Antioxidants and Free Radical Damage

Antioxidants and free-radical damage are considered so vital to our understanding of the origins of cancer, aging, illness, and disease that they have become a profound area of research. An "antioxidant" isn't a type of ingredient, but the function a specific ingredient can perform on the skin. Free-radical damage is what antioxidants are supposed to take care of, either by stopping new damage, or by reversing earlier damage caused by free radicals.

Let's begin by saying that free-radical damage is bad for the skin. Theoretically, free-radical damage can cause deterioration of the skin's support structures, decreasing elasticity and resilience. The presence of antioxidants in the diet, and, possibly, the topical application of antioxidants in skin-care products, plays a part in slowing down free-radical damage. Antioxidants are ingredients such as vitamins A, C, and E; superoxide dismutase; flavonoids; beta carotene; glutathione; selenium; and zinc.

Despite the proliferation of skin-care products containing antioxidants, according to Dr. Jeffrey Blumberg, chief of antioxidants research at Tufts University, "there is no conclusive scientific evidence that antioxidants really prevent wrinkles, nor is there any information about how much antioxidant(s) or exactly which one(s) has to be present in a product to have an effect."

Even if antioxidants did work to prevent free-radical damage on the skin, the results would hardly be immediate. Free-radical damage in the human body can continue for years before any deterioration can be detected and you can't slap on an antioxidant and expect to immediately notice your wrinkles disappearing.

Despite this lack of hard evidence, fashion magazines and cosmetics companies have heralded the elimination of free-radical damage as the fountain of youth. The excitement around antioxidants is understandable. According to many skin experts, all aspects of aging, including wrinkling, are caused by free-radical damage. Vitamin and cosmetics companies want you to believe their antioxidant products can eliminate it. It isn't known is whether or not you can really stop free-radical damage from taking place on the skin.

Free-Radical Damage
Free-radical damage occurs on an atomic level. Molecules are made of atoms, and a single atom is made up of protons, neutrons, and electrons. Electrons are always found in pairs. However, when oxygen molecules are involved in a chemical reaction, they can lose one of their electrons. This oxygen molecule that now only has one electron is called a free radical. With only one electron the oxygen molecule must quickly find another electron, and it does this by taking the electron from another molecule. When that molecule in turn loses one of its electrons, it too must seek out another, in a continuing reaction. Molecules attempting to repair themselves in this way trigger a cascading event called "free-radical damage."

What causes a molecule to let go of one of its electrons, generating free-radical damage? The answer is oxygen or any compound that contains an oxygen molecule, such as carbon monoxide, hydrogen peroxide, and superoxide)?plus sunlight, and pollution.

You may be asking: With all that free-radical damage taking place, and all this oxygen around us (the air we breathe contains about 20% oxygen), how is it that we are still walking around? Why are we still living? The answer to that is antioxidants.

Antioxidants
Antioxidants prevent unstable oxygen molecules (made unstable by loss of one electron) from interacting with other molecules (taking one of their electrons) and consequently causing them to become unstable, a process that starts the free-radical chain reaction. Fortunately, a vast assortment of antioxidants can be found in both the human body and in the plant world.

So what does that have to do with wrinkles? No one is exactly sure, but theoretically wrinkles appear when the free-radical damage originates from natural environmental factors and fails to be cancelled out by some amount of antioxidant protection. If we don't get enough antioxidant protection, either from our own body's production, from dietary sources, or from antioxidants, including those we put on our skin, free-radical damage continues unrestrained, causing cells to break down and impairing or destroying their ability to function normally.

There's just one problem, the fact that free-radical damage is constant and extensive. Major investigation is now underway in this fascinating area of human aging and sun damage, factors that influence wrinkling. However, the research is still in its infancy, and suggesting anything else is sheer fantasy.

Almost every company makes moisturizers that contain antioxidants, so they aren't hard to find. You won't see any difference in your skin, but if free-radical damage can be slowed, then antioxidants should help. Many scientists think that if there is a fountain of youth, antioxidants could be in it.

Information on antioxidants and free-radical damages comes from a number of scientific journals, including these devoted to the subject of antioxidant research and activity: Free Radical Research, Free Radical Biology and Medicine, Antioxidants and Redox Signaling, Oxidative Stress and Aging, Journal of Anti-Aging Medicine, Mechanisms of Ageing and Development, Photochemical & Photobiological Sciences, Photodermatology, Photoimmunology, Photomedicine, and Photochemical & Photobiological Sciences.

Skin Care Facts

Understanding Skin Type

What is Skin Type?
Some women are quite aware of their skin type; for other women it’s a complete mystery, an elusive conundrum of changes that never settles down in one specific direction. That’s not to say understanding skin type isn’t important, because it is, but not in the way the cosmetics industry approaches it or the way we’ve been indoctrinated to think about it.

What I’m really saying is to forget about skin type as the cosmetics industry defines it. The rigid categories you find at cosmetics counters and the information about what your skin needs as analyzed by a salesperson are often wrong or at best incomplete. Skin type strongly influences our decisions about our skin-care routines.

The four most common skin types are:

Normal (no apparent signs of oily or dry areas)
Oily (shine appears on skin, no dry areas at all)
Dry (flaking can appear, no oily areas at all)
Combination (oily and dry or normal areas)

What Influences Skin Type?
Outside factors can and do influence the way your skin looks and feels. To effectively evaluate your skin and determine the correct skin-care routine, the following factors need to be considered:

Internal:
Hormonal changes (pregnancy, menopause, menstrual cycle, etc.)
Health problems (rosacea, psoriasis, thyroid disorders, etc.)
Genetic predisposition of skin type (oily versus dry, prone to breakouts, or sensitive skin)
Smoking
Medications you may be taking

External:
Climate/weather (cold, warm, moist, dry)
Your skin-care routine (over-moisturizing or exfoliating, using irritating or drying products)
Sun exposure
These complex integrated circumstances all contribute to what takes place on and under your skin.

Will My Skin Type Change?
Another problem with skin typing is the assumption that your skin (and skin type) will be the same forever, or at least until you age. That, too, is rarely the case. If your skin-care routine focuses on skin type alone, it can become obsolete the moment the season changes, your work life becomes stressful, or your body experiences hormonal or weight fluctuations or other physical changes, and whatever else life may bring.

To complicate things even more, in any given period you may have many skin types! Over the years, even when using gentle, irritant-free products, I’ve experienced irritated skin patches at the same time I had oily skin, or acne flare-ups along with dry skin around my eyes. It is not unusual for women to have a little bit of each skin type simultaneously or at different times of the month or week. An overview of how your skin behaves and changes is necessary to assess what your skin needs.

As far as the cosmetics industry is concerned, every woman can and should have normal skin. Yet acquiring normal skin is like trying to scale a peak with a slippery, precarious slope. Like the rest of our bodies, skin is in a constant state of change. Even women with perfect complexions go through phases of having oily, dry, or blemish-prone skin. In reality, no one is likely to have normal skin for very long, no matter what she does. Chasing after normal skin can set you up on an endless skin-care buying spree, running around in circles trying everything and finding nothing that works for very long.

In any case, identifying skin type is highly subjective. Many women have really wonderful skin but refuse to accept it. The smallest blemish or wrinkle or the slightest amount of dry skin distresses them. Or some women see a line or two around their eyes and immediately buy the most expensive anti-wrinkle creams they can find in the hope of warding off their worst imagined nightmare. This is one of those times where being realistic is the most important part of your skin-care routine.

Identifying your skin type is made even more difficult by the omnipresent combination skin. Almost everyone at some time or another, if not all the time, has combination skin. The nose, chin, center of the forehead, and the center of the cheek all have more oil glands than other parts of the face. It is not surprising that those areas tend to be oilier and break out more frequently than other areas. Problems occur when you buy extra products for combination skin because many ingredients that are appropriate for the T-zone (the area along the center of the forehead and down the nose where most of the oil glands on the face are located) won’t help the cheek or jaw areas. You may need separate products to deal with the different skin types on your face because you should treat different skin types, even on the same face, differently.

The most frustrating aspect of skin type is the fact that it’s often used (by cosmetics salespeople and by the cosmetics industry in its ads) to instill a sense of immediate need. Once your skin is classified as a type that isn’t normal, or if it stops being normal, then panic can set in. Cosmetics salespeople aim this ploy at the 30-something crowd, with the pitch sounding something like “You better do what you can do now to make sure your skin doesn’t get worse.” I’ve listened to or been personally subjected to a salesperson’s scolding about skin-care mistakes that destroy the skin. What destroys skin is unprotected sun exposure, smoking, and using irritating skin-care products. Not using the right skin-care products (other than a good sunscreen) may cause problems, but it does not damage skin in the long run.

Determining your skin type will not lead to answers to other skin care needs that may not be apparent on the skin’s surface. For example, sun damage is not evident when you are young, but sun protection is imperative for all skin types. Oily and dry skin that are present at the same time, along with some redness, may be an early sign of rosacea, a condition that cannot be treated with cosmetics and may not be easily diagnosed. Your skin may be breaking out now, but those blemishes took a few weeks to get to the surface. Breakouts begin in the pores, and may involve sebum (oil), cellular debris (dead skin cells), dead hair shafts, and/or bacteria. What you see on the surface of the skin does not always indicate the type of skin-care products you should buy, or even that you need a skin-care product at all.

Skin Type Has Nothing to Do with Your Age
Older skin is different from younger skin; that is indisputable. Yet it is a mistake to buy skin-care products based on a nebulous age category. Treating older or younger skin with products supposedly aimed at dealing with specific age ranges does not make sense because not everyone with “older” or “younger” skin has the same needs, yet it’s a trap many women (especially older women) fall into. An older person may have acne, blackheads, eczema, rosacea, sensitive skin, or oily skin, while a younger person may have dry, freckled, or obviously sun-damaged skin. Products designed for older skin are almost always too emollient and occlusive, and those designed for younger skin are almost always too drying. The key issue with skin type needs to be the actual condition of your skin, not your age.

All women, regardless of age, need sun protection and antioxidants, and possibly treatment of skin discolorations (either potential or existing), dry or oily skin, or breakouts. Wrinkles may tend to separate younger from older skin, but the care you give the skin doesn’t necessarily differ. Not everyone in their 40s and older has the same skin care needs. In a way it’s simple: You need to pay attention to what is taking place on your skin, and that varies from person to person.

Does Skin Color or Ethnicity Affect Skin Care?
All skin is subject to a range of problems, regardless of skin color or ethnic background. Whether it is dry or oily skin, blemishes, scarring, wrinkles, skin discolorations, disorders, or sensitivity, and even risk of sun damage, all men and women share similar struggles. So, while there are some distinctions between varying ethnic groups when it comes to skin problems and skin-care options, overall these differences are minor in comparison to the number of similarities.

According to an article in the Journal of the American Academy of Dermatology (February 2002, pages 41–62) “There is not a wealth of data on racial and ethnic differences in skin and hair structure, physiology, and function. What studies do exist involve small patient populations and often have methodological flaws. Consequently, few definitive conclusions can be made. The literature does support a racial differential in epidermal melanin [pigment] content and melanosome dispersion in people of color compared with fair-skinned persons…. These differences could at least in part account for the lower incidence of skin cancer in certain people of color compared with fair-skinned persons; a lower incidence and different presentation of photo aging; pigmentation disorders in people with skin of color; and a higher incidence of certain types of alopecia [loss of hair] in Africans and African Americans compared with those of other ancestry.”

Beauty basics 3

Feed Your Skin the Nutrients It Needs
Three days until your 20th high school reunion. There's no time for a facelift, but you needn't sweat it, says dermatologist Nicholas Perricone, M.D., who promises to have your sallow, dull complexion looking lustrous in as little as 72 hours.

No surgery required—you need only eat the right foods to rejuvenate your skin and take years off your look, Perricone says, and for a more dramatic antidote to tired-looking skin, follow the diet and his recommended regimen of nutrient-rich face creams.

Perricone, an assistant clinical professor of dermatology at the Yale University School of Medicine and author of "The Wrinkle Cure", is not alone in focusing on nutrition as a path to healthy, radiant skin. Hope is growing in the scientific community that the aging process can be slowed, and maybe even reversed, with vitamins.

The shining stars in the scientific race against wrinkles: antioxidants such as vitamins A, C and E. Antioxidants have the potential to overwhelm destructive molecules called "free radicals," which live in every cell of the body and can destroy the skin tissue.

Eat Your Fruits and Vegetables—and Fish
To support healthy skin (and hair and nails, as well), experts agree that certain vitamins and minerals are essential, including:

Vitamin C—This vitamin is critical for strong, healthy skin because of its role in the body's manufacture of collagen, a protein that keeps the skin supple and tight. Even a slight deficiency can compromise the production of collagen.
Vitamin E—The vitamin is thought to help in the fight against free radicals, though deficiency of vitamin E is not known to cause any disease.
Thiamine—This B vitamin is important in ensuring normal cellular function in the skin.
Zinc—Normal epidermal cell growth is reliant on this mineral.
Selenium—This mineral is critical in the production of glutathione, a natural enemy of free radicals.

In most cases, these vitamins and minerals are ingested into the body without any extra effort. Many fruits and vegetables, for example, are loaded with antioxidant vitamins such as A, B, C, and beta carotene.

Says Nick Lowe, M.D., a clinical professor of Dermatology at the UCLA School of Medicine and author of "Skin Secrets: The Medical Facts Versus the Beauty Fiction,"

"If you eat a normal, balanced diet and take vitamin and mineral supplements, that should be more than adequate, and assuming you don't smoke, the skin is a remarkably resilient organ."

True, says Perricone, it's simply about "eating the way we were told." Leaving nothing to chance, however, Perricone specifies the contents of his healthful diet: high-protein foods, antioxidant-rich carbohydrates, and essential fatty acids (found in fish, olive oil and some nuts).

The diet is aimed at reducing skin inflammation, explains the dermatologist, because it's inflammation that makes skin look dull and wrinkled, makes pores appear larger, and causes discoloration of the skin.

Perricone's ideal skin-healthy meal would include a six-ounce serving of fresh grilled salmon, a romaine lettuce salad with lemon juice and olive oil for a dressing, and fresh cantaloupe.

Getting through to your skin
Even if you take in the suggested daily amounts of vitamins and minerals, your skin might not get enough nutrients to be at its fighting best when confronting ruinous free radicals. Because it is thought that only one percent or so of vitamins and trace elements ingested through food becomes available to the skin, topical face creams have been developed as a more direct route to supplying the skin with nutrients.

The face creams are often referred to as "cosmeceuticals"—they are like pharmaceuticals in that they are sold for quasi-medical benefits, beyond mere aesthetic improvements, and are like cosmetics in that they are not intended to treat or prevent disease and don't need FDA's approval before being sold. Nutrient-based skin creams that have been extensively studied include:

Retinoids—Probably the best-known retinoid is Retin-A (tretinoin). These members of the vitamin A family have been shown to effectively rejuvenate sun-damaged skin. Though some versions are sold over the counter, retinoids are most effective—and quite possibly only effective—in prescription strengths.
Antioxidants—The antioxidant vitamins A, C and E are commonly included in skin creams to counter the damaging effects of free radicals. A recent study suggests that these types of topical vitamins can indeed protect the skin, providing a break from fighting UV rays and even allowing the skin to repair its own lines and wrinkles to some degree.

Dermatologist Perricone's skin cream recommendations for "beautiful skin for the rest of your life" include these cosmeceuticals: an alpha lipoic face cream (designed to increase circulation and achieve a healthy glow); alpha lipoic eye therapy with vitamin C ester eye therapy (to reduce eye puffiness and erase dark circles); and concentrated vitamin C ester cream containing DMAE, short for dimethylaminoethanol (to tighten and smooth the skin).

Because cosmeceutical manufacturers can sell their products without FDA approval based on a showing that the product is safe and effective and its claims truthful, it's up to consumers to decide for themselves if product claims are believable.

"The problem with cosmeceuticals and their claims," says dermatologist Lowe, "is that proof with controlled studies is largely missing in the industry." Considering using a cosmeceutical product but have some doubts? Talk to your dermatologist, Lowe recommends.


Diet Do's for Glowing Skin
Long for smooth, supple skin to go along with that slimmer waistline? Then step up to the plate — of salmon and asparagus, that is — to get a double shot of good effect. Living on some more typical low-fat meals, on the other hand, will ravage your body and your brain, leaving you wrinkled as well as fat and fatigued, according to dermatologist Nicholas Perricone, M.D.

Eating right can improve our looks "to a tremendous extent," says Perricone, an expert on eating your way to superb skin. On his anti-inflammation diet, his patients start to look younger — and what's more, their acne clears up and their eczema improves. If you long to look better, too, know the elements of Perricone's "wrinkle-free diet."

Eat generous portions of the right kinds of protein
Protein is necessary for cell repair and helps keep aging in check. On the best-choices list, fish ranks first, followed by these other protein-packed animal products: egg whites, skinless chicken and turkey breast.

Don't fear fat — believe it or not, some is healthy — even essential
Fats and oils can provide anti-inflammatory protection and youth-preserving antioxidants. Fatty fish provides hefty helpings of anti-aging omega-3 fatty acids; salmon, mackerel and albacore tuna are among your best bets for staying beautiful. Also tops among anti-inflammatories: extra virgin olive oil. It'll make you look lovely, and meanwhile could lower your bad cholesterol.

Steer clear of inflammation-inducing sugar and high-glycemic carbohydrates
This category of food includes potatoes, rice and pasta. These foods can cause blood sugar to spike and lead to dangerous chemical changes in your body. Their ability to fuel creation of age-accelerating free radicals and to break down collagen has earned them high rank among skin's greatest foes. Your body needs carbohydrates, though, so get your fill from low-glycemic fruits and vegetables. Choice picks run from arugula to zucchini — they're packed with youth-preserving antioxidants.

Know three more keys to the Perricone plan: Drink water, drink water, drink water
At the risk of repeating himself, the doctor himself drinks glass after glass — eight to 10 glasses of water each day, he reports, to help his own organs and cells function efficiently. Spring water's better than the kind from the tap with all its chlorine and heavy metals.

Perricone's system of eating and drinking your wrinkles away is a way of life for some youth seekers, but if you're not interested in a long-term commitment just yet, the doctor provides quick-fix remedies for those in a rush to look radiant for a reunion or other occasion. Have a special day scheduled for this Saturday? Start Wednesday morning eating fish at least twice a day — by the fourth day, Perricone promises, "The dark circles will be gone, and you'll look radiant and amazing."

Diet not doing enough for your taste? Consider trying antioxidant creams — Perricone says they feed your face and body the extra vitamins (including A, C and E) that you need to extend your youth.


Natural Cosmetics - Do They Bring Hype or Hope?
Should you consider the switch to all-natural cosmetics? Here's what you need to know.

First, department store make-up counters are known to use engaging promotional ploys. Big-time brand names command high prices and compete with big promises.

Enter the "naturals" to health food stores and the Internet. You'll recognize them by words like "organic" and "holistic." Are these features worth it in cosmetics? Or is it hype?

According to Dr. Roberta Palestine, who did her residency in dermatology at the Mayo Clinic, "It really is marketing hype. Natural isn't always better. Synthetic isn't necessarily worse."

"Poison ivy is natural, but that certainly doesn't make it good," Palestine adds. "A chemical is a chemical," she says, "what matters is your skin type.

"If you're prone to acne, learn to read labels. If your skin is more mature, you need moisturizing ingredients," Palestine tells consumers. Others need to prevent allergies.

She points out that "hypoallergenic" means it is free of offending ingredients. It does not mean a product will prevent break-outs or acne.

Testing Your Skin
If you suffer from allergies, ask your dermatologist for the newer, more extensive patch testing. It goes beyond the basic 24 chemicals. This pinpoints the exact chemicals that are problematic for you. Then find out which products use them and avoid them.

"Many so-called natural products use exotic ingredients, but they are really functioning as high-priced moisturizers," says Palestine. There are many fine humectants, the ingredients that bind water to skin, in products at all price ranges.

Common humectants you might find include: glycerin; maltitol syrup; mannitol; propylene glycol and sorbitol.

She advises that more women should adjust the consistency of their skincare products with the season. "Use creamier products for winter, then lotions in the summer," says Palestine.

Even Linda Collinson of LaCrista, an online natural skincare company agrees there are plenty of natural skincare claims that "are alot of bunk."

A self-taught chemist who started her company because she was allergic to everything says, "Plain and simple is often better.

"Look at the top of the ingredient list because they are ranked in order of volume," says Collinson. Be sure the best ingredients are on the top of the list.

Keep the list, which is usually on the box you throw away, so if a product irritates you will know what was in it.

Cosmetics in the Kitchen
Some of Collinson's favorite all-natural skincare regimes are in your kitchen, such as her oatmeal scrub.

Put oatmeal into a coffee grinder and then add powdered milk. Keep a jar of this dry mix in your shower for sloughing off dead skin cells while you shower. It's very soothing," Collison says.

"Lemons can bleach age spots," she adds, "and yogurt with salt is a great scrub for oily skin."

Many women don't realize how irritated their skin is with synthetic, artificial chemicals until they make the switch to natural lines. "Women get used to dry, broken out, scaly, tight, itchy, blotchy skin when it is not normal. It should have a glow, some color," warns Collinson who uses no foundation at all.

"You should switch 100% if you want to go with all-natural products," she says, so your skin goes through its two-week adjustment just once.

"If you think your skin is sensitive, avoid fragrances, alcohol, FD&C colors, mineral oil and formaldehyde," she warns. "Mineral oil is everywhere and the more you use, the drier your skin will get.

Natural Products Scutinized
"Be an educated consumer because price has nothing to do with quality," Collison says. Know that "all-natural" products have gone through more rigorous regulations to make the claim than products that say "natural."

It took 10 years for the U.S. Department of Agriculture to finalize its rules on organic products. Products labeled as "made with organic ingredients" must have at least 70 percent organic ingredients. With this percentage, the U.S. rules are now in line with those of Europe.

Beyond either of these "natural" classifications are the "organic" skincare products that might include, among other items, strawberry, rosemary, curled mint, aloe vera, mulberry, lavender oil, ylang ylang and iris.

Susan West Kurz, president of the Dr. Hauschka products in the United States says, "We're beyond natural. We take a holistic approach. "We believe your skin is a perfect cosmetic on its own. It rebuilds. Moisturizes. Protects itself," says Kurz. "We treat skin holistically, not symptomatically."

The Dr. Hauschka line, which used items such as witch hazel and St. John's Wort, relies on "biodynamic" growing methods to create its own ingredients from organic farms in Turkey, Bulgaria and other parts of Europe.

"Skincare is preventative healthcare, not a luxury anymore," adds Kurz. "It should be nurturing, aesthetically pleasing but necessary for your health."

When asked whether artificial and synthetic ingredients really cause harm, Kurz points out: "Often you can't prove a problem until the damage is done.

"There's a place for synthetics, for example if a teenager needs steroids or medicinal treatments for acne because her condition causes psychological problems," Kurz adds, "but not for six years."

Questions You Should Ask
Consumers should ask these questions, warns Kurz. Where do the ingredients come from? Do they cause environmental damage? Are there short and long-term effects? What are the economics around the product?

Whether you choose natural or synthetic products you can be certain they've been scrutinized by the Cosmetic Ingredient Review, a non-profit scientific group and comply with FDA and other regulations.

Most producers are members of the Cosmetic, Toiletry & Fragrance Association www.ctfa.org, which offers a Buyer's Guide to help consumers track the 10,000 ingredients and 40,000 trade names. The site also answers Internet rumors about hazardous products.

Beauty basics 2

What is Aging Skin?
We begin to age the moment we are born, and throughout our lives the effects of aging are evident in our bodies. Up to about age 20, the most visually prominent effects of aging are in growth and development. Starting in our 20s, the effects of aging begin to be visible in the skin.

Genetically programmed chronologic aging causes biochemical changes in collagen and elastin, the connective tissues that give skin its firmness and elasticity. The genetic program for each person is different, so the loss of skin firmness and elasticity occurs at different rates and different times in one individual as compared with another.

As skin becomes less elastic, it also becomes drier. Underlying fat padding begins to disappear. With loss of underlying support by fat padding and connective tissues, the skin begins to sag. It looks less supple, and wrinkles form. The skin may be itchy with increased dryness. A cut may heal more slowly.

Simultaneously with genetically programmed aging, the process of photoaging may take place. Photoaging is the effect of chronic and excessive sun exposure on the skin. Cigarette smoking also contributes to aging effects by the biochemical changes it brings about in skin tissues.

Photoaging interacts with chronologic aging and may appear to hasten the process of chronologic aging. In fact, photoaging may be responsible for the majority of age-associated changes in the skin's appearance: mottled pigmentation, surface roughness, fine wrinkles that disappear when stretched, "age" or "liver" spots (lentigines) on the hands, and dilated blood vessels. Chronic sun exposure is a major risk factor for skin cancers — basal cell carcinoma, squamous cell carcinoma and melanoma.

The effects of photoaging accumulate over years of chronic sun exposure. At first, the effects may be invisible to the casual glance, even while they are on the increase. Photos taken with ultraviolet light will dramatically reveal the accumulative effects of chronic sun exposure. In the following series of photos, the accumulative effects of chronic sun exposure are clearly seen. In each set of photos, the first two pictures were taken in ordinary light, the third picture in ultraviolet light. As skin ages and accumulates sun damage, a number of lesions (sores or spots on the skin) become more common. These include:

"Age" and "liver" spots (lentigines) — flat, brown areas with rounded edges usually found on the face, hands, back and feet. They are age-related and photoaging-related, and have nothing to do with the liver. While they are unsightly, they are not dangerous. However, a large, flat, dark area with irregular borders should be examined by a dermatologist to make sure it is not melanoma.

Actinic keratoses — thick, warty, rough, reddish growths on sun-exposed areas of the skin. They may be a precursor to squamous cell carcinoma.

Seborrheic keratoses — brown or black raised spots, or wart-like growths, that appear to be stuck to the skin’s surface. They are not cancerous or precancerous, and are easily removed.

Cherry angiomas — harmless, small, bright red domes created by dilated blood vessels. They occur in more than 85 percent of middle-aged to elderly people, usually on the body. A dermatologist can remove them.

Telangiectasias ("broken capillaries") — dilated facial blood vessels, usually related to sun damage. A dermatologist can treat them.

Bruising — often a result of skin having lost its fat padding and becoming more susceptible to injury. Some drugs may cause bleeding under the skin. Bruises that persist should be examined by a dermatologist.

Wrinkles — changes in the elastic tissue from exposure to sunlight, effects of gravity, or motion factors in the skin. A dermatologist can treat wrinkles with dermatologic surgery.

Skin diseases more common in older people include shingles, leg ulcers and seborrheic dermatitis.

Prevention of Photoaging
While you can't slow down or stop the effects of chronologic aging, you can do something to inhibit the skin damage caused by excessive and chronic sun exposure. To avoid skin damage from sun exposure, always use a sunscreen with an SPF rating of 15 or higher, a hat with a brim, and protective covering of arms and legs. Don't deliberately sunbathe, and limit sun exposure during the hours of 10 a.m. to 4 p.m., when the sun's rays are strongest. Avoid deliberate tanning in tanning salons or under sunlamps. If your skin is already sun damaged, you can still benefit from these measures.

Your best bet for avoiding the skin damage caused by long-term cigarette smoking is to quit.


Through the Decades: How Skin Ages

Beauty is but a flower, Which wrinkles will devour. — Writer Thomas Nashe, 1600

It's almost automatic until puberty, but your all-clear, wrinkle-free complexion can hit some bumps in the road as early as adolescence, in the form of dreaded pimples. And as you age, skin becomes less and less stable, with genetic changes and sun damage taking their combined toll. You can't control certain factors of natural aging, but today we know that the sun — not our genes — is mostly to blame for our baby-fresh faces turning blemished and wrinkled. Besides limiting sun exposure and wearing protection from damaging UV rays, focus on these other changes you can make to keep bad elements at bay: Don't smoke. Limit your alcohol intake. And choose a skin care regimen that makes you feel comfortable in your skin.

Here's how skin ages through the years, and what you can do at each life stage to keep it looking splendorous.

First Signs of Trouble In Your Teens - As early as puberty, hormonal changes can turn your fresh-faced complexion into an acne-prone one.
Saving Face at This Age: In addition to using simple over-the-counter washes and pimple remedies, or consulting a dermatologist if a more potent treatment is needed, wearing an SPF 15+ daily is the best thing you can do to save your skin.

Some Wear-and-Tear In Your 20s - Expression lines will begin to form from talking, laughing and frowning. The collagen and elastin that have kept your skin supple begin to break down.
Saving Face at This Age: Wearing sun protection remains your best bet for controlling the amount of damage.

Early Environmental Damage In Your 30s - Sun-induced wrinkles are starting to form. Good news is, they're hardly seen so there's time to to start wearing an SPF 15. The skin's collagen and elastin are losing still more of their spring.
Saving Face at This Age: A cosmetic or doctor-prescribed alpha hydroxy acid cream can return your skin's youthful radiance.

Skin Irregularities In Your 40s - It can be the decade of dry skin. More dead skin cells are sticking around, darker patches may appear, and expression lines can become entrenched.
Saving Face at This Age: If you're dealing with dry skin, make a moisturizer a regular part of your successful skin care routine.

The Sun's Damaging Effects Can Become Evident In Your 50s - Expect that some damage has already been done if you haven't been a loyal wearer of sun protection. Wrinkles, age spots and spider veins are bound to be developing, and skin can be dryer than ever these days.
Saving Face at This Age: It's not too late to start using a daily SPF 15 cream — you can still reap some rewards in terms of slowing down sun damage and perhaps even repairing some of it.

Starting in Your 60s, a Lifetime of Skin Protection Pays Off - Skin should be pretty stable these days, with women having survived the menopause-induced hormonal imbalances. Wrinkles, red veins and dark spots are common, but are probably less pronounced if you made a habit of protecting your skin from the sun.
Saving Face at This Age: If basic skin care isn't cutting it anymore, ask your dermatologist or a plastic surgeon about microdermabrasion, chemical peels, laser procedures, facelifts and other options that might make just the dramatic difference you're searching for. It's true that some wrinkles might be inevitable as we age. But healthy habits — most of all wearing sunscreen every day — can go far to preserve the pretty bloom of youth.

Beauty basics 1

The following articles are designed to help you get on the road to beautiful skin by covering the basics of skin care.


Face Washing Do's and Don'ts
Beauty consultants might recommend a facial treatment trifecta — cleanse, tone and moisturize — but dermatologists say that comfortable-for-you cleansing is key, and moisturizing may help some skin types.

First and Foremost: The Cleanser Itself
Use a gentle, water-soluble cleanser to avoid irritating the skin — not one that needs to be wiped away with a tissue or washcloth.
Besides the fact that it washes away with water (use tepid, not hot), all you need to know about a cleanser is that it makes your skin feel soft, clean and neither dry nor greasy. Experts' picks for efficient, mild cleansing: Cetaphil, Aveeno, Neutrogena and Eucerin brands.

Second for Some: A Separate Toner
If you feel you need a toner, think about finding a better-for-you cleanser instead.
A toner's role is to remove oily residue and provide a fresh feeling; it does nothing to firm the skin long-term. With today's rinse-off cleansers, you'll rarely need a toner — you might want one, though, if your face has become oily over the course of the day.

Last but Not Least: Should You Use a Moisturizer? Maybe.
For dry-skin sufferers, a moisturizer can soothe and protect — the test is whether your skin feels too tight. There are many effective moisturizers — try one (sample size available?), then listen to your skin. These brands come recommended: by day, Oil of Olay; while you sleep, Estee Lauder.

Additional Products: A Matter of Preference
To exfoliate or not?
Removing dead skin cells can make your skin look less dull, but go easy or you could injure skin that's sensitive. Instructs dermatologist Lisa Donofrio, M.D.: Use a little grapeseed or olive oil, a non-soap cleanser like Burt's Bees or Cetaphil, or a cold cream such as Pond's, and with the rough side of a washcloth make small, gentle circles all over your face.

Can creams turn you into a cover girl? These three ingredients are common in face creams:
Retinoids - For rejuvenation of photo-damaged skin, these members of the vitamin A family (the best-known being Retin-A) are effective — in prescription concentrations, at least — in reducing wrinkles, as well as clearing up acne.
Alpha hydroxy acids (AHAs) - Also known as fruit acids, these can give the skin a luster by keeping the skin free of dead cells. Over-the-counter preparations don't make as dramatic a difference as the ones used by dermatologists.
Antioxidants - The vitamins A, C and E are said to have the ability to protect and possibly repair the skin by fighting destructive molecules called free radicals.


Looking Good Naturally
On Friday afternoons, Kathlyn Quatrochi walks through her garden in Southern California with a group of women, gathering herbs and talking about the chemical properties that enable the plants to cleanse and heal the skin. Later, inside her cozy inn with its stuffed chairs and mahogany tables, Quatrochi shows her guests how to mix the herbs with ingredients like oats, buttermilk or perhaps whipping cream to make facial treatments.

Sounds appealing. But who has time for a getaway? It's actually closer than you might think. Many of the ingredients for the facials that Quatrochi prepares at her Sage Herb Farm are in your kitchen and possibly your garden. And the treatments, say Quatrochi and other natural skin care experts, are better for you than most of the cleansers and toners that you buy at the drugstore.

Open up the cupboard and look around in the fridge; cast a fresh eye on the herbs that grow in your garden. The right mix of oats, parsley, dried chamomile and hot water makes a nice cleanser. A mixture of sage, peppermint, lemon juice and water is a refreshing toner for oily skin. Quatrochi includes these recipes and more in her book, "The Skin Care Book: Simple Herbal Recipes", published by Interweave Press. Quatrochi, a master herbalist and a doctor of naturopathy, says that natural remedies are much kinder to the skin than synthetic products. Quatrochi started researching natural skin care about 20 years ago, after her younger sister was diagnosed with heavy metal poisoning that was traced to cosmetics she had used.

Fascination with Nature
Growing up, Quatrochi had always been fascinated by the natural remedies created by her mother and grandmother, concoctions that included mustard plasters, potato poultices, oatmeal masks and vinegar hair rinses. Over the last two decades, Quatrochi has developed her own line of natural skin care products and a philosophy that encourages women to take time for themselves. "Women are under a lot of stress," says Quatrochi. "When a woman doesn't take time, time takes the woman."

Aging, the environment, improper diet and stress take a toll on the skin, the largest organ of the body. Glands in the skin produce oil and sweat, which create a film on the surface of the body called the acid mantle. The slightly acidic pH of the mantle supports healthy bacteria and wards off harmful bacteria. Herbs have hydrophilic (water) properties and lipophilic (oil) properties that help the skin to maintain the acid mantle.

A Few Simple Remedies
You'll need a few simple supplies to get started: a few spoons and whisks, a couple of small glass bowls, a small electric food processor or chopper, a few small jars with lids and zip-lock sandwich bags. Quatrochi's book is a great source for recipes. Some of the recipes call for oats, buttermilk, apple cider vinegar and honey. If you're a gardener, you might already have some of the herbs, like lavender, lemon verbena, sage and thyme.

For those looking for a shortcut to natural skin care, Ruth Ann Kondylas sells natural products from plants that she grows on her Everlasting Herb Farm on the Eastern Shore of Maryland. Her products are seasonal, depending on what's growing at the time. During the summer, Kondylas sells products like rose water and dill soap at the outdoor FreshFarm Market in Washington D.C.

"There are a lot of things from the garden that you can safely put on you body," says Kondylas. "We live such fast-paced lives. We want everything quick, and often we don't think about what we're using on our bodies." Kondylas, who learned to garden growing up in the Appalachian Mountains of southwest Virginia, cultivates herbs on about 1½ acres. She says, however, that you don't need a lot of space to grow enough herbs to suit your needs.

"It's amazing what you can do with what you cut from a small planter box," she says. "When I sell my products, I try to introduce what a wonderful thing it is to have a garden. It's just so nice not having to buy everything in the grocery store."


Beauty Starts With Healthy Skin
Maybe it's true for some that age is a case of mind over matter — if you don't mind it doesn't matter, as Jack Benny's well-known quote goes. Easy for Benny to say, if there's any truth to another famous saying, from 19th-century English poet Mortimer Collins: "A man is as old as he's feeling, a woman as old as she looks." If it matters to you to look as youthful as you can, healthy skin's the ticket — skin's the thing that can either give away your age or belie it.

The skin is a cloak that shields our internal organs from the elements — it protects us from bacteria, chemicals and the sun's UV rays — while it regulates our body's heat and signals pain to protect us against injury. Three layers make up the skin — the top layer called the epidermis is where skin cells and pigment are made; the middle layer called the dermis contains the supportive collagen and the elastin that makes the skin snap back into place; and the cushiony bottom layer called the subcutis consists largely of fat cells, along with some blood vessels and nerve and muscle fibers.

Pretty Important Body Part
Beyond the biological, the skin plays a second important role — the body's thin blanket is the wrap we show to the world, causing some to say that healthy skin is where beauty begins.

To keep your skin looking taut and smooth, take steps to help this outermost organ stand the test of time.

Cleansing. Wash your skin the way that feels best — choose the products that feel pleasant and wash the number of times that makes your face feel fresh. (See "Face-Washing Do's and Don'ts.")

Moisturizing - If it ain't dry, don't moisten it. But many skin types get dry and cracked if you skip this step. (See "Face-Washing Do's and Don'ts.")

Sun protection - No two rays about it — for all skin types, and at every age, slathering on an SPF 15 or higher is a have-to habit, to protect against the UV rays that cause wrinkles as well as skin cancer.

Eating — and drinking — right - In general, protein is a plus and carbohydrates can be bad. Water has been described as the elusive fountain of youth. Knowing what to eat — and why to avoid skin-damaging sugar — can restore life to a dull complexion. (See "Diet Dos for Glowing Skin" and "Shun the Sugar for Sweeter-Looking Skin.")