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