Lydia Evans, MD
Dermatologist
Hormones
Precautions
Skin Care Ingredients
There are many factors which impact the quality of our skin, some we can control and some we cannot. Both our internal and external environments impact on the health and beauty of our skin. Genetics and hormones both play a major role in determining moisture levels, oiliness or dryness, color, tone and texture. As we age, oil production decreases, the turnover rate of skin cells slows down, and repair mechanisms are both less efficient and less effective.
First let's examine the external influences that affect the quality of our skin. Two factors over which we have direct control are smoking and sun exposure. In addition to being highly detrimental to our general health, smoking is clearly deleterious to the well-being of our skin. It barrages the skin with an onslaught of free radicals, and at the same time diminishes local blood flow to the area surrounding the nose and mouth. This means that smoking simultaneously causes damage to the local tissues, and impairs the body's ability to repair that damage. The end result is the premature development if deep lines around the lips, as well as an increased rate of skin cancer of the mouth and lips. Sun exposure presents the same double punch to the skin. It dramatically increases the risk for all three major forms of skin cancer (basal cell, squamous cell, and melanoma), as well as enhances and accelerates the development of lining, sagging, and discolorations.
Optimally, sun protection is a lifelong commitment. But since sun damage accumulates over your lifetime, it is important at any age to protect yourself from the damaging effects of ultraviolet radiation. Other external environmental challenges, over which we may have less control, include ambient humidity, wind exposure and pollutants. Very dry and windy conditions can cause loss of moisture from the skin. Environmental pollutants can be very inflammatory, especially to delicate facial skin.
Collagen fibers are the basic building blocks of our skin, and provide its structural support. Elastin fibers, which are intermingled with the collagen fibers, give the elasticity or "bounce" to our skin. As most women reach their late 30's or early 40's, the production of these two types of fibers begins to falter. The fibers produced are thinner and more easily fragmented. This leads to the onset of fine lines and wrinkles, and eventually sagging. These changes generally first begin around the eyes and upper cheeks, and progress to the lower cheeks, the jowls, and the area around the mouth. Discolorations due to ultraviolet exposure, which may be brown, yellow, white or pink, also tend to appear at this time.
Hormones have a major influence on the appearance and function of the skin. During perimenopause, women may have difficulty with adult acne, prompted by fluctuating hormone levels. This problem usually resolves after menopause, but other concerns take its place. The skin generally becomes thinner and more fragile, leading to easy bruising. One of the most critical jobs of the skin, known as barrier function, is also often impaired. Barrier function is essentially the ability of the skin to prevent external substances and toxins from penetrating, while at the same time maintaining an intact surface layer that retains moisture.
Drops in estrogen levels impair the metabolic functions of the skin, and consequently the barrier function is often impaired. These changes can result in very dry skin, which can give a dull appearance. These changes can also lead to flaking, itching and when severe, an uncomfortable dermatitis. With lower estrogen levels, our skin's immune function and repair mechanisms are also hampered. The decreased metabolic rates that accompany aging mean not only impaired production of new cells, but difficulty in repairing or removing old and damaged cells. The result is poor wound healing, and more vulnerability to all of the insults that greet our skin daily.
Precautions - In addressing these changes that accompany aging, both general health measures and specific skin care measures are helpful. First and foremost, avoid excess sun exposure and always wear a product with a sunscreen of at least SPF 15 (never lower!). It is safest to make this a daily routine, since sun penetrates clouds and ultraviolet A light can penetrate glass. Avoidance of outdoor activities between the daylight hours of 10 and 3 when possible is always a good idea. When sun exposure is unavoidable, wear a broad-brimmed hat, sunglasses (ultraviolet light can damage the eyes as well) and cover exposed arms and legs. Tightly woven and dark colored fabrics offer more protection than loosely woven and light colored materials. There are also several manufacturers of sun protective clothing which have an SPF built right into the cloth. Secondly, if you smoke, stop! In addition, a healthy supply of fruits and vegetables helps provide optimum levels of vitamins and minerals needed for both the healthy growth and development of skin cells, and the proper functioning of the skin's repair mechanisms. Regular and adequate sleep also helps these vital functions to operate at their best.
Skin care should be designed for an individual's needs. If you observe your skin over the course of the day for several days, you will have a good idea of your "skin type". When choosing a skin care regimen, trust your instincts. Guidelines have been provided by age categories that are helpful in selecting products. Always remember, however, that these are only guidelines. If your skin type is at the edge of the "bell curve" for your age, meaning that it is particularly dry, oily or sensitive, your needs may be better met by products that are designed for someone older or younger. Cleansers are much better for your face than traditional soaps, because soaps tend to strip all of the natural oils and moisture from your skin. Good cleansing twice a day is important. Always try to wash your face before going to bed to remove the day's accumulated oils, dirt, environmental pollutants and make-up. Leaving these contaminants on your skin overnight increases the risk of clogged pores and inflammation.
Toners, used once or twice a day after cleansing, are especially helpful if you have oily skin, wear a lot of make-up, or work in a dirty or hot environment. Moisturizers range in texture from light lotions to rich creams. It is very important to match your moisturizer to your skin quality. Those with oily skin will probably do best with a light lotion, those with normal skin a richer lotion or light cream, and those with dry or sensitive skin, a richer and more emolliating cream. Since it is so essential to protect your skin from sun damage every day, a moisturizer with an SPF of 15 or higher is an easy solution. Lastly, change your regimen as your skin's needs change. Adjust your moisturizer for significant climate changes and seasonal variations, as well as expected changes with the passage of time.
Skin Care Ingredients - There are individual ingredients that can be found in moisturizers and cleansers, as well as specific treatment products, which should be considered when developing an optimum skin care program. Salicylic acid, lactic acid and glycolic acids can all help improve adult acne. One of the most essential ingredients in the fight against fine lines and wrinkles is retinol. Retinols have been clearly demonstrated to help stimulate collagen and elastin fiber production, which ultimately can improve lining. Vitamin E, soy proteins, green tea extracts, and grape seed extracts, amongst others, have all been shown to have anti-oxidant properties. Mature skin can benefit from the addition of certain nutrients, like calcium and Vitamin C.
Specific treatment products, added to your daily regimen, can further promote fresher, younger, and healthier looking skin. Exfoliants and scrubs which utilize microdermabrasion technology by incorporating the aluminum oxide crystals that are used in microdermabrasion machines, can create an immediate smoothing and softening to the texture of the skin. Used over time, they can also help to diminish clogged pores and discolorations. These exfoliants can be used easily and quickly (requiring about two minutes in the shower) to give the skin's appearance an instant freshening. Glycolic acid peel kits can help to diminish discolorations as well, and also improve the appearance of fine lines and wrinkles.
Products designed to have a plumping effect on deeper lines that run along the sides of the nose to the mouth and chin can soften the effects of aging in these areas. Feeling confident about your appearance has clearly been shown to both enhance performance and sense of well-being. Every individual is unique, and skin care regimens should be chosen to meet both lifestyle demands and personal skin characteristics.
But one truth is universal for all of us; it is never too early or too late to care for your skin.
