Taking care of our skin
Skin-care is a multibillion dollar industry which includes not only lotions, creams and topical products, but also cosmetic and beauty treatments and spas.
Americans spend more than $43 billion each year on skin care, and according to a recent marketing report the global skin care product industry will reach $135 billion by 2021.
We are bombarded daily with skin and hair cosmetics advertisements promising smooth and supple skin and shiny, dandruff free hair. These ads play on our inner fears, desires and fantasies, they suggest that external beauty and ageless skin are within easy reach, that all that is needed is to buy a certain brand or use a specific "natural" or "organic" product or undergo a "detox" or "cleansing" treatment.
In fact, there are many positive steps that you can take to look after your skin, and not all of them involve expensive cosmetics. Don't let their fancy claims and packaging fool you.
Even though beauty is only skin deep, our skin's health and the speed at which it ages, depends on many "inner" factors such as what we eat, how much we sleep and our habits. Aging is inevitable, but it is within our reach to make the best of it, and this also applies to our skin.
Some Myths and Truths about Skin Care
The truth behind some beauty and cosmetic skin-care treatments:
Facials claim that they reduce tension, promote relaxation and reduce the levels of stress-hormone cortisol and increase the body's feel-good hormone oxytocin.
However a study (Moyer et al., 2011) ( 1 ) reported that the "cortisol-effect" is: "generally very small and, in most cases, not statistically distinguishable from zero".
Neither do oxytocin levels change during massage. A study by Bello (2008)( 3 ) found that a 20-minute massage provoked the same release of oxytocin as a 20-minute book reading session. So reading a book and getting a facial are equally relaxing in terms of oxytocin production.
Oxytocine promotes pro-social behavior and helps relax by reducing stress responses and building trust.
Facials are also supposed to help "encourage lymphatic drainage" and "reduce fluid buildup". Neill (2012) ( 3 ) looked into this claim: "A normal person does not have lymphatic problems on their face".
However aging reduces the number of lymphatic vessels, whose purpose is to drain away excess fluid from the spaces between your body's cells. This reduction, especially in people whose skin has been damaged by the sun, would cause fluid to accumulate. A facial may help promote lymphatic flow. But if this acutally happens is not known.
Natural or organic products are not always good for you
Pay attention to what you put on your skin you may be sensitive and break out in hives, rash or worse.
A paper by Hankinson, Lloyd and Alweis (2014) ( 7 ) reports a case of skin damage (cell death, blistering, injury to the epidermis and damaged cell membranes) caused by a photochemical reaction (a reaction triggered by sunlight) involving certain toxic compounds called furocoumarines found in certain common plants.
The case of phytophotodermatitis (from "phyto" = "plant", "photo" = "light", and "Dermatitis" = "skin inflammation") was caused by lime juice on the hands of a nurse that was exposed to sunlight.
Furocoumarines are found in lime, lemon, grapefruit, bergamot, celery, parsley, hogweed and wild parsnip. They are not allowed in cosmetics in the European Union in dosages larger than 1 ppm (part per million).
Read more about Natural ingredients for skin care:
Skin Care and Aging
As you age your skin changes, it looses flexibility, thins out, it becomes drier, subcutaneous fat disappears and it takes longer to heal when you hurt it.
The visual effects of ageing such as wrinkles, frailness and dryness are sometimes distressing, skin reflects our age like no other part of our body.
The effects of aging on the skin
Farage et al., (2013) ( 8 ) describe what happens to your skin as you grow older:
The dermis (which is the layer that lies under the outer epidermal layer of your skin, and which contains the hair follicles, sweat glands, nerve ends and blood capillaries), becomes thiner. Some cells begin to decrease in number, such as mast cells (these release histamines during allergic reactions and are also involved in wound healing) and fibroblasts (which produce the collagen that forms the structure that supports the skin cells, and also intervenes in tissue repair).
Natural moisture factors in the skin such as glycosaminoglycans (that can hod up to 100 times their weight in water) and hyaluronic acid also decline. This causes skin dryness and flaking. Itching and scaly skin are the consequence.
As fibroblasts disappear collagen production declines. Elastin, an elastic connective tissue protein begins to calcify with age, becoming less flexible.
Thes changes make the dermis more rigid, less flexbile. Your skin loses elasticity and is more prone to damage by tears and scratches.
These effects take place quicker in women than in men.
The outermost layer of the skin, the epidermis, becomes thinner too, losing part of its barrier effect.
And the innermost layer, the subcutaneous fat begins to thin out after the age of 70, it redistributes: facial fat is lost (leaving sagging skin there) and more accumulates on hips, thighs, belly and waist (with the purpose of insulating the vital organs from heat loss).
The effects of decades of sun exposure or habits like smoking also degrade the skin.
Farage reports that "Most people over 65, in fact, have at least one skin disorder, and many have two or more." and these affect quality of life.
Dark spots, freckles, moles, wrinkles, dry spots and even skin cancer may appear. But don't despair, you can prevent some of the side effects of an aging skin:
Itching dry skin, especially on the lower legs and arms can feel rough, scaly and be quite a nuisance. There are many possible causes for dry skin and also, some things that you can do about it:
Older people don't realize how easy it is to dehydrate.
Not drinking enough water can help provoke dry skin.
An adequate water intake helps you keep prevent dry skin and improves your complexion. Read more about water and a healthy skin:
Does drinking water improve skin complexion?
Adopt a healthy lifestyle
Adopting a healthier lifestyle can improve skin complexion. Castillo (2017) ( 9 ) studied the relationship between eating a healthy diet and and skin complexion; he found that:
- Drinking alcohol had a negative effect on skin complexion.
- Fruit, vegetable, yogurt consumption were positively correlated to skin type (improving it)
- Healthy habits plus water intake also improved skin complexion
Schagen ( 10 ) suggests eating a prebiotic diet (with plenty of fiber: eat more vegetables and fruits) to minimize skin sensitivity; it was found to reduce acute allergic skin response in mice.
Smoking tobacco apart from having terrible health consequences also damages the skin (Ortiz and Grando, 2012) ( 11 )
Being out in the Sun
Excessive exposure to sunlight, tanning or being in the open in very dry places put a strain on your skin.
You should always apply a sunscreen that protects against both types of ultraviolet radiation found in sunlight: UVA and UVB.
Apply it 15 to 30 minutes before going outside, reapply every 2 hours and use it on cloudy days too.
Stay out of the sun between 10 AM and 4 PM. Wear a hat and protective clothing. Use sunglasses that block at leas 99% of the sun's rays.
Don't tan, don't use sunlamps or tanning beds. Only expose yourself to the sun enough to allow your body to syntesize vitamin D, especially in winter.
Take home point
Keep out of the sun and use sunscreen with a high SPF.
Outdoors and dry climates
Apply a moisturizer, lotion or cream to humidify your skin before going outdoors in dry climate areas.
Drink extra fluids to keep hydrated in dry areas, you will loose more fluids due to evaporation.
Certain medical conditions such as diabetes or kidney disease can cause dry skin. Visit your health-care provider to make sure this is not the case, or if it is, to have it treated.
Soaps and fragrances
Avoid using too much soap, it will leach out the protective fat from your skin. Switch to a milder soap. Frangrances can cause irritation and rashes. Alcohol in fragrances has a dehydrating effect on the skin.
Keep an eye on your skin
Thinner skin can be broken easily, itching skin can provoke scratching which in turn can cause bleeding. A a breach in the skin barrier is a potential entry point for microbes which can cause infection. Be aware of any wounds and apply disinfectant to them.
Other skin conditions in older people
Thin skin bruises easily and takes longer to heal than younger people. If you suddenly notice an increase in bruises, visit your doctor.
Age spots, which at one time were called "liver spots" are caused by decades of exposure to the sun. They appear on the face, shoulders, back, feet and hands. Using a good sunscreen will prevent them from appearing.
They are harmless but if they become irritated and bother you, they can be removed.
Quite common in America, it can appear in anyone regardless of skin color. White skinned people are at a higher risk. Early detection is the key to curing it in most cases.
Most cases involve basal cell carcinoma and squamous cell carcinoma, two slow growing cancers that don't tend to spread to other parts of the body (metastasis).
The third type of skin cancer, melanoma, is not so common but is deadly as it spreads quickly to the rest of the body.
Check your skin regularly (on a monthly basis) following the ABCDE rule: ( 12 )
- A for Asymmetry. One half of the spot is different to the other half.
- B for Borders that are not regular.
- C for Color changes: multicolored spots.
- D for Diameter: the spots are wider than the diameter of a pencil
- E for Evolving: the spot grows, changes in color, shape, size. Becomes itchy, its surface may bleed. Skin cancer rarely hurts.
If you notice any of these symptoms or a mole bleeds frequently, visit your doctor to rule out skin cancer.
Nutrition and skin health
Farage et al., (2013) (8) also point out that your focus should shift from the merely aesthetic (most skin-aging therapies concentrate on trying to reverse the unwelcome visible signs of aging) to the quality of life aspects: an aging skin and its loss of structure (it becomes brittle, fragilea and thin).
As a person ages, his or her skin ages too, cells reproduce at a slower rate, their DNA is damaged by chronic sunlight exposure spanning decades. Internal "free radicals" (more on them below) damage cellular membranes and structure; smoking, pollutants and inadequate diets lacking antioxidants compound this free radical damage.
Vitamins and antioxidants in skin care products
Many skin care products contain vitamins and plant extracts (botanicals) because their "nutritional" or anti-oxidant properties supposedly prevent skin aging and prolong youthful skin appearance. But, what is the truth behind these claims? Let's see what science has to say:
A team led by Schagen (2012) (10) reviewed the scientific papers that studied nutritients and skin aging. They found the following:
Why does skin age?
Two different processes cause skin to age:
- Intrinsic aging, due to the normal aging processes of our bodies, just like your muscles, joints and internal organs age, so does your skin.
- Extrinsic aging, caused by external factors such as the environment, pollution, smoking, lack of sleep and unhealthy eating habits.
While you can't prevent aging, you can act upon the external factors and take preventing actions to avoid them: protect yourself from the sun's UV radiation, sleep well, don't smoke, and lead a healthy lifestyle.
Free radicals (also known as reactive oxygen species or ROS) are highly reactive chemical compounds that have unpaired electrons. As molecules tend to balance unpaired electrons, the free radicals snatch an electron from another molecule in a process called "oxidation". Oxidation damages this second molecule, and at the same time turns it into a new free radical, which starts off the cycle again.
This series of oxidation reactions is a vicious circle that damages more and more molecules provoking "oxidative stress".
They also damage your skin.
ROS damage your DNA and the proteins and fats in your cells nucleus and membranes. This disrupts the way cells work and is harmful to your health.
Free radicals are produced by external factors such as smoking, air pollutants, X-rays, UV radiation from sunlight and industrial chemicals and pesticides.
Your body also produces free radicals naturally during its daily metabolic processes; the problem is when these ROS are produced in quantities that overwhelm your body's antioxidant mechanisms.
ROS are also produced when your body becomes inflammed (due to disease or excess fatty tissue: fat produces inflammation).
Exercise also produces free radicals, but these have a protective and anti-aging effect because these ROS stimulate the production os some special enzymes (kinases) which move into the cell's nucleus to help produce some anti-oxidative enzymes which protect the cell against ROS.
As their name indicates, they inhibit the action of free radicals, preventing oxidative reactions. They interrupt the chain reaction by "trapping" the ROS or reacting with substances that produce free radicals.
A balanced diet with an adequate content of nutrients and antioxidative rich food helps keep the body supplied with antioxidants.
A healthy lifestyle that includes physical activity and low body weight (remember that fatty tissue causes inflammation) combined with antioxidants helps minimze the presence of harmful free radicals.
Some of the antioxidants are vitamins (A, E and C) and also flavonoids, polyphenols and some omega-3 fatty acids.
Antioxidants and the Skin
Vitamin E (tocopherol)
Studies have given controversial results but apparently "high doses of oral vitamin E may affect the response to UVB in humans", that is, it reduces the impact of B fraction of Ultraviolet rays.
It is found in many vegetable oils and also protects the collagen in the skin from crosslinking (which reduces its elasticity) and the fat in skin cells from degrading due to oxidation by free radicals (collagen gives the skin structure).
Vitamin C (ascorbic acid)
This vitamin also protects our skin from UVB but it degrades very quickly in the presence of oxygen that its effectiveness as an ingredient in creams or lotions may be negligible.
Vitamin A (retinols and carotenoids)
β-carotene is a natural colorant that tints carrots, pumpkin, mangos, sweet potatoes yellow. It is is used by the body to synthesize vitamin A. It also has antioxidant properties.
Other carotenoids include lycopene (found in tomatoes and other red fruits and vegetables) which is an antioxidant and has protective properties against UV rays (photoprotection)
Both lycopene and β-carotene are found in higher concentrations in the skin, which may reflect their function as "photoprotectors".
The skin produces another antioxidant, vitamin D3, in presence of sunlight, but this ability decreases with age, an 80-year old person produces roughly half the vitamin D3 that a 20-year one old does. This is due to factors such as limited sun exposure and poor nutrition in the elderly- they may lack a chemical clled 7-dehydrocholestreol, a precursor to vitamin D3.
Wedad and Rehab (2015) ( 13 ) mention vitamin D's skin health properties, as an antimicrobial, immuno protective, photoprotective and wound healing compound.
Compounds found in plants such as grapes, berries ad green tea have proven in animal studies to help protect the skin from UV radiation (coupled with sunscreen) and the risk of certain skin cancers.
Conclusions on Vitamins and antioxidants
Skin care products containing these antioxidant compounds may have a positive impact on your skin's appearance. But supplementation with high doses of antioxidants may not have the same effect as the natural food-sourced ones. The best source is the natural one: eat a healthy balanced diet:
Take home point
Eating a balanced diet with food such as fruit and vegetables rich in antioxidants and vitamins is a safe way to maintain a youthful skin appearance.
Read more about Vitamins and Supplements:
Vitamins & Supplements
Having a healthy skin in your senior years will add to your quality of life.
It requires taking some common sense steps such as eating a balanced diet, protecting yourself from the sun and not smoking.
Cosmetics, creams with antioxidants can also help, as well as drinking plenty of water and keeping physically active.
Cite this article:
A. Whittall. ©2018. Body Care. Patagonia Wellness, Nov. 02 2018. http://www.patagoniawellness.com/wellness/body-care.html
Subject: Body Care: tips on how to maintain your physical looks, looking after your skin and hair as you age. Pampering your body with a healthy lifestyle, antioxidant cosmetics and more.
References and Further Reading
(1) Moyer CA, Seefeldt L, Mann ES, Jackley LM, (2011). Does massage therapy reduce cortisol? A comprehensive quantitative review. J Bodyw Mov Ther. 2011;15(1):3-14. doi: 10.1016/j.jbmt.2010.06.001
(2) Bello D, White-Traut R, Schwertz D, Pournajafi-Nazarloo H, Carter CS (2008). An exploratory study of neurohormonal responses of healthy men to massage. J Altern Complement Med. 2008;14(4):387-394. doi: 10.1089/acm.2007.0660
(3) Ushma S. Neill (2012). Skin care in the aging female: myths and truths. J Clin Invest. 2012 Feb 1; 122(2): 473-477. 2012 Feb 1. doi: [10.1172/JCI61978]
(4) Nandini D. Basavaiah and Deepak B. Suryakanth (2012). Propolis and allergic reactions. J Pharm Bioallied Sci. 2012 Oct-Dec; 4(4): 345. doi: [10.4103/0975-7406.103279]
(5) Rutherford T, Nixon R, Tam M, Tate B. (2007). Allergy to tea tree oil: retrospective review of 41 cases with positive patch tests over 4.5 years. Australas J Dermatol. 2007 May;48(2):83-7.
(6) Miest RY, Yiannias JA, Chang YH, Singh N. (2013). Diagnosis and prevalence of lanolin allergy. Dermatitis. 2013 May-Jun;24(3):119-23. doi: 10.1097/DER.0b013e3182937aa4
(7) Andrew Hankinson, Benjamin Lloyd and Richard Alweis, (2014). Lime-induced phytophotodermatitis. J Community Hosp Intern Med Perspect. 2014; 4(4): 10.3402/jchimp.v4.25090. 2014 Sep 29. doi: [10.3402/jchimp.v4.25090]
(8) Miranda A. Farage, Kenneth W. Miller, Peter Elsner, and Howard I. Maibach, (2013). Characteristics of the Aging Skin. Adv Wound Care (New Rochelle). 2013 Feb; 2(1): 5-10. doi: [10.1089/wound.2011.0356]
(9) Castillo V. (2017). Relationship Between Water Consumption and Overall Skin Complexion Satisfaction in Individuals Ages 18-24. Thesis, Texas Christian University
(10) Silke K. Schagen, Vasiliki A. Zampeli, Evgenia Makrantonaki, and Christos C. Zouboulis, (2012). Discovering the link between nutrition and skin aging. Dermatoendocrinol. 2012 Jul 1; 4(3): 298-307. doi: [10.4161/derm.22876]
(11) Ortiz A1, Grando SA., (2012). Smoking and the skin. Int J Dermatol. 2012 Mar;51(3):250-62. doi: 10.1111/j.1365-4632.2011.05205.x
(12)NIH. National Institute on Aging, Health Information Skin Care and Aging. Accessed: 02.Nov.2018. Content reviewed: October 01, 2017
(13) Wedad Z. Mostafa and Rehab A. Hegazy, (2014). Vitamin D and the skin: Focus on a complex relationship: A review. J Adv Res. 2015 Nov; 6(6): 793-804. 2014 Feb 8. doi: [10.1016/j.jare.2014.01.011]