Friction. Clap your hands, stomp your feet, or give them a mini-massage. But you already know that one, so consider…

Yoga. Lie on your back with legs against wall, perpendicular to the floor for as long as comfortable. When leg muscles relax, blood vessels open up and circulation improves.

Aerobic exercise. Take a walk, ride a bike, or do jumping jacks—anything that makes you work up a sweat.

Still feeling frosty? Consider thermal bio-feedback, a natural therapy that trains patients to warm their hands and feet in about 20 sessions. For a referral, talk to your care provider or go to bcia.org.

How to Shake Off a Chill The Saturday Evening Post

Although the cause remains unknown, strong evidence points to a triad of genes that make people more susceptible to the physically harmless yet socially distressing and hard-to-treat condition. When patients are upset by their appearance, months-long use of topical lotions and carefully controlled exposure to laser rays or light boxes may help stop the immune system attack and coax cells to grow back and re-pigment the area, says Dr. Kroshinsky. Others opt to cover up faded areas with skin dyes, medical-grade cosmetics, and self-tanning creams.

RESEARCH HIGHLIGHTS

Advances in surgical techniques hold promise for treating vitiligo, according to information presented at American Academy of Dermatology’s 70th Annual Meeting in March 2012 by Rebat M. Halder, MD, FAAD, professor and chair, department of dermatology, Howard University, Washington, D.C.

Skin Grafts

· What it is: Normal skin is transplanted to areas affected by vitiligo and begins producing pigment. Phototherapy is often used to boost pigment production in treated areas.

· Who is eligible: Patients with limited and extensive vitiligo that has been stable for at least six months.

· Success rate: 80 to 90 percent in most patients.

· Availability: Uncommon in the United States, this outpatient procedure is widely available in South America, Europe, Southeast Asia, India and China.

Melanocyte Transplants

· What it is: Cells (melanocytes and keratinocytes) found in the top layer of skin are obtained surgically under local anesthesia and grown overnight in the lab. Then cells are placed or applied on the skin’s vitiligo patches. Phototherapy is often used to boost pigment production in treated areas.

· Who is eligible: Patients with limited vitiligo that has been stable for at least six months.

· Success rate: 95 percent in most patients.

· Availability: Few dermatologic centers in the U.S. are currently offering this specialized outpatient procedure, but Dr. Halder expects that it will be more available in the future.

 “It is important for anyone who notices any unusual changes in the pigmentation of their skin to see a dermatologist, as vitiligo treatments are more successful the earlier they are started,” said Dr. Halder. “The newest surgical grafting techniques and transplant procedures hold a lot of promise for successfully treating vitiligo, and I think we’ll see more dermatologists offering these cutting-edge procedures in this country in the future.”

For more about vitiligo and to find a board-certified specialist contact the American Academy of Dermatology.

Disappearing Act? The Saturday Evening Post

But with so many face-cleansing products now on the market, it’s little wonder that many people are doing unnecessary harm to their skin, say board-certified physicians of New York-based Advanced Dermatology and the Center for Laser and Cosmetic Surgery. Restore simplicity and common sense to face cleansing by following their kinder, gentler approach.

Where We Go Wrong

“The most common mistake we make is to over-wash, over-scrub and over-dry our faces,” says Dr. Meryl Blecker Joerg. “Daily cleansing is important, but facial skin has fewer layers than skin on most other areas of the body. As a result, it is more easily damaged.”

Using the wrong product is another big no-no, adds Dr. Valerie Goldburt, who explains people tend to be “overly aggressive” by using one or more products that may be too harsh for their skin.

How to Do it Right

Cleanse face twice daily with warm water if you have oily or normal skin, or once a day if skin is dry or damaged, advises Dr. Joerg. “I recommend washes (not scrubs) with salicylic acid. Scrubs can break up acne and cause scarring.”

“Only use bar soap, gel, or liquid cleanser that is formulated for use on your face—not on your body,” cautions Dr. Goldburt.

In general, use a mild moisturizing cleanser that removes oil and residue without leaving skin dry, tight, or flaky. Foaming facial cleansers that work into a lather and rinse off often leave the face refreshed; they come as lotions, gels, creams, and aerosols. Bar-type products for the face may be labeled beauty bars, facial soap, mild cleansing bars, or sensitive skin bars. Opt for deodorant-, fragrance- or antiseptic-free products.

“Beautiful skin is healthy skin,” Dr. Goldburt reminds us. “While it’s important to maintain a high-quality skin care regimen, it’s equally important to maintain good nutrition, drink plenty of water, eliminate skin-damaging habits like smoking, and avoid excessive sun exposure. Also don’t forget your sunscreen; your skin will reward you for it!”

Tips on Choosing a Face Cleanser The Saturday Evening Post

W.D.M.

Lubbock, Texas

We’re always up for a challenge! After checking with physicians and researchers, we turned to other key members of the health care team—nurses. Here’s expert advice from Suzanne Prevost, R.N., Ph.D., associate dean at the University of Kentucky, College of Nursing and president-elect of Sigma Theta Tau International, a global network 
of nurse leaders:

“Persistent itchiness (pruritus) has many causes and is the most common skin problem among seniors. It is wise to consider medications, especially if people note increased itching when a drug regimen is changed. Itching may be a side effect of vitamins and minerals, including folic acid, calcium, iron, vitamin D, and vitamin B12. Prescription drugs such as prednisone (Deltasone, Liquid Pred), methotrexate (Rheumatrex, Trexall) for rheumatoid arthritis, and furosemide (Lasix) for edema can also cause skin changes.”

Ironically, getting wet can dry you out, too. “Daily bathing with hot water dries the skin,” says Prevost. “Instead, take two or three baths per week with lukewarm water to exfoliate dead cells that increase itchiness. Just after exiting the tub or shower, apply a heavy moisturizing cream (which is more effective than a lotion) while skin is still damp. Over-the-counter preparations referred to as ‘body butter’ are good choices. Keep nails trimmed very short. Scratching provides momentary relief, but ultimately increases inflammation and the itching sensation. If your home tends to be dry, adding a humidifier may help.

“Finally, don’t give up on health care providers. The problem you are experiencing causes tremendous discomfort and deserves to be treated seriously. If you have not already done so (and regardless of your age), consider seeking help from a geriatric dermatologist or nurse practitioner who is familiar with this problem.”

Ditch Itchy Skin The Saturday Evening Post

But with so many choices, which treatments actually improve and protect the skin’s appearance, and which ones simply add a new wrinkle to the budget? The best way to answer that question is to look first at what it is you’re saving your skin from:

When outdoors, wear a wide-brimmed hat and tightly woven clothing that covers your body.

Block the Sun

Protecting your skin from ultraviolet (UVA/UVB) radiation exposure (including indoor tanning), extremes of heat and cold, and air pollution can significantly reduce your risk of wrinkles and skin cancer.

“Baby boomers didn’t know better and received a great deal of harmful sun exposure before sunscreens were available,” says Dr. C. William Hanke, an eminent dermatologist and past president of the American Academy of Dermatology. “Ultraviolet light causes malignant melanoma, as well as basal cell and squamous cell carcinomas, which are much more common skin cancers.”

Thankfully, broad-spectrum sunscreens protect against both UVA and UVB rays and are widely available today. They’re crucial for skin protection, and not just in the summer. While the sun’s UVB rays are strongest in the northern hemisphere May through September, UVA rays are present year round, penetrating windshields, light clothing, and office windows.

However, comparing the ingredients of one sunscreen to another can leave one bleary-eyed and confused.

“Check the product label,” advises Dr. Hanke. “Good broad-spectrum sunscreens have an SPF of 30 or greater and contain protective ingredients that include: avobenzone, ecamsule, oxybenzone, titanium dioxide, and zinc oxide.”

Choose a sunscreen that works best for you. People with oily skin may prefer an alcohol-based gel. Individuals with dry skin want a cream for moisture.

When applying sunscreen, don’t forget less obvious, but vulnerable areas, such as the ears, neck, and face—anywhere that is exposed.

“We see golfers in my clinical practice all the time,” says Dr. Hanke, who reports an increasing number of cancers on the lips, ears, and eyelids of outdoor enthusiasts who fail to adequately protect sensitive areas. “They golf for five or six hours at a time and need to wear sunscreens. The same advice applies to winter skiers as well.”

Clothing also adds an extra layer of protection. “Wear a hat,” stresses Dr. Hanke. “Men with hereditary hair loss who don’t wear hats are at higher risk for premalignant lesions and skin cancers—mostly squamous cell carcinomas—on their scalps. It can be a huge problem.”

When choosing sun-protective clothing, opt for dense, tightly woven fabrics.

“If you hold the hat or shirt up to the light and can see through it, so can the sun,” Dr. Hanke adds. “The hat should have a tight weave to protect the scalp.”

Today, most sporting goods companies, apparel stores, and online outlets sell sun-protective clothing.

Snuff Out Smoke

Aside from the serious health consequences, smoking and secondhand exposure is also bad for your skin—next in line to the sun in causing wrinkles. Nicotine impairs blood flow to the skin, accelerating the normal aging of epidermal tissue.

Keep It Clean

Science of Skin
Older skin is thinner and more fragile, and the deep layers 
contain less elastic tissue. Blood vessels are also less elastic, so that even minor injuries can cause bruising. The skin may be mottled with small, flat brown areas called lentigines (from the Latin word for lentils).

Young Skin: A thick outer layer and a large number of elastic fibers in the deeper layers help maintain the smoothness of young skin.

Older Skin: A thinner outer layer and fewer elastic fibers in the deeper layers result in skin that appears loose, with deeper creases and wrinkles.

Images reprinted from The Human Body, ©1995 Dorling Kindersley Ltd.

Facial hygiene is also critical. One of the first steps is choosing the right cleanser.

“If you have oily skin, you can use any soap you want, and it will probably not be irritating,” Dr. Hanke says. “The soap that I recommend for most people and use myself is plain white Dove. People with dry or oily skin can use it.”

For people with rough and scaly skin, occasionally using an exfoliant makes skin appear smoother and feel softer.

“As you age, dead cells build up on the skin surface,” Dr. Hanke explains. “Exfoliation removes the dead surface layer, and moisturizing helps keep skin soft.”

Cleanse your face twice a day—once in the morning and again at bedtime, then apply a moisturizer based on your skin type. For dry skin, opt for an occlusive moisturizer that covers the skin with a waterproof film through which water cannot evaporate or escape. For sensitive skin, some experts recommend applying a moisturizer containing soothing ingredients, such as bisabolol, a chamomile extract.

“As we get older, our skin is not the barrier that it once was,” says Dr. Hanke. “It dries out more easily. As a result, people need to moisturize their skin more frequently.”

Do high-end products equate with higher quality?

“Some inexpensive moisturizers such as Neutrogena and Oil of Olay are very good, as are some very expensive ones, such as La Prairie and LaMer,” notes the dermatologist. “Find one that works for you and does not irritate your skin.”

A word of caution: Don’t introduce too many products at the same time.

“Stick with one product line,” advises Dr. Hanke. “Different products can inactivate each other through chemical reactions and potentially irritate the skin surface.”

Rejuvenating Aging Skin

Innovations in anti-aging skin care are on the fast track to meet the growing demand of baby boomers (and their parents). From nonprescription “cosmeceuticals” to laser treatments, therapies are available that improve the skin’s surface texture, reduce irregular pigmentation, and help reverse the effects of sun damage.

Topicals: Typically used to address milder signs of aging. For example, retinol, a vitamin A compound, is the first antioxidant topical widely used in nonprescription creams and is the less potent cousin of tretinoin (Retin-A, Avage, Renova), a prescription-strength treatment for acne and fine wrinkles.The fastest growing segment of topical skin care, cosmeceuticals combine aspects of the cosmetic and pharmaceutical industries. Cosmeceuticals influence the function of the skin with biologically active compounds (vitamins, oils, herbs, and botanical extracts). Botanicals, for example, contain antioxidants that protect the skin’s surface. William Beeson, M.D., clinical professor in dermatology at Indiana University School of Medicine and noted facial plastic surgeon, has researched a cornucopia of compounds that rejuvenate skin tissues. His research led to the discovery of unique properties in rosemary, an herb that contains a potent antioxidant called carnosic acid. After demonstrating clinical efficacy, Dr. Beeson and colleagues developed a formulation called Effulgere (effulgere.com) that penetrates the skin surface more deeply and helps “protect the skin from further damage by enhancing the skin’s lipid barrier, brightening the skin, and improving its texture and tone.”

Chemical Peels: A chemical solution—such as phenol, tricholoacetic acid (TCA), or alpha hydroxy acids (AHAs)—that removes damaged outer layers of the skin, revealing the healthier layers below. Wrinkles from sun damage, aging, and heredity can be significantly reduced by undergoing a series of peels that also improve irregular skin pigmentation and remove early skin cancers (actinic keratoses).

Lasers: Many laser treatments are now used to minimize wrinkles, scars, skin discolorations (freckles or “age spots”), and blemishes on the face, neck, chest, and back of hands by removing the outer layer of skin (epidermis). The treatment simultaneously heats underlying tissues (dermis), stimulating the growth of new collagen fibers that form smoother, firmer skin. One of the more popular areas in minimally invasive cosmetic surgery, fractionated carbon dioxide (CO2) laser treatment is performed under topical anesthesia on select areas of damaged skin. The outpatient procedure creates microscopic holes in the skin, which then heal with new collagen that tightens skin and evens tone. Newer technologies offer surgeons a greater level of control in laser surfacing, permitting extreme precision, particularly in delicate areas.

Fillers: These reduce the appearance of facial lines and wrinkles by “plumping” furrows and hollows in the face, giving the skin a more youthful-looking appearance. Fillers (Juvaderm, Restylane, Gore-Tex) are very effective at contouring specific areas on the face, such as around the lips, including long, vertical “marionette” lines that start at the corners of the mouth and extend down the chin. Botulinum toxin type A (Botox, Dysport) injections also diminish lines and wrinkles associated with facial expression, including vertical lines between the eyebrows and on the bridge of the nose, forehead lines and furrows, and crow’s feet.

Saving Face: Skin Care Tips The Saturday Evening Post

Protection is the key to saving your skin. Fortunately, consumers have a wide array of choices of sunscreens, sunglasses, sunless tanning products, and clothing that offers coverage from the No. 1 cause of all skin cancers and the primary cause of aging—the sun.

To learn more about current measures to preserve the skin and reduce the appearance of sun-damaged, the Post interviewed dermatologist Zoe. D. Draelos, M.D., F.A.A.D., vice president of the American Academy of Dermatology. A consulting professor of dermatology at Duke University School of Medicine, Dr. Draelos is also editor-in-chief of the Journal of Cosmetic Dermatology and has written eight dermatology textbooks, 32 book chapters, and more than 300 scientific articles. She has served as president of the North Carolina Dermatology Association and as a member of the board of directors of the American Society for Dermatology Surgery.

PP: Why do so many products use botanicals in their ingredients?

ZD: Botanicals are usually used as antioxidants, which are designed to prevent the damage that occurred from UV radiation striking the skin. But botanicals can be used for many purposes in anti-aging products—for their anti-aging properties, to color or scent the product, and many other purposes.

PP: What do you see as the major anti-aging breakthroughs in skin treatment today?

ZD: One of the big breakthroughs is understanding aquaporins, which are responsible for regulating the transport of water and other small solutes across plasma membranes, ultimately acting as pores within the walls of skin cells to keep skin moisturized and hydrated.

Old-fashioned ingredients, such as glycerin, actually affect the amount of water the skin holds. Many moisturizers now contain very high glycerin levels. Anti-aging moisturizers attempt to reduce the appearance of fine lines and wrinkles by enhancing the skin’s water-holding capacity. Glycerin is a well-known emollient and lubricant that is great for dry skin. Glycerin—a basic ingredient for Corn Husker’s Lotion—has been rediscovered for its water-holding ability. When you increase the water-holding capacity in the skin, you can get rid of the fine lines of dehydration.

Many sophisticated fillers (see below) that doctors use to rid wrinkles contain a substance known as hyaluronic acid (HLA), which soaks up water. Holding water in the skin is a very powerful cosmetic tool to improve skin appearance. This water balance is like the spigot on the hose. When you turn the spigot down, not as much water comes out, so the skin is better hydrated. If you open it up and let a lot of water out, the skin becomes dehydrated. It may be that the aquaporin channels are defective and the reason why the skin dries out is because too much water is leaving the body. Understanding how aquaporins work would allow you to develop therapeutic moisturizers to increase the water-holding capacity of the skin and alleviate dry, itchy skin that is especially found in elderly people.

Rejuvenating Aging Skin

Innovations in anti-aging skin care are on the fast track to meet the growing demand of baby boomers (and their parents). Therapies are available that improve the skin’s surface texture, reduce irregular pigmentation, and help reverse the effects of sun damage.

Fillers: These reduce the appearance of facial lines and wrinkles by “plumping” furrows and hollows in the face, giving the skin a more youthful-looking appearance. Fillers (Juvaderm, Restylane, Gore-Tex) are very effective at contouring specific areas on the face, such as around the lips, including long, vertical “marionette” lines that start at the corners of the mouth and extend down the chin. Botulinum toxin type A (Botox, Dysport) injections also diminish lines and wrinkles associated with facial expression, including vertical lines between the eyebrows and on the bridge of the nose, forehead lines and furrows, and crow’s feet.

Saving Face: Exclusive Web Update The Saturday Evening Post

World health leaders are issuing the strongest warning yet about indoor tanning and cancer risk, labeling the devices as “carcinogenic to humans” as smoking cigarettes and exposure to arsenic and asbestos.

The new research, published in The Lancet Oncology medical journal, found a higher-than-expected risk of potentially deadly skin cancer in people using sunlamps and tanning beds for cosmetic purposes. Not surprisingly, those who began the practice as teens or 20-somethings were most at danger.

“The risk of skin melanoma is increased by 75 percent when use of tanning devices starts before 30 years of age,” states the report from the International Agency for Research on Cancer, the World Health Organization agency that developed the most widely used system for classifying carcinogens. The group also found a link between tanning bed use and risk of melanoma of the eye.

Indoor tanning is a multibillion-dollar industry in the United States. The FDA is currently reviewing the language and positioning of warning labels on tanning equipment to convey a shorter and more forceful message.

But the American Cancer Society recommends people avoid tanning beds altogether.

“This new report confirms and extends the prior recommendation of the American Cancer Society that the use of tanning beds is dangerous to your health, and should be avoided,” says Len Lichtenfeld, M.D., deputy chief medical officer of the American Cancer Society. “Young women in particular are the heaviest users of tanning beds, and, as noted in the report, are at the greatest risk of causing harm to themselves.”

The findings also put to rest the argument that tanning with UVA light is safe, Lichtenfeld says.
“Previously, the cancer-causing effects of ultraviolet light were thought to be primarily related to UVB, or ultraviolet B radiation. This new report now extends the cancer-causing effects of solar or sun-related radiation to UVA light, as well,” he says.

Conventional tanning beds produce an average 95 percent UVA and 5 percent UVB rays. Newer versions, however, emit higher levels of UVB to speed up the tanning process.

Indoor Tanning: The Warning You Need to Read The Saturday Evening Post

My mother has blotches on her arms and legs that look like blood vessels have burst below the skin surface. They spread across the arms and/or legs and are purple and black in color. It’s very distressing to her. What causes these to appear, and how might we address the problem?

R
Alabama

Keep Skin Moist to Prevent Bruising The Saturday Evening Post