Askanesthetician's Blog

An esthetician explores skincare issues and concerns

PCOS and Your Skin October 24, 2013

Some of the most challenging skin issues I have ever tried to treat are those of women who have PCOS – polycystic ovarian syndrome.  It is hard for me to forget the skin of one client who by far had the worst acne I have ever tried to help get under control or the client who told me she wasn’t going to try to treat her acne since it was caused by an internal hormonal issue (PCOS) and since there was no cure for PCOS there was nothing she could do for her acne. Both clients got me thinking – is there really nothing you can do for someone’s acne if they suffer from an internal hormonal issue?  That question prompted this post.

First of all, though the focus of this post is skin and PCOS I think it is necessary to very briefly explain what PCOS is and its symptoms.  The Mayo Clinic explains:

Polycystic ovary syndrome (PCOS) is a common hormonal disorder among women of reproductive age. The name of the condition comes from the appearance of the ovaries in most, but not all, women with the disorder — enlarged and containing numerous small cysts located along the outer edge of each ovary (polycystic appearance).

Infrequent or prolonged menstrual periods, excess hair growth, acne and obesity can all occur in women with polycystic ovary syndrome. In adolescents, infrequent or absent menstruation may signal the condition. In women past adolescence, difficulty becoming pregnant or unexplained weight gain may be the first sign.

The exact cause of polycystic ovary syndrome is unknown. Early diagnosis and treatment may reduce the risk of long-term complications, such as type 2 diabetes and heart disease.

Polycystic ovary syndrome signs and symptoms often begin soon after a woman first begins having periods (menarche). In some cases, PCOS develops later on during the reproductive years, for instance, in response to substantial weight gain.

Signs and symptoms vary from person to person, in both type and severity. To be diagnosed with the condition, your doctor looks for at least two of the following:

  • Menstrual abnormality. This is the most common characteristic. Examples of menstrual abnormality include menstrual intervals longer than 35 days; fewer than eight menstrual cycles a year; failure to menstruate for four months or longer; and prolonged periods that may be scant or heavy.
  • Excess androgen. Elevated levels of male hormones (androgens) may result in physical signs, such as excess facial and body hair (hirsutism), adult acne or severe adolescent acne, and male-pattern baldness (androgenic alopecia). However, the physical signs of androgen excess vary with ethnicity, so depending on your ethnic background you may or may not show signs of excess androgen. For instance, women of Northern European or Asian descent may not be affected.
  • Polycystic ovaries. Enlarged ovaries containing numerous small cysts can be detected by ultrasound. Despite the condition’s name, polycystic ovaries alone do not confirm the diagnosis. To be diagnosed with PCOS, you must also have abnormal menstrual cycles or signs of androgen excess. Some women with polycystic ovaries may not have PCOS, while a few women with the condition have ovaries that appear normal.

Causes:

Doctors don’t know the cause of polycystic ovary syndrome, but these factors likely play a role:

  • Excess insulin. Insulin is the hormone produced in the pancreas that allows cells to use sugar (glucose) — your body’s primary energy supply. If you have insulin resistance, your ability to use insulin effectively is impaired, and your pancreas has to secrete more insulin to make glucose available to cells. The excess insulin might boost androgen production by your ovaries.
  • Low-grade inflammation. Your body’s white blood cells produce substances to fight infection in a response called inflammation. Eating certain foods can trigger an inflammatory response in some predisposed people. When this happens, white blood cells produce substances that can lead to insulin resistance and cholesterol accumulation in blood vessels (atherosclerosis). Atherosclerosis causes cardiovascular disease. Research has shown that women with PCOS have low-grade inflammation.
  • Heredity. If your mother or sister has PCOS, you might have a greater chance of having it, too. Researchers also are looking into the possibility that mutated genes are linked to PCOS.
  • Abnormal fetal development. Some research shows that excessive exposure to male hormones (androgens) in fetal life may permanently prevent normal genes from working the way they’re supposed to — a process known as gene expression. This may promote a male pattern of abdominal fat distribution, which increases the risk of insulin resistance and low-grade inflammation. Researchers continue to investigate to what extent these factors might contribute to PCOS.

There are different ways to treat PCOS symptoms, remember there is no cure.  Some ways to treat this condition is through medications and another way is through lifestyle changes such as the ones described by PCOS for Dummies:

How to Manage PCOS

If you’re willing to overhaul your diet and start a simple exercise program, you can gain a great deal of control over your PCOS symptoms. Insulin resistance causes many PCOS symptoms, and diet and exercise help control insulin resistance.

  • If you’re overweight, lose weight by limiting yourself to 1,500 calories per day. Losing weight is one of the biggest factors in controlling PCOS symptoms, particularly if you’re trying to get pregnant.
  • Eat regular meals (but don’t pile your plate), and have a couple of small snacks during the day.Don’t let yourself get hungry.
  • Follow a low-GI diet by substituting low-GI carbs for high-GI carbs. The glycemic index (GI) measures how a carbohydrate affects blood sugar. High-GI foods break down quickly into glucose while low-GI foods are absorbed more slowly. Low-GI foods stabilize your blood sugar, while high-GI foods cause a rapid rise in blood sugar levels. Refined sugars are high-GI foods, while fruits and vegetables are generally low-GI.
  • Limit the fat in your diet. Cut down particularly on saturated and trans fats (including fatty meat, butter, cakes, pastries, and cookies).
  • Use as little salt as possible. Look at labels of processed foods to try to keep your total sodium intake below 2,400 milligrams a day.
  • Eat at least five helpings of fruit and vegetables every day.
  • Get some physical activity every day. Half an hour is great, but an hour is even better to help keep your weight under control. Remember to start slowly and incorporate both aerobic and weight-bearing exercise into your routine. You don’t have to do all your exercise at one time — 10 minutes of exercise three times a day is just as good as 30 minutes all at once.

PCOS and Skin

As already mentioned above many women who suffer from PCOS also suffer from acne.  Their acne can be very bad with many papules and pustules and can be hard to control because of the excessive androgen in the body.  While birth control pills may help control some of the hormonal issues associated with this condition, what other lifestyle changes can help the acne caused by PCOS?  While I still believe that using anti-acne ingredients such as salicylic acid and retinol can help pores from becoming excessively clogged with dead skin cells and excess oil, are there any other solutions as well?  According to one article from the website Beauty Bible dietary changes may be the key to controlling PCOS related acne:

First – to explain the underlying situation – Dr Marilyn Glenville, author of Natural Solutions to PCOS, says this:

‘PCOS creates a vicious cycle of hormone imbalances, which has huge knock-on effects throughout the rest of your body. The problem often starts with the ovaries, which are unable to produce the hormones they should, and in the correct proportions. Linked to this is the common problem of insulin resistance. Women with PCOS very often have difficulties with blood sugar levels, which can cause weight gain and the excess insulin can stimulate your ovaries to produce yet more testosterone (the male hormone). Half of all women with PCOS do not have any problems with their weight, yet they can still have higher insulin levels than normal. ‘

The aim, Marilyn says, ‘is to balance your hormones in order to control the hormonal breakouts from the inside out. There is now overwhelming evidence to suggest that diet plays a significant role in helping with PCOS and also increasing the chances of conceiving.’

‘Adapting your eating habits so that you keep your blood-sugar levels on an even keel throughout the day is essential.  If your adrenal glands are over-stimulated by ever-fluctuating sugar highs and lows, they produce too much adrenaline – the stress hormone – and also too much testosterone, preventing ovulation altogether.’

Aim to eat little and often to keep your blood sugar under control and follow a low GI (glycemic index) diet, with little sugar of any kind, including fruit and fruit juices as well as the more obvious cakes, biscuits, etc.

The article also recommends taking various supplements though I recommend you speak to a doctor before following that advice.  I also found a personal testimonial about how one women changed her diet to successful control her PCOS acne:

According to Women’s Health UK, the elevated androgen level associated with PCOS causes the production of DHT, and this leads to acne. Additionally, insulin resistance is also typically part of PCOS, and insulin resistance further increases androgen levels. This leads to even higher DHT levels, and induces more acne breakouts.

Also, as PCOS women consume high amounts of refined carbohydrates, more negative changes occur in the body. Refined carbohydrates have a high glycemic index and consuming them increases your blood sugar. In response to the increase, your body produces more insulin, further increasing your androgen levels.

In short, it’s a terrible cycle that needs to be broken before clear skin can make an appearance.

What do I do about PCOS acne?
After learning all of this information, I finally decided that I should be treating the acne problem from the inside out, reasoning that my skin is only as good as what is circulating in my body. So, after talking to my OB/GYN and a Naturopath, I started tackling my hormonal problems the natural way. I began taking Vitex (Chastetree) to balance my hormones, and began a fairly strict low carb way of eating to treat the PCOS.

I stuck to plenty of fresh fruits and vegetables, ate meat and dairy, and kept my daily intake of carbohydrates below 45 grams (although this number will vary widely by person). I also made sure to drink at least 10 glasses of water every day.

Needless to say, I was thrilled when my skin began clearing up after only 2 weeks. There were fewer pimples, and my skin tone was more even. Motivated and excited, I carried on with my new way of life. Within 6 weeks, my skin was completely clear and smooth – I was cured of my terrible skin. I wanted to shout it from the rooftops! After nearly 15 years of trouble skin, I had a found a way to get the skin I had always dreamed of having.

Even more exciting – my PMS was practically gone, and “that time of the month” was no longer accompanied by a nightmarish number of breakouts.

To this day, my skin is still free of acne, and I couldn’t be happier about it. If you have the type of acne I did, and you think you might have PCOS, talk to your doctor, and try some low carb eating and Vitex – you have nothing to lose besides your breakouts!

I’ve addressed the issue of acne and diet numerous times in this blog (you can read my posts by clicking on the links below in the “further reading” section) so I am definitely a believer when it comes to linking acne and diet.  Do I think that simply changing your diet if you suffer from PCOS will clear your skin?  That’s a hard one to answer.  PCOS is a complicated condition so while it is good to hope for the best when making lifestyle and dietary changes you might have to temper your hopes as well.  Being under the care of the right doctor or naturopath can go a long way in helping you achieve clearer skin and control your PCOS.

Further Reading:

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What Is Milia and How Do You Treat It? October 10, 2013

There are some skincare issues that, in my opinion, are more vexing than others.  To name a few –  hyperpigmentation, acne, and milia.  Just what is milia, how do you get it, and how do you treat it?

What is Milia and What Causes It?

According to Dr. Ellen Marmur in her book Simple Skin Beauty (pages 201-206) milia and whiteheads are very similar:

… both are closed-over keratin plugs – but milia is not associated with acne.  They are caused by aging and slower cell turnover.  Milia are tiny white bumps formed by trapped keratin compacted in the pore, but there is no bacteria or oil involved.  …

Milia is a case of keratin-obstructed pores caused by skin that isn’t shedding normally.  It is not an acne issue and happens frequently as we age; it generally starts to show up in your thirties.  Milia can also be a side effect of laser resurfacing, because the skin is growing at an accelerated rate (as a wound-healing response) and can trap keratin inside the pores.

The website Dermadoctor expands further on the causes of milia in an article by Dr. Audrey Kunin :

Milia are deep seeded white bumps that form when skin cells become trapped rather than exfoliate naturally. The trapped cells become walled off into tiny cysts that appear like white beads below the surface of the skin. Milia can occur on the skin or even on mucous membranes such as the inner surface of the cheek or the vermillion border of the lips.

As the surface is worn away, the tiny cyst may resolve on its own. Far too often, though, intervention to remove the cyst may offer more rapid resolution.

Why Me?

Milia form for a variety of reasons. Some you can fix, others aren’t so easily dealt with. But you need to scrutinize your skin care routine whenever milia make their appearance. Although some people naturally make milia, and I certainly expect everyone to have an occasional bump at one time or another, milia are often the result of a problem that has affected the skin’s surface.

Are there any skincare habits that contribute to the formation of milia?  According to Dr. Kunin yes there are:

  • No doubt the most common reason milia form is from smothering your skin with heavy skin care products or hair care items. Comedogenic creams and lotions may prevent the sloughing of dead epidermal skin cells. Hidden problem products include make-up removers not labeled oil-free or non-comedogenic, hair spray, hair mousse and gel, heavy sunscreens and some moisturizers. The eyelids are very thin and more likely to experience problems with milia due to cosmetics. Re-evaluate your eye make-up and eyelid make-up remover if you are finding this to be a concern.Certain lipsticks, lip balms and products meant to help with chapped lips may be the cause of little white pearly milia developing around the lipstick edge (aka vermillion border) of the lips. Again, if you see these forming, take a good look at the ingredients on the label.
  • Prolonged History Of Sun Damage
    The formation of milia can also be due to cumulative sun exposure. Aging skin forms a thicker epidermis that may make it far more difficult for skin cells to find their way out of the glands. And thicker skin also makes for more road blocks in the pathway to exfoliation.
  • Porphyria Cutanea Tarda
    Milia can also be associated with certain skin diseases, particularly blistering disorders such as Porphyria Cutanea Tarda. Fortunately, there are other symptoms associated with these blistering diseases. Blisters, for one and increased hair on the face and backs of hands and knuckles, for another. PCT is an unusual disorder. If you have milia, don’t initially jump to the conclusion you have a blistering condition.
  • Genetics
    Sometimes we just inherit certain undesirable skin tendencies.

What Can Be Done to Prevent and Treat Milia?

Both doctors I quoted above believe that regular exfoliation and retinols can help fight milia.  Dr. Kunin explains:

Exfoliation can go a long way in helping deal with milia prone non eyelid skin. By keeping the epidermis thin and smooth, you can cut down on their formation. By mentioning exfoliation, I’m not talking about scrubbing off the top layer of your skin!

Retinol is also very helpful for both fighting and preventing milia. Again, retinol should not be applied to the upper eyelids.

Sometimes milia won’t come out in spite of your best efforts. Then you may need the milia to be extracted by your dermatologist. In a physician’s office, milia are easily removed. The skin is cleansed with some rubbing alcohol or other antiseptic. The skin overlying the milia is gently opened with a sterile lancet or needle. Then pressure is applied with a comedone extractor, and the milia typically pop out. I find that one of the most difficult areas from which to remove milia is the upper eyelid. There simply isn’t a good way to press on the area and avoid the eyeball, so the lid has to be pulled either upwards or to the side, which is somewhat challenging.

Furthermore, since extensive sun exposure can cause milia be sure to be vigilant, if you weren’t already, with using a sunscreen that won’t clog pores.  And if you’ve tried everything to get rid of your milia and it isn’t working please see a professional.  Don’t go stabbing your face with a needle on your own.

Further Reading:

Image from jacintak.com

 

What Is Seborrheic Dermatitis? October 3, 2013

When I was in esthetics school we discussed skin diseases, and I do remember that seborrhea was mentioned.  According to my textbook from school (yes, I still have my textbook) they divide seborrhea and seborrhea dermatitis into two different categories:

Seborrhea: Severe oiliness of the skin; an abnormal secretion from the sebaceous glands

Seborrheic Dermatitis:  A common form of eczema

(From Milady’s Standard Fundamentals for Estheticians, 9th edition, page 203)

Before I became an esthetician I had come across a common form of seborrheic dermatitis which is cradle cap.  My son had had severe cradle cap as an infant so I was quite aware of what that was.  Yet once I was introduced to the concept of seborrhea as explained above, “severe oiliness of the skin”, I didn’t come across this condition at all while working in the US.  Then I moved back to Israel and I couldn’t believe how many people I encountered for facials that would tell me they had seborrhea.  I was surprised to say the least.  I couldn’t figure out how in one part of the world I had never come across this condition and in another part of the world I couldn’t seem to escape it.  I wondered if the definition of this skin condition had changed from country to country, from language to language.  The skincare companies that I worked with in the US never mentioned this condition to me or had products that treated it, unlike Israeli skincare companies that do both.  Truthfully I am still trying to figure this one out, but in the meantime I realized that I better brush up on my knowledge about seborrhea.

What is Seborrheic Dermatitis?

Dr. Carl Thornfeldt in his book The New Ideal In Skin Health defines seborrheic dermatitis as (page 86):

These lesions are usually found on areas of the body with more sebaceous glands, such as the forehead, eyebrows, around the nose and ears, scalp, midchest, and central trunk. It is characterized by greasy yellow scaling on erythematous patches of various thicknesses.  It usually has no itching.  It may be associated with rosacea.  Dandruff is a mild form on the scalp.  It is most common in infants (cradle cap) and elderly.  It may also be flared by physical and emotional stress.

Furthermore, according to the American Academy of Dermatology seborrheic dermatitis is characterized as:

The skin tends to have a:

  • Reddish color.
  • Swollen and greasy appearance.
  • White or yellowish crusty scale on the surface.

One or more of these rashes can appear on the body. Sometimes, the affected skin itches.

Seborrheic dermatitis can look like psoriasis, eczema, or a skin allergy.

What Causes Seborrheic Dermatitis?

The Mayo Clinic explains:

Doctors don’t yet know the cause of seborrheic dermatitis. Factors that may play a role include:

  • A yeast (fungus) called Malassezia. This fungus is one of the normal microscopic life forms that grow, along with certain bacteria, in your skin’s oily secretion (sebum). Creams, foams or lotions containing an antifungal agent, such as ketoconazole (Ketozole, Extina), often help reduce flare-ups, supporting the idea that this yeast is a contributing factor. But seborrheic dermatitis itself isn’t considered an infection, and it’s not contagious.
  • Change of season. Episodes are often worse in winter.
  • Neurological conditions. Seborrheic dermatitis may occur more frequently in people who have Parkinson’s disease and certain other neurological disorders.
  • Stress and fatigue. Stressful life events and situations may help trigger an episode or make it worse through mechanisms that aren’t yet understood. The role of neurological disorders and stress may be related through effects on the nervous system.
  • HIV/AIDS. Seborrheic dermatitis may occur more commonly and tend to be more severe in those with HIV/AIDS.

The American Academy of Dermatology expands on the causes and just who is affected by seborrheic dermatitis:

Who gets seborrheic dermatitis?

People of all colors and ages get seborrheic dermatitis. You have a higher risk if any of the following apply to you.

Age

People in these two age groups are most susceptible:

  • Infants 3 months of age and younger.
  • Adults between 30 and 60 years of age.

Medical conditions

Your risk increases if you have any of these medical conditions:

  • HIV (About 85 percent of people infected with HIV develop seborrheic dermatitis).
  • Acne, rosacea, or psoriasis.
  • Parkinson’s disease.
  • Epilepsy.
  • Stroke or heart attack (recovering from).
  • Alcoholism.
  • Depression.
  • Eating disorder.

Medical treatments

If you are taking any of the following medicines, your risk for seborrheic dermatitis increases:

  • Interferon.
  • Lithium.
  • Psoralen.

Facts about Seborrheic Dermatitis

For adults there is both good news and bad news about seborrheic dermatitis.  The good news is that the condition can be treated by a doctor and/or with proper home care.  The bad news is that this is chronic condition, with no cure. According to the Mayo Center:

Seborrheic dermatitis doesn’t affect your overall health, but it can be uncomfortable and cause embarrassment when it develops on visible parts of your body. It isn’t contagious, and it’s not a sign of poor personal hygiene. Seborrheic dermatitis tends to recur, but you may be able to manage flare-ups by recognizing its signs and symptoms and by using a combination of self-care steps and over-the-counter (nonprescription) medications.

How to Treat Seborrheic Dermatitis

First and foremost if you think that you are suffering from seborrheic dermatitis go see a dermatologist before trying to treat yourself.  The doctor can determine if you need prescription products or not to keep your condition under control.  Some skin conditions simply cannot be treated with over the counter products but with seborrheic dermatitis it depends on the severity of the condition.

The Mayo Clinic explains further how to treat this condition:

Seborrheic dermatitis tends to be chronic, and there’s usually no strategy that stops it permanently. But treatments — including many you can try at home — may control your signs and symptoms during a flare-up. The best approach for you depends on your skin type, the severity of your condition, and whether your symptoms affect your scalp or other areas of your body.

Creams and lotions that you apply to affected body areas and medicated shampoos are all mainstays of treatment. In very severe cases, physicians may prescribe oral medications with whole-body effects. Products are available with several kinds of active ingredients. Some preparations include active ingredients from more than one category.

The following over-the-counter treatments and self-care tips can help you control and manage seborrheic dermatitis.

  • Wash your hair with a medicated anti-dandruff shampoo according to the recommended schedule. If you don’t see results, try a shampoo with a different active ingredient.
  • Use an over-the-counter antifungal cream. Application of nonprescription-strength ketoconazole may be helpful.
  • Apply an anti-itch cream or lotion to the affected area. A short course of a nonprescription hydrocortisone cream containing at least 1 percent hydrocortisone can temporarily relieve itching.
  • Avoid harsh soaps and detergents. Be sure to rinse soap completely off your body and scalp.
  • Wear smooth-textured cotton clothing. This will help keep air circulating around your skin and avoid irritation.
  • Shave off your beard or mustache. Seborrheic dermatitis can be worse under mustaches and beards. If this is the case for you, shaving might ease your symptoms.
  • Avoid scratching whenever possible. Scratching can increase irritation, making you more uncomfortable and increasing your risk of infection.

What else can you do at home to keep your condition under control?  Dr. Thornfeldt recommends in his book using a gentle facial cleanser that doesn’t strip the skin’s pH.  He recommends that the homecare products that:

… contain ingredients such as low concentrations (<2%) azelaic acid, salicylic acid, zinc pryrithone and/or willow bark extract to help kill surface bacteria, reduce redness and scaling, and smooth skin texture.  (Page 87)

The American Academy of Dermatology recommends the following:

Adolescents and adults: Skin

  • Wash the skin daily with a soap that contains 2% zinc pyrithione.
  • Soften scale by:
    • Wetting the skin thoroughly before washing.
    • Applying a moisturizer after bathing.
    • Applying a tar cream, letting it sit on the skin for several hours before rinsing.
    • Applying a cream containing salicylic acid and sulfur.
    • Do not use petroleum jelly to soften the scales. It tends to worsen seborrheic dermatitis.

 

Bottom Line:  In adults seborrheic dermatitis is a chronic condition without an actual cure.  Proper home care coupled with prescription medications can help keep this skin condition under control.

 

Sources and Further Reading:

 

Image from http://www.aad.org

 

Psoriasis Information March 13, 2013

Filed under: Skin Conditions — askanesthetician @ 7:30 am
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Lately I have come across a few articles about the skin disease psoriasis so I thought I would share the information here.  I’ve addressed the issue of psoriasis before in this blog (see my post August is Psoriasis Awareness Month), but I wanted to go into greater detail here about this disease.

Just what is psoriasis and how many people does it affect?  In the article The Biology Behind Eczema and Psoriasis in Skin Inc. Dr. Claudia Aguirre explains:

Psoriasis has been confused with eczema, lupus, boils, vitiligo and leprosy. Because of the confusing connection with leprosy in ancient times, psoriasis sufferers were even made to wear special suits and carry a rattle or bell, like lepers, announcing their presence. Only in the 19th century was a distinction made between psoriasis and leprosy, alleviating some of the psychosocial impact of this highly visible and distressing skin disease.9 As with eczema, it presents as itchy, red skin and involves altered immunity. However, its complexities reach far beyond the surface of the skin. People with psoriasis have an increased risk of cardiovascular disease, metabolic syndrome, obesity and other immune-related inflammatory diseases—even cancer. The mysteries behind this complicated and debilitating skin disease are only beginning to be unraveled. Psoriasis is a chronic, inflammatory multisystem disease affecting 1–3% of the world’s population.3 Whereas the rashes on eczematous skin can have irregular edges and texture, psoriatic lesions tend to be more uniform and distinct. Red or pink areas of thickened, raised and dry skin typically present on the elbows, knees and scalp. This presentation tends to be more common in areas of trauma, abrasions or repeated rubbing and use, although any area may be affected. Unlike eczema, psoriasis comes in five different forms: plaque, guttate, pustular, inverse and erythrodermic.

Plaque psoriasis affects about 80% of those who suffer from psoriasis, making it the most common type. …

It may initially appear as small red bumps that can then enlarge and form scales. The hallmarks of this type are raised, thickened patches of red skin covered in silvery scales. The other types are less common and present inflamed skin with red bumps; pustules; cracked, dry skin; and even burned-looking skin. Clients will most likely be under a physician’s care, who will diagnose the type of psoriasis present.

As of today, psoriasis has no cure. A single cause of the disease has yet to be uncovered, but it is known that developing the disease involves the immune system, genetics and environmental factors. In psoriasis, aberrant immune activity causes inflammatory signals to go haywire in the epidermis, causing a buildup of cells on the surface of the skin. While normal skin takes 28–30 days to mature, psoriatic skin takes only 3–4 days to mature and, instead of shedding off, the cells pile up on the surface of the skin, forming plaques and lesions. The underlying reason may be due to the hyperactivity of T-cells, which end up on the skin and trigger inflammation and keratinocyte overproduction. Although it is not known why this happens, it is known that the end result is a cycle of skin cells growing too fast, dead cell-debris accumulation and resulting inflammation.

Many psoriasis sufferers receive medication from their doctors but there is encouraging research that the use of OTC AHA (alpha hydroxy acids) can help improve psoriasis symptoms.  In the post How Alpha Hydroxy Acids Could Help Treat Psoriasis Rebecca Harmon writing on Future Derm explains:

In common plaque psoriasis, the overgrowth of skin cells that collect at elbows, knees, hands, scalp, face and other areas can cause embarrassment and in some cases can be painful as clothing catches and pulls on the dry skin patches.

During a particularly hard-to-manage outbreak in my late 20’s, I was desperate to avoid the greasy and expensive steroid cream ($50 for a small tube) and smelling like the back end of a large coal truck wasn’t working for me either.  My particular case was cosmetically disturbing but not medically-complicated so I decided to stop buying the $50 prescription cream and turned to the beauty industry which was just beginning to offer face cream with AHA’s.

I quickly became a fan as I discovered that the flaky psoriasis patches on my face disappeared with a skin care regimen that included a daily application of the AHA face cream. Those were my stay-at-home-with-babies days, and I was as far removed from research or academic writing as one could be, but I didn’t need the denial of a null hypothesis to tell me that this was working.  I used it twice daily on my face and then started rubbing it in to my elbows and knees.  I still laugh remembering the cosmetic rep who finally asked how much face cream I was using (I ordered a lot of this stuff!).

And, yet, the research is in my favor. One study of 12 patients found that a creams with 15% glycolic acid, as well as .05% betamethasone, respectively, were helpful in reducing erythema, transepidermal water loss (TEWL), and lowering Laser Doppler values (Dry Skin and Moisturizer). And alpha hydroxy acids mixed with betamethasone were found to be even more effective in treating psoriasis in a double-blind, split-face, single site clinical study (JEAVD).

I have experienced mild outbreaks of psoriasis since that period but have continued to treat them with AHA-based lotions with consistent results.

And Rebecca isn’t the only extolling AHAs as a psoriasis cure from personal experience.  In the post We Answer Cara Delevingne’s Skin SOS: Psoriasis Alexandra Owens writes in Allure that:

A few years ago, I accidently discovered that Bliss Ingrown Eliminating Pads relieved my symptoms even better than prescription creams I’d tried. I asked New York dermatologist Doris Day why they work so well. “The alpha and beta hydroxy acids [in the pads] would help thin out the plaques of psoriasis, and the oat extracts, witch hazel, and lavender oil would soothe and hydrate the skin—but I would still apply a moisturizer after using them,” she says. “The nice thing about the ingredients being in a pad is that it’s easy to apply to the affected areas.” Another nice thing: You don’t need to see a doctor to get your hands on them.

When it comes to treating clients with psoriasis at the spa keep things simple and gentle and place an emphasis on encouraging relaxation.  Once again I’ll turn to the Skin Inc. article mentioned above:

Both eczema and psoriasis clients have impaired barrier function and increased inflammation, so your goal will be to protect and repair. Remember to always check first with your client’s physician for contraindications to medications and therapies, because some ingredients may counteract each other. For example, salicylic acid may seem a likely choice for exfoliating psoriatic skin, but could, in fact, inactivate a common topical treatment for psoriasis.

Once a full consultation with the client and possibly her physician is completed, proceed with a treatment using minimal products and procedures. A good way to compensate for minimal skin treatment time is to add on stress-relieving techniques, because there is a psychological component to eczema and psoriasis. Complementary therapies, such as aromatherapy, acupressure, reflexology, massage and inhalation techniques can be coupled with skin treatments to lower stress hormones and control inflammation.

Gentle cleansing and exfoliation is crucial to allow the penetration of rich, emollient moisturizers used on dry, sensitive skin. Avoid harsh exfoliants and detergents, and look for ingredients, such as lactic acid. Use anti-inflammatory ingredients, such as red hogweed, ginger, oats and chamomile, coupled with barrier-repairing oils, including evening primrose, borage, argan and sea buckthorn. Finishing a treatment with a physical sunscreen, such as zinc oxide or titanium dioxide will ensure that harmful UV rays do not cause further damage.

Bottom Line:  Though there is currently no cure for psoriasis there are ways to keep symptoms under control.  Since stress makes psoriasis worse finding ways to reduce stress is an integral part of psoriasis treatment and estheticians can certainly be a positive part of that process.

Further Reading:

Image from worldinfo.info

 

May is Skin Cancer Awareness Month May 14, 2012

If there is one consistent subject that I write about repeatedly in this blog it is sun protection.  There is a very good reason for that – non- melanoma skin cancer has reached epidemic rates in the US.  May is Skin Cancer Awareness Month so I wanted to share some important information about the subject with my readers.

According to The Skin Cancer Foundation:

Skin cancer is a lifestyle disease, affecting young women, older men and everyone in between. One in five Americans will develop skin cancer in the course of a lifetime; 13 million Americans are living with a history of nonmelanoma skin cancer, and nearly 800,000 Americans are living with a history of melanoma, the most dangerous form of skin cancer.

But there is good news: because skin cancer is chiefly lifestyle disease, it is also highly preventable.

“About 90 percent of nonmelanoma skin cancers and 65 percent of melanoma cases are associated with exposure to ultraviolet (UV) radiation from the sun,” says Perry Robins, MD, President of The Skin Cancer Foundation. “Everyone, regardless of skin color, should make staying safe in the sun a priority and incorporate sun protection measures into their daily life.”

In my opinion the scariest phenomena occurring right now is the rapid rise in the cases of melanoma among young women who use tanning beds.  Let me be very clear – tanning beds are not safe!  I wish the FDA would ban them entirely.  If someone tells you that tanning beds aren’t harmful they are lying to you – period.

Since skin cancer is almost entirely preventable the key to protecting yourself (and your loved ones) is in your hands.  Remember to:

  • Use a broad spectrum sunscreen – 365 days a year.
  • Don’t skimp on sunscreen – apply plenty of sunscreen to all exposed skin and reapply every 2 to 3 hours when outdoors.
  • Seek shade and wear protective clothing when outside.
  • Don’t burn!
  • Never, ever use tanning beds!!
  • Do self exam to check your moles and to see if you have developed any suspicious lesions.
  • See a dermatologist for a professional mole check yearly.
Sources and Further Reading:

Image from skinsheen.com

 

April is Rosacea Awareness Month April 23, 2012

Filed under: Skin and Skincare,Skin Conditions — askanesthetician @ 5:00 am
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April is Rosacea Awareness Month so I thought it would be a good time to remind my readers about this skin disease.

Here are some basic facts about rosacea:

Rosacea usually first strikes individuals between the ages of 30–60, and may initially resemble a simple sunburn or an inexplicable blush. Suddenly, without warning, a flush comes to their cheeks, nose, chin or forehead. Then, just when they start to feel concerned, the redness disappears.

Unfortunately, it happens again and again, becoming ruddier and lasting longer each time–and eventually visible blood vessels may appear. Without treatment, bumps and pimples often develop, growing more extensive over time, and burning, itching and stinging are common.

In severe cases, especially in men, the nose may become enlarged from the development of excess tissue. This is the condition that gave comedian W.C. Fields his trademark red, bulbous nose. In some people the eyes are also affected, feeling irritated and appearing watery or bloodshot. Severe cases of this condition, known as ocular rosacea, can result in reduced visual acuity.

Among the most famous rosacea sufferers is former President Bill Clinton, whose doctors disclosed that he has this condition in The New York Times. Others reported to have suffered from the disorder include Princess Diana, financier J.P. Morgan and the Dutch painter Rembrandt.

In new NRS surveys, 69% of rosacea patients said they experienced a flare-up related to emotional stress at least once a month, and more than 90% of the respondents said they had suffered some form of physical pain from their condition. A burning sensation was the most commonly reported discomfort, named by 75%, followed by itching, cited by 65%, and stinging, mentioned by 62%. Other types of pain associated with rosacea included swelling (44%), tightness (42%), tenderness (40%), tingling (31%), prickling (23%) and headache (20%).

Perhaps even more ravaging than its physical effects, rosacea often inflicts significant damage to people’s emotional, social and professional lives.

Source:  Only on SkinInc.com: April is Rosacea Awareness Month – Are You Helping Rosacea Clients Cope?

Though there is no cure for rosacea this skin disease can be kept under control by making lifestyle adjustments (avoiding alcohol and steam rooms, applying proper sun protection, and avoiding other individual triggers) and using the right skincare products.  The right skincare products will be soothing, gentle, and anti-inflammatory.  Figuring out what triggers your rosacea to become worse and then avoiding and controlling those triggers makes a huge difference in how your rosacea looks and then affects your life.

Hopefully in the future scientists and doctors will find a cure for this skin disease.

Sources and Further Reading:

Image from buynaturalskincare.com

 

Inflammation: The Ultimate Skin Enemy? January 24, 2012

One of the hottest topics in the skincare and dermatology world is the topic of inflammation and how it affects the skin.  Just as inflammation in the body can lead to disease and aging, inflammation in the skin can cause wrinkles, acne, hives, even eczema and rosacea.  With inflammation so prevalent in our bodies and skin how do you protect yourself and your skin?

What Is Skin Inflammation?

According to the article “Skin’s New Enemy” from Allure magazine (unfortunately the article is not available online):

Inflammation has become the hottest topic in dermatology today, since research suggests it plays a role in acne, aging, skin cancer, eczema, psoriasis, rosacea, and even hair loss.  “After the sun, inflammation is the skin enemy number one,” says David J. Leffell, professor of dermatology and dermatologic surgery at Yale School of Medicine.  …  Technically, inflammation is a necessary self-defense mechanism – the immune system’s response to infection, irritation, or injury.  The body produces inflammatory substances, such as histamines and cytokines, and blood vessels swell, sending immune cells to the skin to kill bacteria, says Bryan B. Fuller, adjunct professor of biochemistry and molecular biology at the University of Oklahoma Health Science Center in Oklahoma City.  It’s a kind of scrimmage, then, at a cellular level, with bacteria and viruses the losers (one hopes).  With foreign invaders vanquished, healing can begin.  The problem is that sometimes, thanks to genetic and environmental factors, inflammation becomes chronic.  Like a runaway train, it gains speed (stimulating production of skin-eroding enzymes) and mows down everything in its path (collagen, elastin).  While there are obvious states of inflammation, like a pimple or a rash, we may not even be aware that our bodies are on “red alert”.

Furthermore, according to the article “Seeing Red” in the January, 2012 issue of Day Spa magazine (once again – not available online):

Non-acute, or chronic, inflammation manifests in various ways, including ongoing swelling in the feet and ankles, sinus issues and skin problems.  “The skin is a telltale,” [Wallace] Nelson [naturopathic doctor and president of M’lis] says.  “In skin, inflammation manifests as acne, eczema, psoriasis and rosacea.”  Many people, including Nelson, see a dietary connection.  We know that compounds in the blood called C-reactive proteins are at high levels when inflammation is present.  “Saturated fats, salt, refined sugars and high-glycemic carbohydrates like those made from white flour are foods that set off C-reactive proteins,” says Nelson.

Dr. Amy Wechsler in her book The Mind-Beauty Connection   explains that most of us are not even aware of the fact that our bodies may be victims of chronic inflammation (pages 174-175):

Eventually, you do have to take note of [inflammation] when it builds up over time and results in an ailment or disease, from simple skin rashes and persistent acne t more serious problems like heart disease and cancer.

What fuels the endless burn of chronic inflammation?  Oxidative stress, or free-radical damage that can cause wrinkles and cancer.  Because free radicals steal electrons from other molecules, rendering those molecules handicapped and damaged, they both trigger inflammation and are created by it.

The sun’s UV light also generates an army of free radicals.  It’s estimated that half of the sun’s skin damage is caused by them.  Inflammation and UV assaults are like a one-two punch to your skin because its major components – fats, proteins, and DNA – are favorite free-radical targets.  The end results is, yes, skin aging: collagen breaks down, abnormal elastin increases, moisture is lost, wrinkles accumulate, and skin cancer may start brewing, too.

How Do You Treat Skin Inflammation?

There are actually a lot of different ways that you can treat your skin in order to reduce inflammation:

  • Eat a diet rich in antioxidant foods – think brightly colored fruits and vegetables.  Drink green tea.
  • Eat anti-inflammatory foods like those with omega-3 fatty acids like fatty fish (think salmon), flaxseed, and fish oil.
  • Follow a low glycemic diet – eliminate white flour, processed foods, and sugar.
  • Apply topical antioxidants.  No one antioxidant is better than other; they are all anti-inflammatory and soothing.  Vitamin C, green tea, coffeeberry, and resveratrol are all good antioxidants to try in skincare products.  For more information on antioxidants see my post Skincare Tip: Add Antioxidants to Your Home Skincare Regime for more details on antioxidants and specific product recommendations.
  • Quit smoking.  Smoking creates more free radicals and causes vascular injury which the body then tries to repair thus setting off the inflammatory process in the body.  For more information about how smoking negatively affects your skin see my previous post How Smoking Ruins Your Skin.
  • Allergies to skincare product ingredients, such as fragrance and preservatives, can increase inflammation.  Once you figure out which ingredients have caused a reaction keep a list with you so you can avoid them in the future.
  • Moisture often – skin dryness can lead to the skin barrier, your skin’s first line of defense, being compromised which can trigger more skin inflammation.  A soothing moisturizer can help your skin restore its natural ability to protect and heal itself.  One line of moisturizers to try is from Epionce.  The concept behind this whole skincare line, developed by dermatologist Carl Thornfeldt, is to soothe, protect, and repair damaged skin barriers.  (I’ve been trying these products lately through my job, and I can definitely say that the feel great on the skin and smell wonderful too)
  • Protect your skin with sunscreen.  Too much sun can lead to further skin inflammation.

Though preventing skin inflammation (and inflammation in the body as well) can seem daunting you can take some small but concrete steps to protect your skin.  Start by quitting smoking (if you smoke), use skincare products with antioxidants, and protect your skin with both moisturizer and sunscreen daily.

Further Reading:

Image from achooallergy.com

 

 
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