aging

casserole dish, vegetables, mushrooms

Whole-Food Plant-Based (WFPB) Diet and the Skin

AC Skin Health provides this summary of the article written by Solway J, McBride M, Haq F, Abdul W, Miller R. published at the Journal of Clinical and Aesthethetic Dermatolology May 2020.

Diet and Dermatology: The Role of a Whole-food, Plant-based Diet in Preventing and Reversing Skin Aging – A Review

WHAT IS WHOLE-FOOD PLANT-BASED DIET?

Kaiser Permanente defines a whole-food, plant-based (WFPB) diet as, “an eating plan that includes lots of plant foods in their whole, unprocessed form, such as vegetables, fruits, beans, lentils, nuts, seeds, whole grains, and small amounts of healthy fats. It does not include animal products, such as red meat, poultry, fish, dairy, or eggs. It also does not include processed foods or sweets.”

BENEFITS OF WFPB DIET

  • Lengthens telomeres which results in reversal of the aging process of DNA
  • Proven to prevent and reverse leading chronic diseases in the US such as coronary artery disease
  • Reduces amount of gerontotoxins
  • Increases amount of antioxidants
  • Provides the nutrients, vitamins and minerals to maintain cell health
  • Excludes high amount of saturated fat from animal products which can damage cells
  • Inflammation is a major culprit of many common dermatologic conditions, including accelerated skin aging.

IMPLICATIONS OF SKIN AGING

  • Cosmetically poor appearance
  • Affects skin fucntions such as skin permeability, angiogenesis, lipid and sweat production, immune function, and vitamin D
  • Impaired wound healing, skin atrophy, vulnerability to stimuli, development of benign and malignant lesions

GERONTOTOXINS

Gerontotoxins is a contributor of inflammation to our body. These toxins accumulate within the skin and can cause a rapid stiffening of collagen, elastin, vitronectin, and laminin. This can present clinically as skin ulcers and delayed skin healing.

Meat and processed foods contained the highest number of AGE units.

Cooking foods using high, dry heat (e.g. roasting, grilling) appeared to increase AGE content.

ROLE OF ANTIOXIDANTS IN SKIN HEALTH

Antioxidants exist to neutralize and mitigate ROS through the donation of electrons.

On average, plant foods contain 64 times more antioxidants than animal products.

Green vegetables (because of chlorophyll) contain the highest amount of antioxidants among vegetables.

Berries contain the highest amount of antioxidants of any fruit

Darker colors in plant food translate to more antioxidants.

VITAMIN E: PRIMARY ANTIOXIDANT

Aka tocopherol, alpha tocopherol most biologically active source of vitamin E in the skin

Terminate lipid radical chain reactions, stabilizing cell membranes against dAmage by phospholipase A, free fatty acids and lysophospholipids

Prevent damage from oxidative stress

Vitamin C, CoQ10 and glutathione can recycle the oxidized form of vitamin E

VITAMIN C: SECONDARY ANTIOXIDANT

L-ascorbic acid

Important role in collagen production, wound healing

Promote fibroblast proliferation, migration and replication of base excision repair of potentially mutagenic DNA lesions

VITAMIN A: TERTIARY ANTIOXIDANT

Quenches singlet oxygen species

CHLOROPHYLL AND COQ10

Chlorophyll blocks damage to DNA from carcinogens

POLYPHENOLS

Fruits and plant-derived breverages – fruit juice, tea, coffee, red wine, vegetables, cereals, chocolate, dry legumes

Antioxidant and potential prevention of certain cancers and cardiovascular, neurodegenerative diseases

ZEAXANTHIN

Lutein – antioxidant to prevent wrinkles and improve skin hydration

ROLE OF FATTY ACIDS IN PROTECTING AGAINST SKIN AGING

PUFA particularly EPA and DHA modulate and reduce skin inflmammation

ALA reduces senile dryness and skin atrophy – ALA is precursor of EPA and DHA

MUFA olive oil, potential prevent severe skin aging

Eat healthy and be merry. One of the solutions to aging is here, and it is as basic as what you eat.

Cheers to healthy skin!

For inquiries and to set your appointment, CONTACT us here.

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beauty, smile, happy

Botox 101

Botox or Botolinum toxin is a neuromodulator that blocks release of acethylcholine hence preventing muscle contraction. Whew! That’s a lot of technical terms! Simply put, it is a toxin that relaxes or weakens your muscles.

In Dermatology, it is mostly used to treat dynamic wrinkles on the face. Common areas are:

  • Crow’s feet (lateral side of eyes)
  • Forehead lines
  • Frown lines (between eyebrows)
  • Bunny lines (nose wrinkles)
  • Cobblestone chin

There is also a procedure called “Botox lift” to produce that fresh, youthful look with a lifted appearance.

Botox can also treat TMJ disorders and bruxism (night teeth grinding).

It is also helps in producing a more V-shaped contour of the face.

Botox also helps with excessive sweating or hyperhidrosis. Patients with axillary or underarm hyperhidrosis greatly benefit from this treatment.

Fact Alert! Botox is actually a brand of the neurotoxin but is commonly used as a generic term for the procedure.

The procedureBotox for wrinkles

Your dermatologist will plan the injection sites and number of units to be used on your face. She will ask you to make facial expressions to map out where the best injection spots are for you.

We use a very fine needle to minimize the pain with injection. Other modalities may be used such as applying ice, tapping, or if necessary, applying topical anesthesia. Most patients tolerate the procedure well and ice compress is more than enough.

When do I see the effect of my Botox treatment?

Most patients appreciate the effect after a few days of the treatment. If a touch up is necessary, this is scheduled at least two weeks after the initial treatment.

Effect of a single treatment may last 4-6 months. Factors affecting this include: strength of facial muscles, how animated or active your facial muscles are, and the number of units used.  Once the effect of Botox wears off, your face will not be worse than before you had the treatment! A lot of patients worry about this. Botox will not make your wrinkles worse once it wears off, but you will do notice your wrinkles coming back.

Side effects

Some of the possible side effects are:

  • Pain
  • Swelling
  • Redness
  • Bruising
  •  Mild headache (uncommon)

Frozen face – we do not like this either! We aim to give you a natural, youthful look while preserving your facial expressions.

Am I a candidate for Botox?

Don’t wait to have the permanent creases or wrinkles on your face before getting a Botox treatment. Those deep lines you see in older people are harder and more expensive to treat.

The trend now is to maintain and prevent the signs of aging, as early as you can.

Experienced dermatologists can plan the best treatment for you. The number of units and the injection points vary from face to face because each face is unique!

Cheers to healthy skin!

For inquiries and to set your appointment, CONTACT us here.

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woman, age, in the free

Aging Skin Basics

Aging skin basics by Dr. Mary Amy Fatima Cagayan-Chua, FPDS. This article originally published in Health and Lifestyle magazine August 2019 issue. This is also published in their website.

Learn more about aging skin basics: factors affecting aging, changes in the laters of the skin, and basic skin care for the elderly.

Aging of the skin is a complex process characterized by the interplay of both intrinsic and extrinsic factors. Intrinsic, or natural skin aging, is largely determined by genetics – and is inevitable with the passage of time. Hormonal changes, such as those seen in postmenopausal women, also contribute to intrinsic aging.

Extrinsic, or external skin aging, is primarily caused by ultraviolet (UV) radiation (photoaging). As much as 80 percent of facial skin aging is due to photoaging. Photoaging is markedly observed in sun-exposed areas, such as the face, neck and hands. Photoaged skin is wrinkled, rough skin, with poor skin elasticity, with pigmentary changes and growth of benign and possibly malignant neoplasms. Other extrinsic factors include atmospheric pollution, lifestyle (smoking, sleep deprivation) and diet.

Aging of the skin occurs throughout the different layers of the skin.

Epidermis

In aged skin, flattening of the dermo-epidermal junction (DEJ) is observed. This leaves the epidermis with insufficient blood supply and nutrients, resulting in impaired thermo regulation and skin pallor. There is also a slower epidermal turnover, which contributes to the dull and rough appearance of the skin. The epidermal changes influence the delay in wound healing.

Dermis

As we age, the dermis undergoes about 20 percent decrease in thickness and has relatively fewer cells and blood vessels. Both intrinsic and extrinsic aging are characterized by increased expression of matrix metalloproteinases (MMP), enzymes which degrade collagen. Collagen production decreases at a rate of about 1 percent per year. Collagen bundles in the aged are thicker but more disorganized and fragmented, resulting in less structural support. Decreased collagen types IV and VII at the base of the wrinkles imply their role in wrinkle formation. Degenerative changes seen in elastin result in sagging skin with poor elasticity and resilience. There is also a decrease in glycosaminoglycans (GAG), particularly hyaluronic acid. The decrease in functional melanocytes causes decreased protection from harmful UV rays.

Subcutis

On a deeper level, there is atrophy of subcutaneous fat particularly in the face and back of the hands. This contributes significantly to sagging or the aged look.

All these changes in the skin predispose the elderly to skin disorders and not just aesthetic concerns. With the increasing life expectancy, there is now more focus on the aging skin disorders and skin care. The most common skin disorder in the geriatric population is senile xerosis. This is closely associated with pruritus, or itching.

Geriatric patients are also frequently diagnosed with skin tears and moisture associated skin damage (MASD). Skin tears are commonly found on the arms and are associated with trauma, such as bumping into furniture. MASD is linked to incontinence-associated dermatitis (perineal dermatitis), intertrigo, ostomy leakage, periwound skin, etc.

Skin care regimen

The most basic and important goal of skin care for the aging is to maintain the integrity of the skin barrier. These are the recommendations in literature.

1. Use gentle cleansers. It is best to use syndets (liquid) with neutral pH and preferably with an emollient.

2. Avoid further friction with use of scrubs, bath cloths, and loofahs. Instead, gently pat the skin dry using a towel.

3. Avoid hot and prolonged baths (i.e., more than 10-15 minutes).

4. Generally, bath oils are not recommended in the elderly due to an increased risk of accidents (may result in slippery floors, causing falls).

5. To relieve xerosis (drying of the skin), pruritus and prevent skin tears, use emollients containing humectants (moisture-retaining substances) and skin lipid replacement agents. Some ingredients to look for are ceramides (20-40 percent concentration), dimethicone, lactic acid (5 percent), urea (10 percent), glycerin and alpha-hydroxy acids (AHA). These improve hydration of the stratum corneum and enhance skin barrier function.

6. Some also advise avoiding perfumes and fragrances that can cause skin irritation.

7. For incontinence-associated dermatitis, a protective barrier cream is recommended. These are usually emulsion with a metal oxide (zinc or titanium), or siliconbased with dimethicone.

8. In the geriatric population, it is still important to protect the skin from UV radiation. Apply a generous amount of a broad-spectrum sunscreen in sun-exposed areas. Wear wide-brimmed hats and clothes with UV protection when outdoors. Often neglected areas include the ears, eyelids, and lips.

Lifestyle and the aging skin

The aging population is advised to increase intake of antioxidant-rich food and avoid a hyperglycemic diet. Attaining the recommended nutritional micronutrients is more challenging in the elderly due to their usually restricted diets and the loss of some of their ability to absorb nutrients.

Avoid smoking and exposure to secondhand smoke. Minimize exposure to pollution, if possible.

A good night’s sleep is important in maintaining healthy skin. A study has shown that elderly women who slept for less than 5 hours a day had compromised transepidermal water loss and skin barrier recovery after UV-induced erythema. Likewise, poor sleep quality results in disruption of the circadian rhythm, leading to cellular dysfunction and changes in various tissues, including the skin.

With the increase in life expectancy, we expect its related comorbidities including its effects on the skin. Having a thorough understanding of the causes of skin aging can help us manage the skin problems of our patients.

  • Bibliography:
  • Addor FAS. (2018). Beyond photoaging: additional factors involved in the process of skin aging. Clinical, Cosmetic and Investigational Dermatology, 20(11), 437–443. doi: 10.2147/CCID.S177448.
  • Baumann, L. (2009). Cosmetic Dermatology: Principles and Practice Second Edition. McGraw-Hill.
  • Humbert P, Dréno B, Krutmann J, Luger TA, Triller R, Meaume S, Seité S. (2016). Recommendations for managing cutaneous disorders associated with advancing age. Clinical Interventions in Aging. 12(11), 141-8. 10.2147/CIA.S96232.
  • Kottner J, Lichterfeld A, Blume-Peytavi U. (2013). British Journal of Dermatology.169(3), 528-42. doi: 10.1111/bjd.12469.
  • Ruxton, C. (2016). Tea: Hydration and other health benefits. Primary Health Care, 26(8), 34-42. doi:10.7748/phc.2016.e1162 Tobin DJ. (2017). Introduction to Skin Aging. Journal of Tissue Viability. 26(1), 37-46. doi: 10.1016/j.jtv.2016.03.002.

For your anti-aging skin concerns, you may book your appointment with our board-certified dermatologists and plastic surgeon, just follow the link.

Cheers to healthy skin!

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Wrinkle Remedy: Botox

Want to learn more about Botox as a wrinkle remedy?

Wrinkles are lines on the skin that appear with facial expressions such as frowning, raising our eyebrows, squinting, smiling, etc. There are several factors contributing to the development of wrinkles. Intrinsic aging or natural aging is largely genetic and is inevitable with the passage of time. Exposure to UV rays, cigarette smoke, poor quality and lack of sleep, and stress can accelerate the aging of skin hence earlier appearance of unsightly wrinkles.

Over time, with repetitive facial expressions these wrinkles become permanent creases even when our face is not showing any emotion or even when we are not moving. These permanent creases are much more difficult to treat. It will cost you a lot more to treat the permanent wrinkles! So the best time to treat your wrinkles is now.

What do I need to prepare for my Botox appointment?

Inform your doctor of any history of Botox treatments and other facial cosmetic procedures. Tell your doctor if you are taking any medications especially blood thinners such as Aspirin.

What happens during this procedure?

Botox involves injection of the toxin in small amounts to targeted muscles. Pain is minimal as we use a very fine needle.  Most patients tolerate the procedure well. For people who are very sensitive to pain, inform your doctor and ask if “painless” option is possible.

When do I see the effect of my Botox treatment?

The full effect of a Botox treatment can be appreciated about 7 to 14 days after the procedure. Some patients may already experience the benefit of Botox after 3 days.

Any side effects?

These have been the reported side effects with Botox treatment: redness, swelling, soreness, bruising. Uncommon side effects are mild headache and temporary eyelid drooping.

Numbness or loss of sensation is not seen with Botox treatment.

After care?

You may go back to work immediately after the treatment. You may apply make up taking care not to apply pressure on the treatment points. Keep upright for a few hours after the treatment. Avoid facial massage or rubbing the treated areas for the next few days.

Follow up?

You may follow up with your dermatologist 2 weeks after your treatment. Some patients may need correction or injection of additional units.

Dermatologists who are experienced with Botox can plan the best treatment for you. The number of units and the injection points vary from face to face because each face is unique!

Our goal with Botox is to have a natural look while minimizing wrinkles. We want you to retain facial expressions and not have a frozen face.

Cheers to healthy skin!

For inquiries and to set your appointment, CONTACT us here.

Stay tuned for updates and promos, follow and like us on Facebook, Instagram and Twitter.

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