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It has often been debated what if any effect our diet has on our skin.  Does chocolate lead to acne?  We’ve all heard these sorts of questions.  Well several studies have recently shown that a diet rich in certain nutrients can give your skin a healthier glow.  Other foods, when avoided, may prevent break outs or poor skin appearance. Here’s a short list (put together by the authors of Eat This, Not That) of skin friendly nutrients and the best foods in which to find them.

Vitamin E: Almonds are packed with vitamin E, which is a powerful anti-oxidant which scavenges free radicals which can cause skin breakdown.  In one study where participants consumed 14mg of vitamin E (about 20 almonds), they had less evidence of UV skin damage after sun exposure.

Omega 3 fatty acids: The omega 3’s are essential fatty acids, meaning you don’t make them on your own and have to get them through the diet.  They are linked to lower triglycerides and have several beneficial effects for the heart.  Flax seeds are packed with omega 3’s. In one skin study, participants that consumed a half teaspoon of flax seed for 6 weeks had more plump and hydrated skin with less redness and irritation.  Salmon is also a great source of omega 3’s.

Almonds for better skin

Lycopene: This free-radical found most commonly in tomatoes can also give extra protection from UV radiation.  Cooking tomatoes will concentrate this nutrient.  Lycopene is also found in watermelon.

Vitamin C: This is a key ingredient in collagen and is found in lots of foods, including citrus fruits and carrots.  Sweet potatoes are an excellent source.  One study showed that consuming 4mg daily over time can reduce the formation of wrinkles by as much as 11%.

Folic acid: Leafy green vegetables are a great source of this nutrient, which is integral to DNA repair.  Studies have shown that those who eat a diet rich in green vegetables including folic acid have half as many skin tumors as those who have diets sparse on these vegetables.

Omega 6 fatty acids: Described as the ultimate moisturizer, omega 6 fatty acids have been shown to reduce scaly, itchy skin and may be of great benefit to people with eczema.  Safflower oil is an excellent source.

Vitamin A: This fat soluble vitamin helps reduce the overproduction of surface skin cells, reducing skin oils and clogged pores.  Carrots are a great source.

Catechin: This anti-oxidant is prominent in hot green tea. It has been shown to have anti-inflammatory and anti-cancer properties.  It has been shown to reduce the effects of sun damage in people drinking 2-6 cups daily.

green tea for good skin

Flavanols: Dark chocolate is rich in this anti-oxidant shown to reduce the roughness of skin and prevent skin cancer.

A good rule of thumb is to eat a diet high in vegetables, incorporating as many colors as possible.  Avoiding foods with a high glycemic index has also recently been associated with clearer skin.  In addition, dairy has been recently linked to acne and anecdotal evidence has spurred a number of new studies.  Bottom-line, a healthy diet will be evident in a brighter, healthier countenance.

 

 

This past week I took a basal cell skin cancer off the eyelid of a man younger than I, and I’m in my mid-thirties.  Remember when skin cancer was something your grandma and grandpa dealt with?  Well those days are past and we are ushering in a generation of young people who will be dealing with skin excisions, biopsies, deforming surgeries and possibly early death due to their love of the sun, tan skin, and refusal to believe they are causing themselves harm.  On a recent trip to a sunny locale, I was applying sunscreen before going out on a  morning of boating.  A friend repeatedly scoffed at my use of sunscreen, insisting I needed more color and couldn’t understand what I was worried about.  Everyone in this person’s circle of friends was tan, young and feeling great, but what will the next few years hold for them.  Here are a few tanning myths that you need to get by right away to avoid being a shriveled up raisin of skin cancer in your golden years.

Myth #1: “I have to get a base tan so I won’t burn on my vacation. Many believe they need to achieve a “base tan” early in the spring, usually at a tanning booth, so they won’t get sunburned later.  Some even think this is protective against sunburns and thus skin damage.  Don’t buy into this farce. Any sun or tanning bed exposure that causes a tan is damaging your skin, end of story.  UV rays are still blasting away at your DNA and collagen no matter the color of your skin. Spray tans are no help either. Some believe that these will somehow protect you from a burn or damage.  Not true.

Myth #2: “I only need sunscreen if I’m going to the beach.”  Most people don’t think to put on sunscreen, unless they are expecting to be outside for an extended period of time.  A recent New England Journal of Medicine article showed a man who drove a delivery truck for 28 years. He developed dramatic changes to the left side of his face, which was bombarded by UVA rays, while the right side of his face was protected from the shade.  Check out the difference between the sides in the picture below.

Facial aging from sun exposure

Myth #3: “I’ve got dark skin so I don’t get sunburned.”  Many people born with naturally darker toned skin think they don’t need to protect their skin as they don’t burn as easily.  Whether or not you get a sunburn, the UVA and UVB rays are still bombarding you, causing mutations in your DNA and ruining your skin’s elasticity.  Olive skinned people don’t look any better in their old age than fair skinned people. Very dark skinned people are also at risk for sun damage.  Acral lentiginous melanoma accounts for 50% of melanomas in dark skinned individuals and is often missed as it develops on the palms and soles of the feet. Bob Marley died of this form of melanoma.

Myth #4: “It’s cloudy, so I’ll skip the sunscreen. ”  UV rays are still present on cloudy days. If you are going to be outside, apply sunscreen.

Myth #5:  “I wear sunscreen, so I’ll never have skin problems.”  I wish sunscreen was that good. The mistake most of us make is not reapplying it often enough and not realizing that it doesn’t block all UV radiation.  When possible, wearing hats, sunglasses and longer clothing will block out more UV radiation and further reduce your potential skin damage. Sunglasses are especially important to reduce early cataracts and surface damage to the eyes, including unsightly yellow spots on the eyes called pinguecula (see photo).

pinguecula

Pinguecula

 

 

 

 

 

 

 

 

 

 

 

 

 

Myth #6: “Tanning beds are a safer way to tan.”  And O.J. Simpson is innocent.  The tanning bed industry is constantly working to convince people that tanning beds are safe or even healthful.  Some claim their bulbs emit lower UVB and other say tanning is a great way to get your vitamin D. Both of these claims are misleading.  All tanning beds cause accelerated skin damage.  Multiple studies have shown that people who use tanning beds have a higher rate of melanoma.  And regarding vitamin D, you need about 2-10  minutes a day of sun exposure a day to produce plenty. If you drink milk regularly or take vitamin D supplements you don’t need any extra sun exposure.

Think about the first image that crosses your mind when you hear the word Botox or facial filler. It is likely one of a plastic, frozen faced woman with evidence of one too many facial plastic surgery procedures, unnatural facial proportions, oversized lips and unnaturally tight skin.  These are the extremes that websites and the media have convinced us are common place.  For this reason, many of my patients are hesitant or scared about using these products as they don’t want that unnatural look.  But they are still in my office asking about what can be done.  So where is the happy medium?  Reverse aging changes in a way that doesn’t appear artificial.  Herein lies the art of facial plastic surgery.  Artfully using these medications can yield great improvements in facial appearance.  Misuse or overuse can do the opposite at great cost to you.

The key to Botox/Dysport is putting the right amount in the right place.  That seems intuitive, but results can vary greatly by the technique used and experience of the injector.  Botox is popular because it works and most people who are happy with their Botox treatment get a nice flattening of the lines between the brows, on the forehead and in the crow’s feet.  When improperly placed, brows drop or have a “Spock” appearance, lower eyelids can sag, and the face may look too inanimate to be real.  To get a natural effect, first start with an experienced injector, one that will study your facial expression and target the problem muscles, rather than just injecting in a standard pattern.  Then, expect to be invited back after the first week to ensure the proper result was attained.  Sometimes, I feel I’ve given my patients enough to relax the forehead evenly, but after a week I need to add a few more units to the outer forehead muscles.  This allows me to better map out the face and subsequent injections will be on target.  Where a few get into trouble is wanting to eliminate every facial wrinkle with Botox and convincing someone to inject them.  Your face needs expression, which is an underappreciated part of facial beauty.  An appropriate dose of Botox will allow for this movement and still soften the telltale signs of aging.  If your doctor takes his/her time and follows up, your results should end up exceeding your expectations.

In like fashion, the key to good filler is the right filler, in the right amount, in the right place.  Again, that seems intuitive, but many people get into trouble when they want either the wrong type of filler or too much filler placed.  An experienced injector will have a preference for certain brands and types of fillers in different areas of the face.  This is usually based on their experience and results. It is in your best interest to let the injector direct you on what filler they want to use.  If you have a strong preference, seek out a person who specifically advertises using that brand.  With regard to the amount of filler placed, many people think more is better.  This is where the unnatural appearance is most likely to enter the picture.  Overinflated lips, cheeks and tear troughs are dead giveaways that work has been done.  My advice is start slow and add as necessary. Fillers all come by the vial.  An injector can inject part or all of the vial and save the rest for a few days until the initial swelling has resolved.  This allows a metered approach and can give you a maximum improvement without overdoing it.  The flip side to this comes when patients expect a maximum improvement at a minimal cost.  Often two to three (or more) vials are necessary to get a significant improvement, especially in the smile lines and cheeks.  With one vial retailing for around $500-600, many people aren’t willing to spend that much on a non-permanent procedure.  This is where you need to have a frank discussion with your injector about what result you can expect and whether you’d be better off saving for a surgical procedure or maximizing other less invasive treatments.  Having appropriate expectations is key to your satisfaction.

 

I came across this video segment from ABC news about men and facial plastic surgery.  Botox use and eyelid surgeries among men are becoming increasingly popular.  I’ve seen and operated on quite a few men the past few months, many of whom were told by their wives that it was time to address their drooping eyelids. Check out the video below.