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Archives for May 2020

The best anti-aging treatments for your skin

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Anti-aging products: Sunscreen, Retinoids, Vitamin C

It’s a question patients ask me all of the time: “what are the best anti-aging treatments for my skin?”. There are countless anti-aging treatments on the market, and the sheer number of options can be overwhelming. Product reviews help us make choices, but are they really accurate? How many of us have raved about a product one week, only to find that it caused irritation or breakouts the next? In addition, each individual’s skin is unique, and a treatment that works for one person may not benefit another.

Fortunately, there is a better way to determine which anti-aging ingredients are best: look at the science. The three essential anti-aging ingredients that are consistently backed by scientific studies are: 1) sunscreen 2) retinoids and 3) vitamin C. These superstar products help fight aging and keep your skin looking fresh and young.

Sunscreen

My favorite sunscreens

The sun causes the skin to age. These changes can appear as sagging, wrinkles, freckles, and/or dark spots. However, sunscreen greatly reduces the amount of damage the sun does to your skin. A large study of over 900 patients in Australia showed that application of daily sunscreen reduced skin aging by 24% (Hughes, M., Williams, G., Baker, P., & Green, A., 2013). Individuals enrolled in the same study had no detectable increase in skin aging after 4.5 years of daily sunscreen use.

Most people slather on sunscreen when they are in direct sunlight, but they often forget to apply when indoors or on cloudy days. High energy visible (HEV) light—the light emitted from phones, computers, tablets, and some overhead lighting—can also damage the skin. Therefore, individuals need to use sunscreen consistently, regardless of the weather or time spent outdoors. 

A good sunscreen contains both UV-A and UV-B protection and is at least SPF 30 or higher. Mineral sunscreens (zinc oxide and titanium dioxide) are preferred over chemical sunscreens due to a better safety profile. The FDA recently raised concerns about chemical sunscreens, after it was found they entered the bloodstream at unacceptably high levels.

Retinoids

Retinoids in different treatment forms

There is a good reason topical retinoids are considered the holy grail of anti-aging products. They have a proven-track record of preventing wrinkles, reducing discoloration, and improving overall skin tone. Vitamin A, along with its natural and synthetic derivatives, make up the retinoid family. They exert their anti-aging effects by increasing collagen synthesis in the skin as well as neutralizing free radical production. Topical retinoids are usually available only by prescription, however, one synthetic retinoid—adapalene—is approved for over-the-counter use. 

Retinol is a much weaker form of vitamin A, and is typically added to over-the-counter anti-aging creams and serums. Prescription-strength retinoids are approximately 100 times stronger than their retinol counterparts. For individuals new to retinoids, over-the-counter retinol is a good place to start.

All retinoids have the potential to be irritating to the skin, so care should be taken to introduce these products slowly into your skin care routine. They can also cause significant sensitivity to the sun, therefore, consistent sunscreen use is essential. Finally, retinoids should be applied at night, since sunlight renders them inactive. 

Vitamin C

Vitamin C serums

Vitamin C should be a key ingredient in your anti-aging arsenal. It is a potent antioxidant that has been shown to neutralize toxins and free radicals that accumulate in the skin after exposure to environmental pollutants or UV radiation. While normal skin contains high levels of vitamin C, aged or photodamaged skin is associated with depleted levels. Replacing Vitamin C in topical form can brighten the skin, reduce hyperpigmentation, and improve overall texture and moisture barrier function. Like retinoids, vitamin C serums can be irritating to the skin in some individuals, but they are generally well-tolerated. They should be applied in the morning and combined with sunscreen for extra anti-aging protection.  

To wrap up, the best anti-aging treatments for your skin are sunscreen, retinoids, and vitamin C. Use these three ingredients on a consistent basis and turn back the clock on skin aging.

Watch anti-aging video to learn more:

References

Baldwin, H., Nighland, M., Kendall, C., Mays, D., Grossman, R., & Newburger, J. (2013). 40 years of topical tretinoin use in review. Journal of Drugs in Dermatology, 12(6), 638-642.

Fitzpatrick, R. & Rostan, E. (2002). Double-blind, half-face study comparing topical vitamin C and vehicle for rejuvenation of photodamage. Dermatologic Surgery, 28(3), 231-236.

Hughes, M., Williams, G., Baker, P., & Green, A. (2013). Sunscreen and prevention of skin aging: A randomized trial. Annals of Internal Medicine, 158, 781-790.

McDaniel, D., Mazur, C., Wortzman, M., & Nelson, D. (2017). Efficacy and tolerability of a double-conjugated retinoid cream vs. 1.0% retinol cream or 0.025% tretinoin cream in subjects with mild to severe photoaging. Journal of Cosmetic Dermatology, 16(4), 542-548.

Mukherjee, S., Date, A., Patravale, V., Korting, H., Roeder, A., & Weindl, G. (2006). Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clinical Interventions in Aging, 1(4), 327-348.

Neighmond, P. & Neilson, S. (2019). Confused about sunscreen ingredients? Here’s what we’ve learned. Available online at: https://www.npr.org/sections/health-shots/2019/08/04/747648291/confused-about-sunscreen-ingredients-heres-what-we-ve-learned. Accessed 5/16/20.

Poon, F., Kang, S., & Chien, A. (2014). Mechanisms and treatments of photoaging. Photodermatology, photoimmunology, & photomedicine, 31(2), 65-74.

Pullar, J., Carr, A., & Vissers, M. (2017). The roles of vitamin C in skin health. Nutrients, 9(8), 866.

Mindfulness for Glowing Skin

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These are stressful times. As the world grapples with the impact of the COVID-19 pandemic, many of us have been thrust into a state of endless worry about our health, our jobs, and our future. We may not be sleeping well, eating our normal diets, or living our lives the way we used to. Unfortunately, this state of chronic stress can take a drastic toll on our skin. Many individuals with chronic skin diseases have noticed worsening of their conditions, and new skin diseases have begun cropping up in susceptible individuals. Let’s examine how stress impacts the skin and discuss ways we can mitigate these effects to optimize our skin’s health.

Stress and the Skin

The skin is the largest organ in the body, so it should come as no surprise that chronic stress impacts the skin in a big way. The main pathway stress damages the skin is through an increase in the production of cortisol—a stress hormone that triggers inflammation. Inflammation is at least partially responsible for a host of skin diseases, ranging from itching and rashes to hair loss. 

The most common conditions affected by stress include:

  • Acne
“Acne vulgaris” by Adams999
licensed under CC BY-NC-SA 2.0

Spikes in cortisol have been shown to trigger an increase in sebum (oil) production. Sebum-loving bacteria thrive in oily skin environments, multiplying and causing secondary inflammation. Inflammation then manifests as red, irritated bumps on the skin, otherwise known as pimples. 

  • Eczema and psoriasis
Acute eczema flare
Photo courtesy of CDC/Susan Lindsley

These two common skin conditions are primarily inflammatory in nature, so stress can play a significant role in disease flares. In addition to its inflammatory effects, stress has been shown to disrupt the skin barrier, leading to dryness and increased susceptibility to rashes. 

  • Rosacea

Rosacea causes flushing and red bumps on the face and may be provoked by emotional stress. Many people turn red, or “blush”, when they are embarrassed or angry, but for some individuals, this process of flushing can become chronic. Daily measures to reduce stress can be very helpful in treating this condition.

  • Hair loss

Stress has been linked to a type of hair loss known as alopecia areata. In this disease, the body attacks its own hair follicles resulting in patches of hair loss on the scalp and/or body. Hair typically grows back, but symptoms may recur with future stressful life events. 

  • Itching

The link between stress, anxiety, and itch has been well-established. Stress and anxiety can cause a compulsion to scratch at the skin. Stressful situations can also lead to nervous system changes that result in burning or itching sensations of the skin. Unfortunately, frequent scratching can lead to a phenomenon known as the “itch-scratch cycle—where scratching makes the itching worse, which causes further scratching. 

  • Aging

Many individuals are surprised to learn that stress, and the sleep troubles that typically accompany it, are associated with accelerated skin aging. These changes manifest as fine lines, uneven pigmentation, and reduced elasticity, or sagging, of the skin. 

So, what can we do about stress?

Fortunately, there are many stress reduction techniques that can be easily implemented with little time or effort. 

Breathing/Meditation

Taking a few slow, deep breaths from the abdomen provides a simple way to disengage from racing and distracting thoughts. Guided imagery and meditation techniques require a bit more time to implement but can also be helpful in reducing stress. For example, trying to visualize yourself in a beautiful, soothing setting can help cultivate relaxation and calm. Apps like “Headspace” and “Calm” provide guided meditation sessions for those of us who need help getting started.

Mindfulness

Bringing your attention to the present moment without concern for the past or future is called mindfulness and is one of the most effective stress-reduction techniques. It can easily be practiced multiple times throughout the day until it eventually becomes second nature. Scanning the body to notice and release areas of tension can help boost our awareness of the mind-body connection.

Yoga

Yoga and other ancient arts have been used for years to reduce stress, increase strength, and improve the flexibility of the body. Scientific studies have demonstrated that yoga results in a clinical reduction in cortisol levels. It also helps improve mood and generate self-compassion. Will all of its benefits, it’s no wonder yoga has become a global phenomenon.

Exercise

Exercise increases overall health and a sense of well-being, while also being an excellent stress reducer. Exercise is essentially “meditation in motion”, meaning it requires so much of your focus and attention that you forget your worries long enough to return to the present moment. Furthermore, exercise can help with sleep, which is commonly disrupted during times of stress. 

With all of the helpful stress-reducing techniques out there, it should be easy to find one that works for you. So, get started today implementing these strategies into your day-to-day routine. Your skin will thank you for it!

What are other healthy strategies you use to relax? I would love to hear from you!

References

Arck, P., Slominski, A., Theoharides, T., Peters, E., & Paus, R. (2006). Neuroimmunology of stress: skin takes center stage. Journal of Investigative Dermatology, 126(8), 1697-1704.

Chen, Y. & Lyga, J. (2014). Brain-skin connection: stress, inflammation, and skin aging. Inflammation and Allergy Drug Targets, 13(3), 177-190.

Corliss, J. (2019). Six relaxation techniques to reduce stress. Harvard Health Publishing: Harvard Medical School. Available at: https://www.health.harvard.edu/mind-and-mood/six-relaxation-techniques-to-reduce-stress. Accessed 5/10/20.

Mayo Clinic Staff. (2018). Exercise and stress: get moving to manage stress. Available at: https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469. Accessed 5/10/20.

Riley, K. & Park, C. (2015). How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry. Health Psychology Review, 9(3), 379-396.

Sanders, K. & Akiyama, T. (2018). The vicious cycle of itch and anxiety. Neuroscience and Biobehavioral Reviews, 87, 17-26.

Collagen supplements for beautiful skin

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If you read beauty blogs and magazines, chances are you have heard of the latest craze to hit the anti-aging market–collagen supplements. Collagen supplements claim to make the skin look younger, may help with brittle nails, and may even reduce the appearance of cellulite. But do they really work? Let’s look at the current scientific literature to determine if collagen supplementation can transform your skin and make you look years younger.

What is collagen?

Collagen is the most abundant protein in the body and is responsible for the structure, stability, and strength of the underlying tissues. The deposition of collagen into the skin gradually decreases over time as the skin ages, but it can be accelerated due to photoaging from excessive sun exposure. Aside from aging, the biggest reason individuals are deficient in collagen is a poor diet. Consuming animal and vegetable sources that are protein-rich, such as beef, chicken, fish, beans, eggs, and dairy products can help ensure adequate intake of collagen.  

The science:

Several limited studies have shown promising results in individuals taking collagen supplements for their skin. These studies have noted benefits in transepidermal water loss (skin hydration), skin elasticity, roughness, and wrinkles. Two separate studies showed a possible benefit of collagen supplementation in patients who have brittle nail syndrome as well as in women who suffer from moderate cellulite. Animal studies further revealed that administering collagen hydrolysates to mice for 6 months led to significantly increased collagen content and density of the skin.

Can I benefit from taking a collagen supplement?

If you are eating a healthy diet and feeding your body all of the nutrients it needs to make collagen, you probably do not need a supplement. However, as the body ages, you may no longer absorb or synthesize nutrients as efficiently as you used to. Taking a collagen supplement can make up for a deficiency if it is present. A 2017 study in the Journal of Agriculture and Food Chemistry showed that collagen hydrolysates can be transferred through the bloodstream directly to the skin, which explains the probable pathway for the beneficial effects of taking a supplement. However, some scientists postulate that the skin is a much lower priority to the body than major muscles, like the heart, diaphragm, and brain, where collagen will be distributed first. Therefore, only patients with a significant deficiency will likely benefit from taking collagen supplements. In addition, the cost and bulk of supplementation may be prohibitive for patients. Supplements in pill form require swallowing six a day to get a 6-gram dose. Powders are often double the price of pills, running from $15-$40 for a month’s supply.

Bottom line:

Limited studies on the benefits of collagen supplements have shown some promise, however, questions remain regarding which patients will benefit and how much collagen is actually absorbed into the skin. Cost and administration may be factors in compliance. It should be noted that for individuals who wish to add more collagen to their diet, bone broth—while not in hydrolysate form—offers six grams of collagen-rich protein and may be a tastier way to get your collagen fix.

*See accompanying recipe for bone broth to get your collagen fix!

References:

  1. Jhawar, N., Wang, J. & Saedi, N. Oral collagen supplementation for skin aging: a fad of the future? Journal of Cosmetic Dermatology, August 14, 2019. https://doi.org/10.1111/jocd.13096
  2. Choi, F.D., Sung, C.T., Juhasz, M., Mesinkovska, N.A. Oral collagen supplementation: A systematic review of dermatological applications. Journal of Drugs in Dermatology. 2019; 18(1): 9-16.
    1. Vollmer, D.L., West, V.A., & Lephart, E.D. Enhancing skin health by oral administration of natural compounds and minerals with implications to the dermal microbiome. Int. J. Mol. Sci. 2018, 19(10), 3059.
  3. Hexsel, D., Zague, V., Schunck, M., Siega, C., Camozzato, F. & Oesser, S. Oral Supplementation with specific bioactive collagen peptides improves nail growth and reduces symptoms of brittle nails. Journal of Cosmetic Dermatology; August 2017, available online at: https://doi.org/10.1111/jocd.12393.
  4. Krieger, E. Collagen supplements show early promise for skin and joints, but don’t stock up yet. March 26, 2018, The Washington Post. Available online at: https://www.washingtonpost.com/lifestyle/wellness/collagen-supplements-show-early-promise-for-skin-nails-and-joints/2018/03/23/1cd480e2-27d6-11e8-bc72-077aa4dab9ef_story.html
  5. Schunck, M. Zague, V., Oesser, S., & Proksch, E. Dietary supplementation with specific collagen peptides has a body mass index-dependent beneficial effect on cellulite morphology. Journal of Medicinal Food. Dec 17, 2015: Available online at: https://doi.org/10.1089/jmf.2015.0022
  6. Cruel, J. Does drinking collagen supplements actually do anything for your skin? Self, August 22, 2017. Available online at: https://www.self.com/story/collagen-supplements.