Skin Care GuideThe Ultimate Guide to Skin Care

Summer is officially on the horizon, are you ready? Mentally, of course! Aren’t we all? But what about your skin? Most of us have lived in pants and sweater for months now; is your skin looking fresh and summer-ready? The chances are good that your skin needs a little TLC before you are ready to pull out the summer clothing.

7. Out With the Old - Buy a New Sunscreen
Throw away last year’s unused sunscreen for a new bottle. Sunscreens aren’t meant to last forever, and seeing most people don’t use as much as they should, I bet you have a bottle or two stored away. Be safe and pick up a new one. And don’t forget the most important sunscreen advice: USE IT. You should be using a shot glass full for your body, and a full teaspoon just on your face. Reapply every 1-2 hours that you are in the sun to ensure a summer full of safe sun fun.

Your busy lifestyle leaves little time for pampering skin care. The result: Your skin isn’t the baby-soft body glove you were born with. As you age, your skin gradually becomes thinner and finely wrinkled. Oil-producing (sebaceous) glands grow less active, leaving your skin drier. The number of blood vessels in your skin decreases, your skin becomes more fragile, and you lose your youthful color and glow.

Good skin care — such as avoiding the sun, washing your skin gently and applying moisturizer regularly — can help delay the natural aging process and prevent many skin problems. These simple skin-care habits will help you protect your skin to keep it healthy and glowing for years to come.

1. Protect yourself from the sun

The most important way to take care of your skin is to protect it from the sun. Ultraviolet light — the invisible but intense rays from the sun — damages your skin, causing deep wrinkles, dry, rough skin, liver spots, and more serious disorders, such as noncancerous (benign) and cancerous (malignant) skin tumors. In fact, most of the changes seen in aging skin are actually caused by a lifetime of sun exposure.

For the most complete sun protection, use all three of these methods:

• Avoid the sun during high-intensity hours. The sun’s rays are most damaging from 10 a.m. to 4 p.m. Reduce the time you spend outdoors during these hours.
• Wear protective clothing. Cover your skin with clothing, such as long-sleeved shirts, long pants and wide-brimmed hats. Also, keep in mind that certain clothing styles and fabrics offer better protection from the sun than do others. For example, long-sleeved shirts offer better protection than short-sleeved shirts do. And tightly woven fabrics such as denim are better than are loosely woven fabrics such as knits. Several companies now make sun protective clothing (SPF clothing), which is specifically designed to block out ultraviolet rays while keeping you cool and comfortable.
• Use sunscreen. Choose a broad-spectrum sunscreen with a sun protection factor (SPF) greater than 15. Apply liberally 20 minutes before going outdoors and reapply every two hours, after heavy sweating or after being in water.

2. Don’t smoke

Smoking accelerates aging of your skin and increases wrinkles. Skin changes from smoking can appear in young adults after 10 years of smoking.

Smoking causes narrowing of the tiny blood vessels in the outermost layers of skin. This decreases blood flow, depleting the skin of oxygen and nutrients, such as vitamin A, that are important to skin health. All of these factors increase damage to the elastic fibers (elastin) and collagen, which give your skin strength and elasticity.

In addition, the repetitive facial expressions you make when smoking — such as pursing your lips when inhaling and squinting your eyes to keep out smoke — may contribute to wrinkles. It’s also possible that repeated exposure to the heat from burning cigarettes may damage your facial skin over time.

3. Wash your skin gently

Cleansing is an essential part of caring for your skin. The key is to treat your skin gently.

• Use warm water and limit bath time. Hot water and long showers or baths remove oils from your skin. Limit your bath or shower time to about 15 minutes or less, and use warm, rather than hot, water.
• Avoid strong soaps. Strong soaps — those most capable of stripping oil from your skin — can leave your skin dry. Instead, choose mild soaps or detergent substitutes with added oils and fats. Good choices include Dove, Vanicream, Cetaphil and Purpose.
• Avoid irritating additives. If your skin is sensitive, avoid products containing perfumes or dyes. These can irritate your skin and may trigger an allergic response.
• Remove eye makeup carefully. Use a soft sponge, cotton cloth or cotton balls when removing eye makeup to avoid damaging the delicate tissue around your eyes. If you wear heavy, waterproof makeup, you may need to use an oil-based product, such as Eucerin, Aquaphor or petroleum jelly, to remove makeup.
• Pat dry. After washing or bathing, gently pat or blot your skin dry with a towel so that some moisture remains on the skin. Immediately moisturize your skin with an oil or cream.

4. Moisturize regularly

Moisturizers help maintain your skin’s natural moisture levels. They work by providing a seal over your skin — to keep water from escaping — or by slowly releasing water into your skin.

The moisturizer that’s best for you and the frequency with which you need to moisturize depend on many factors, including your skin type, your age and whether you have specific conditions such as acne. A good way to test if you need a moisturizer is to wait 20 minutes after bathing. If your skin feels tight, you should apply a moisturizer.

Select a moisturizer with an SPF of at least 15 to help protect your skin from damaging ultraviolet rays. If you have sensitive skin, look for products free of heavy dyes, perfumes or other additives. If your skin is very dry, you may want to apply an oil, such as baby oil, while your skin is still moist. Oil has more staying power than moisturizers do and prevents the evaporation of water from the surface of your skin. If your skin is oily, you may want to skip moisturizing.

5. Shave carefully

Shaving is a common and inexpensive way to remove unwanted hair. But shaving can cause skin irritations, especially if your skin is thin, dry or very sensitive. For a smooth shave:

• Press a warm wash cloth on your skin before shaving to soften the hair. Or shave after a warm bath or shower.
• Don’t shave dry skin, which can cause razor burn. Apply shaving cream, lotion or gel before shaving to protect and lubricate your skin.
• Use a clean, sharp razor. If using an electric razor, don’t use the closest setting, which can aggravate the skin.
• Shave in the direction of hair growth, not against it.
• Rinse your skin afterward with warm water.

If irritation does occur, apply a lotion that doesn’t contain ethyl or isopropyl alcohol. Though alcohol and alcohol-based products may feel cooling, they don’t really soothe irritated skin because the alcohol evaporates rapidly from the skin.

The end of summer is rich in apples. You think it’s ordinary fruit without any surprising qualities, but you are mistaken. Apples contain sugar, tannin, organic acids and pectin. Thanking this great content, apples nourish, moisten, soften and renew skin very well. Today I offer some original recipes of apple masks for facial skin. Choose and try!

The mask for normal skin. Add 3 tablespoons of hot milk to 1 tablespoon of oaten flakes and keep for 10 minutes. Grate one apple and mix with beaten yolk, add flakes and mix everything carefully. Put on the face and neck and keep for 10 minutes. Then wash with warm boiled water. This mask nourishes and moistens damaged skin from sun.

Two masks for dry skin. Mix 1 tablespoon of grated apple with 1 tablespoon of butter. Beat one yolk with 1 teaspoon of honey and add to apple mixture. Mix everything and put on the face and neck for 20 minutes. Then clean the face with napkin. You’d better to use this mask before sleep.
This mask has the great tonic effect. Grate one apple, add 1 tablespoon of honey, 1 yolk, 1 teaspoon of ascorbic acid, 1 teaspoon of apple vinegar and 1 teaspoon of vegetable oil. Mix everything carefully and put on the face. Keep for 30 minutes and then wash with cool water.

For greasy skin. Beat up white of egg and add 2 tablespoons of grated apple, 1 teaspoon of potato starch and grinded apricot (or half a peach). Mix everything carefully and put on the face for 15 minutes. Then wash with warm water.
Also you can grate one big green apple and add 1 teaspoon of grinded horseradish. Beat up white of egg and add to mixture. Put on the face and keep for 15 minutes. Then wash with cool water. This mask draws pores and tonics greasy skin.

The mask for sensitive skin. Boil one potato (without salt), clean it and knead with fork. Add grated apple, 1 teaspoon of vegetable oil and yolk. Mix everything carefully and put on the face and neck. In 20 minutes wash the face with cool water.

Masks for aging skin. Grate one carrot and 1 green apple. Mix them and put on the face for 15 minutes. Wash with cool water. This mask moistens skin and gives the healthy color.
Beat up an egg; add grated apple and 3 grinded apricots (or 1 peach). Mix everything and put on the face and neck. Keep for 20 minutes and then clean the skin with ice-block.

And finally the mask for all types of skin. Mix 1 teaspoon of apple sauce with 1 teaspoon of mayonnaise. Put the mixture on the face and in 20 minutes wash with warm water. It’s very easy and fast mask for any type of skin.

Temporary hair removal is accomplished with conventional treatments such as shaving, waxing and epilation. Another method is the use of selective photolysis, which is light energy that is produced by the laser, and is targeted at the pigment in hair. This causes destruction of hair follicles while sparing surrounding structures (i.e., the skin).

Long lasting hair removal can be achieved with the use of several available lasers. Total temporary hair removal, which lasts for several months, can be done in almost all patients. However, total permanent laser hair removal is not commonly done. Stable permanent hair removal may be possible in some cases and usually requires multiple treatment sessions.

FAQ

1. Is laser hair removal painful?

Laser hair removal can be mild to moderately uncomfortable. Each individual hair follicle is surrounded by nerve endings. While some patients may be able to tolerate the procedure without the use of an anesthetic, others may find the application of an anesthetic cream (such as EMLA) helpful. A generous layer of anesthetic cream is applied for 30-60 minutes before the procedure and can provide adequate relief from discomfort during the procedure.

2. How many treatments are necessary?

For satisfactory, long-lasting hair removal most patients require three to six treatments. The interval between treatments varies between 4 and 12 weeks, and will depend on your hair color, the type of laser used, and the location treated.

3. What are the complications?

Fortunately, the complications of laser hair removal are rare if it’s done by an experienced and skilled physician. You should expect a certain degree of pain, swelling and redness around the hair follicle after each treatment session. These symptoms resolve over the following 24 hours and include:

- Pigment alteration: Postinflammatory hyperpigmentation or darkening of the skin next to the treated area has been reported in 5% of patients and is sometimes seen in darker skinned individuals. Strict sun avoidance is recommended. Hypopigmentation, or lightening of the surrounding skin, has also been reported. These adverse effects are usually temporary. Alteration in underlying pigments is also a risk, especially when Q-switched lasers are used.
- Infection: Bacterial Skin Infections are rare and occur when the superficial skin is injured. Antibiotic treatment may be prescribed, but generally good wound care is sufficient to prevent infection. If you have had prior episodes of cold sores or herpes simplex infections, you may develop a recurrent episode after a laser treatment. If you have a history of herpes simplex infections, your doctor should prescribe appropriate antiviral medication prior to laser hair removal to prevent a recurrent herpes episode.
- Scarring may rarely occur and generally follows an infection or superficial skin injury.

Who is a candidate for Laser Hair Removal?

Almost anybody who has undesirable hair is a candidate for laser hair removal. However certain conditions may complicate treatment. Laser hair removal achieves the best results with light-skinned, dark-haired individuals. Lasers with longer wavelengths are generally useful for darker-skinned patients.

Caution must be exercised in certain situations:

• The presence of an active bacterial or viral infection prevents treatment until the condition resolves.
• A history of hypertrophic scarring or keloid formation requires less aggressive laser treatments in order to avoid any complications.
• The presence of a suntan makes laser hair removal less effective and increases the likelihood of scarring or skin injury.
• If you have psoriasis or vitiligo, you should be warned about the possibility of causing more lesions in the treated areas.
• Most dermatologists recommend waiting 1 year after taking isotretinoin (Accutane®) before doing laser hair removal because of atypical scarring that has been associated with use of this drug during treatment.

Where?

Laser hair removal can be performed on virtually any hair bearing part of your body including your arms, legs, bikini area, back, etc.

Objectives of Therapy

1. The primary objective is safe and effective hair removal.
2. Total permanent hair removal, while desirable, is not always possible.
3. Total temporary hair removal lasting several months is a reasonable expectation.
4. Some permanent hair reduction in treated areas is possible, especially after multiple treatments.

Preoperative Care

1. You should strictly avoid sun tanning and artificial tanning products.
2. You should avoid waxing, plucking or electrolysis of any areas to be treated for at least 6 weeks before your laser treatment.
3. The use of shaving and depilatory creams is allowed.
4. If you have darker skin, you should consider a bleaching cream or skin lightening regimen.
5. You should shave the treatment areas within 24 hours prior to treatment.
6. Anesthetic cream can be applied 30-60 minutes prior to treatment
7. You should remove cosmetics prior to treatment.

Postoperative Changes

1. You will see redness and swelling around the treated hair follicles immediately following treatment.
2. Blisters and crusting are rare, though more commonly seen in darker skinned individuals.
3. Several days after treatment, hair may be extruded from the follicle.

Postoperative Care

1. Immediately following treatment, cold compresses can be applied to the skin surface
2. Emollients and/or topical corticosteroid creams can be used to keep areas moist and reduce redness and swelling.
3. Blisters and crusting are treated with antibiotic ointment and daily soaks.
4. You should strictly avoid the sun in order to prevent pigmentary changes.

Lasers used for Hair Removal

Laser energy, through the principle of selective photothermolysis (a process that involves selective absorption of an intense light pulse at wavelengths that are absorbed by the hair follicles, but not by the surrounding tissue), targets the pigment in the hair follicle. This causes destruction of hair follicles while sparing surrounding structures (i.e., the skin). Growing hair is more sensitive to destruction than resting hairs. Many of the lasers listed below utilize epidermal or skin cooling techniques. The effect of cooling the surface of the skin serves to minimize discomfort during treatment while increasing the effectiveness of the laser treatments.

1. Ruby Laser (694 nm, normal mode)
- All patients will see a growth delay of their hair. Some patients will see a permanent reduction in hair growth.
- This laser is more effective for dark hair. Blonde and gray hairs are more resistant.
- White hairs do not respond to treatment
- Epilaser® (Palomar) and Epitouch® (Sharplan) are examples of ruby lasers

2. Alexandrite Laser (755 nm, normal mode)
- All patients will see a growth delay of their hair. Some will see a permanent reduction in hair growth.
- It is effective for dark hair. Blonde and gray hairs are more resistant.
- White hairs do not respond to treatment
- It is potentially safer for darker skin than the ruby laser
- Rapid repetition rates of the laser will reduce treatment time
- Apogee® (Cynosure) uses a cooling gel on the skin
- Gentlase® (Candela) uses dynamic cooling spray

Sun damage or photo damage produces both skin cancers as well as photo-aging. Photo-aging shows itself on the skin as wrinkling, scaling, dryness, and mottled pigmentation. Ultra-violet light is absorbed by skin, which in turn produces a photo-chemical reaction.

The UVA light is absorbed by both DNA as well as urocanic acid, the photo-chemical reaction produces oxidation of both DNA, nucleide acid, and protein, as well as lipids, this is known as oxidative damage. Anti-oxidants have been evolved to protect against, and reverse some of the damage produced by sunlight. An anti-oxidant mechanism is very advanced in plants that protect against the damage from sun exposure.

Oxidation:

Oxidation is produced by reactive oxygen molecules. The DNA absorbs ultra-violet light mostly in the UVB (290-320 manometres) range. This produces damage mainly within the epidermis. UVA (320-400 manometres) penetrates deeper into the skin and produces damage in the epidermis, the dermis as well as affecting blood vessels. The UVA has a much more oxidizing effect on cells.

The carcinogenic or cancer forming effects of ultra-violet B produce mutations within the DNA. This initiates tumours within the epidermis. The UVA promotes these tumours as it has much more oxidizing stress on the skin than UVB. It may as a result be more cytotoxic and immunosuppressive.

Sunscreens:

Sunscreens certainly protect against ultra-violet light, the sunburning spectrum is UVB and sunscreens are very effective. Ultra-violet A is the most difficult to protect against. It is important to realize that the SPF numbers are calculated with an amount of sunscreen on skin that exceeds what most of us put on our own skin.

The SPF is calculated with a quantity of 2mg. of sunscreen per centimetre2. Most people will put on about half to one quarter of this when used as sun protection. Unfortunately, low quantities of sunscreen of per centimtre2 will have minimal sun protective effects. Usually if 5mg. per cm.2 of sunscreen is applied to the skin, the sun protective factor is in the region of an SPF of 3.

Anti-Oxidants:

Anti-oxidants play a significant part in the protective and repair mechanisms within animals and plants. This can be achieved by anti-oxidants that are produced within the skin itself or by those consumed or applied from plants. The anti-oxidant effects can be divided into those that have their protection through enzymes, and those that tend to reduce the quantity of hydrogen peroxide as well as lipid hydroperoxides.

Topical Anti-Oxidants:

The use of topical anti-oxidants has certain requirements, these have to be stable as well as being cosmetically acceptable. It is clear that anti-oxidants have a photo-protective benefit. The physiological anti-oxidants include vitamin C, vitamin E, and ubiquinol. Vitamin C is water-soluble and is a free radical scavenger, it is required for collagen synthesis and may inhibit elastin formation in the dermis.

It may also reduce pigment synthesis, as well as enhance epidermal barrier function. For it to be active it must be present on the skin at a pH of 3.5 or lower in order to have an anti-oxidative effect. Vitamin E is different from vitamin C, in that it is lipid soluble, there is evidence that combining vitamin E and vitamin C may be of some benefit. Other anti-oxidants to be considered will be selenium as well as zinc.

Plant Anti-Oxidants:

Plants synthesize vitamin C, vitamin E and flavones, and polyphenolic compounds.

• Silymarin
• Soy isoflavones
• Tea
• Polyphenols

These are all potent plant anti-oxidants.

Silymarin:

This is a Milk Thistle extract, the main component in terms of anti-oxidants is silybyn. This prevents lipid peroxidase action. It also has been shown to inhibit tumour promotion in animals.

Soy isoflavones:

Soy has been connected with a reduction in cardiovascular disease, and in some incidents’ of breast cancer when taken by mouth in large quantities. It has a phytoestrogen effect, which can reduce menopausal symptoms. The isoflavones are genistein and gaidzein. The genistein has a collagen synthesis effect. It is also anti-cancer. It has been used both orally as well as topically.

The genistein is a powerful scavenger of peroxyl radicals. This has a significant reduction in lipid peroxidase activity. It has been shown to reduce redness in the skin of mice which are subject to ultra-violet A. It also has an anti-inflammatory effect. The use of this compound reduces the immune suppression effect of ultra-violet light.

Tea polyphenols:

Tea is fermented initially to green, and then to black tea. The drinking of black tea has been shown to reduce the frequency of squamous cell carcinomas. Work done with green tea both topically and taken orally, shows that it reduces the ability of ultra-violet to produce skin cancers and redness, particularly in animals. The possibility of combining tea, plus vitamin E, to work together as anti-oxidants is interesting.

Much more work needs to be done in order to establish how combining anti-oxidants with sunscreens will have a very beneficial effect on reducing sun damage to skin.