I recently asked a patient (and a well-known blogger) what makes a good blog.  She said that as long as it is humorous, insightful or educational, there will be people who are willing to read it.  In this blog, I’ll be writing regularly on beauty and skin, but also a little bit on myself, my family and my friends.  I hope everyone will find something they can relate to here, something they can learn or at least have a good laugh (or  cry).

Let’s talk skin

What is skin? The skin is the soft tissue outer covering our entire body which protects us fom the elements, microbes, helps us regulate temperature and also a huge collection of sensors which connects the brain to our environment.    Many of you already know this but the skin is the largest organ in the entire body.  What you may not know is how complex the skin really is but I’ll try to simplify it as much as possible here.

The skin is made up of three different layers – the epidermis, the dermis and the subcutaneous layer (from outermost to innermost).   Each layer contains different structures and has different functions and each layer can be affected differently by different skin ailments.  Always refer to the diagram below if references are made  in subsequent blog articles to any specific layer of the skin.

Skin Color

As we look around us, everyone has a slightly different skin color and even on the same person, skin can have different colors depending on location.  So what determines skin color? Melanin is the pigment which gives our skin its color.  Many of us wish we were fairer and had ‘less melanin’ but did you know that melanin is actually protective against the sun’s UV rays? And for that particular reason, people who live in tropical regions have more and darker melanin particles in their skin.  People who live further from the equator have less and lighter melanin particles to enable adequate vitamin D production through sun exposure.

Melanin and it’s pattern  of deposition in the skin is behind many of the skin pigmentation abnormalities we encounter daily including freckles and even skin cancers like melanoma.

Skin texture

We hear and use this term frequently – skin texture.  What is skin texture?  Skin texture refers to the feel, appearance and consistency of the skin.  Everyone wishes for baby skin – soft, supple, flawless but more often than not, we either have sun damaged, age-wrinkled or acne scarred skin.  Good skin texture depends on interplay of all the different components and layers of the skin.

Beautiful skin

Without a doubt, skin is one of the major determinants of a person’s beauty; hence the expression “beauty is skin deep”.  Everyone desires beautiful skin, we want to have beautiful skin and we want to look at beautiful skin.  What exactly do we mean by beautiful skin?  Basically ‘beautiful skin’ is defined as naturally having the following characteristics:

• Clear and blemish free
• Smooth
• Firm
• Elastic (not saggy)
• Well hydrated
• Dewy (in between matt dry and shiny oily)

If you have all the above, congratulations, you are probably one of the very few who have achieved the holy grail of skin perfection.  If you haven’t achieved the above, not to worry, you’re not alone.  In fact you’re one of a majority of people who desire to see improvements in their skin.

Good skin care

Like most men, I never used to pay much attention to my skin and am still guilty of that nowadays.  I have been blessed with relatively good skin despite some early struggles with acne.  Patients ask what sort of skin care regimen they should use and in my opinion, there are skin care tips which are universal and should be practised by everyone; there are also particular skin types which require particular skin care regimens.

Let us begin with universal skin care tips (things you should definitely already be doing!):

1. Eat healthily and drink lots of water

You are what you eat and that applies to your skin too.

Water: Drink at least 6-8 glasses of water a day to keep your skin well hydrated and supple.  Dehydration makes your skin look dry, tired and feel less supple.

Vitamin C: Vit C is an excellent anti-oxidant which can prevent free-radical damage to cells and prevent premature skin ageing.  It also helps with the immune system in general to ward of infections. Sources: berries, oranges, papaya, guava, broccoli

Vitamin E: Vit E also acts as an anti-oxidant.  Sources: nuts, avocado, sunflower and corn oil

Selenium: Selenium is also an anti-oxidant.  Sources: nuts, broccoli, tomatoes, eggs and fish

Zinc: Zinc is important for skin repair and keeping it supple.  Sources: fish, lean red meat, nuts

Omega-3 and -6 fatty acids: Omega fatty acids can protect against inflammatory skin diseases like eczema and psoriasis Sources: oily fish, flaxseed

2. Manage stress

We often feel like our acne worsens during times of stress but did you know that stress can also worsen other skin problems like eczema, rosacea and alopecia (hair loss)?  Stress has been shown to increase our body’s level of stress hormones e.g. cortisol which increases oil production in the skin and its related skin ailments.  Also stress has been shown to trigger auto-immune conditions as well.  This can be a vicious cycle as poor skin can cause a person to feel distressed and the additional stress than worsens the skin condition.  So take some time to relax and de-stress with your favourite activities.  You might just be surprised how much your skin improves and of course a smile doesn’t hurt either 🙂

3. Don’t smoke 

We all know smoking worsens the appearance of our skin.  How does this happen? The heat from the cigarettes directly damages cells around the lips and peri-oral region.  The elastic fibers of the lips and skin are also damaged by vasoconstriction of blood vessels and free radical generation.  All this leads to premature ageing of the skin including wrinkle formation, broken blood vessels (telangiectasia) and uneven skin tone.  Smoking has also been shown to be associated with an increased risk of skin cancers and oral cancers.  So now you have another reason to put that cigarette out! Remember, it’s never too late to quit.

4. Protect yourself from the sun 

We all know the sun damages our skin and causes premature ageing.  It does this by causing uneven pigment deposition in the epidermis (e.g. freckles) and also damage elastin fibres causing wrinkling and sagging.  In Singapore, this is particularly a problem as a tropical country like ours receives intense and direct sunlight all year round.  Be smart when it comes to the sun; avoid unnecessary prolonged unprotected exposure.  You can do this by staying indoors or with long sleeved clothing.  Also sunblock should be part of your regular skin regimen, to protect your skin against those harmful UV rays.  Here are some important sunblock tips from the American Academy of Dermatologists that you should always keep in mind:

1. Choose a sunscreen that has an SPF of 30 or higher, is water resistant, and provides broad-spectrum coverage
2. Apply sunscreen generously before going outdoors. It takes approximately 15 minutes for your skin to absorb the sunscreen and protect you. If you wait until you are in the sun to apply sunscreen, your skin is unprotected and can burn.
3. Use enough sunscreen. Most adults need at least one ounce of sunscreen, about the amount you can hold in your palm, to fully cover all exposed areas of your body. Rub the sunscreen thoroughly into your skin.
4. Apply sunscreen to all bare skin. Remember your neck, face, ears, tops of your feet and legs. For hard‐to‐reach areas like your back, ask someone to help you or use a spray sunscreen. If you have thinning hair, either apply sunscreen to your scalp or wear a wide‐brimmed hat. To protect your lips, apply a lip balm with a SPF of at least 15.
5. Reapply sunscreen at least every two hours to remain protected, or immediately after swimming or excessively sweating. People who get sunburned usually didn’t use enough sunscreen, didn’t reapply it after being in the sun, or used an expired product. Your skin is exposed to the sun’s harmful UV rays every time you go outside, even on cloudy days.

I find most people follow the above tips quite strictly except for no. 5.  It is especially hard for women to reapply sunblock regularly especially when they’ve applied their makeup.  What I normally suggest is to bring a simple makeup kit to work and find time during lunch to reapply the sunblock and a light layer of makeup.  That extra effort with the sunscreen can make a world of difference.

5. Cleanse 

Cleansing should be part of everyone’s skin care regimen, no matter what the skin type.  The only difference is how often you should do it and the type of cleanser you use.  Cleansing, as the name suggests, rids our skin of overlying dirt which can damage the skin and make it look tired and sallow.  Are you cleansing your face correctly?  Here’s how you should be doing it.

• Wash your hands before you cleanse your face
• Wash your face at least twice a day (morning and bedtime) using lukewarm water and an appropriate cleanser
• Rinse – Gently but thoroughly rinse off all cleanser from the face using lukewarm water
• Don’t use water that is extremely hot or extremely cold since this can damage your skin and trap grease and dirt inside your pores.
• Gently massage your face with slow, circular motions. Don’t scrub! Scrubbing will cause skin irritation, redness, or breakouts.
• Treat the skin around your eyes extra gently, as it is the most delicate, sensitive skin on your face. Plus you don’t want to end up with cleanser in your eyes!
• Don’t over-wash your face! Even if you have oily skin, over-washing can cause dryness, and your skin will produce more oil to compensate, which means you could end up with oilier, more blemished skin.
• Pat dry – Always pat dry using a clean soft cloth rather than a used hand/body towel. Avoid excessive rubbing especially since your skin is most sensitive after a good cleansing

6. Moisturise

Moisturisers don’t really add moisture to your skin; instead it traps the existing moisture in the skin to that it doesn’t dry out quite so quickly.  Dehydrated skin tends to be irritable and appear dull and lifeless.  In the long run, dehydration leads to permanent loss of skin elasticity and wrinkling.  A good moisturiser also act as a barrier to protect the skin from environmental irritants and pollutants.  The best time to moisturise the skin is always after cleansing.

There you go, 6 skin care tips that everyone should take note off for better skin.  If you’re not already doing all the things mentioned, it’s time to start.  In case you’re worried you’ll forget, cut out the below and put it somewhere easy to see to remind yourself.  Now sit back, and watch your skin improve.

6 STEPS TO BETTER SKIN 1.       EATING WELL, DRINKING MORE WATER 2.       DE-STRESS 3.       STOP SMOKING 4.       SUN-PROTECTION 5.       CLEANSE 6.       MOISTURISE