WE SPEND A GOOD PART OF OUR LIVES worrying about our skin, especially that of our faces. It all begins on the Wednesday before the big homecoming dance when our adolescent complexion abruptly breaks out. Eventually, after a few years contemplating suicide, it dawns on us one day while looking in the mirror that our acne has disappeared. We’re young adults now. With pimples behind us and wrinkles still to come, our skin should be in its prime–clear, resilient, aglow. But our faces often seem tired or a little bumpy. And for women this can be especially problematical, if they are influenced by the ubiquitous magazine cover-face, with its unnaturally flawless skin. If you use the right creams, lotions, blushes, and shadows, the magazine’s ads and beauty pages insist, you too can have skin that resembles the cover girl’s.
Before too long a more serious problem develops. Wrinkles creep into the picture. Of course, skin experts reasoningly offer more remedies–collagen creams and injections, Retin-A, or just an old-fashioned face lift.
As we grow older, we acquire some wisdom and realize the futility of worrying too much about how we look. But just about the time we’ve made peace with our appearance, brown splotches start popping up over our face and hands. We despise age spots as much as we hated pimples and wrinkles. In time, however, we accept these, too. Finally, we stop thinking about our tired, prune-dried, blotchy faces…until a cluster of pearly nodules surfaces on the forehead one day and doesn’t go away. Skin cancer.
Of course, not everyone suffers all of these afflictions. But skin problems, let’s face it, are a fact of most people’s lives. And in these youth-worshipping times, those in the business of helping people to put on their best face are a busy bunch. Dermatology is one of the fastest growing specialties in medicine, and if its popularity continues to grow, face lifts could one day be as common as haircuts. Cosmetics manufacturers are wearing big smiles, and, recently, pharmaceutical companies have leaped into the anti-aging fray with their own lines of youth-saving gels, creams, and sunscreens. Despite these product booms, there is much that the individual can do, in terms of dietary and lifestyle changes, and making use of natural products and self-care techniques, to assure oneself of attractive–and healthy–skin.
THERE’S NO DOUBT THAT THE vanity of the me-decade generation is helping to fuel the current obsession with flawless skin, but folks have been stuck on themselves and how they look since the first time they caught a glimpse of their reflections in pondwater.
In his excellent skin care book, Natural Organic Hair and Skin Care, cosmetics manufacturer Aubrey Hampton notes that sixth century B.C. Hindu healers incorporated an “advanced knowledge of cosmetics,” and that physicians at that time were familiar with rhinoplasty, or nose surgery. Cosmetic hygiene, Hampton notes, by the fourth and fifth centuries A.D. included the “compounding of creams, oils, pastes…make-up of every kind, and hair dyes….” And Hampton assures us that “the amount of these products used by men was almost equal to that used by women.”
The word “cosmetics” is derived from the Greek kosmetikos, skilled in arranging, whose root is kosmos, order. Order for the Greeks expressed itself in diverse ways, such as the perfect order of the stars, or mathematical or musical order. And just as beautiful music complied with rules of harmony, a person’s attractive appearance, the ancients believed, signified that he or she was in harmony with the universe. If you had skill in “kosmetically” perfecting yourself, you were in harmony with the surrounding world. This skill entailed purifying one’s inner self to help create outer beauty.
Today’s meaning of cosmetics is radically different. Instead of revealing a person’s inner attunement with the outer world, cosmetics are usually designed to give only the illusion of harmony, the appearance of beauty. And it is a very narrowly defined, Miss Universe kind of beauty at that. Moreover, the products that are sold to confer this illusion often have a questionable impact upon one’s health, including skin health, and in the long run possibly accelerate aging.
All this raises some basic questions: Are commercial skin potions beneficial, or are they just money down the drain? Worse, do they actually harm the skin?
Answers, of course, depend on whom you’re asking. Some skin experts view the skin as a minor actor in the vast physiological drama staged inside the body. They might acknowledge that certain internal disorders are associated with skin conditions, such as diabetes with itching, but they generally believe that external conditions reveal little of what’s happening internally. They seldom discuss the relationship between skin tissue and other organs. Thus, in their view, what’s done to the skin doesn’t (within reason) significantly affect a person’s overall health, and a person’s overall health doesn’t affect the skin. The skin, they believe, in addition to its routine jobs such as regulating body temperature and acting as a sensory receptor, is essentially a barrier protecting the rest of the body.
According to other experts, however, the skin is that and much more. These health care practitioners consider skin to be a major eliminative organ, along with the kidneys, lungs, and intestines. Many inflammatory, itchy, dry, or oily skin conditions occur as a result of excessive food consumption or an unbalanced diet, or when toxic substances are taken in through food, water, and air. At such times elimination can’t be completed solely by internal organs. When the kidneys are overworked, for instance, the blood expels wastes through the skin. The solution, these practitioners believe, is to decrease the intake of substances that overwhelm the organs of elimination and to encourage elimination. This is accomplished in a variety of ways, such as with sweating, careful dieting, breathing exercises, blood-purifying foods and herbs, and so on. The worst thing to do is to stop or impede elimination, which is precisely the effect of many lotions and creams used for skin problems.
WHAT EXACTLY IS BELOW the surface of our selves that we so diligently scrub and scrutinize? A thin layer of cells wrapped around the human body, measuring one-thirty-second-to one-eight-inch thick, weighing around seven pounds on an adult and covering some twenty square feet, the skin is an amazingly complex lattice of microscopic structures. Throughout our lives, its tiny pumps, pipes, reservoirs, electrical circuits, and other devices busily move blood, secrete oil, excrete wastes, feed cells, send messages to the brain, and perform a vast number of other important tasks.
In an average square inch of skin can be found some sixty-five hairs, 100 sebaceous glands, 650 sweat glands, seventy-eight heat sensors, thirteen cold sensors, 1,300 nerve endings, almost 10,000 cells, nineteen yards of blood vessels, seventy-eight yards of nerves, and 165 separate structures to perceive pressure. This tough old human hide obviously evolved for more than an aesthetic function.
Skin consists of three layers–an outer epidermis, an inner dermis, and a subcutaneous layer. The epidermis includes five paper-thin strips of cells, the uppermost of which is called the stratum corneum. Epidermal cells form at the deepest level of the epidermis, the basal layer. As they form they push older cells toward the surface. When these latter reach the stratum corneum, they are flat, tightly packed, fairly dry, dead cells, which fall off or are scraped from the body, usually as an almost invisible powder. Roughly twenty-eight days elapse from the birth of an epidermal cell until it leaves the body.
Most activity takes place inside the dermis, or “true skin,” as it’s called. The dermis is packed with blood vessels, nerves, sweat and oil glands, hair follicles, muscles, and other connective tissue. Each of these has its assignments. Blood vessels deliver oxygen and nutrients and constrict or dilate to help regulate body temperature. If the temperature is too low, they constrict, shunting blood away from the cooler ambient air and toward the body’s internal heat.
Nerve endings provide a vital alarm system, triggering instant responses to heat, irritation, cold, and pressure. Equally important but less understood is their capacity for absorbing healing energy or sensations of pleasure. It’s likely that nerve endings in skin produce hormonal and nervous system reactions that have far-reaching effects on a person’s mood and immune strength. Conversely, many skin eruptions may be triggered by emotional stress.
Collagen, an important connective protein tissue that plays a role in determining the smoothness of skin, is found in the dermis. Structural changes in collagen result in wrinkles.
The third skin layer, subcutaneous tissue, is an extension of the dermis but also includes fatty tissue that provides cushion, contour, and evenness to skin surface.
Although skin care advisors would have us believe that radiant, smooth skin is a result of applying the right cosmetics, truly healthy and appealing skin more likely depends on many factors, including what we don’t put on it. Acne is a good example of why this is so.
ACNE MAY BE LARGELY AN adolescent problem, but it affects many adults, too. The mechanisms unleashing severe acne in young people, with red sores and pimples, are the same as those that cause milder complexion problems for people of all ages.
Acne is caused by plugged-up follicles. Follicles, or skin pores, are column-shaped indentations of the skin’s surface. Under normal conditions, dead stratum corneum cells continually flake off the body. Those along the inside lining of a follicle are carried up and out of the follicle by hair growth (in follicles where hair grows) or simply by the flow of oil secreted by sebaceous glands located at the base or on the sides of follicles. This oil is called sebum. (Sweat glands have separate invisible openings to the surface and are unrelated to oil pores.)
When oil flows freely and carries all dead epidermis cells to the surface, acne does not occur. If the oil doesn’t flow freely, dead cells stick together and clog the follicle. Acne results. All forms of acne–from rough, sandy skin to large cysts and boils–are caused by plugged follicles.
As dead cells accumulate in the pore, the follicle balloons and eventually is detected on the skin as a slight swelling or bump. If the opening at the surface stretches apart, the pore may appear stuffed with dark matter. If you squeeze this “blackhead” at the sides, the stuff that oozes out consists of dead cells and sebum, plus bacteria that feed on the dead, oily cells. The dark color at the top of the blackhead is not dirt, as is often believed–it’s oxidized sebum.
When the follicle becomes so swelled that the opening closes over at the top, pressure soon builds inside the follicle. If the pressure becomes great enough, the sides of the follicle will rupture, releasing sebum, dead cells, and bacteria into the dermis below, where they don’t belong. Blood capillaries immediately dilate, white blood cells rush in to clean up the spillage, and there is the usual red inflammation that accompanies the body’s immune response to an invasion of foreign substances. This inflammation is a pimple.
Acne most often occurs on very oily skin. An oily skin surface may create viscous congestion at the openings of follicles and thereby inhibit movement of dead epidermal cells to the surface. Sometimes, however, if most pores are completely plugged with dead cells, the surface may be dry. No oil is reaching it.
In summary, a plugged follicle may either remain open at the surface and become a blackhead, it may close at the surface without rupturing and cause a bump on the skin, or it may close at the surface and rupture internally, causing a red, inflamed pimple.
Many variations of this can occur, producing all types of lesions and less-than-perfect skin conditions. The basic process, however, is the same and is critical to understanding what creates healthy, clear skin.
Adolescents experience classic acne, including swollen and red pimples, far more frequently than adults do, because androgen, a hormone for male sexual development, is very active at the time of puberty and it stimulates production of large quantities of sebum. (Females have lesser quantities of androgen than males.) With more oil secreted from sebaceous glands during adolescence, there is greater likelihood of oil filling and plugging pores.
Even without active hormones, however, adults get acne. Their pores can clog in a variety of ways. This, then, brings us to the question, What causes pores to plug up, if it’s not entirely from adolescent hormone activity?
ONE THING THAT MOST conventional dermatologists agree on is that acne is not caused primarily by diet. At one time it was believed that certain foods, such as chocolate and nuts, triggered acne. Joseph P. Bark, a dermatologist who appears frequently on radio and TV and who wrote Skin Secrets, recommends a “well-balanced diet” to his acne patients. However, other than giving advice to avoid dairy and pork products, Bark generally debunks the acne-diet connection. “As far as I’m concerned,” he writes, “my patients can have all the chocolate, Cokes, candy, nuts, potato chips, French fries, and hamburgers that they want.”
To say the least, Bark’s idea of an apparently “well-balanced diet” and the reasons why he believes most foods don’t influence acne need to be examined. One early study that persuaded physicians to think that diet was unrelated to acne was conducted at the University of Missouri in 1965 by Doctors J.D. Grant and P.C. Anderson. In a forty-eight-hour period, volunteers ate almost twenty ounces of chocolate, a food many then suspected of causing acne. Kenneth Flandermeyer, another dermatologist specializing in acne, commented on these experiments: “To the surprise of the patients involved in the study, nothing [happened]! The expected flare did not occur.”
Flandermeyer then conducted his own experiment using peanuts and got the same results. Other studies followed and confirmed the original findings.
Surprisingly, however, Flandermeyer ignored his own discussion of how acne develops. In his book Clear Skin, which includes a lucid description of how acne forms, Flandermeyer writes that the “little bumps” appearing during early stages of acne take months to reach that size. Flandermeyer says, “By the time a blackhead can be seen it may already be several months old. The appearance of a blackhead tells us that a tiny invisible plug was there perhaps as long ago as six months.” That being the case, it’s hard to understand how acne could be expected to immediately flare up in patients who eat a lot of chocolate for just two days.
In a similar vein, many dermatologists also disbelieve that fats in foods have anything to do with sebum produced by sebaceous glands. Flandermeyer writes that two doctors, Gerd Plewig and Albert Kligman, concluded after extensive research that fats entering the body through the mouth do not exit through the skin, and that fats in sebaceous glands do not resemble fats in the blood.
Arnold Klein, M.D., James Sternberg, M.D., and Paul Bernstein echo this opinion in The Skin Book: “If you eat oil, it does not go into the bloodstream and magically wind up in the skin.”
Others have questioned this logic, however. If oil and fats in foods don’t enter the bloodstream (which unquestionably circulates in the skin and just as certainly bathes sebaceous glands), then it’s hard to understand where it goes. Digested foods become the body’s blood, and the characteristics of that blood depend considerably on what foods are eaten. Skin pores obviously don’t manufacture Crisco all-purpose vegetable oil, but fatty acids in sebum are related to fatty acids in dietary fats.
The doctors’ opinions also fail to explain why so many skin care professionals strongly recommend sound dietary practices to promote healthy skin or why so many of them claim to have had considerable success in clearing the skin with dietary prescriptions, including a lowered fat intake.
The amount and type of sebum, as well as the overall condition of a person’s skin, are likely tied to a variety of factors. Hormones, circulation, and oxygenation of cells play a part, as well as genetics and the amount of stress we undergo. Ultimately, all of the factors that help establish good health for the rest of the body also contribute to healthy skin.
Skin tissue, however, is in one way very different from, say, liver tissue. We can apply substances directly to the skin. In so doing, we can choose to apply ones that help keep skin clean and nourish its cells, or we can apply those that clog its pores or are toxic to its cells. The value of any skin care program vitally depends on the choices we make.
MANY DERMATOLOGISTS, INcluding Flandermeyer and Bark, agree that substances applied to skin can cause skin problems. Bark calls cosmetics “one of the leading causes of acne in this country,” and he writes that “this situation is compounded for older women since our looks-conscious society demands a continued youthful appearance. The result often is an increasing use of cosmetics to mask minor flaws. Then the cosmetics…cause a plugging of oil glands, or some change in the secretion of oil.”
In addition to plugging glands, cosmetics are often made with questionable synthetic ingredients that penetrate the body. Hampton, whose Aubrey Organics company sells a line of natural cosmetics, says he’s “skeptical of industry’s ability to determine that a particular chemical or combination of chemicals is good” for the body. Hampton instead is “more comfortable with Mother Nature’s ability to create superior beneficial substances.”
Hampton deplores how cosmetics are promoted today. Oil of Olay, for instance, is powerfully advertised by famous personalities like Roberta Flack, who sings “The First Time Ever I Saw Your Face” to promote it. It well could be the first time ever your face saw some of the ingredients that are in Oil of Olay: mineral oil, potassium stearate, sodium stearate, cholesterol, cetyl palmitate, butyl paraben, sodium carbomer 934, potassium carbomer 934, propyl paraben, methyl paraben, sodium laurate, potassium laurate, castor oil, sodium myristate, potassium myristate, myristeryl alcohol, cetyl alcohol, sodium palmitate, potassium palmitate, stearyl alcohol, fragrance, and FD & C Red No. 4.
Aubrey Organics and such other leading natural cosmetic companies as Dr. Hauschka, Weleda, Jason, and Paul Penders appear to have set a standard for skin care products that exceeds any commercial products. For example, most natural cosmetic companies use no petroleum-based hydrocarbons, prefering herbs and plant parts. Chemically synthesized additives, preservatives, and colors, and often any animal products (or even any ingredients tested on animals) are avoided by the best natural cosmetic companies.
More importantly, perhaps, most suggest a skin care program centered on keeping the skin clean, instead of covering it up. steam with herbs and hot water; massage