About Your Skin
Did you know your skin is the largest organ in your body? It’s also the body’s first line of defense against infections and potentially harmful environmental irritants, such as allergens and pollution. So, proper skin care is essential — for your health and appearance.

Your skin has three layers:

• Epidermis (thin outer layer)
• Dermis (thicker middle layer that contains blood vessels, nerves, hair roots and sweat glands)
• Subcutaneous tissue (mostly made of fat)

Beauty Starts on the Inside
The key to healthy skin lies beyond which soap you use. Eating well, exercising, coping well with stress and getting enough rest can help keep your skin radiant and prevent signs of aging.

• Eat right. It’s important to eat a varied, nutritious diet with lots of fresh fruits and vegetables and fish. Antioxidants found in foods packed with vitamins A, C and E, as well as omega-3 fatty acids, help protect the skin. The best foods include: whole-grain cereals, fish, citrus fruits, berries, tomatoes, carrots, sweet potatoes and green leafy vegetables such as spinach and broccoli. Drinking freshly brewed green tea is also good for your skin.
• Exercise regularly. Exercising 1) flushes impurities out of your skin, 2) facilitates the production of sebum, the skin’s natural moisturizer, and 3) improves blood flow to the skin. Your blood carries oxygen and valuable nutrients to help maintain skin health.
• Counteract stress. Stress has a way of showing up on your face and skin. A number of skin conditions can flare up when someone is stressed. A recent study found teenagers under high levels of stress — for example during mid-term exams — are more likely to have a severe outbreak of acne. Prolonged stress can affect your immune system and lead to nervous habits such as nail biting or picking at the skin.

The Skinny on Skin Care
Below are some helpful hints to keep your skin looking its best:

• Use a daily moisturizer with an SPF of 15 or higher to keep your skin hydrated and protect against the sun’s harmful rays.
• Wash your face with warm water and a mild cleanser. Be gentle. Don’t scrub your skin too hard as this can irritate your skin and make pimples worse.
• Avoid touching your face and fight the urge to pop pimples, which can lead to spreading and more swelling and redness.
• Eat a balanced diet and avoid sugar. Shoot for five small meals per day.
• Exercise regularly.
• Drink lots of water to stay hydrated and help release toxins.
• Stay away from tanning beds. Spray-on tanning is smarter.
• Identify daily stressors and take steps to reduce anxiety (e.g., exercise, deep breathing, talking with friends, massage).
• Quit smoking or don’t start.
• Consult a dermatologist, if you have repeated outbreaks or notice changes in your complexion.

Sun Safety and Your Skin
Even though you may feel healthier and more attractive sporting a tan, soaking up the sun can be harmful to your health. That glowing tan is, in fact, a visible sign of skin damage. When UV rays enter the skin, the skin tries to protect itself by producing more pigment and melanin, which gives the skin a golden or red color.

Too much sun can cause:

• Premature wrinkles and skin aging
• Freckles and age spots
• Skin texture changes
• Dilated blood vessels
• Skin cancer

Although these changes won’t show up for many years, the damage starts when you’re young.

A Word about Tanning Beds
UV rays from tanning beds, booths and lamps not only inflict damage similar to sunlight, but they are also up to 20 times more intense than natural sunlight. Many tanning salons use UVA bulbs, which, according to the American Academy of Dermatology, cause deeper skin damage and contribute to more permanent damage (early wrinkling, loss of elasticity, freckling/dark spots and skin cancers).

Remember:
UVB rays have been associated with sunburn. The SPF rating is only for UVB presently.
UVA rays go deeper into the skin causing more lasting damage. There is no rating system for UVA protection. Think B for burning, A for aging.

Skin Cancer Alert
More than 1 million cases of skin cancer are diagnosed each year in the United States, and this number is growing primarily because many young people continue to tan, despite the known health risks. The three most common forms of skin cancer are:

• Basal cell carcinoma
• Squamous cell carcinoma
• Melanoma, the most dangerous form of skin cancer. It typically appears as a mole-like patch and can be deadly if untreated.

It’s important to start checking for unusual blemishes or changes in the pattern or appearance of freckles and moles early on. If you notice any changes, talk with your doctor or dermatologist.

Use the ABCD rule when inspecting moles to help tell the difference between a normal mole and one that might signal a problem.

A: asymmetry — one half of the mole does not match the other half.

B: border irregularity — the edges of the mole are ragged or notched.

C: color — the color of the mole is not the same all over. There may be shades of tan, brown or black, and sometimes patches of red, blue or white.

D: diameter or darkness — the mole is wider than about one-quarter inch (larger than a pencil eraser).  Darkness means if one mole gets darker than the others, it should be checked.

Skin patches that continue to be itchy, scaly or painful should also be checked out.

Protecting your skin from UV radiation now can prevent premature aging and the risk of skin cancer later in life.

Top Sun Tips
Protect your skin by minimizing sunburns.

• Use a “broad spectrum” sunscreen with an SPF (sun protection factor) of at least 15 that blocks both UVA and UVB rays. We suggest Blue Lizard sunscreen which is sweat and water resistant.
  • Apply sunscreen 20–30 minutes before going outside.
  • Reapply more often, especially if you go swimming or are sweating.
• Shield your face and sun-exposed areas of your skin, especially your back, legs, forearms and neck. Keep a hat, sunglasses and protective clothing handy to cover up.
• Limit the time you spend outdoors during peak sunlight hours when UV rays are at their strongest (typically between 10 a.m. and 4 p.m.).
• Seek shade or create your own with a beach umbrella.
• Look for labels on medications that increase your sensitivity to the sun, such as certain antibiotics and blood pressure medications.

Don’t Believe Skin Myths

Myth:

I don’t have to worry about sun damage because I tan easily.

Truth:

The damage inflicted by the sun and other environmental irritants accumulates over the years, so even if you don’t burn, you are still increasing your risk of skin cancer and wrinkles.

Myth:

I don’t need to use sunscreen when it’s cloudy or cool.

Truth:

Although the sun feels hotter and more intense on bright, sunny days, you  still are at risk on overcast or cool days if your skin is unprotected. According to the CDC, 32 percent of the UV rays still reach the earth’s surface on an overcast day. It’s equally important to protect your skin during the winter. Snow reflects up to 80 percent of the sun’s rays, according to the American Academy of Dermatology. Sand and water also increase the sun’s effects. Bottom line: wear sunscreen anytime you’re out in the sun no matter what the season or climate!

Myth:

Acne is a sign of dirty skin.

Truth:

Acne is not caused by poor hygiene or dirty skin. Frequent washing will not improve the skin and may further irritate the skin and reduce the effectiveness of medications. Many adolescents and adults struggle with acne due to hormones, genetics or other factors.

Myth:

Tanning clears up acne.

Truth:

Although a tan may temporarily mask blemishes and breakouts, the sun causes such long term side effects, others treatments are better.

Questions to Ask Your Health Care Provider
Here are some questions you may want to ask during your next doctor’s appointment.

• Does my diet influence my skin’s health? Are there certain foods I should steer clear of?
• What’s the best way to conceal breakouts?
• Are sunless tanning lotions safe?
• When should I start seeing a dermatologist for routine skin checks?
• How do I find a dermatologist?

Resources
American Academy of Dermatology
1-888-503-7546
www.skincarephysicians.com

Susan will talk with you about:

• sunscreens
• brown spot removal
• spider veins
• or whatever dermatological improvement happens to be on your to-do list.

Call Now! (615) 352-0011

General Dermatology

Cosmetic Dermatology

Symptoms

The primary symptom of hyperhidrosis is wetness.

Treatments may include:

• Antiperspirants. Excessive sweating may be controlled with strong anti-perspirants, which plug the sweat ducts. Products containing 10% to 15% aluminum chloride hexahydrate are the first line of treatment for underarm sweating. Some patients may be be prescribed a product containing a higher dose of aluminum chloride, which is applied nightly onto the affected areas. Antiperspirants can cause skin irritation, and large doses of aluminum chloride can damage clothing. Note: Deodorants do not prevent sweating, but are helpful in reducing body odor.
• Medication. Anticholinergics drugs, such as glycopyrrolate (Robinul, Robinul-Forte), help to prevent the stimulation of sweat glands. Although effective for some patients, these drugs have not been studied as well as other treatments. Side effects include dry mouth, dizziness, and problems with urination. Beta-blockers or benzodiazepines may help reduce stress-related sweating.
• Iontophoresis. This FDA-approved procedure uses electricity to temporarily turn off the sweat gland. It is most effective for sweating of the hands and feet. The hands or feet are placed into water, and then a gentle current of electricity is passed through it. The electricity is gradually increased until the patient feels a light tingling sensation. The therapy lasts about 10-20 minutes and requires several sessions. Side effects include skin cracking and blisters, although rare.
• Botox. Botulinum toxin type A (Botox) is FDA approved for the treatment of severe underarm sweating, a condition called primary axillary hyperhidrosis. Small doses of purified botulinum toxin injected into the underarm temporarily block the nerves that stimulate sweating. Side effects include injection-site pain and flu-like symptoms. If you are considering Botox for other areas of excessive sweating talk to your doctor in detail. Botox used for sweating of the palms can cause mild, but temporary weakness and intense pain. Watch our video for more information
• Endoscopic thoracic sympathectomy (ETS). In severe cases, a minimally-invasive surgical procedure called sympathectomy may be recommended when other treatments fail. The procedure turns off the signal that tells the body to sweat excessively. It is usually done on patients whose palms sweat much more heavily than normal. It may also be used to treat extreme sweating of the face. ETS does not work as well for those with excessive armpit sweating.

Sweating helps the body stay cool. In most cases, it is perfectly natural. People sweat more in warm temperatures, when they exercise, or in response to situations that make them nervous, angry, embarrassed, or afraid.

However, excessive sweating occurs without such triggers. Those with hyperhidrosis appear to have overactive sweat glands. The uncontrollable sweating can lead to significant discomfort, both physical and emotional.

When excessive sweating affects the hands, feet, and armpits, it’s called primary or focal hyperhidrosis. Primary hyperhidrosis affects 2 – 3% of the population, yet less than 40% of patients with this condition seek medical advice. In the majority of primary hyperhidrosis cases, no cause can be found. It seems to run in families.

If the sweating occurs as a result of another medical condition, it is called secondary hyperhidrosis. The sweating may be all over the body, or it may be in one area. Conditions that cause second hyperhidrosis include:

• Acromegaly
• Anxiety conditions
• Cancer
• Carcinoid syndrome
• Certain medications and substances of abuse
• Glucose control disorders
• Heart disease
• Hyperthyroidism
• Lung disease
• Menopause
• Parkinson’s disease
• Pheochromocytoma
• Spinal cord injury
• Stroke
• Tuberculosis or other infections

Visible signs of sweating may be noted during a doctor’s visit. A number of tests may also be used to diagnose excessive sweating. Tests include:

Tests include:

• Starch-iodine test. An iodine solution is applied to the sweaty area. After it dries, starch is sprinkled on the area. The starch-iodine combination turns a dark blue color wherever there is excess sweat.
• Paper test. Special paper is placed on the affected area to absorb the sweat, and then weighed. The heavier it weights, the more sweat has accumulated.

You may be also be asked details about your sweating, such as:

Location

• Does it occur your face, palms, or armpits, or all over the body?

Time pattern

• Does it occur at night?
• Did it begin suddenly?

Triggers

• Does the sweating occur when you are reminded of something that upset you (such as traumatic event)?

What other symptoms do you have, for example:

• Weight loss
• Pounding heartbeat
• Cold or clammy hands
• Fever
• Lack of appetite

Prognosis

Aluminum Chloride: Initially a patient may need to use it three to seven times a week. After sweating becomes normal, the person may need to use it only once every one to three weeks. If skin irritation is a problem, a doctor may temporarily prescribe a steroid-based cream.

Botox: Swelling goes away in a few weeks. The effect of a single injection can last up to a few months. Some patients need additional injections.

Iontophoresis: Sweating may be reduced after six to 10 sessions. After that, the person may need treatment once every one to four weeks.

Complications

Some of the causes of hyperhidrosis can be serious. Always consult a doctor if you have excessive sweating.

When to contact a doctor

Call your health care provider if you have:

• Prolonged, excessive, and unexplained sweating
• Sweating with or followed by chest pain or pressure
• Sweating with weight loss
• Sweating that most often occurs during sleep
• Sweating with fever, weight loss, chest pain, shortness of breath, or a rapid, pounding heartbeat – these symptoms may be a sign of an underlying disease, such as hyperthyroidism

In the U.S. , more than four million Americans will be diagnosed with the disease each year.

Do you have any sores that have not healed within three weeks, moles that look different from others, or any that bleed or itch?

Call for your complete skin exam: (615) 352-0011.

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