The cardinal rule of skin care: Do no harm

Do no harm to your skin. This may sound like a cliché, but if you were to remember
just one thing about intelligent skin care, this should be it. You'd be surprised,
but many (and often most) visible signs of skin aging are the result of harmful
external factors rather than the natural aging process. Therefore, the easiest,
cheapest and most effective step you can take to jumpstart your skin care strategy
is to minimize avoidable external damage. By doing so, you will create a
foundation for effective anti-aging treatments. Otherwise all your skin care
efforts (except perhaps radical plastic surgery) are likely to bring minimal
results.

Unfortunately, when it comes to complex biological systems, including the skin,

things are rarely as simple as they appear. To avoid skin damage, you need to know
what are the likely causes. You also need to realize that skin damage does not
always cause pain or even visible irritation, and so may keep accumulating at low
levels unnoticed. Below is the summary of the most common causes of skin damage
and how to avoid it.

Ultraviolet radiation

Most people know that UV-rays from the sun and tanning beds contribute to wrinkles
and skin aging as well as increase the risk of skin cancer. What most people don't
know is that many sunscreens do not adequately protect from skin aging and that
staying out of direct sunlight will prevent only part of sun damage. Since sun
damage is partly irreversible, it should be prevented as much as possible.

Harsh detergents

Harsh detergents, particularly the so-called ionic detergents, may be harmful for
the skin. They are called ionic because their molecules become charged when
dissolved in water. The most common and ubiquitous ionic detergents are sodium
lauryl sulfate, sodium laureth sulfate (both acronymed SLS) and their analogs,
such as ammonium lauryl sulfate, ammonium laureth sulfate and others. In facts,
SLS is often used to produce experimental skin damage in clinical studies of skin
protectors. As they are powerful detergents, SLS and analogs are widely used in
household and body care products, such as shampoos, soaps, dishwashing liquids,
laundry detergents, and so forth. (FYI, even regular soap contains primarily ionic
detergents albeit not as strong as SLS).
Read the ingredient list on all products that come in contact with your skin. If
they contain ionic detergents, eliminate or minimize such contact by using similar
products with nonionic detergents, alternative cleansing methods, wearing gloves
when washing dishes, etc. For example, if your shampoo or soap has SLS or its
analogs, you can switch to non-irritating baby shampoo and glycerin-based
moisturizing soap.

Chlorine and hot water

Hot showers and baths feel like a good thing. Your skin may disagree. Chlorine in
tap water is an oxidative agent (that's how it kills bacteria) and may cause some
skin damage. The hotter the water, the greater the damage because the rate of
chemical reactions increases with temperature. Limit baths and showers to once a
day or less and don't soak for too long. Make it warm, not hot.
Irritants

Skin irritants may inflict skin damage in two ways. First, they may directly
damage skin matrix and cells. Second, they may trigger an inflammatory and/or
allergic reaction in the skin, which, in turn, can cause skin damage by releasing
destructive free radicals and the so-called metalloproteinanses or MMP (the
enzymes that degrade skin matrix, chopping up collagen and elastin). Oftentimes
the damage caused by the skin's reaction is greater then the damage caused by the
irritant. This is particularly true for people with sensitive skin, whose skin
develops inflammatory and/or allergic reaction in response to even very mild
irritants. Everyone should try to avoid skin irritants. However, people with
sensitive skin should be particularly careful.

Inflammation

Inflammation is a reaction of the body in response to various types of damage

including infection, trauma, abrasions, burns and so forth. Occasionally,
inflammation is a result of an autoimmune response (a malfunction of the immune
system), in which case it may exist without external cause. Inflammation is an
important and necessary part of the healing process. However, prolonged and/or
excessive inflammation is damaging to the skin or any other organ where it occurs.
In particular, inflammation causes a release of large amounts of damaging free
radicals and MMP, which, among other things, accelerates the aging process. While
occasional short-term and self-limiting inflammation from cuts, abrasions or
cosmetic procedures should not be a major concern, chronic inflammation has to be
dealt with.

The most common cause of skin inflammation is acne. Chronic acne should be
treated. Keep in mind that some acne treatments (e.g. benzoyl peroxide) are
irritants and can themselves cause skin damage if used improperly or excessively.
Treatment should never cause more damage then the disease. Work with your
dermatologist to find an effective nonirritating or minimally irritating treatment
appropriate in your case. Don't settle for treatment that improves your acne but
leaves your skin chronically irritated.
Other common skin conditions causing chronic inflammation include eczema (exema),
psoriasis, dermatitis and inflammatory form of rosacea.

Puffiness

Puffiness in the eye area is a common manifestation of mild facial edema. Edema is
a term for the excess fluid accumulation in soft tissue manifested by swelling.
Edema stretches the skin and eventually leads to wrinkles and sagging. The eye
area is particularly prone to edema due to the dense capillary network and lack of
fat padding. It is important to know that significant edema (especially if not
confined to face) may be a sign of a health problem, such as an allergy, kidney
insufficiency or liver disease. It has to be investigated by a physician to rule
out medical conditions.

A more common situation, however, is morning puffiness (mild facial edema that
occasionally occurs in the morning and goes away during the day) caused by
lifestyle factors (such as lack of sleep, alcohol consumption and others) rather
than a health condition. It is important to minimize morning puffiness not so much
because it is a transient nuisance on awakening but because it is one of the
biggest contributors to the aging of the eye area.

Facial expressions

Certain facial expressions, if repeated often enough, cause the so-called motion
wrinkles. In particular, squinting creates motion wrinkles known as crow's feet
while frowning causes forehead wrinkles known as frown lines. Many people squint
or frown without knowing it. Ask people who see you every day whether you tend to
squint or frown. The first step towards reducing squinting and frowning is being
aware of it. The next step is to develop a habit / reflex to relax your face,
especially when you feel that you are beginning to squint or frown. Also,
squinting is common among people who are nearsighted and either do not wear
glasses or have insufficiently strong ones. If you don't see clearly in the
distance when your eyes are relaxed, chances are you tend to squint. Adjust your
eyewear to ensure clear vision.

Overuse of makeup

Makeup products often contain potential skin irritants. For the sake of long-term
skin health, it is best to use makeup in moderation, particularly in the eye area.
Long-lasting makeup may be particularly harmful because it tends to contain
harsher chemicals and also requires highly irritating solvents for its removal.

Overuse of skin care products

Indiscriminate use of multiple skin care products may have significant drawbacks.
First, some products are simply ineffective: not only are they a waste of money
but they may also prevent optimal absorption of the effective products. Second,
some products can contain ingredients with potential for low-level long-term skin
damage. Finally, many products with scientifically proven skin benefits, such as
retinoids, vitamin C or alpha-hydroxy acids, may cause skin irritation and/or
damage if misused or overused. Be very selective regarding what products you use
and how you use them. Any extra time spent on research would not only save you
money, but may help avoid unnecessary skin damage.

Excessive cleansing and exfoliation

Some skincare activities may do more harm then good when misused or overused. In
particular, excessive cleansing strips the skin of protective sebum and may lead
to dryness, skin sensitivity and other problems. Avoid cleansing with harsh
detergents (see above) and alcohol-based solutions. (Alcohol-based cleansers /
toners may be useful for people with very oily skin, but are too drying for
everyone else.) Avoid washing your skin with hot water. Avoid cleansing and/or
washing your skin more than two times a day.

Another overused practice is exfoliation. Occasional exfoliation may be useful: it

refreshes the skin surface, increases circulation and brightens the appearance.
However, exfoliation is a potentially damaging procedure: you use controlled
destruction to strip off the top layer of skin cells. Ideally you remove only the
dead cells on the surface of the skin a.k.a. stratum corneum. However, if you
exfoliate too frequently or too aggressively, then you also remove and/or cause
damage to living cells. Eventually that may produce long-term skin damage and
exhaust the skin's long-term capacity to regenerate

Ingredients you may want to avoid

Here we list a few ingredients which may be capable of causing skin damage with
prolonged use, or are simply redundant.
Imidazolidinyl Urea and Diazolidinyl Urea: Used as preservatives to prevent
bacterial growth although ineffective against fungi. Known to be a relatively
common cause of contact dermatitis. Two trade names for these chemicals are
Germall II and Germall 115. Germall 115 may release formaldehyde, a potentially
toxic chemical. Potential for low level skin damage in the long term is unproven
but appears likely.
Sodium Lauryl Sulfate: A detergent common in shamoos and cleaners, where it is
relatively safe due to short contact time. If exposure is prolonged is likely to
cause skin irritation, dryness and other damage. In fact, sodium lauryl sulfate is
sometimes used as a model skin irritant in the experiments where skin protectors
are tested. Avoid products with sodium lauryl sulfate unless time of contact with
the skin is very short. Even skin cleansers should rather be without it.

Mineral oil: petroleum derived hydrocarbons; used as inexpensive base in some

products (less today that in the past). Is moderately comedogenic. Mineral oil may
also interfere with normal perspiration and other skin functions.
Synthetic Colors: Whether synthetic colors are completely safe or mildly damaging
in the long run is unknown. Since they serve no useful purpose, they are best
avoided (except perhaps when avoiding them means foregoing an otherwise great
product). They are labeled as FD&C or D&C, followed by a color and a number, e.g.
FD&C Red No. 6 or D&C Green No. 6.

Synthetic Fragrances: There are over 200 synthetic fragrances used in cosmetics.
There is no way to know which particular ones are in your product, since on the
label it will simply say "Fragrance." Safety of most synthetic fragrances is an
open question. Best to avoid them since they provide no skin benefits. True, it is
good to have a nice smelling cream. However, apart from the questionable safety,
frangrance may mask spoilage of your product, an effect you would want to avoid.
Ethanolamines (Monoethanolamine aka MEA, Diethanolamine aka DEA, Triethanolamine
aka TEA): common pH stabilizers; when exposed to oxygen/air form nitrosoamines,
which may be irritating and/or toxic. The amount of nitrosoamines formed during
typical use of skin care products with ethanolamines is unclear.

Parabens (e.g. Methyl, Ethyl, Propyl and Butyl Paraben): Used as preservatives;
inhibit microbial growth and extend shelf life of products. Methyl paraben may
degrade releasing methanol, a potentially toxic chemical. However, the amounts of
methanol that might be released from methyl paraben in skin care products are too
small for any known systemic effects. Most people don't have an obvious skin
reaction to parabens. However, more research is needed to determine whether they
are truly nontoxic or may cause low level skin damage in the long term.

What diet is best for your skin?

To ensure than all essential nutrients are consumed in adequate amounts, it is

desirable to consume a wide variety of foods.

Fruits and vegetables

You may have heard it from your grandma, but now it's official! Eating plenty of
fresh fruits and vegetables is good for your health. Fruits and vegetables are
particularly important for preventing premature skin aging because they contain a
wide variety of antioxidants. Many of the pigments responsible for the color of
fruits and veggies are -- among other things -- potent antioxidants. These
antioxidants help protect skin cells from damage by free radicals which are
especially rampant in the skin due to environmental exposure (see also the article
about antioxidant nutrients in this section). To ensure that your fruits and
veggies have all their antioxidants intact, make sure they are fresh and uncooked
(or only minimally cooked) since heat inactivates most antioxidants. Also, some
fruits and veggies are significantly richer in antioxidants than others.

Fluids
A well-moisturized skin is somewhat less prone to developing of wrinkles. Drinking
plenty of fluids throughout the day ensures proper hydration of the body and helps
reduce skin dryness. Experts usually recommend drinking 6-8 glasses of water a
day. Coffee and sodas are not a good substitute for water because they contain
caffeine, which is a diuretic, i. e., a substance promoting the excretion of water
via urine. Also, do not drink too much fluid 2-3 hours before going to bed. This
may cause morning puffiness and excessively stretch your skin.
Calories
Except for frying oneself in direct sunlight at noon, the quickest way to get
wrinkles is to put on a lot of weight and then lose it. The reason is obvious:
when you gain weight, extra fat stretches the skin, then, when you lose weight and
body fat goes away, the skin sags and crumples up. The degree of skin sagging
after weight loss varies with the person's age (it tends to be worse the older you
are), genetics and other factors. Let the desire to retain youthful skin be
another incentive for you to watch your calories and avoid weight gain - even if
you plan to lose weight later on. Also, keep in mind that gaining and losing
weight in cycles may have negative effects not only on the skin but on your
overall health as well.

Cooking
The central theme in cooking is heat-treatment of foods. As written in bold print
in every college chemistry course, increasing temperature causes exponential
increase in the rate of chemical reations. What does this mean to us, the eaters?
Every time a food is heated up, the rate of reactions of degradation and oxidation
of nutrients jumps up dramatically. In other words, cooking depletes food of many
essential nutrients and antioxidants and increases the content of oxidative by-
products (free radicals). As a result, we consume less essential nutrients and
more aging-promoting free radicals. True, complete avoidance of cooked foods is no
fun. You don't have to stop eating cooked foods altogether to avoid most of the
negative effects of excessively cooked foods. For starters, reduce cooking time
and avoid deep frying, grilling and cooking in large amounts of oil or fat.

Acne myths and misconceptions

Acne is caused by diet.

So far, studies have found no relation between food and acne, be it chocolate,
sugar or fried food. Some experts argue that certain indigenous populations do not
develop acne, which may be related to their diet. However, other factors, such as
genetics, may explain this observation. Of course, if you think some foods
exacerbate your acne, you may just as well avoid them. Healthy diet has benefits
whether it prevents acne or not.

Acne is caused by poor hygiene.

Many people believe that comedones are caused by dirt accumulating in pores. This
is incorrect. Pores are blocked by oil secreted by sebacious glands inside the
pore as well as skin dead cells and bacterial by-products inside the pore. Since
washing does not clean the insides of the pore, it cannot, by itself, prevent
acne.

Acne is caused by stress.

The relationship between stress and acne, if any, is complex. Acne increases
production of some adrenal, hypothalamic and pituitary hormones, which may
contribute to acne. On the other hand, in men, stress may reduce production of
androgens (male hormones) by the testes and thus mitigate acne. Presumably, for
some people the net result of these effects may be exacerbation of acne. In
reality, typical day-to-day stresses are not intense enough to produce major
shifts in the body's hormonal balance. Unless stress is unusually severe, it is
unlikely to be among the top factors contributing to acne in most people.

Acne is caused by sex related behaviors.

There is no evidence that frequency of sex, masturbation or other aspects of
sexual behavior have any impact on acne.

Sunlight is a good acne treatment.

UV rays, which are part of sunlight, kill bacteria, including acne-causing P.
acnes, and may temporarily reduce acne outbreaks. However, UV rays harm skin cells
as much as they harm bacteria, causing long-term skin damage and accelerating skin
aging. Besides, if you have dark skin or develop tan, sunlight becomes less
effective in killing bacteria in the pores because dark pigment reduces its
penetration. Overall, the drawbacks of sunlight as acne treatment far outweigh its
benefits.
Acne will clear on its own once a person reaches adulthood.
Sometimes this is true. However, in many cases acne persists as late as the middle
age. Yet adult acne tends to be less severe than teenage acne.