Sun worshippers discover the sun is not their friend
By Rita Baum
"Everyone wants to live a long life but no one wants to look old," said Dr. Albert Kligman, inventor of Retin-A Cream. Yet it's hard to avoid looking old if we allow the environment, negligent care and poor lifestyle to have their way.
The skin is an amazing paper-thin shield but it undergoes many changes with age. Skin is composed of three layers. The epidermis, or outer layer, consists mostly of dead cells. The dermis, or middle layer, consists of millions of living cells, nerves, blood vessels, a compound protein called collagen, and elastic fibers called elastin. The bottom layer is subcutaneous fat.
The inner and outer layers get thinner with age, although males have a thicker dermis, an advantage in later years. Fat cells and moisture naturally decline, and decades of exposure to the ultraviolet light of the sun causes photoaging.
Moisture from blood cells in the living layer of skin passes through the dead layers to the surface. If the outer layer loses moisture too fast in the dry cold of winter, or as a result of indoor heat, sunshine, harsh soaps or smoking, the skin loses water and fine lines appear.
Age-related changes can be demonstrated by pinching the skin on the back of the hand for ten seconds. It takes two seconds for forty-five year old skin to spring back to its original smoothness, and 50 seconds for 70 year-old-skin.
Overuse of certain muscles for frowning or smiling also takes its toll. But don't be discouraged, not all skin ages alike. There is variety in time of onset and degree of change. And experts agree that lifestyle and environment--the things we can control--are twice as important in the prevention of skin damage and cancer then either age or genes. The popular saying "Old people deserve the face they get" has a ring of truth since much of the decline in skin appearance is avoidable.
A dramatic illustration of the influence of lifestyle on skin appearance is demonstrated in Dr. Amy Newburger's book, Looking Good at Any Age. The author shows photos of 71-year-old twin sisters. One of them took care to protect her skin and looks much younger than her seven decades would warrant. The other, an outdoorswoman and sun worshiper looks remarkably older than her twin.
Leonard Hayflick, Ph.D., one of the most respected pioneers in the biology of aging, says that the sun is worse for the skin than all other factors combined. Those who worship the sun in their youth and participate in outdoor activities for days and hours on end will pay the price with earlier and deeper wrinkling.
Most sun damage occurs by age 20. Yet precautions should always be taken from childhood onwards, such as wearing wide-brimmed hats, staying covered as much as possible and applying sunscreen that contains both UVA and UVB protection.
Many people believe that using sunscreen enables them to endure long hours in the sun. Harvard Health Letter recommends SPF 15 Bain de Solei--but cautions prudence, above all. Perhaps the best advice comes from 20th-century playwright Noel Coward, who wrote "only mad dogs and Englishmen go out in the midday sun." Before 10 a.m. and after 4 p.m. are the best times to be outside.
Mayo Clinic Family Health Book advises that glowing skin, thick healthy hair and strong flexible nails start with a well-balanced nutritious diet, exercise and adequate nonalcoholic, noncarbonated fluids. This book outlines the three simple rules for skin care--protect the skin from the sun; keep the skin clean, and (for normal or dry skin) use moisturizer.
Soap and tepid water on the face morning and evening discourages bacteria and possible infection. A mild cleansing bar is recommended for normal and dry skin and a super-fatted soap in drier winter months.
Oily skin does better with two washings with an antibacterial or deodorant soap to prevent pimples and blackheads.
Clinic experts say that specialty cleansers other than soap do not have an advantage over soap and water, and an occasional scrub with a washcloth helps remove dead cells. Avoid hot water and long, frequent showers and tub baths to avoid drying the skin. Use a moisturizer while the skin is still damp to replace natural skin oils that normally form a barrier to prevent evaporation of moisture, especially when humidity is low.
Most dermatologists say that money spent on expensive moisturizers is unnecessary, and that the benefits of extra ingredients such as collagen and vitamins are unproven. An exception is the inclusion of vitamin A found in retinoic acid, which may reverse some sun damage.
Consumer Reports concurs, saying that price is no measure of product effectiveness. This consumer advocacy group lists the top three facial moisturizers as L'Oreal Plenitude, Ponds Nourishing Moisturizer and Alpha Hydrox Moisturizer, all available with SPF 15 sunscreen for less than $3 per ounce.
Some lower scoring products were priced from $20 to $32 an ounce. The highest scoring body moisturizers were Vaseline Intensive Care, Curél and St. Ives, all priced at less than 50 cents per ounce.
Moisturizer provides known skin care benefits, but a newer and perhaps equally beneficial product is one that Cleopatra may have known about centuries ago. She bathed in milk to make the wrinkles go away. More recent studies show that a 12 percent lactic acid lotion, sold by prescription, increases the number of spongy water-holding molecules in the middle layer of the skin.
Indeed, lactic acid, derived from sour milk, is one of five types of alpha hydroxy acids (AHA) that have become available in the last decade as anti-aging creams. The most common AHAs are glycolic and lactid acid, which are derived from various fruits, sugar cane and milk.
These products exfoliate or "slough off" the outer layer of skin to expose newer, moister skin, making wrinkles less visible. The drawback is that AHA products make skin highly sensitive to the sun, and if not used with sunscreen could cause the wearer to have an increased tendency to develop wrinkles and skin cancer.
Alpha Hydroxy products sell in drug and department stores in strengths of 10 percent or less, and, like other skin products you can pay from $10 to $50 for this one.
The Food and Drug Administration has approved Renova, a version of Retin-A for use as a wrinkle cream for sun-damaged skin or wrinkles.
Products such as Retin-A or Renova are available for about $80 dollars by prescription. AHA does not remove facial spider veins, more common in women than men, although the veins are often successfully removed by a laser treatment.
In the end, the defense against aging skin requires more than just choosing the right product.
No product will reverse the damage done to skin by unhealthy habits practiced over a lifetime. Fortunately, it is never too late to start reaping the benefits of good skin care.
And, is beauty only skin deep after all? An old best seller tells us that though "our outward man perish, yet the inward man is renewed day by day."
Skin Care Resource List
Looking Good at Any Age by dermatologist Dr. Amy Newburger. At book stores and libraries.
Consumer Reports. "The Skin Game," January 2000.
Mayo Clinic Family Health Book. At libraries and bookstores.
Don't Go to the Cosmetic Counter Without Me by Paula Begoun. The author has researched thousands of products, rating their effectiveness and value.
How and Why We Age. Leonard Hayflick, Ph. D.
Beyond Soap,Water, and Comb, A Man's Guide to Good Grooming and Fitness. Ed Marquand.
A Closer Shave. Wallace G. Penfold discusses shaving methods and beard types. Humorously illustrated.
American Academy of Dermatology (AAD) 800.462.3376, and www.asds-net.org.
Rita Baum is a Los Gatos resident. She has a master's degree in gerontology and has 20 years experience working in the field of aging.
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