Acne Lesions: There's more than one?

Acne is usually associated with hormonal fluctuations experienced during your teenage years, but adults can experience acne too. Identifying which type of acne you’re experiencing is key to successful treatment. Acne may be noninflammatory or inflammatory. Subtypes of acne within these two categories include: 

Open Comedone (Blackhead) – a buildup of sebum, dead skin cells, bacteria, and other debris inside the follicle. Appears dark because the oil has been oxidized (exposed to oxygen). An open comedone may be referred to as congestion.

Closed Comedone (Whitehead) – a buildup of sebum, dead skin cells, bacteria, and other debris inside the follicle. Appears flesh colored. Because the follicle opening is blocked, the sebum has NOT been oxidized. A closed comedone may also be referred to as congestion.

Papule – Papules are tender red bumps, usually fairly small, up to a cm in diameter, and somewhat raised. The defining factor is that they are not filled with pus, although they may go on to fill with pus later on and become a pustule.

Pustule – Pustules are your classic pimple. Hard, inflamed, and full of pus that has the defining white or yellow centre. May remind you of a volcano. While it’s ever tempting to pop these, please try to refrain.

Nodule – a very deep lesion, similar to a papule. A nodule often involves more than one follicle.

Cyst – a closed sac of tissue. May contain air, fluid, dead skin cells, and pus. In the case of acne, a cyst is a nodule with a large amount of inflammation (white blood cells). Acne scarring is due to cysts that rupture.

Milia – tiny, white, hard, pearly masses under the skin, typically around the eyes and nose. Composed of keratin (trapped dead skin cells). Often mistaken for a whitehead. These tiny cysts have no opening, so they cannot be extracted and must be excised with a lancet.

Open and closed comedones are categorized as non-inflammatory acne. Papules and pustules are inflammatory lesions.

How should acne be treated?

Blackheads and whiteheads are the mildest forms of acne. These can sometimes be cleared up with OTC topical medications, such as salicylic acid-based toners or benzoyl-peroxide spot treatments. If they don’t respond to OTC medications, comedones are easily treated with topical retinoids. There is even one type of retinoid, known as adapalene, which is now available over the counter. It’s very effective in clearing blackheads and whiteheads.

Pustules and papules are more moderate forms of acne. These may or may not clear up with OTC meds. Widespread moderate acne may require an oral or topical prescription from a dermatologist.  Nodules and cysts are the most severe form of acne. You have to see a dermatologist to clear up severe acne. Picking or popping nodules and cysts can lead to scars.

The Layers of your Skin

The skin is the body’s largest organ. It forms a barrier that helps prevent harmful microorganisms and chemicals from entering the body, and it also prevents the loss of body fluids. It protects the vital structures inside the body from injury and from the potentially damaging ultraviolet rays of the sun. The skin also helps regulate body temperature, excretes some waste products, and is an important sensory organ. Both delicate and resilient, the skin constantly renews itself and has a remarkable ability to repair itself after injury.




Layers of the skin


The epidermis is composed of keratinized, stratified squamous epithelium. It is made of four or five layers of epithelial cells, depending on its location in the body. It does not have any blood vessels within it . Skin that has four layers of cells is referred to as “thin skin.” From deep to superficial, these layers are the stratum basale, stratum spinosum, stratum granulosum, and stratum corneum. Most of the skin can be classified as thin skin. “Thick skin” is found only on the palms of the hands and the soles of the feet. It has a fifth layer, called the stratum lucidum, located between the stratum corneum and the stratum granulosum. The epidermis is a continually renewing layer and gives rise to derivative structures, such as pilosebaceous apparatuses, nails, and sweat glands. The basal cells of the epidermis undergo proliferation cycles that provide for the renewal of the outer epidermis. The epidermis is a dynamic tissue in which cells are constantly in unsynchronized motion, as differing individual cell populations pass not only one another but also melanocytes and Langerhans cells as they move toward the surface of the skin.


The dermis might be considered the “core” of the integumentary system, as distinct from the epidermis (epi- = “upon” or “over”) and hypodermis (hypo- = “below”). It contains blood and lymph vessels, nerves, and other structures, such as hair follicles and sweat glands. The dermis is made of two layers of connective tissue that compose an interconnected mesh of elastin and collagenous fibers, produced by fibroblasts. The dermis comprises the bulk of the skin and provides its pliability, elasticity, and tensile strength. It protects the body from mechanical injury, binds water, aids in thermoregulation, and includes receptors of sensory stimuli. The dermis interacts with the epidermis in maintaining the properties of both tissues.


The hypodermis (also called the subcutaneous layer or superficial fascia) is a layer directly below the dermis and is the deepest section of the skin. It serves to connect the skin to the underlying fascia (fibrous tissue) of the bones and muscles. It is not strictly a part of the skin, although the border between the hypodermis and dermis can be difficult to distinguish. The hypodermis consists of well-vascularized, loose, areolar connective tissue and adipose tissue, which functions as a mode of fat storage and provides insulation and cushioning for the integument. The hypodermis refers to the fat tissue below the dermis that insulates the body from cold temperatures and provides shock absorption. Fat cells of the hypodermis also store nutrients and energy. The hypodermis is the thickest in the buttocks, palms of the hands, and soles of the feet. As we age, the hypodermis begins to atrophy, contributing to the thinning of aging skin.


This is a very basic overview of the physiology of the skin to learn more refer to the American Academy of Dermatology.

How Hormones Effect Our Skin

Teens: The Oily Years
 

Girls start puberty around ages 12 or 13, sometimes this number differs based on genetics and environmental factors. During puberty, the female body starts producing sex hormones, namely estrogens and androgens, in higher quantities than before as it gears up towards adulthood.


When it comes to popular hormones, estrogen takes the prize for most widely known and discussed. However, there are many misconceptions about this elusive and incredibly important substance. First of all, it is not purely a female hormone. True, it is primarily made in the ovaries and is abundant in females, but it is also found in males and made in different tissues outside of the ovaries. Secondly, the word estrogen actually encompasses a group of chemically similar hormones, so it is not a single substance. Estrogens include estradiol, the most abundant form in adult females, estriol, the primary estrogen during pregnancy and estrone, which is produced during menopause. During puberty, estrogen also communicates to other parts of the body through specialized receptors, causing breasts to develop, for example, or giving a new curve to hips and thighs. In the skin, estrogen decreases pore size, creating a smooth surface. It also helps build collagen and elastin, proteins that give the skin its springiness and elasticity, respectively. And, it helps the skin heal and maintain moisture.


Androgens include testosterone, which is generally thought of as the male hormone, but, as with estrogen and males, testosterone and other androgens are also present in females. During puberty, a boost in androgens stimulates coarser, thicker hair growth, particularly pubic and underarm hair. In the skin, the hormones enlarge pores and boost the production of sebum, an oily substance produced in the skin.What you get is the telltale sign of teenage skin: acne.


20s to Mid-30s: The Best of Times

Estrogen peaks during your 20s, giving most women their best-ever complexion: luminous, taut, and even-toned. The shift in hormone levels around your period, however, can lead to acne.


If the cycle remains on schedule, estrogen peaks right before ovulation, which can make the skin appear to glow (this is the same hormonal boost that gives pregnant women their shining skin). Testosterone also peaks, which drastically increases the likelihood of blemishes and breakouts. The hormone also increases the libido.After ovulation, both estrogen and testosterone drop.


Late 30s and 40s: Getting Drier
                                                                                                                                  

Your 30’s are when estrogen levels start to dip, heralding sinking levels of skin-tightening collagen and elastin and skin-plumping hyaluronic acid.


As the overall level of estrogen decreases, the skin does not bounce back the same way. Instead, collagen and elastin production decreases, which causes the skin to get drier and lose its elasticity. Estrogen loss impacts aging skin far more quickly than sun damage.


By their mid-to-late 40s, most women are in perimenopause, the transition between regular ovulation and menopause, which is when ovulation stops completely. As the hormone cycles change to accommodate this new stage, you may experience adult acne, increased facial hair and a thinning head of hair.


50s and Up: Menopause Realities

Menopause has usually started once a woman is in her 50’s. The ovaries still produce hormones, including estrogen and testosterone, but the levels are very low. The main hormone that affects the skin during menopause is estrogen and, as it fades, the skin produces less collagen and elastin. During this time, the skin gets thinner, drier and more wrinkled. Menopause may cause other skin problems, including acne or rosacea.


Drops in estrogen can also cause hot flashes. These flashes can cause a sudden sensation of warmth in the face and chest, making your skin appear very red.


Every human being experiences the changing of our skin as we age, the best way to keep your skin at it’s healthiest is to have a proper skin care routine that will need to change as we age. Make sure you check in with your skin care professional to make sure you’re using the right products for your age and skin type.

The Benefits of Vitamin C for your Skin

When you think of Vitamin C, you tend to think about immune defense and beating those pesky colds and flu. Yet, Vitamin C is an essential beauty nutrient too!

Vitamin C is an antioxidant that slows the rate of free-radical damage -- free radicals are unstable molecules that damage collagen and cause skin dryness, fine lines and wrinkles.  It also has a profound effect on Collagen.  Vitamin C is a required component for the production of hydroxyproline and hydroxylysine, both of which are needed to bind the molecules that produce collagen. This, in turn, firms and tones the skin. Collagen deficiency makes the skin dull and lifeless. Collagen rejuvenates the skin from the roots and reduces wrinkles and symptoms of aging.  Collagen also provides the structure for the blood vessels. The tiny blood vessels under the skin carry oxygen and nutrients that keep the skin healthy. Without enough nutrients, the skin will become rough and dry. Creams containing Vitamin C improve the appearance and texture of the skin.  Vitamin C increases the formation of elastin which thickens, protects and heals the skin cells. The thickening effect helps retain moisture, increases the skin circulation and plumps up the skin surface.

Vitamin C not only helps to prevent UV damage, acting like a mild natural sunscreen, it also helps to fade sides of damage already done by the sun due to it’s powerful free radical fighting properties.  Protecting from UV damage should be done all year round, but, with our now sunny Spring days leading into summer, you can never protect yourself too much.

Vitamin C is a water soluble vitamin, so your body does not store it and it needs to be replaced every day.  You can replace it with the foods you eat.  There are plenty of natural sources including Kiwi, Broccoli, Goji berries, Strawberries, Papaya, and of course, Oranges.  

There are also many skin care products that hone the healing and protective powers of vitamin C.  Ask about my LIFTING AND FIRMING TREATMENT WITH VITAMIN C!  This intensive Vitamin C treatment stimulates the skin’s vital functions and repairs cell damage. Excellent for sun damaged skin and skin showing loss of firmness.

Your skin has a lot of big jobs to do for you, do something nice for your skin. 

How to Keep your Skin Hydrated

Your body is 70 % water, so we don’t have to tell you that hydration is important.  Due to normal tasks of living water is depleted through sweat, evaporation and usage.  You have to replace that water for your body to function the way it was designed to and to look and feel it’s best.  This includes your skin.  Even slight dehydration can cause flaky irritable skin, dermatitis, and eczema .  Your body is in need of constant rehydration.

Adequate water intake promotes the body's natural healing process.  It flushes out toxins, such as chemicals and free radicals, which can be very damaging.  There are also more vanity conscious reasons to keep your skin hydrated.  Properly hydrated skin becomes more plump, diminishing the appearance of lines and wrinkles and supplying a radiant glow.  Not to mention it will feel better on the inside and out.  

So how much water do we really need to drink in a day?  The Institute of Medicine (IOM) established some general guidelines for water intake in 2004. Healthy adult women need around 91 ounces of total water and healthy adult men need about 125 ounces every day.   However, keep in mind that you don’t have to stand around throwing back cups of water all day.  Some of that tally comes from water that’s in your food or other beverages, even tea or coffee.  Remember that if you’re working out, pregnant or breastfeeding you will require a little extra water.  Also,  keep in mind that if you’re thirsty, you’re already dehydrated.  Thirst is a symptom.  Make sure you sip on water slowly throughout the day so it has a chance to get equally distributed throughout your body.  

Another dry skin culprit that people miss is their home.  Due to most of our homes being temperature regulated with filtered air our skin can become dry.  An easy remedy to this is to run a humidifier.  If you don’t wish to run one all day long, placing a small humidifier in your bedroom and run it while you sleep. It will make a world of difference!

Importance of Sleep for Healthy Skin

Getting or not getting enough sleep can affect many aspects of your life.  In your skin’s case, it’s a pretty big effect.  A good night's sleep can mean healthy skin.  If you don’t have good sleep,  your body makes more of the stress hormone cortisol. Elevated levels of cortisol can lead to increased stress and inflammation in the body, hurting your skin’s quality.    

Not getting enough sleep can:
 

• Worsen skin conditions-it creates inflammation which can flare up acne, dermatitis, and eczema
• Develop dark circles under your eyes-If you lie on your stomach, liquid can pool in the trough of your under-eye throughout the night and cause puffiness.  It’s always best to sleep on your back or side if possible.  Sleeping on your stomach can also increase the likelihood of stress lines on the face from being pressed into a pillow.
• Drier skin-sleep is nourishment for your entire body, if you’re not getting adequate amounts your body can’t go through it’s normal functions or normal lubrication-resulting in flaky, dry, and non lustrous skin.
• Fast track for aging-Sleep deprived skin is aging skin.  During deep sleep, the rise in growth hormones allows damaged cells to become repaired.  Without REM sleep, this won't happen, so your skin doesn’t get the repair that it needs, resulting in older looking skin.

Basically, sleep is something we all need.  So how can I increase my sleep and the quality of that sleep?

1. Develop a routine and go to bed at the same time every night-if your body gets on a schedule it will normally keep it.  If you get used to going to bed at 10pm every night you should start getting sleepy around that time.  
2. Plan your work-out- early, midday, or dusk. Ideal times. Big cardio after dark revs up the metabolism and makes sleep elusive.
3. Stop caffeine mid-day- and no sugary treats after 7pm.
4. Eat dinner earlier- A light dinner also requires less digestion which helps sleep to arrive earlier.
5. Shut down those electronic devices by your bedside- Turn the computer off and relocate that TV to another room. A dark, quiet,   cool bedroom promotes deep, peaceful sleep.

Not getting enough sleep wreaks havoc on your life and your skin, but all is not lost.  Start trying to implement these tips into your day and you’ll be on your way to healthier skin!

The effects allergies have on skin

 Puffy eyes, a red, runny nose — allergy symptoms aren’t pretty. Seasonal allergies not only affect how you feel, but how you look. And we know you feel your best when you’re looking good, too.  

Congestion, drowsiness, and itchy, watering eyes aside, seasonal allergies don’t only make you feel less than stellar, their symptoms can also manifest on your complexion. If you suffer from allergies during this transition period between seasons, the puffy eyes and dry, red patches you’re experiencing aren't merely a coincidence.   The time change can also wreak havoc with your hormones and increase the likelihood of breakouts.

So how do you combat all of these issues?  Taking an allergy pill is always a good start.  Like any allergy symptoms, avoidance is your best solution for allergy-related skin problems. Staying inside when pollen counts are at their highest, washing outdoor clothes, like jackets, more often, washing your hair before bed, leaving shoes outside the door and even rinsing out your sinuses.   You should also combat your allergies and the skin issues that come along with it by changing your skin routine to one for Spring.  

Exfoliate

As skin dries more during the winter it builds up more dead cells on the surface.  So first thing’s first, we need to help our skin to get rid of those dead cells. As skin underneath is still more sensitive it is recommended to use a gentle exfoliator 1 to 2 times per week.

Moisturize

During the seasonal transition periods the moisture levels in our skin always change.   Thus, with added moisture in the air, skin tends to become oilier during the transition period as the weather gets warmer. To help balance skin’s naturally changing moisture level, choose a lighter lotion instead of a cream, and go for an oil-free formulation if you already have oily or combination skin.

Sunscreen

Although you should be wearing an SPF for every season,  Spring presents more challenges as the sun gets more active and we like to hang out to enjoy the beautiful weather.  So, the skin is exposed for longer times and gets more sensitive to the sun.

Use products that address your specific skin type

It is very important to use products formulated for your skin type to avoid irritation and other related problems. Abstain from products formulated with chemicals, parabens or fragrances. Do not use products based on mineral oils as they contain allergens that could further irritate skin and clog pores.