How to Keep Your Skin in Top Shape

by Pauli Morrow | Mar 17, 2022 | Skincare

How to Keep Your Skin in Top Shape

Your skin is your connection to the world. You hear in the elementary or middle school that skin is your largest organ. True. Let’s learn how to keep it in top shape.

COULD YOU GIVE ME A QUICK LESSON ABOUT WHAT OUR SKIN IS MADE OF?

In a nutshell, your skin has three layers. The very top layer is called the epidermis, this is the skin that you see. Keratinocytes (which is also the material in hair and nails) make up most of the epidermis. Melanin is produced in this top layer and it determines how much pigment we have in our skin. Melanin is also our natural protection from the sun’s UV rays.

The next layer is the dermis and it has collagen and elastin to give your skin its strength and elasticity. This is where sweat glands, hair follicles, blood vessels, nerve fibers and oil glands live. Below the dermis is the subcutis which is basically a layer of fat cells.

WHY IS IT IMPORTANT TO BABY AND PROTECT MY SKIN?

All of your skin layers are constantly undergoing renewal and need on-going respect.

Everyday life can take a toll on your skin. UV, pollution and smoke creates free radicals and destroys your skin cells. A dry environment then breaks down the surface layer. Skin is our biggest defense against the outside world.

This is why it’s important to repair damaged cells – with things like vit C serum, antioxidant serums and peptides. And continue to protect cells with avoiding sun, wearing sunscreen, not smoking and keeping you skin barrier healthy by moisturizing, and not exposing it to harsh chemicals or irritants (like antibacterial soap and cleaning products).

HOW DO I TAKE CARE OF MY SKIN?

Having a regular skin care regimen can make all the difference.

Cleanse: Washing your face in the evening removes all the dirt, oil, sweat and environmental pollutants from the day. If these are left on your skin, they can clog pores and make your skin look dull. What do I look for in a cleanser? For everyday you should use a gentle non-soap cleanser that is suitable for your skin type. Basically, the best cleanser is one that doesn’t make your skin feel tight. I use Epionce Gentle Cleanser (which is sold in doctor’s offices) – but Cereve gentle foaming cleanser is another good brand that’s easy to find at Target or Amazon. How often? Once to twice a day. Washing in the evening is most important. Washing in the morning is something you should do unless you have sensitive/dry skin. In this case, rinsing with water should do the trick. Over washing, scrubbing and using harsh soaps can cause skin to get irritated – resulting in dryness, more fine lines and redness.

Exfoliate: Once to twice a week to remove any dead skin cells. Be careful with this one… it should be effective yet gentle and respectful. Choose a pH-neutral exfoliation product, which is perfect for smoothing the skin while respecting its natural balance. And alpha and beta hydroxy acid cleansers are perfect here. I use Epionce Lytic Cleanser and love the spa-like tingle it has. Another good choice is Alba Acnedote Cleanser (sold in drugstores or on-line) – it is great if you like those scrubby particles.

If you are acne prone, don’t pick at your pimples. It’s tempting to do, but popping pimples can lead to more swelling and redness and even scarring.

Moisturize: Keeping moisture in the skin is important for the barrier of your skin to function at its best. The type of moisturizer really depends on how much natural oil you have in your skin. Thicker creams are reserved for those with dry skin. Whereas thinner lotions or oil-free moisturizers may be better for oilier skin types or those who are acne prone.

Antioxidants and Peptides: These are beneficial at repairing damaged skin cells and fighting free-radicals (that further damage skin). They can be used both night and morning if your skin can tolerate them without irritation. To mention in this section is a retinoid (like Retin-A or retinol) that should be applied at night. Retinoids are amazing and can help with collagen production, fight acne and help skin texture. But be aware that they can make skin sensitive and more prone to sun damage if SPF is not used daily.

Sunscreen: This needs to be an everyday routine – even if it’s cloudy or cold. It’s not just sunburn, but chronic sun exposure that causes wrinkles, age spots and skin cancer. Protecting your skin from the sun is a must. And don’t forget to reapply.

READ BLOGS RELATED TO SUNSCREEN

Skin care blog from Pauli Morrow and Evolution Dermatology in Boulder CO

Take care of yourself: How you live your life can have an impact on your skin too. Remember, your skin is an organ just like your heart and lungs. A healthy immune system and lifestyle help your skin stay healthy and glowing. Maintain a healthy diet, get plenty of beauty sleep, drinks lots of water (like 8 glasses a day), no smoking, exercise regularly and limit stress (when you can!).

WHAT ORDER DO I APPLY TOPICAL PRODUCTS?

In general, you want to apply the lightest to heaviest. Meaning, a serum would go on first and an emollient moisturizer on top. If your sunscreen is not your moisturizer, it should go on last.

WHAT ARE THE BEST SKIN ATTRIBUTES?

Healthy skin is seen as beautiful skin. In general, women with smooth, healthy skin are not just lucky – they are working at it. The best way to head towards your healthiest skin is to take time to respect it and get your new skin regimen going!

Why Sunscreen is the Secret Sauce

by Pauli Morrow | Mar 17, 2022 | Ageless skin, Skincare, Sun Damage, Sunscreen

Why Sunscreen is the Secret Sauce

Can you believe that the best tool out there for ageless skin is inexpensive, easy to use and is probably already sitting in your bathroom?

This fabulous secret sauce is sunscreen! Not only does sunscreen prevent sunburn and skin cancer – It can preserve and may even reverse the visible signs of sun damage. A whopping 90% of the visible signs of aging (including hyperpigmentation, broken blood vessels, sagging skin and wrinkles) are caused by sun exposure.

WHAT EXACTLY IS SUNSCREEN?

Sunscreens combine several ingredients to help prevent the sun’s ultraviolet (UV) radiation from reaching your fragile skin. The SPF label only indicates how much UVB protection you are getting. UVB is what can lead to sunburn, while UVA rays penetrate the skin on a deeper level and can cause leathery skin, wrinkling and brown spots and increases the carcinogenic effects of UVB rays – leading to an increased risk of skin cancer. Look for the label “broad-spectrum” to make sure it has ingredients that protect against UVA and UVB.

WHAT DOES SPF MEAN?

Sun Protective Factor. It is a measure of a sunscreen’s ability to prevent UVB rays from damaging your skin. Here is how the number of SPF is determined: If it takes 10 minutes for your skin normally get sunburned, using an SPF 30 sunscreen theoretically prevents sunburn 30 times longer — about 5 hours. The only problem is that sunscreen does not stay effective longer than 2 hours. So during that 5 hour period, you would need to be reapplying the SPF 30 every 2 hours. Another way to look at the SPF is what percentage of rays it is blocking. SPF 15 filters about 93% of UVB rays, whereas SPF 30 is 97% and SPF 50 can keep out about 98%. But keep in mind the time of day you are in the sun. The sun is stronger in the middle of the day compared to early morning and early evening hours. That means your risk of sunburn is a lot higher in the middle of the day. The sun’s intensity is also related to geographic location, with greater sunburn risk at higher altitudes. So with Boulder, CO at 5430 feet elevation, the sun is much more intense!

WHY WEAR IT EVERYDAY, ALL DAY AND LOTS OF IT?

So you don’t end up like this guy:

clear trucker.jpg — This is a 69 year old truck driver. He has left sided sun damage from driving a truck for 28 years. No sunscreen was used here!

Sunscreen is not just for the beach. Sun damage is cumulative and each minute you get (even driving down the road or walking to lunch) adds to destruction of healthy cells in your skin.

-Sunscreen decreases your risk of skin cancer. Skin cancer is the #1 form of cancer in the US!

-Using sunscreen sets an example for your kids.

-No excuses, it’s more convenient than ever! You can choose between creams, sticks, sprays and even powders. And now that the zinc particles are micronized – there is less of that white mask look.

-It will keep your skin looking youthful and decrease wrinkles and leathery skin

WHAT IS THE DIFFERENCE BETWEEN CHEMICAL AND PHYSICAL/MINERAL SUNSCREENS?

Mineral sunscreens contain either zinc or titanium or both. The minerals create a barrier between skin and the sun’s rays instead of absorbing them (like the chemical SPFs). Many brands realize we don’t want white faces and have micronized the mineral particles (sometimes called nanoparticals) to reduce chalkiness. BTW – if you have heard that the smaller particles are a concern because they might enter the bloodstream and cause harm – this theory has been disproved. Experts agree that these mineral small particles are safe. Mineral sunscreens are great if you have sensitive skin or worry about absorbing the chemicals in non-mineral SPF. Zinc is actually a natural anti-inflammatory and believe it or not is the main ingredient in diaper cream for this reason.

Chemical sunscreens use UVB absorbers like homosalate, octisalate or octocrylene in addition to avobenzone, which absorbs UVA rays. One of the UVB absorbers, oxybenzone, has had a bit of controversy. It is a chemical that interfers with our hormones and may actually increase our risk of skin cancer. So read those labels!

WHAT SPF SHOULD I WEAR?

The simple answer is a broad-spectrum (to protect you from both UVA and UVB rays) that is an SPF 30 or higher. However, on days that you are mostly inside wear its okay to wear a moisturizer with SPF 15 or 30. But when you are not inside all day and running around, make sure to wear an SPF of close to SPF 50. Anyone who knows me knows that I don’t leave the house without sunscreen on my face, neck and chest…everyday.

WHAT TYPE OF SUNSCREEN IS BEST FOR YOU?

The one you will use!

Spray:

Easy to apply and good for squirmy kids. Make sure you use a lot to fully get coverage and try not to breath it in. Watch out if you have sensitive skin – a lot of these can be irritating and cause rashes.

Moisturizer with built-in sunscreen:

This is great for everyday and when you are indoors most of the day. They tend to be lighter and easy to apply with SPFs around 15 and 20. You will need additional SPF if you plan to spend time outside.

Mineral/Physical Blocks:

These contain zinc or titanium and are perfect for sensitive skin. They sit on top of the skin and act as a blocker with little to no irritation. These are especially great if you have melasma.

Sweat/Water Resistant:

The FDA no longer allows the terms “waterproof” or “sweat-proof”. So you will find only “water-resistant” on the label. These are made to stay on the skin if you are wet or sweaty – but know that they still have to be applied every 2 hours to be effective. They are usually formulated with a bit more oil, silicones (like dimethacone), or a film polymer (like sodium polycrylate) to give them the staying power when water is involved. Interestingly, a study came out recently that found water-resistant sunscreens were less effective in chlorinated pools than in salt water. The chemicals in the chlorinated water can disintegrate the active ingredients. Best to reapply after every swim session!

Powders:

These are the BEST for reapplication. You can leave one in your purse and reapply before that afternoon hike.

DO SUNSCREENS EXPIRE?

Yes. They are required by the FDA to last about 3 years. Check the label for an expiration date. But realize that they can breakdown with heat. If you have been leaving the sunscreen in your hot car all summer, it probably needs to be tossed.

WHAT’S THE DEAL WITH MAKING SURE YOU GET ENOUGH VITAMIN D?

Vitamin D is important for strong bones and a good immune system. It’s fine to get some of your vit D from the sun’s UV radiation – but limit it and keep your face and chronically exposed areas out of the mix. The Skin Cancer Foundation suggests that you get your recommended daily 600 IU of vit D from food sources like fish and cereals or from supplements.

PROTECTION POINTERS:

Apply at least 20 minutes before getting into the sun (the chemical ones take that long to absorb).
Reapply, reapply and reapply… every 2 hours and after chlorinated pool swims.
With sticks, you need to apply 4 passes to get effective protection – so rub that stuff all over!
If you have sensitive skin – stick to mineral sunscreens to avoid chemical irritation.
Keep sunscreen somewhere convenient – by the front door, in your gym bag or purse. But avoid keeping in your car so that the heat doesn’t degrade the active ingredients.
Make sure to cover your lips – especially your lower lip because it is 12 times more likely to be affected by skin cancer.
By the way – I have heard some chatter from sunscreen skeptics and natural-types who feel you can skip sunscreen altogether and use more “natural” oils like coconut, raspberry seed and carrot seed. But know that these only provide a small protection (about SPF 4) against UVB rays and no protection against UVA. So best not to count on these when out playing in the sun.

Injectables, Anything but Superficial. They can help you feel good too!

by Pauli Morrow | Mar 17, 2022 | Botox, Injectables

Injectables, Anything but Superficial. They can help you feel good too!

Could Botox and cosmetic dermal fillers help with depression?

These injectables are typically used to improve the appearance of facial wrinkles, but now studies have shown that Botox may be an effective treatment to help depression. Why not get rid of wrinkles and improve your mood at the same time?!

WHAT IS AN INJECTABLE?

Injectables are really anything injected into the body with a needle. But in the derm world we are referring to dermal fillers (brands like Juvederm, Restylane and Radiesse) and “neurotoxins” (brands like Botox, Dysport and Xeomin). Injectables like these are the number one cosmetic procedure in the US…and for good reason. Not only can they make you look more youthful, they apparently can make you feel better about yourself too!

IS THERE ANY PROOF IN STUDIES THAT BOTOX CAN HELP MY MOOD?

Botox has been investigated and found to ease symptoms of depression and elevate mood in actual scientific studies.

It was first reported in the Journal of Cosmetic Dermatology, 2009, by Michael Lewis, PhD and Patrick Bowler MB, BS, that non-depressed patients who received Botox injections above the eyes frowned less and felt better than those who did not receive the injection. Dr. Lewis concluded that, “Smiling makes us feel happy whereas frowning makes us feel sad. People who have undergone chemical denervation (with Botox) of their frown muscles cannot frown. We have found that these people (possibly because they can no longer get the feedback from frowning) are happier than people who have had other forms of cosmetic treatment.”

Then in 2012, The Journal of Psychiatry Research reported a study done in Switzerland showing, “a single treatment of the glabellar region with botulinum toxin (Botox) may shortly accomplish a strong and sustained alleviation of depression in patients, who did not improve sufficiently on previous medication. It supports the concept, that the facial musculature not only expresses, but also regulates mood states.” Translation…Botox treated depression in patients that did not respond to antidepressant meds. Impressive!

More recently in a larger study in 2014, Eric Finzi, MD, PhD and Norman Rosenthal, MD (Clinical Professor of Psychiatry at Georgetown Medical School) showed groundbreaking evidence that there was a significant improvement in depression in the study group treated with Botox. Dr. Eric Finzi even made the comment (in the New York Times) that, “This new research supports earlier facial feedback theory of Charles Darwin which suggests that facial expressions influence mood.”

CAN YOU TELL MY MOOD BY LOOKING AT MY EXPRESSION?

Believe it or not, there is historical support for a connection between emotions and facial muscle activity. Back in the Victorian era the “omega sign” was what they called the facial expression where you wrinkle between your eyebrows and nose because it resembles the Greek letter omega. They believed the “omega sign” was diagnostic of a depressive disorder.

With all of this info, it seems possible that a more positive facial expression can make you feel better about the way you look and therefore improve social interaction, elevating your mood. As you look in the mirror and see a face without negative expression it elevates your mood. If you look happy, you start to feel that positive, cheerful vibe!

WHERE DO FILLERS COME IN?

Well, if Botox was found to create a more positive outlook in the patients that were studied, why not fillers? Cosmetic dermal fillers have not been directly studied, but they also can create a happier looking face. Fillers can literally turn that frown upside down! This is done by injecting the marionette area (the lines that can develop from the corners of the mouth to the chin). Fillers can be injected in lots of other areas to create a more positive, happy looking face too – like in the cheeks to help defy gravity, or between your eyebrows to get rid of that furrow.

WITH ALL THIS INFORMATION WE CAN FEEL EVEN BETTER ABOUT GETTING INJECTABLES DONE. NOT ONLY CAN YOU LOOK MORE YOUTHFUL, BUT YOU JUST MIGHT HAVE A LITTLE PEP IN YOUR STEP!