redness and (shudder) wrinkles. UVA rays are different from UVB rays in other ways—they penetrate to the dermis rather than the epidermis where they may do longer-lasting damage, they are present from sun-up to sun-down and they go through clouds and glass. Because their effects are insidious damage testing is not as easy as it is with UVB–with UVA one doesn’t burn, one ages.
Unfortunately it is not safe to make the assumption that because one is wearing a sunscreen with a high SPF rating one is automatically protected against UVA rays. Remember, an SPF rating refers only to the UVB range. Indeed, the typical sunscreen which contains the most commonly used chemicals does NOT protect against UVA rays. For example, benzophenone -3 protects from 290-360 nm, while octyl methoxycinnimate protects in the 290 to 320 range.
Three ingredients commonly used by sunscreen manufacturers provide protection for the longer UV wave-lengths: Avobenzone, 310-400 nm, Titanium dioxide, 290 to 360 nm, and Zinc oxide, 290-400 nm. Avobenzone looks like a good bet, but unfortunately it degrades after 30 minutes in the sun, so sunscreens including avobenzone as an active ingredient must be applied very frequently if one is to receive adequate protection.
Range of Protection of Common Sun Protective Agents
UVC UVB UVA
200nm—–290nm——- 320nm—————-400nm _________________________________________________
200 245 290 300 310 320 330340350360370380390
PABA ————————–
Avobenzone (Parsol 178) ———————–
————Octyl methoxycinnimate
Octyl salicylate————
Oxybenzone————————————-
(Benzophenone-3)
Zinc oxide —————————————
Titanium dioxide —————————-
This leaves zinc oxide, an excellent choice as it is inert, anti-inflammatory and provides superior, full-spectrum protection. However, it has not been popular with the public as it tends to leave a white, greasy film on the skin. Since UVA protection is an everyday affair (this means EVERY day, not just when it’s sunny, but even on those cloudy days when you don’t plan on going outside) sunscreen formulation has become more and more the purlieu of the cosmetic chemist, who is faced with the challenge of formulating a product that is both protective and light enough for people to wear.
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04.12.08
Posted in Skin Aging Facts at 3:55 pm by Administrator
Glycation and Skin Aging
I have been talking about glycation and skin aging for a few years now (see The Yoga Facelift, page 118). The Europeans are finally jumping on the bandwagon, with Dr. Maes, Vice-President of global research and development for Estée Lauder, saying in the British issue from November, 2007 of Harper’s Bazaar:
“We now know that between 40 and 50% of skin ageing is caused by glycation - the damage directly resulting from eating sugar. It’s one of the worst skin agers; more than sun, more than the environment.”
Forty to fifty percent seems a bit high, but it is certainly true that glycation, a process whereby the formation of protein-sugar compounds promotes increased production of brittle, cross-linked collagen fibers, does contribute to the creation of wrinkles in the skin. Indeed, Advanced Glycation End-products or aptly acronymed AGES produced by non-enzymatic glycation can wreak havoc throughout the body, not just the skin. Dr. Maes also points out that “Glycation impairs the body’s ability to produce and utilise antioxidants.”
Before you have the symptoms of “sugar scare”—characterized by watering mouth and an overwhelming desire for a Snickers bar– do bear in mind that glycation is a natural process that happens as part of the collagen break-down and build-up process crucial to maintaining healthy skin. The problem lies with non-enzymatic, “spontaneous” glycation that can result, at least sometimes, from eating too much refined sugar and too many high-glycemic index foods.
Well-known skin experts and dermatologists have weighed into the sugar argument from another perspective. Dr. Perricone, my mainstream hero, has this to say: “I believe that inflammation is at the basis of aging in all organ systems, including the skin. One of the reasons inflammation occurs is from a rapid rise in blood sugar, which causes biochemical changes in the cell that result in accelerated aging”…. “Of the internal causes of inflammation, one of the big ones is diet. In addition to biochemical changes, sugar causes damage to the skin in another way: When blood sugar goes up rapidly, sugar can attach itself to collagen in a process called “glycation,” making the skin stiff and inflexible. Losing this elastic resilience of young skin will give you deep wrinkles and make you look old.” Right on, Dr. Nick.
To Counteract Glycation
Topical:
Topical Anti-oxidant products will help counteract glycation by increasing the amount of anti-oxidants available to the body.
Glycation inhibitors like aminoguandine and l-carnosine help prevent collagen destruction. Renaissance, Renaissance ultra and Wrinkle Smoother from Marie-Veronique contain glycation inhibitors and glyconutrients to prevent damage from spontaneous glycation and AGES.
Glyconutrients provide needed saccharides for bio-synthesis of glycosamineglycans like hyaluronic acid, which keeps the skin plumped-up and firm. The correct carbohydrates aid in ensuring that enzymatic glycation proceeds normally. The new MarieVeronique Skin SuppleMent contains colostrum, which is high in hard-to-get glyconutrients.
Diet:
Stay away from refined sugar and high-fructose corn syrup type products. I have found that eating a high protein diet helps stave off sugar cravings. I have also found that if you cut down on the sugar the cravings go away after a week or so. Remember, it’s not you that’s craving the sugar, it’s all the little “bad bacteria” that you’ve built up in your gut that are clamoring for it. Just tell those little buggers to give it a rest. And eating plain yoghurt (not the flavored sugary variety) will help balance the bacteria in your gut so you can get back to normal.
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Posted in Skin Aging Facts, skin care news at 3:49 pm by Administrator
Benefits to your skin of Vitamin C
We all know about the benefits of Vitamin C. In order to keep skin smooth, supple and wrinkle-free it is crucial we have enough Vitamin C every day. As we get older we can take as much as 1-2 grams or even more. Besides internal supplements Vitamin C applied topically can also be of great benefit. Here’s why:
• Vitamin C is an excellent antidote against photoaging of the skin when applied topically. Research studies have shown that regular application of topical Vitamin C provides wavelength-independent ultraviolet protection and results in clinically visible anti-wrinkling.
• When exposed to sunlight, topical Vitamin C products prevent sunburn damage without blocking vitamin D synthesis, unlike other sunscreen products in the market.
• Once applied, it is absorbed in the skin and cannot be washed or sweated off. In addition to being a powerful anti-oxidant Vitamin C plays a crucial role in two processes that become very important as we get older—collagen synthesis and inhibition of melanogenesis.
• A critical step in the bio-synthesis of collagen involves Vitamin C. If it is not present, collagen production halts, it’s that simple.
• In the presence of UV light the melanogenesis process goes to work to produce melanin—the brownish-red and back-brown pigments that look like freckles or tanning, or in worst-case scenarios like age spots, sun spots, blotchiness or hyperpigmentation (uneven distribution of pigment). Vitamin C works at the first step of the process to turn off melanogenesis.
The Problem with Vitamin C Creams, Lotions and Serums
There is a major problem associated with topicals containing Vitamin C, namely, that in the presence of air, liquid or other oxidizing agents it is easily converted to oxidized forms. Oxidized vitamin C is not only incapable of boosting collagen synthesis or scavenging free radicals, it may actually promote free radical formation.
• Most serums and creams contain oxidized Vitamin C, which means that not only are they providing no benefits, they may actually be harming your skin.
• Only highly concentrated preparations (10% or more) deliver enough vitamin C to the cells to be topically effective.
The solution is simple—add powdered Vitamin C to your daily sunscreen just before you apply it to your face, neck and hands. In a very short time you will see amazing changes in your skin.
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Posted in yoga facial exercises and botox news at 3:45 pm by Administrator
The Ugly Face of Botox
A recent study appearing in the April 2nd issue of the Journal of Neuroscience suggests that Botox does not necessarily remain at the injection site as previously believed. It has been shown to migrate along axonal pathways, for example, in the case of injection into the optic tectum, Botox effects appeared in synaptic terminals within the retina. The report concluded with the mild comment that their findings will “have important implications for the clinical uses of this neurotoxin.”*
Indeed they will, and I am glad to see clinical studies confirm what I had long suspected, namely, that Botox does not necessarily remain at the injection site, but may migrate to other areas.
The potential problems don’t end there. Botox works by blocking neurotransmitter release at synaptic terminals. For example, over time a message telling your brow to contract may create vertical lines between the brows called scowl lines, or sometimes “Botox lines” because this facial site is a common treatment area. When the message gets blocked the muscles governing scowling are effectively paralyzed, and the brow remains smooth.
Nature, however, has other ideas. Your body views paralysis as a problem to be fixed, so it begins to look for other nerve pathways that still work in order to keep sending messages. The end result may mean muscle contractions in other parts of the face, with a patient developing expression lines in unexpected areas if Botox is continuously injected in the same sites. Therefore it is advised that Botox injections be site-alternated where treatments are on-going.
Aside from these potential aesthetic problems Botox users should be very conscious of the other serious risk associated with prolonged usage. Imagine you’ve just taken your newly healed broken arm out of its cast after three months of immobility. The first thing you must do is exercise the arm muscles, which have become quite flaccid through non-use. The same principle applies to facial muscles—if you don’t use them, you lose them. For this reason it is very important that Botox users in particular make sure that in between injections the facial muscles get some exercise. If too many muscles remain in a permanently frozen state the result may very well be absence of lines accompanied by irremediable sagging.
Natural solutions
Cosmetic treatments are fine up to a point, but the law of diminishing returns applies to beauty as much as to economics. When you cease getting the same bang for your buck it’s time to search out alternatives. Facial exercise of the right sort (the kind that doesn’t cause dynamic wrinkling) can make a huge difference in delaying the visible effects of aging such as sagging, and should be a crucial part of maintenance for anyone who uses Botox regularly.
Web links
For more information on facial exercise please go to www.marieveronique.com or www.organicskintherapy.com.
To read the article in The Journal of Neuroscience please refer to the page on my blog or go to:
http://www.jneurosci.org/cgi/content/abstract/28/14/3689?lookupType=volpage&vol=28&fp=3689&view=short&eaf
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