1. Make-up remover This is not just for women using make-up but also for men who use concealers or foundations to hide spots and blemishes. Correct and complete cleansing at the end of the day helps to open out skin pores and avoids blackheads and white heads. Also certain long wearing cosmetics do not come off with soaps or cleansing lotions and require specific remover pads. Eye make-up requires a little extra attention as skin around the eyes is very sensitive and delicate.
2. Soap-free skin cleanser The basic and most essential yet, sadly, the most neglected aspect of skin care is using the correct cleanser. Soaps dry out the skin, hastening the ageing process. They also make the skin more prone to bacterial infections by changing its pH or chemical balance to alkaline instead of its normal acidic value. So a soap-free deep cleanser is a must for all ages and both sexes.
3. Exfoliant Though not a daily use product, it is a wonderful way to keep off dead cell build-up that takes away the glow from your skin. Use a coarser one for the body and a gentler one with synthetic, rounded granules for the face and neck. Use these not more than twice a week for 5 – 10 minutes each time. You could also use scrubs that contain small quantities of salicylic acid for acne prevention or alpha hydroxy acid for skin rejuvenation.
4. Sunscreen The single most important skin care product needed in a tropical country is a sunscreen or a sun block. It should be used from childhood onwards, everyday, always. The main aim here is not to just prevent a tan or sunburn, but to avoid the deleterious effects of sunlight on the skin like wrinkling, ageing, sun spots, pigmentation and, most importantly cancer.
5. Skin toner A dab of this highly underrated product after every face wash ensures a protective mantle on the skin that guards against infections. It also tightens up the pores, thereby controlling excess oil secretion and maintaining a steady moisture level for many hours. However, it’s not for those with normal or dry skin.
6. Moisturiser Choosing the correct one for your skin is easier said than done. You need a non-comedogenic one for acne prone skin, one with ceramides for dry skin and a hypo allergenic, perfume free one for sensitive skin. Thankfully, many good quality moisturisers fulfil most of these requirements. A moisturiser helps the water to enter the upper layer of your skin, plumping the cells and making the skin look smooth and shiny. So they are best used frequently, over damp skin to lock in the moisture.
7. Under eye cream Skin around the eyes is very thin making it one of the first areas to show signs of ageing, be it wrinkles, crow’s feet, puffiness or dark circles. A good under eye cream, preferably one that contains vitamin K and deep hydrators is a must.
8. Night cream Again, the options of which one to choose are endless. Since night creams get an uninterrupted 8 – 10 hours to work on your skin, it’s very important to get the right one. Once you’re over 40, creams with retinoic acid work very well for fine lines and wrinkles. An added bonus is the presence of fruit acids like glycolic or mandelic acid which help to clarify pigmentation. You may also pick one with added ingredients like arbutin, liquorice or berry extracts which all help to reduce pigmentation.
9. Vitamin C serum This vitamin is one of the best things in nature that can do wonders for your skin. It helps to build collagen which prevents sagging, it protects from the sun, it strengthens the tiny blood vessels in the skin, thus preventing age spots. But before you dash off to rub an orange over your face, know the facts. It needs high concentration of vitamin C, 20 per cent or more, to show effects. Creams that contain less than five per cent are practically useless. Also it is an unstable vitamin, so most serums need to be stored properly and used quickly after opening the bottle. Serums containing stabilised vitamin C are also available and though usually very expensive they are worth the spend. Use it daily before applying sunscreen.
10. Peptide creams Protein does wonders for the body, whether taken orally or when applied to sagging skin to tone it. Collagen and elastin are the two proteins present in lower layers of skin which are responsible for its tautness, smoothness and youthful appearance. With age, they diminish, leading to sagging and wrinkles. Peptide creams are formulated with special micro-sized protein chains and carrier molecules to transport them to deeper layers of skin where they can revive and replenish the existing collagen. Thus, they take years off from your appearance. These can be used overnight in addition to or as a replacement for your regular night creams.

Last but by no means the least, one thing you need in your skin care armamentarium is a good pillow—nothing rejuvenates the body like adequate sleep—make sure you get plenty of it.

This was first published in the November 2012 issue of Complete Wellbeing.

The post A checklist for your skin care products appeared first on Complete Wellbeing.

Which to choose

There are hundreds of sunscreens—commercial and medical—in the market to choose from. To decide which one works best for you, get to know more about your ‘enemy’. You are fighting against two types of ultra-violet radiation in the sun’s rays: UVA and UVB. UVA causes immediate, temporary tanning and photoageing [sagging or wrinkling of skin]. UVB causes sunburn [redness, pain and peeling], delayed long-lasting tanning and photoageing. Both rays can cause skin cancer. Therefore, for complete protection from the harmful effects of the sun, your sunscreen must give adequate protection from both.

The only thing people consider when buying a sunscreen is the ‘SPF’ quotient as it is the most advertised aspect. However, ‘SPF’ is an indicator of only UVB protection, NOT UVA! As per an international standard called ‘Boots Star Rating’, the UVA protection a sunscreen offers is supposed to be mentioned separately as a star rating on the pack, ranging from 0 to 5 stars. For the Indian climate, you need a sunscreen with minimum three stars. A mere handful of sunscreens boast a three- or four-star rating—these are obviously the best. You also need to keep in mind your skin type. Oil free, gel-based sunscreens are available for acne-prone individuals and moisturising ones for those with dry skin. Fair-skinned people require sunscreens with a higher protection because the lighter the skin, the more easily it burns. For wheatish complexion [olive skin], a sunscreen with SPF 30 and 3-star UVA protection suffices.

Get a sunblock with higher protection if you are prone to sun allergy, any sunlight-aggravated disease or if you are undergoing a dermo-cosmetic treatment such as skin peeling, polishing or laser therapy.

When to apply

Sunscreens must be applied daily, in all seasons including monsoons, and irrespective of whether you are indoors or outdoors. Sunscreens are a must even indoors as the light from fluorescent lamps and computer screens also affects your skin, though not as much as direct sunlight.

How to apply

Apply the lotion/cream on all exposed areas, which most often means your face, arms and legs. Don’t forget your neck and also the area around your collar bones, if exposed.

Do not be stingy with the amount applied—sunscreens give you the mentioned protection only if you use them in the right quantity. Using sub-optimal quantities decreases their potency manifold. For instance, using half the needed requirement can decrease protection by 80 – 90 per cent! Using inadequate sunblock is, in fact, dangerous because you tend to subject yourself to long hours of sunlight in the erroneous belief that you are protected. And when this happens chronically, it magnifies the risk of skin cancer. So, how much is enough? A coin-sized quantity for the face and neck, ditto for each arm, and double that for each leg.

But for continued protection, reapply, reapply, reapply! The effect of a sunscreen lasts not more than 3 – 4 hours, so aim for at least three applications between 8am and 5pm.

Waterproof sunscreens are now available that are specifically for use in a swimming pool, at the beach, in a water park or even for those who sweat a lot. These bind to the skin and resist getting washed off with water. Even if you use one of these, it is still recommended that you reapply every 80 minutes or every time you towel yourself dry in case you are swimming or are in the water continuously.

Most sunscreens also act as moisturisers but those with extremely dry skin may need added moisture. If that’s the case, apply the moisturiser first and the sunscreen after a couple of minutes. If you need to use make-up—foundation, powder, colour cosmetics—it has to be used over the sunscreen. Do not rely on just the sun protection factor mentioned on the foundation as it’s usually insufficient.

If you are supposed to apply a medicated cream or ointment, say an acne cream, apply this first, then the moisturiser [if required] and then the sunscreen. The sunscreen has to be the topmost layer. The exception to this rule is when you have to use a subgroup of sunscreens known as ‘second skin’ sunscreens that need to interact chemically with the skin to become active. These go as the first layer, then the moisturiser and so on. Your dermatologist will guide you about using these, if s/he prescribes them to you.

As with any other pharmaceutical product, keep checking the expiry date and do not use the sunscreen beyond it. Sunscreens protect you from sunburns, reduce tanning and pigmentation, slow down skin ageing, and help prevent skin cancer. Regular use will allow you to enjoy your moments in the sun!

This was first published in the April 2012 issue of Complete Wellbeing.

The post Sunscreen sense appeared first on Complete Wellbeing.

Cellulite is an alteration in the topography of the skin that occurs almost exclusively in women, affecting the pelvic region, upper arms, thighs and abdomen.

The affected area looks lumpy and padded like a badly stuffed mattress and the skin develops a puckered, dimpled ‘orange peel’ appearance. The culprit is not just fat, but poor blood and lymph circulation in the area that causes tiny leakages of these fluids into existing fat pockets.

Fluid and fat collects into a lump, which further gets enclosed in fibrous tissue. Because of this ‘sealing-in’ effect of the fibrous walls, it is difficult to dissolve or drain this lumpiness or simply lose it with diet and exercise. Even a lean, exercised limb may have cellulite in patches of poor circulation like the back of the thigh due to long hours of sitting in one position. Thus, it’s a frustrating problem for women who work out, yet cannot flaunt their legs or midriffs.

What causes cellulite?

The most important factor in developing cellulite is the hormone oestrogen. That is why it occurs predominantly in women, starts after puberty, worsens in pregnancy and with oestrogen therapy, like hormone-based contraceptive usage.

It also tends to run in families and has some racial predisposition, occurring more frequently in white women than their Asian or African counterparts. Latin women tend to develop it on their hips, whereas Anglo-Saxon women tend to develop it on the abdomen.

Lack of exercise leading to lesser muscle mass and poor blood flow in the veins can also be blamed for cellulite. Tight clothing worsens the problem by restricting blood circulation. Obesity, of course, compounds the situation by increasing fatty tissue.

Can cellulite be treated?

Treating cellulite is a challenge for even the most experienced dermatologist. Some treatments work for some women, while they don’t for others—results are unpredictable. Lifestyle changes MUST be enforced—including regular cardiovascular workouts to lose fat, build muscle mass and improve circulation. Smoking and oestrogen-based oral contraceptives should be discouraged strongly.

Regular massaging can help in the early stages by draining lymph from the area. The massage must be firm, though, and performed in a specific direction to drain fluid from limbs towards the heart. Some oils claim to have anti-cellulite properties.

There is no scientific evidence to back their claims. Anecdotal incidents where they’ve worked could be due to the massage rather than the oil itself.

Evening primrose oil supplements work in some cases because it contains a plant derivative that affects oestrogen levels. It must be taken orally in the form of capsules; applying it doesn’t help.

Super pulsed radiofrequency therapy has been used to create deep heating in the affected areas and rupturing the fat lobules. The effects are variable and range from excellent in some to barely perceptible in others.

Mesotherapy works much better for cellulite. Tiny doses of a fat dissolving medication [lipolytic cocktail] are put in using a Mesogun or special Meso-syringes in the affected areas. The treatment is repeated every few weeks and 4 – 8 therapies are needed to smoothen the area. The treatment dissolves fat that has divided into compartments and pushes it into the blood circulation to be metabolised by
the body.

Ultrasonic cavitation is another method that uses sound rays [to be precise, waves of a frequency lesser than audible sound] to break the fat lobules, akin to using ultrasound to rupture a kidney stone.

Laser lipolysis achieves the same effect using laser energy that penetrates skin and reaches the fat layer without damaging the surface. However, both these treatments result in temporary bruising due to their destructive nature.

Even after getting rid of cellulite, lifestyle changes like regular exercise and weight control are a must for long-term resolution because cellulite is notorious for reappearing.

The post Cellulite: Dimpled skin appeared first on Complete Wellbeing.

Substantial blame also falls on our lifestyle—using poor quality sunscreens, unhealthy eating, staying dehydrated, overworking our minds and bodies, indulging in substance abuse, overusing cosmetics and not giving enough time to our bodies to heal the damage…all take a toll.

Your first attempt should be in delaying the ageing processes from an early age. However, if your skin is in really bad shape and has aged prematurely, don’t hesitate to take medical help. There are several options:

Chemical peels

Glycolic or retinoic acid peels done regularly help remove damaged layers of skin. The resulting resurfacing gets rid of fine lines and wrinkles, dullness and superficial pigmentation.

Regular peeling also helps in remodelling the collagen thus tightening the skin. Peels are quick, affordable and safe procedures that don’t need hospitalisation.

Mesotherapy

This is a technique of placing active ingredients and medications under the skin so that they reach target cells faster and in a more efficient manner.

Drugs like vitamin C or AHAs [alpha hydroxy acids] can be infused into the skin that help form new collagen, decrease production of pigment by melanocytes and give antioxidant protection to damaged cells. The results are quick and the ‘glow factor’ is terrific.

BOTOX

For dynamic wrinkles nothing beats the botulinum toxin treatment. By relaxing targeted muscles, a few tiny injections can iron out frown lines, crow’s feet around the eyes and bunny lines around the nose.

Advanced Botox techniques are used to lift a sagging jawline [a.k.a Nefertiti lift] or enhance the eyebrow arch.

Contrary to popular fears, it’s a safe treatment and does not cause paralysis or rebound wrinkling. Effects start within 3 – 5 days of treatment, last up to six months and can be repeated as often as desired. Age is not a limiting factor—it can be used in patients as young as 25 if the condition demands it.

Fillers

Our skin naturally contains a substance called hyaluronic acid, which helps retain water and adds bulk and shape to the lower layers of the skin.

Artificially-synthesised hyaluronic acid is available as ‘fillers’ that can be injected in depressed or furrowed areas like laugh lines around the nose and mouth or tear troughs under the eyes, to lift them and make them look fuller and thus younger.

Fillers integrate with existing proteins in the skin and are gradually reabsorbed. The treatment takes half an hour and effects last 12 – 14 months. Anaesthetic fillers are painless and give instant results.

There are plenty of solutions for retaining a youthful look without having to go under the knife. It’s equally important to not let looks become an obsession and develop a paranoia about ageing.

Many people suffer from depression or a Body Dysmorphic Disorder where they’re always dissatisfied with their looks.

Stay realistic, don’t expect to look 20 at 50 and don’t run for a treatment just because your neighbour or best friend has done it. Seek correct guidance and aim to stay healthy and happy, you’ll automatically look younger.

Make wrinkles wait

• Start using a sunblock that gives adequate protection against UVA as well as UVB rays. Both the rays are responsible for ageing. SPF is only the measure of UVB protection offered by a sunscreen.The International Academies of Dermatologists have all agreed on a star rating to be displayed on the bottle of medical sunscreens indicating a particular brand’s UVA protecting capacity as well.Few Indian sunscreens have been awarded this rating, so choose carefully. Use a 3-star rated sunscreen for normal skin and 4-star rated sunscreen for sensitive skin. The recommended SPF value is 30.
• Dieticians have tired of telling us to eat more fruits, vegetables and to drink enough water. But it’s important to develop these habits early in life to slow down ageing. Berries, pomegranates, grapes, walnuts and fish oil are some of the most potent age-defying foods.
• Sleep is nature’s own rejuvenator. When we sleep a lot of work gets done on the skin—damaged DNA is repaired, dehydrated cells are hydrated, and cells multiply to replace dead ones. Get at least an uninterrupted 6 – 7 hours of shuteye every day.
• Kick the butt immediately. Smoking is the worst of all ‘bad habits’ as far as inducing ageing is concerned.
• Use night creams with anti-ageing products like retinoids or alpha hydroxyl acids to erase fine lines; hydrators like hydroxydecine to combat dryness; and depigmenting agents like kojic acid to lighten age spots.

The post Undo ageing appeared first on Complete Wellbeing.

The appearance of the skin is closely linked to internal health. It’s thus a good indicator of its own health and also reflects health problems inside the body. Here are a few signs that spell imminent danger:

Sudden dryness, dullness, and loss of elasticity

These are indicators of dehydration. In severe cases, pinched skin takes a second or two to go back. This could happen due to diarrhoea, vomiting or long hours of exposure to hot or humid conditions.

Remedy: Have electrolyte drinks or tender coconut water immediately.

Spots or discolouration

Ill-defined white patches on the face do not always indicate calcium deficiency or vitiligo. In most cases, they indicate sun sensitivity of the skin and are the skin’s emergency call for you to start using a high SPF [sun protection factor] sunscreen. Usually, black/brown patches, especially on the cheeks, nose or forehead is melasma [dark skin discoloration] and occurs due to a hormonal imbalance.

Remedy: You must use a heavy sun block and consult a dermatologist for professional lightening treatments.

Acne

In an adult, acne is reason to stop and think. There could be an underlying hormonal defect, especially if it’s combined with excess hair growth or weight gain. It could also imply that you’re exposed to too much dirt and pollution that’s clogging up your pores. Or, you’ve started using a new cream or cosmetic.

Remedy: Use a salicylic face wash and check your skin care product labels to see if they say ‘non comedogenic’ [use them only if they do, else don’t].

Excessive sweating

If you sweat all the time, it could be a condition called hyperhidrosis [overactive sweat glands]. It usually affects the palms, soles and underarms.

Remedy: Use antiperspirants containing aluminium hydroxide. A semi-permanent solution is to use botox—it decreases sweating for 6 to 8 months.

Mole that behaves different

You’ve had a mole for years and suddenly it starts growing in size, bleeds on friction or develops satellite patches of colour around it—don’t neglect this at all.

Remedy: Run to a doctor for a biopsy as it could be cancerous.

Recurrent boils on the skin

Recurrent boils on or repeated itchiness in the body folds may be due to diabetes. Slow response to medication or poor healing of infections and wounds may also be a consequence of high sugar levels.

Remedy: Get your blood sugar level evaluated immediately.

Skin is losing its pinkness

There is hair loss over the shins and a whitish/bluish appearance of skin over the toes or fingers. These indicate poor blood circulation and it’s possible that high blood pressure is damaging the blood vessels or there is a heart problem not allowing the heart to pump enough blood to distant areas of the body.

Remedy: A full cardiovascular check up at the earliest is advisable.

The post Messages from your skin appeared first on Complete Wellbeing.

Approximately, one per cent of the world population is affected by this disease and the incidence is higher in dark-skinned races. Second only to leprosy, in courting ostracism and social rejection, this disease has probably the most myths and unscientific, untrue beliefs associated with it.

Here we attempt to discredit some of the major ones.

Myth: Vitiligo is caused by the wrath of the gods; it’s a punishment for our sins. Or it’s caused by touching dogs with white patches on their forehead.

Fact: If vitiligo was divine retribution for our sins, all of us would be carrying at least one white patch. But Vitiligo has nothing to do with God or past life, it is caused by antibodies produced by our own cells, which destroy melanocytes [the colour manufacturing cells in the skin].

Another line of study points towards a neurogenic origin i.e. chemicals released at nerve endings block the formation of melanin [brown skin pigment] by melanocytes.

The third reason is an inherent deficiency in the natural protective mechanism of melanocytes due to which the cells are unable to get rid of toxic melanin precursors and thus self destruct.

Myth: Vitiligo is aggravated by sour foods.

Fact: There is actually no relationship of the disease with diet. It is useless to deprive the patients of curd, lemon, pickles and tomatoes in the hope of decreasing the severity of the disease.

Aggravating factors are injuries i.e. new patches appear where skin is subject to friction of trauma like scratches, burns, cuts, and pressure sores.

Patches increase in size when immune levels of the body fluctuate leading to more melanocyte destruction.

Myth: Patients with vitiligo are mentally retarded or have low intelligence and defective systems or poor health.

Fact: Vitiligo has no systemic effects. It is only limited to the skin and does not affect other organs or systems of the body, including intelligence levels.

Myth: Tattooing over a vitiligo patch is a good way to camouflage it.

Fact: Tattooing is actually a bad idea because a phenomenon called ‘Koebnerization’ can occur, in which the injury caused by tattoo needles stimulates the disease, and encourages it to spread.

Also, over a period of time tattoos display something called ‘Tyndall effect’ due to sinking of pigments into the lower layers of the skin. Even perfectly matched skin coloured pigments tattooed in, start looking bluish grey and unnatural in a couple of years due to this.

Myth: Vitiligo runs in the family.

Fact: This is one myth, which has some basis of truth. Different studies report inheritance to be anything from 15/20 – 30/40 per cent. However, it can appear as an isolated case—it is not necessary to have an affected relative. Nor is it necessary that the affected person’s progeny will definitely have the disease.

Myth: Vitiligo is contagious. Those affected must be isolated, as it is a type of leprosy.

Fact: Since it’s not an infectious disease, there is no way it can spread by touching, maintaining close contact with the affected or by sharing towels or bed-sheets used by them. Though light-coloured skin patches may appear in some forms of leprosy, vitiligo is not related to this disease.

Myth: Vitiligo is untreatable.

Fact: Medical science has given us an entire armament to battle this disease—treatments like immunomodular drugs, steroids, ultraviolet A and the newer narrow band ultra violet B. In addition, various surgical options like punch grafting, split thickness grafting or micro fine grafting [suction blister grafting] can be done.

The latest technique is melanocyte transfer in which only melanocytes from normal skin are harvested and inoculated into the vitiliginous patches. Excimer laser is also an excellent treatment modality for vitiligo.

Treatment is no doubt difficult and slow and not all patients respond alike; however, it is more important to treat the stigma than the disease as the mental impact is far more than the effect on physical wellbeing.

Spreading awareness and education is the only tool to counter the erroneous beliefs that still prevail in our society.

The post Vitiligo: White lies exposed appeared first on Complete Wellbeing.