a nickel, it’s a good idea to let a doc look at it. She may want to treat it with an antibiotic cream called Silvadene that kills bacteria and keeps the wound moist.
IT WRINKLES: We all know that wrinkles generally don’t look all that good—not in dress shirts and not on your skin. In fact, one main indicator of body aging is wrinkles, especially vertical lines above the lips and between the eyes (each of these stereotypically means different things; cigarette smoking and inflammation in your blood vessels cause lip wrinkles, while vertical lines between eyes reflect stress). How do we get wrinkles? In a couple of ways, actually. Since skin is attached to the muscle beneath it, your skin creases when your muscles move. Over time, that creates a well-worn groove. It’s actually like a stress fracture—the repeated bending of skin over the underlying muscle creates inflammation and the collagen gets squeezed together. Young skin stretches and recoils over the muscle, but thinned, old skin loses this ability. And, like an overbent piece of cardboard, it eventually cracks. As we get older, the connections between the skin and underlying connective tissue stretch out, which can cause sagging of the skin. When that happens, gravity pulls down, and the sagging contributes to the formation of wrinkles (see Figure 1.2).
Figure 1.2 Fine Lines Many things can cause wrinkling, including cigarette smoking and sun exposure. Ultimately, it’s caused by thinned, damaged collagen and a loss of elastin fibers (think of it as a kind of stress fracture). When skin loses its elasticity, gravity pulls down on it, and the sagging causes even more wrinkles.
How Skin Ages
When it comes to skin, most of us can spot the good kind a mile away. That’s because we can instantly identify all the characteristics of healthy and beautiful skin—it’s well hydrated, tight and elastic, not overly oily, has clean pores, and all that. But here’s the big myth about skin—that you can stop your skin from aging. No matter what products you use or procedures you undergo, you can’t stop time from pulling, tugging, and tearing at your skin. What you can do, however, is slow it down considerably and encourage all of those things that make your skin appear and be healthier.
Skin aging can happen in the matrix between cells, within the dermis, or on the surface. Here’s how:
In the matrix: Skin aging happens when your collagen becomes damaged and loses its tight weave, and your elastin loses its zing. The fibroblasts (and their DNA) that produce both collagen and elastin are prone to damage from UV radiation, and as they falter, that DNA, which makes collagen and elastin, makes less and/or defective collagen or elastin. Also, glycosaminoglycans (say that three times fast) are large sugarlike molecules that plump up a bit and fill the skin when they bind with water. As you get older, they become more like an old sponge and don’t suck up water as efficiently. The decrease in water content means that the skin becomes like a bad keynote speaker—dull and dry. And those old glycosaminoglycans can link up with proteins and cause yellowing (or browning) of your skin (that’s called glycation, and though it happens to all of us, it’s especially visible in diabetics).
On the surface: Your skin secretes fat (the technical term is lipids). Fatty acids called ceramides help protect an outer layer of your skin called the stratum corneum, so that you have better skin hydration and are less susceptible to irritation. Think of these fatty acids as a coating on you, like the slimy coating fish have on them; they serve as an extra buffer layer between you and the outside world. Ceramide concentrations decrease with aging and with washing with fat emulsifiers like soap and alcohol—our mantra isn’t “use just water” if you touch people and dirty objects, but using just water helps save those ceramides to help you.
Thinner, duller, less vibrant is what you can expect from your skin as you age, but you can control how fast those changes occur in your skin.
FACTOID
Most of the day, gravity pulls your skin down (contributing to facial sagging and wrinkles). When you sleep faceup, gravity exerts a light stretching effect on your skin; when you sleep face pressed to the pillow, you’ll look puffier in the morning and develop sleep lines. There are other reasons for puffiness upon waking. Allergy to dust mites or dust mite poop is common, as are allergies to feather pillows and laundry detergent. These all cause repeated nighttime eyelid swelling. You can prevent leakage of mite poop protein or mites by covering your pillow with a 1-micron case that feels like a pillowcase or a latex cover that feels a bit plasticky; both work to decrease mite allergies and the subsequent puffiness.
In your 40s, your skin becomes thinner and more translucent so capillaries show through. And those capillaries increase in number as a response to years of inflammation from sun damage. Signs of photoaging—such as wrinkles, age spots, and uneven pigmentation—may show up, especially if your parents or you weren’t diligent about sun protection during childhood and in your 20s and 30s. Your skin will produce less oil naturally in your 40s, leading to increased dryness. Cell turnover also is slower, which can cause skin to appear dull.
In your typical 50s, you may experience a deepening of facial lines and wrinkles due to the loss of subcutaneous fat, moisture loss, and accumulated sun damage. As skin elasticity declines, skin may start to sag, especially around the jawline and eye area. If you are postmenopausal, the related drop in estrogen can make your skin thinner, dryer, and more easily irritated. Hydrating moisturizers will decrease water loss but can lead to unnecessary dependence on them (you’ll feel as though you always need them). Vitamin A and E creams increase the water content of the skin. Regular exfoliation is a good start, decreasing the thickness of the dry, rough epidermis (more details later).
Soap It Up
How does soap work? It emulsifies oils—that is, it makes oily substances float away in water. Soaps are all derived from fats—the type of fat used determines the qualities of the soap. In its simplest form, soap is fat mixed with lye. Modern soaps add a chemistry set to the mix, but the simplest soaps are really the best, since every added chemical increases the likelihood of skin irritation, called dermatitis, or allergic reactions to fragrances or preservatives (in the subtle form of puffy eyes or red hands).
We like solid soaps because they can be made with a minimum of ingredients. Liquids often add many chemicals and preservatives. The simplest type of soap is made of saponified olive oil, with a small amount of an essential oil such as lavender or peppermint to give it a nice fragrance. Examples of simple, low-chemical bar soaps are Kiss My Face Pure Olive Oil Soap and Plantlife Aromatherapy Soaps. To prevent the spread of bacteria between users, treat the soap bar as you would treat a toothbrush—don’t share.
For liquid soaps, we like Neutrogena and Cetaphil. Check the ingredients—fewer is generally better. You might try See the Dawn Purity facial cleanser, which contains glycerin, aloe vera, and lavender flower–scented water, or Garden of Eve Facial Cleansing Nectar, which contains glycerin, safflower oil, wax, sunflower oil, and water.
If you are typical and natural, in your 60s, 70s, 80s, and 90s, cell turnover and skin healing are even slower, and your skin may be very dry, as well. Mature skin may need special care, starting with hydrating moisturizers and regular exfoliation to encourage cell turnover.
Your Skin: What Else Can Go Wrong
As the primary part of your body exposed to external threats, your skin is not only your body’s greatest protector* but also extremely vulnerable to the outside world.
Of course, we’re most concerned with cancerous growths. Keep an eye out for precancerous growths by self-exam with the help of a partner (have your spouse or a close friend look at all the areas you can’t see and photograph your total skin surface), and have anything new or different evaluated by a dermatologist. You can even use your cell phone camera to record pictures that
