The skin is the largest organ of the human body, and its job is to maintain hydration, protect us against solar radiation while regulating body temperature, and shield the underlying tissues from infection. Clear, glowing skin is a bonus that contributes to the impression of overall health and beauty. There are several layers of the skin, each of which has a key role in its appearance and function. The top layer, the epidermis, contains keratinocytes (form a barrier to moisture loss and prevents the entry of bacteria and foreign material), melanocytes (cells that make pigment), Langerhans cells (assist in immune regulation of the body), and Merkel cells (exact function is unclear). The epidermis itself is divided into several layers. Cells are formed at the deepest layer, and then gradually move up to the top layer where they are eventually sloughed off. The cells in the epidermis renew on a regular basis, but this process slows down as we age. While babies renew their epidermis every 14 days, teenagers do so every 21-28 days. Adults turn over the epidermis every 28-42 days, and this can reach every 48 days after the age of 50. This is why most aestheticians recommend a facial every six weeks. In addition, after changing your skin care regimen, this is also the length of time usually needed to see the results.
The next layer, the dermis, contains many elements, including hair follicles, sweat glands, sebaceous glands, lymphatic vessels, and blood vessels. The dermis itself is composed of three types of connective tissue: collagen (a protein that provides strength and structure to the skin), elastin (a protein that allows tissue to resume its shape after stretching or contracting), and reticular fibers (structural fibers that support the skin). Stretch marks from pregnancy represent ruptures of the elastic fibers in the dermis. Tattoo ink is injected into this layer as well.
The deepest layer consists of subcutaneous tissue, which contains fibroblasts (assists in wound healing), macrophages (engulfs and digests cellular debris and pathogens), and adipocytes (fat cells for padding and insulation). This layer attaches the skin to the underlying muscle, blood vessels, and nerves.
Don’t forget that your diet and environment are crucially important in achieving healthy skin. Drink lots of water, get enough sleep, and eat well. If you live in an area with polluting factors such as smog, your skin may be more prone to dullness or breakouts. In addition to cleansing, toning, and moisturizing, your skin will benefit from weekly masques and professional facials every six weeks.
Cleansing your skin is the easiest and one of the most important things you can do. Cleanse twice daily, morning and night. The morning cleanse can be brief, as you are removing surface oils and skin cells that have accumulated during the night. The night cleanse should be more thorough to remove all traces of makeup and toxins that may have been deposited during the day. Cleanse all the way from your collarbones up to your hairline. This will keep your pores clear, and allow penetration of your toner and moisturizer.
Toning the skin is generally believed to be necessary to balance the pH of the epidermis, which then allows the moisturizer to be absorbed effectively. However, a gentle cleanser will not change the pH of the skin, and therefore a toner is not necessary for all patients at all times. When a toner is used, it should not contain alcohol as its primary agent, as this will dry out the skin. The ideal toner refreshes and mildly tightens the skin.
Our skin provides its own moisturizer by excreting sebum and sweat. Moisture on the skin maintains softness and suppleness by keeping water in the outer layer of the skin, and safeguards the body by preventing the penetration of bacteria. Moisturizers made of water and oil are used to replenish any deficiencies. These are normally applied twice daily after cleansing and toning, while the skin is still damp. However, this step can be safely skipped if the skin appears to be well-hydrated. Skin naturally changes with the seasons, and will maintain its natural hydration better in the warm summer months than in cold, harsh weather.
Exfoliation removes the layers of dead skin cell buildup which are not completely removed with cleansing. These can clog the pores and dull the complexion. Removing these cells on the top layer of the skin has been shown to stimulate the production of new cells in the epidermis. People with oily skin in particular tend to accumulate cells, and therefore they in particular will benefit from regular exfoliation. In addition to removing dead skin cells and improving product penetration, exfoliation stimulates blood flow and smoothes the skin, evening out the skin tone. Gentle exfoliation once or twice each week can produce smooth and translucent skin, but over-exfoliation will damage the barrier function of the skin and predispose to sun damage. Sunscreen is mandatory following exfoliation, since the skin is more vulnerable to burns during this time.
Shielding your skin from the sun will prevent wrinkles and reduce your chance of skin cancer. An SPF of 15 protects the skin from 93% of harmful UVA and UVB rays. A quarter-sized amount should be applied to the skin every day (even if it is cloudy).
Damage from UV radiation, pollution, stress and diet can release free radicals, which then can start a chain reaction which damages cells. As we age, our bodies cannot fight free radical formation as effectively. Anti-oxidants fight the free radicals which can lead to fine lines, uneven skin tone, and skin cancer. Natural sources of anti-oxidants include vitamins C and E, green tea (when ingested orally), fig fruit from the banyan tree, amla fruit, lemon, mango, orange, pomegranate, saffron, and turmeric. Amla, lemon, mango, and orange each contain vitamin C, and this likely is the source of their anti-oxidants. Vitamin C effectively scavenges free radicals, but it requires a delivery system to reach the deepest layers of the skin. It is able to stimulate collagen and elastin production, reduce hyperpigmentation, smooth wrinkles, and increase blood flow to the skin. Vitamin E, long known for its skin healing effects, can also increase the effects of other anti-oxidants. Daily use of a product containing an anti-oxidant is recommended.
Acne can appear during times of stress, during the menstrual cycle, or in response to pollution. Breakouts can be treated by spot application of product to affected areas. For those who regularly have breakouts, cleansing and toning with oil-free products is very helpful. Exfoliation should be done once or twice each week to deep cleanse the pores. Finally, a masque can be used once each week for deep cleaning and soothing. Don’t forget to moisturize with a non-comedogenic product. Recurrent, severe acne should be evaluated by a qualified dermatologist.
Uneven skin pigmentation can be a source of significant distress. When skin is clearer, it appears younger. In addition, in some cultures pigmentation spots can be associated with bad luck. Uneven skin pigmentation can result from sun exposure, hormonal shifts, scarring secondary to acne or surgical procedures, and even malignancy. The correct treatment for hyperpigmentation is determined by the diagnosis, and therefore if there is any uncertainty about the cause, you should seek consultation with a specialty physician. The simplest method of treatment of benign pigmentation is with a topical lotion or cream. Treatment for a minimum of 4-6 weeks is generally required to see results. More invasive methods of treatment must be tailored depending upon both the cause and the underlying skin tone.
While facials are seen as a luxury, they do allow deep cleansing of the pores and moisturization of the skin. The benefit of a regular facial done every six weeks is that a skilled aesthetician can examine your skin under magnification and advise you on any areas of concern. A good facial does not need to be painful, or leave your skin red and inflamed.