http://www.skinclinicofvirginia.com/test.txt Skin Care Tips Sunlight has a profound effect on the skin causing premature skin aging, skin cancer, and a host of skin changes. Exposure to ultraviolet light, UVA or UVB, from sunlight accounts for 90% of the symptoms of premature skin aging. The sun gives off ultraviolet radiation that we divide into categories based on the wavelength. <u>UVC Radiation</u> UVC radiation is almost completely absorbed by the ozone layer and does not affect the skin. <u>UVB Radiation</u> UVB affects the outer layer of skin, the epidermis, and is the primary agent responsible for sunburns. It is the most intense between the hours of 10:00 am and 2:00 pm when the sunlight is brightest. UVB does not penetrate glass. <u>UVA Radiation</u> UVA was once thought to have a minor effect on skin damage, but now studies are showing that UVA is a major contributor to skin damage. UVA penetrates deeper into the skin and works more efficiently. The intensity of UVA radiation is more constant than UVB without the variations during the day and throughout the year. UVA is also NOT filtered by glass. Both UVA and UVB radiation can cause skin damage including wrinkles, lowered immunity against infection, aging skin disorders, and cancer. The process is not fully understood. Some of the possible mechanisms for UV skin damage are collagen breakdown, the formation of free radicals, interference with DNA repair, and inhibition of the immune system. In the dermis, UV radiation causes collagen to break down at a higher rate than with just chronologic aging. Sunlight damages collagen fibers and causes the accumulation of abnormal elastin. Enzymes that normally remodel sun-injured skin actually break down collagen. When the skin repeats this imperfect rebuilding process over and over, wrinkles develop. UV radiation causes the walls of blood vessels to become thinner leading to bruising with only minor trauma in sun-exposed areas. The sun also causes the appearance of telangiectasias, tiny blood vessels, in the skin especially on the face. The most noticeable sun-induced pigment change is a freckle or solar lentigo. A freckle is caused when the melanin-producing cell, or melanocyte, is damaged causing it to get bigger. Large freckles, also known as age spots or liver spots, can be seen on the backs of the hands, chest, shoulders, arms, and upper back. These are not actually age related but sun-damage related. UV exposure can also cause white spots especially on the legs, but also on the backs of the hands and arms, as melanocytes are destroyed. UV radiation causes an increased number of moles in sun-exposed areas. Sun exposure also causes precancerous lesions called actinic keratoses that develop especially on the face, ears, and backs of the hands. They are small crusty bumps that can often be felt better than they can be seen. Actinic keratoses are felt to be premalignant lesions because 1 in 100 cases per year will develop into squamous cell carcinoma. UV exposure also causes seborrheic keratoses, which are warty looking lesions that appear to be "stuck on" the skin. In contrast to actinic keratoses, seborrheic keratoses do not become cancerous. The ability of the sun to cause skin cancer is a well-known fact. The 3 main skin cancers are melanoma, basal cell carcinoma, and squamous cell carcinoma. Melanoma is the most deadly skin cancer because it metastasizes more readily than the other skin cancers. It is believed that the amount of exposure of the skin to the sun before the age of 20 is actually the determining risk factor for melanoma. Basal cell carcinoma is the most common skin cancer and tends to spread locally, not metastasize. Squamous cell carcinoma is the second most common skin cancer, and it can metastasize although not as commonly as melanoma. The risk of getting basal cell carcinoma or squamous cell carcinoma is determined by a person's lifetime exposure to UV radiation and the person's pigment protection. There is no such thing as a safe tan! Sunscreen. Free radicals are unstable oxygen molecules that have only one electron instead of two. These molecules scavenge electrons from other molecules, and the process is repeated. This process can damage cell function and alter genetic material. Free radical damage causes wrinkles by activating the enzymes that break down collagen. They cause cancer by changing the genetic material, RNA and DNA, of the cell. UV radiation is one of the major creators of free radicals. Some other common sources of free radicals are fried foods, smoking, exhaust, pollution, and our own bodies. Antioxidants STOP free radicals and all antioxidants act as anti-inflammatories. Antioxidant therapy can improve the health of the skin and slow down development of new lines. Collagen is the dermis’ principal component and is basically a chain of amino acids. Ascorbic acid (vitamin C) is involved in the metabolism of several amino acids and stimulates the growth of fibroblasts, leading to the formation of collagen. Ascorbic acid also intercepts free radicals effectively in the aqueaous phase and acts synergistically with vitamin E. The dermis is responsible for the skin’s elasticity. For repair of the dermis, the best agent is Vitamin C. The treatment of choice for comedonal acne, or whiteheads and blackheads. It works by increasing skin cell turnover promoting the extrusion of the plugged material in the follicle. It also prevents the formation of new comedones. Tretinoin is also the only topical medication that has been proven to improve wrinkles. It takes at least 6 months to see a noticeable difference in wrinkles. The best benefit is seen if Retin-A is used for at least a year. For sensitive skin, Retinol products can help in the reduction of fine lines and wrinkles without the redness and irritation associated with prescription Retin-A. When you first start using Retin-A, apply it every other night or every 3rd night. The flaking and irritation side effects are usually the worst in the first 2 weeks of application. As your skin adjusts to the medicine, you can apply it more frequently. If you notice an increase in the irritation or flaking, it's ok to take a break for a couple of days. Just don't stop completely without consulting your health care provider! Alpha lipoic acid is an antioxidant that preserves and protects vitamin C and vitamin E levels in the skin, which can decrease steadily with constant exposure to ultraviolet (UV) radiation. Alpha lipoic acid can also prevent and reverse scar formation due to acne. For aging or damaged skin, ingredients such as alpha hydroxyl acids (AHAs) tend to restructure an abnormal stratum corneum, giving it a healthier and normalized structure, allowing it to hold onto moisture longer. Glycolic acid, the smallest molecule of all the alpha hydroxyl acids (AHAs), enhances penetration of products and reduces fine lines and pigment areas. Glycolic products increase the skin’s exfoliation process, helping to remove dry, dead skin cells more quickly, bringing to the surface a fresher, younger, normalized skin cell. Used over time, the thickness of the living cells of the epidermis will build, and the deeper dermal skin will manufacture new collagen, elastin and hyaluronic acid. Salicylic acid is beneficial in treating aging skin because it is an exfoliant and has anti-inflammatory properties. Lower your sugar intake. Sugar cross-links collagen, making it stiff. Retinoids, especially tretinoin, reverses wrinkles. Tretinoin is also the only topical medication that has been proven to improve wrinkles. If you are looking for firming action in a cream, look for one containing DMAE. Shampooing less frequently allows your hair’s natural oils to do their job. The more you wash your hair, the drier it becomes as well as the skin on your face. Apply products to moist skin for enhanced penetration. Simple hydration of the skin expands the volume available to active agents. The one exception to this is Retin-A, which can be more irritating if applied to moist skin. The primary path for a product’s penetration of the skin is through lipid-containing intercellular spaces. Oil-based carriers will permeate more easily through the epidermal layers. However, these molecules have a harder time continuing down the path of penetration because the lower epidermal layers have a higher water concentration than the stratum corneum. Product vehicles play a major role in determining the rate of penetration. Penetration enhancers include DMSO (dimethylsulfoxide), oleic acid, propylene glycol and ethanol. On product labels, ingredients appear in descending order of concentration. If the ingredient you’re looking for is one of the last five (or 10 of a very long list), then you won’t be getting enough of the ingredient to make a difference! Peptides and neuropeptides in skin-care products are quite the rage. Algae peptides have the advantage of producing rapid, visible changes – tightening and the appearance of firming. Neuropeptides effectively reduce the depth of fine lines and wrinkles on the face and relax muscles that create the look of wrinkles, promoting the appearance of smooth skin especially in the forehead, mouth and around the eyes. These ingredients must be near the top of the list of ingredients to be effective and they are some of the most highly priced products in the industry. Hyaluronic acid is found naturally in the dermis. It is a known humectant, capable of holding 1,000 times its weight in water. Microdermabrasion works by causing a small amount of trauma to the skin, causing the skin to repair itself in a more organized fashion. This creates younger, healthier looking skin. The dermis is the layer that is the most improved with microdermabrasion. Chemical changes occur immediately that causes the dermal layer to also become thicker and healthier after a series of treatments. Create a daily skin-care regimen and stick with it. At a minimum, believe in a simple concept: cleanser, sunscreen for the day and a treatment product at night that addresses your major concern, from acne to aging. Introduce new products one at a time. And remember, a little flaking is a good thing. It’s called exfoliation! More has been discovered about the skin, its components, functions and structure, in the last ten years than in the last two hundred. The gap between the cosmetic and the clinical is closing in fast. The growing trend for “advanced skincare” products and treatments is taking skincare to a whole new level.