Gear up your smartphone with free apps to crush those annoying goals that show up on our top-10 lists every year:

Lose Weight: Two proven weight-loss strategies—calorie counting and peer support—team up in FitNow’s app (loseit.com). Set a daily calorie budget, track activities, and connect with friends for extra motivation.

Get Organized: Build collections of photos, recipes, and decorating ideas at pinterest.com. Think of it as a personal digital scrapbook that you just happen to share with the entire world.

Manage Money: Track and categorize spending at mint.com. Enter account information, then sit back and watch. As the year unfolds, you’ll begin to notice where to cut back and save.

Learn Something New: Bring global photo journalism into your tablet with this app from Reuters (widerimage.reuters.com). Timely, insightful, sometimes disturbing, always fascinating. (Sorry, it’s iPad only.)

Get a New Job: Access postings from job boards and company websites at indeed.com. Bonus: Personalize and send your search to your smart device.

Quit Smoking: OK, these apps aren’t free—but they’re lots cheaper than smoking. QuitNow! ($2.99, Google Play) and Livestrong MyQuit Coach ($3.99, iTunes) motivate soon-to-be-reformed-smokers with progress trackers, chats, and achievable goals.

Help Others: Find a great place to volunteer at volunteermatch.org.  Make a difference and connect with others in your community with this iPhone app.

Meet New People: Join the largest location-based social network at badoo.com. Meet new friends, chat, and share interests.

Send Cards: Find the perfect card for whenever and whomever at justwink.com. Get reminders and send personalized digital greetings via text, email, or Facebook.

Save the Planet: Go green with the One Small Act app from greenisuniversal.com. Choose from 400+ simple, eco-friendly actions; track progress; and share achievements.

Top 10 Apps for Self-Improvement The Saturday Evening Post

Caffeine: You’re probably well aware that coffee can cause erratic or rapid heartbeats. It can also lead to atrial fibrillation in susceptible people. Some feel palpitations when they consume caffeinated soda, tea, or chocolate.

Overeating: For some individuals over-indulging at the buffet table may cause symptoms. Why? A full stomach can irritate nearby nerves, stimulating the heart and triggering extra heartbeats.

Red Wine: Small amounts of alcohol, particularly red wine, can benefit the heart. In excess, however, alcohol may cause heart arrhythmias and “holiday heart,” or palpitations on Monday after a weekend binge.

Supplements: It’s impossible to say which dietary supplements can potentially affect the heartbeat (or interfere with heart medicines) because most are unregulated and untested. “Natural” does not mean “safe,” and consumers can unknowingly take products that contain hidden and potentially harmful ingredients. Diet pills can be especially dangerous. For example, the FDA warned last October that 20 brands of dietary supplements for weight loss were tainted with sibutramine—the active ingredient in prescription weight-loss drug Meridia that was linked to elevated blood pressure, heart rhythm problems, heart attacks, and stroke and removed from the U.S. market in 2010.

Common Causes of Irregular Heart Rhythms The Saturday Evening Post

Medical students David and John Gallacher from Cardiff University in Wales, UK, say that women in committed relationships have better mental health, while men in healthy relationships have better physical health, concluding that “on balance it probably is worth making the effort.”

Men’s physical health probably improves because of their partner’s positive influence on their lifestyle and “the mental bonus for women may be due to a greater emphasis on the importance of the relationship”, they write in the student BMJ, the international medical journal for students.

But not all relationships are good for you, they point out, referring to evidence that single people have better mental health than those in strained relationships.

The bottom line is no surprise: Don’t shy away from romantic relationships. Just try to avoid the bad ones.

Strong Relationships, Healthier People The Saturday Evening Post

“I have a few questions,” Susana interjected, stopping the pediatrician in her tracks. “What do I do for her?”

“Give her some Tylenol,” she advised. “She’ll be fine.”

“How much Tylenol do I give her?” the new mother asked.

“What is her body weight?” the doctor said, scanning Sofia’s chart.

“I don’t know—no one in 
your office weighed her or took her temperature,” she replied. “Will you please pay more attention to this situation and tell me what’s wrong with my daughter? I need information.”

Because Susana spoke up, her daughter got the attention she needed, and Susana got the information and guidance that she, as a paying customer and concerned mother, had a right to expect from the doctor. But not everyone feels comfortable doing that, even if they should.

Being wise medical consumers means choosing medical partners we can communicate with effectively and trust. When it comes to protecting our health, we have to be sure that we are getting what we pay for. An engaged, concerned, and skilled doctor is the best health care investment we can hope to find.

Illustrated by Pablo Bernasconi

Let’s Talk

Perhaps the most important step to becoming a smart medical consumer is the process of finding and choosing the right GP or family physician. That person will be your closest medical partner and will play an important role in helping you make other decisions about your health care management and practitioners. If 
you are in the market for a new physician, ask your friends and co-workers for recommendations, and go online to find out what doctors within that specialty are located in your area. When you’ve found one you want to “interview,” call the office and schedule an introductory appointment, so you can go 
in, share your medical history, and get a sense of the doctor’s attitudes and approach to medicine. (Tell the scheduling assistant specifically what 
you want to do during the appointment so you have adequate time.)

As with any interview, little things count: The office workers, nurses, and med techs should be friendly and helpful; the office should be clean; the doctor should be open and willing to talk with you about your concerns and interests. Keep it relatively simple, but use your time to determine how well this physician’s working approach suits your own. Does he or she communicate with patients via e-mail when appropriate? Is this doctor comfortable discussing information you’ve gathered? What hospital affiliations does the practice maintain? What regular screening tests does he recommend for someone of your age group? Talk about your major health concerns and listen closely to the answers you receive. If you’re comfortable with the initial meeting, schedule a full physical and use that experience to cement or break the deal with this doc.

Partner with Your Physician

Doctors are not infallible, nor should we expect them to be. Like the rest of us, they occasionally will be distracted and disengaged, and they won’t always seek our active collaboration in the doctor-patient relationship. It is therefore our responsibility to speak up, ask questions, and insist that our voices are heard when we have concerns about our treatment.

We don’t need a degree in medicine to partner with our doctors. We can start with some very simple steps. First, we should realize that our medical history is our business, not just our doctors’ “property.” Most of us know that we should maintain a list of our medications, including dosages and directions for use, along with any alternative health practices and supplements. In addition, many patient advocates advise that we keep track of our medical records, requesting copies from our doctors for our own safekeeping. That way, we know exactly what information is available to new physicians and consulting specialists—and we have the important information we need if we want to do our own research. Further, with copies of our test results in hand, we can be sure that the correct name appears on them and that there wasn’t a mix-up at the lab.

Be Your Own Records Keeper

Illustrated by Pablo Bernasconi

Every time you visit a new doctor, you’re asked to complete a personal health information form that lists family medical history, your history of diseases, illnesses, injuries, hospitalizations, allergies, and so on. You’re also asked to complete a “release of information” form, which enables your previous doctor to release health records to the new doctor’s office. With all this information floating around, you might wonder why anyone would need to keep his or her own personal health record. But, according to the American Health Information Management Association (AHIMA), everyone should do so. That way, no matter when or where we need health care, the medical provider we consult has access to a full and detailed medical history.

These records can be in written or electronic form, stored in a file folder, on a computer hard drive or disk, on a portable USB removable flash drive, or through an online service. The AHIMA maintains a Web site (My Personal Health Record, myphr.com) that offers full information about the benefits of maintaining a personal health record, along with free downloadable electronic forms for compiling one. The site has a search feature to find forms, tools, and software for storing records. Online services typically have access codes and other measures devised to keep information secure and accessible only by those you’ve authorized. Some online storage services are free, while others charge a monthly fee; check each service carefully when making your choice.

Asking Questions, Getting Answers

At some point, most of us will need a medical advocate—a friend or relative who can accompany us to our appointment or examination to help take notes, ask questions, and listen to information. If 
our doctor wants to send us on our way with a prescription, we first should ask for the drug’s name, its purpose, side effects, potential negative interaction, and so on. Then, when we fill the prescription, we need to check its accuracy before we leave the pharmacy. And we should always feel free to ask “why”: Why do I need this drug, treatment, or surgery? How else could we tackle this problem? What benefits will I get 
from this treatment plan, and what risks am I taking?

Some doctors can be prickly when they sense that their authority is 
being challenged. So how do we help make sure that our physician isn’t misdiagnosing our condition? Jerome Groopman, M.D., recommends that patients or their advocates describe to their doctors exactly what worries them most about their symptoms or condition. And ask early—don’t leave important details until the doctor is leaving the room. Groopman also suggests that patients ask questions 
to make their doctors think more deeply about their diagnosis, such as “What else could this be?”

We shouldn’t hesitate to speak up about sloppy practices, either. We can—and need to—ask whether all medical instruments, including stethoscopes and blood pressure armbands, 
have been sterilized, 
and whether we should be started on antibiotics before surgery, to help ward off post-surgical infections.

Illustrated by Pablo Bernasconi

Patient-Physician Compatibility?

Through the years, my expectations for physicians have changed. If you’re going to need ongoing service, such 
as from a cardiologist, dermatologist, internist, or gynecologist, then compatibility is much more important. On the other hand, if you’re seeing a specialist for a (hopefully) one-time treatment, such as an oncologist or surgeon, personality is not as important. What you really want to know is, “How good is the doctor for this type of treatment?” A good question to ask in the first meeting is, “What is your success rate?”

I firmly believe it’s important for patients to be accountable for their bodies and health. We are in a professional relationship with our physicians. We may form close bonds with the health care teams that tend to us or our loved ones, but we can’t afford to overlook potential warning signs simply because we like and trust them. Mistakes happen all the time. Better that we ask why an order has been changed, why a vital sign has been altered, why a medication has been dropped or started, than to have a simple slip-up go unchecked and develop into a fatal error.

Primary Concerns The Saturday Evening Post

After years of research, insulin pills that could make it easier for millions of patients worldwide to manage diabetes are finally moving ahead in clinical trials and a step closer to the medicine cabinet. Investigators are utilizing special coatings for insulin pills that prevent stomach acid from destroying them and additives that make it easier for the intestine to absorb large molecules like insulin. After years of setbacks, several insulin pills are now in various stages of clinical trials, and proof of concept may allow them to move into late-stage and more rigorous clinical testing. Only time will tell, however, whether these much-anticipated pills will make it to the market.

Source: American Chemical Society

Diabetes News The Saturday Evening Post

Frozen Strawberry Pie The Saturday Evening Post

Foods are grouped into starches, fruits, milk, meat, sweets, fats, and free foods. You can exchange or trade foods within a group if they are similar in nutrient content and the manner in which they affect your blood sugar. The recipe we give below, for example, has the following exchange values: Fruit 1, Carbohydrate 0.5, Meat (very lean) 4, Fat 1.5. The Mayo Clinic, in agreement with the American Diabetes Association and the American Dietetics Association, has compiled these practical exchange charts.

Starches
Fruits
Milk
Meat
Sweets
Fats
Free Foods

Don’t have time to cook? Try this easy crock pot recipe featured in The Saturday Evening Post. For more slow cooker recipes, check out the Sep/Oct 2010 issue, available September 1.

Maui Chicken

Maui Chicken Courtesy Fix-It and Forget-It by Phyllis Pellman Good with American Diabetes Association

(Makes 6 servings)

Adapted by the American Diabetes Association to fit into a healthy meal plan, this sweet and savory Hawaiian treat is one the whole family will enjoy.

• 6 boneless chicken breast halves, trimmed of skin and fat
• 2 tablespoons oil
• 14.5-ounce can chicken broth (preferably low sodium)
• 20-ounce can pineapple chunks
• 1/4 cup vinegar
• 2 tablespoons soy sauce (preferably low sodium)
• 1 clove garlic, minced
• 1 medium bell pepper, chopped
• 1/4 cup water

[Editor’s note: Tasters from our test kitchen suggest using an extra tablespoon of soy sauce for added flavor.]

Brown chicken in oil. Transfer chicken to slow cooker. Combine remaining ingredients. Pour over chicken and cover. Cook on High for 4-6 hours. Serve over rice.

Nutrition Facts

Per serving:
(without rice or low-sodium versions)
Calories: 305
Fat: 8 g (saturated: 1.4 g; polyunsaturated: 2.2 g; monounsaturated: 4 g)
Cholesterol: 82 mg
Sodium: 601 mg
Carbohydrate: 25 g
Fiber: 1 g
Sugars: 19 g
Protein: 32 g

Exchange List Values:
Fruit 1, Carbohydrate 0.5, Meat (very lean) 4, Fat 1.5
Recipe courtesy Fix-It and Forget-It Diabetic Cookbook by Phyllis Pellman Good with American Diabetes Association

The Exchange List Values for the Ratatouille and Apple Crisp recipes featured in the Sep/Oct issue are as follows:
Ratatouille: ½ fat exchange and 1 carb exchange
Apple Crisp: 2 carb exchanges and 1 ½ fat exchanges

Diabetes Exchange The Saturday Evening Post

To learn more about prayer shawls, visit shawlministry.com.

Prayer Shawls The Saturday Evening Post

As uninsured ranks grow and insured employees cope with complex health plans with varying copays and coverage options, people struggle with understanding their bills and detecting potential errors. But help is available from a growing cottage industry of health advocates and firms specializing in reviewing medical bills; discovering mistakes; and negotiating with health care providers, insurers, and collection agencies, reports Barb Berggoetz in her Sep/Oct 2010 Saturday Evening Post article “Decoding Your Medical Bills.”

Here’s how to contact the medical billing companies mentioned in her article and take control of your health care costs:

1. Medical Billing Advocates of America

PO Box 1705
Salem, Virginia 24153
billadvocates.com
540-387-5870

2. MedReview Solutions, Inc.

4840 Willow Ridge Court
Zionsville, Indiana 46077
medreviewsolutions.com
317-873-4872

3. Chapman Consulting and Hospital Bill Review

14604 Mansfield Dam Ct Unit #1
Austin, Texas 78734
hospitalbillreview.com
800-906-8085

4. Health Advocate, Inc.

3043 Walton Road, Suite 150
Plymouth Meeting, Pennsylvania 19462
healthadvocate.com
610-825-1222

Decoding Your Medical Bills The Saturday Evening Post

Author Susan Beer is now one of them. In her book, Move On Without Me (Hatherleigh Press, 2010), Beer shares 6 ways to move through the first year of widowhood:

 Focus on the positives. He is forever in your heart and in your memories. So, focus on what you gained and not on what you lost. Start a gratitude list.

 Affirm your accomplishments. It may just be getting through the day, but you did it. Congratulate each discovery of new strengths and resources.

 Acknowledge regrets. You will have regrets. Transform them into learning experiences.

Move on Without Me
by Susan C. Beer
Hatherleigh Press. Distributed by Random House.

 Make yourself the priority. Be honest with yourself and with others.  Only you know how you are feeling, what you need, and when you need it.

 Get up, get dressed, and get out.  Do something that makes you feel good: take a walk, go to an exercise class, get your hair done or restyled, have a manicure, joing a friend for lunch or dinner. And, smile. It makes you feel good, and attracts more of the same.

 Realize that friends, and friendships, change.  Some will come, some will go, and some are there for a lifetime.

Move On Without Me

$15.00 paperback

Hatherleigh Press. Distributed by Random House.

For more information about grief and loss, including a list of related websites, visit Grief & Loss – Topic Guide – Helpguide.org, and Mental Health America: Coping With Bereavement

A Widow’s Life The Saturday Evening Post

Start today!

James suggests taping this list to the refrigerator and adopting one healthy habit a week:

• Begin each day with a good stretch and some deep breaths.
• Plan a week’s worth of meals on your day off.
• Spend 30 minutes twice a week cutting up fresh veggies to have ready for snacks and preparing meals. Next time you want scrambled eggs (or tofu), sauté some veggies first, then add eggs.
• Keep seasonal fruit on hand for when hunger (or a sweet tooth) strikes.
• Vary your food; if you eat it on Monday, don’t have it again until Friday.
• Eat at a table and chew well. Be thankful.
• Make your own vinaigrette with olive oil, lemon juice or vinegar, a little Dijon mustard, a minced garlic clove, and a pinch of salt and pepper.
• Sprinkle grated cheese on top of casseroles instead of mixing in larger amounts.
• Substitute raw nuts and seeds for processed granola bars.
• Have at least one day a week without meat—Meatless Monday, perhaps.
• Eat more leafy greens. Steam kale, chard, spinach, or radicchio, among others, for a couple minutes. Drain and set aside. Sauté some onions, garlic, and shitake mushrooms in olive oil for a few minutes. Add steamed greens, stir, and serve.
• Communicate well. Kindly speak your mind and be done with it. Don’t hold grudges. Forgive yourself and others.

12 Tips for Better Health The Saturday Evening Post

Call First, Act Later The Saturday Evening Post

“Use good S-E-N-S-E, an acronym for Start Exercise Nice and Slow, Every single time.

Step 1: Start easy. Walk a comfortable pace and time. Use a watch to time your walk. Work up to walking for ten minutes at a moderate pace, three times a week.

Step 2: Stick with it for one week.

Step 3: Now, walk for 11 minutes, 3 times a week.

Step 4: Continue increasing your walking time by 10 percent each week. The American College of Sports Medicine recommends getting 30 minutes of moderate exercise, five days a week. But the 30 minutes can be broken up into ten-minute segments.

Remember: Start Exercise Nice and Slow, Every single time. You can do it!”

Watch for a future Medical Update posting to find out what Davis thinks about trendy new fitness shoes.

Click here for information on finding shoes that make you want to walk!

Walk Your Way to Fitness The Saturday Evening Post

“It ruined everything—career, social life, relationships, because I was tired all the time,” Rotherham recalls. With lab results in hand and determined to find an answer, he began researching the Internet for clues. “One thing that kept surfacing was hormone imbalance,” Rotherham found.

The search also introduced him to an Indianapolis physician, noted for success in treating “difficult” cases, who conducted more extensive lab tests that finally revealed a diagnosis—underactive thyroid. Immediately placed on thyroid supplements, Rotherham soon noticed a difference.

“Within a couple of weeks, I felt worlds better,” says Rotherham, now 49, who recently launched his own business. “I went from being literally flat on my back, achy and tired, to being highly functional.”

Rotherham is among the approximately 27 million Americans living with overactive or underactive thyroid, according to the American Academy of Clinical Endocrinologists (AACE). Unfortunately, like Mark Rotherham, many go undiagnosed until something goes terribly awry, at times wreaking havoc on one’s quality of life.

Think of the thyroid as your body’s thermostat. Functioning normally, this butterfly-shaped gland, which sits just below your voice box, releases just the right amount of hormones to regulate your body’s metabolism and keep things running smoothly. However, if the thermostat is turned up too high, the thyroid becomes overactive—a condition called hyperthyroidism. You may feel revved up, overheated, and anxious and notice unexplained weight loss. In contrast, if the thermostat is turned down too low, the thyroid becomes underactive—a disorder called hypothyroidism—and fails to provide enough hormones to meet the body’s demands. As a result, your body slows down, leading to a wide range of ubiquitous symptoms. Of the two, hypothyroidism is the more common—and the more insidious.

Dialing down

The reason hypothyroidism is missed so often is threefold: Doctors don’t always screen for thyroid dysfunction; patients may not know to ask about it; and the symptoms are common to many other conditions.

While some people with hypothyroidism note changes, others overlook symptoms, because they seldom develop overnight and are often subtle. Hypothyroidism is notorious for mimicking changes often associated with aging, such as fatigue and intolerance to cold.

Over time, people may discover that the gland swells 
(see Neck Check) and their eyebrows begin to disappear. Additionally, hypothyroidism decreases sweating and causes slowing of your most vital systems: the heart, the lungs, and the gastrointestinal tract. Patients may experience shortness of breath when exercising, and many develop sleep apnea. Worst of all, hypothyroidism can cause high blood pressure and raise blood levels of cholesterol, two of the biggest aging culprits in America. Identifying the thyroid disorder is crucial, because in rare cases, hypothyroidism can lead to coma or even death. For all of these reasons, I encourage both 
patients and their doctors to have a conversation about hypothyroidism. When left untreated, the complications 
can shave years off your life.

Gauging your risk

Women are especially vulnerable: According to the AACE, hypothyroidism is up to 8 times more common in women than men. But all of us need to pay attention to our thyroids as we age, because underactive thyroid becomes much more common in older adults. By age 60, as many as 17 percent of women and 9 percent of men have an underactive thyroid.

Smoking; exposure to secondhand smoke or large amounts of radiation during childhood or cancer treatments of the head, neck or chest; and some prescription medications (such as the heart drug amiodarone and long-term use of mood-stabilizing lithium) can cause hypothyroidism.

However, the most common culprit in the U.S. is autoimmune dysfunction, when the body’s immune cells start to attack thyroid tissue like it’s a foreign invader. As 
a result, the thyroid gland stops producing hormones the 
way it’s supposed to. Genetics likely play a role; we know 
that people with a personal or family history of autoimmune diseases such as rheumatoid arthritis, type 1 diabetes, 
and psoriasis, among others are at higher risk for hypothyroidism. Researchers are close to discovering which gene types might make us more susceptible to autoimmune thyroid problems. In those who are genetically susceptible, certain environmental factors, such as iodine in our diet, are thought to trigger the autoimmune attack on the thyroid.

Thyroid checkup

If you are worried about your thyroid hormone levels, a simple blood test can help you and your doctor reach a diagnosis. The American Thyroid Association recommends that all adults over the age of 35 undergo thyroid screening; however, there is no firm consensus on mass screening. It’s especially important for people with high cholesterol to ask about having their thyroid levels checked: Many people aren’t screened for thyroid levels and could potentially have hypothyroidism. The good news is that doctors now have a very sensitive “thyroid stimulating hormone” (TSH) test that allows us to diagnose thyroid disorders much earlier—even before symptoms appear. Higher than normal TSH levels can reveal whether your thyroid function is in danger, even if your actual thyroid hormone levels are normal.

If your thyroid blood tests come back sub-par or abnormal, the most common treatment option for hypothyroidism is synthetic thyroid hormone replacements. These oral medications help restore hormone levels that shift your internal thermostat and metabolism back to normal. Evidence suggests that people who take thyroid hormone replacements should do so on an empty stomach. Additionally, certain medications, supplements, and foods may affect your ability to absorb thyroid pills. Talk to your doctor about your present medication regimen to gauge if there is an interaction. For example, generally it’s best to wait about four hours after taking thyroid medication to consume soy and high-fiber products, iron and calcium supplements, antacids that contain aluminium or magnesium, and certain prescription medications such as cholestyramine (Questran). Ultimately, monitoring thyroid hormone levels will determine if there is an absorption problem.

The role of prevention

Even if you’re not a candidate for thyroid hormone medications, dietary changes may help you protect the health of your thyroid. Because both too much and too little iodine can cause hypothyroidism, it’s important to be aware of foods that contain iodine and how they may affect your thyroid. Iodine deficiency is rare in the U.S. because it is added to our table salt. Eating excessive amounts of certain raw vegetables such as brussels sprouts, cabbage, cauliflower, corn, and kale should be avoided because they contain enzymes that can drive down thyroid function. But don’t think I’m telling you not to eat your vegetables—cooking them for just a few minutes deactivates those enzymes and makes them nutritious for your whole body.

In general, to protect the cells in your thyroid and your entire body, I recommend foods rich in:


• Antioxidants (blueberries, cherries, tomatoes, squash,
 bell peppers)

• Omega-3 fatty acids (walnuts, salmon)

• B vitamins (whole grains, fresh vegetables)

Vitamin D is another critical micronutrient that is 
getting a lot of attention for its role in autoimmune disease. We know that up to 70 percent of Americans aren’t getting enough vitamin D and that inadequate levels could put you at higher risk for autoimmune disorders, such as rheumatoid arthritis and multiple sclerosis. Vitamin D also plays a supportive role for the parathyroid glands, four smaller glands located on the larger thyroid, that closely monitor and regulate calcium levels in our blood and bones. One of the best ways to get your daily dose of D is just 10-20 minutes of sunshine each day. Sardines, dark leafy greens, and fortified dairy products are also important sources. I recommend at least 800 international units (IUs) daily for most adults and 1000 IUs for adults over 70.

In addition to warding off problems within the thyroid and autoimmune disease, keeping your vitamin D levels up will also help fight off flu and several forms of cancer.

The key to keeping the thyroid healthy is paying attention to your own body. All too often, we accept that certain changes, such as sluggishness and depression, are just a natural part of the aging process. But hypothyroidism is the secret culprit behind these unexplained symptoms for millions of Americans. When we simply accept weight gain, low exercise tolerance, and mental cloudiness without questioning the cause, we’re risking serious harm to our bodies.

After his hypothyroidism went undiagnosed for a decade, Mark Rotherham is back on his feet.

You can find more information on diagnosing and treating thyroid disease from our exclusive interview with Dr. Jeffrey R. Garber.

Post Investigates: Thyroid Disease 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