What you know about your skin

Your skin is the organ that comes into contact with the rest of the world. It holds body fluids in, preventing dehydration (dee-hahy-DREY-shun), and keeps harmful microbes (MYE-krobs) out—without it, we would get infections. Your skin is full of nerve endings that help you feel things like heat, cold, and pain. If you couldn’t feel these things, you could get badly hurt and not even know it!

Why is healthy skin important?

Since your skin plays such an important role in protecting your body, you should keep it as healthy as you can. This will help you keep from getting sick or having damage to your bones, muscles, and internal organs.

What you might not know about your skin

Skin is actually your body’s largest organ by size. Your skin helps keep your body temperature even. If you get too hot, blood vessels near the surface of the skin, called capillaries (CAP-uh-ler-ees), enlarge to let the warm blood cool down.

Your skin also makes vitamin D (VYE-tuh-min D) when the sun shines on it. Vitamin D is important for the health of your bones and other parts of your body.

You can injure your skin

It’s not too hard to injure your skin. So be careful when you’re doing anything that might injure it (like using sharp tools, working in the yard, or playing a sport). Cuts, bumps, and scrapes are a normal part of life. It wouldn’t be much fun if you tried to avoid them completely. But it’s smart to wear the right protective equipment, like gloves, long sleeves, knee and elbow pads, or helmets.

Be very careful when you’re around anything hot that can burn your skin. Burns, including sunburn, can be very painful and can take a long time to heal. Burns can also get infected easily. Sometimes, burns leave bad scars and permanently damage your skin. If you’re helping out in the kitchen, make sure you use hot pads or wear oven mitts to protect your hands when you’re grabbing something hot.

What to do when your skin is injured

If you do get a cut or scratch, clean it right away with soap and warm water and put on a bandage to protect it while it heals. This keeps dirt and germs from getting into the wound and causing an infection. If you come into contact with a plant like poison ivy, wash your skin and clothing right away. If you develop a rash, ask your pharmacist about over-the-counter medicines. For severe rashes, you might need to see your doctor.

What to do about insect bites

Watch out for insect bites, too. Try not to scratch them, because they could get infected. Cover up your skin as much as possible when you will be in the woods, tall grass, or other areas where there may be ticks (small, 8-legged bugs). It helps to wear light-colored clothing, so you can see ticks before they have a chance to bite. Some ticks can carry germs that will make you sick. If you find a tick attached to your skin, get a trusted adult to help you remove it.

Skin diseases

There are many diseases that can affect your skin. Some like vitiligo (vit-ill-EYE-go) cause the skin to lose its natural color, and some like alopecia areata (al-oh-PEE-shah ar-ee-AH-tah) can make the hair fall out. Another skin disease like epidermolysis bullosa (ep-ee-der-MOL-eh-sis bull-O-sa) can cause painful blisters. Psoriasis (suh-RYE-uh-sis) can cause itchy, scaly red patches. Go see your doctor if you think you might have a skin disease.

Acne

Most teenagers get a skin disease called acne (AK-nee). The blackheads and pimples can be embarrassing and make you feel bad about your appearance, but keep in mind that almost everyone gets them at some point. Acne isn’t usually serious, but severe cases can cause scars that will last for years.

Acne is caused by bacteria (Propionibacterium acnes, often shortened to P. acnes and pronounced P. AK-nees), which live on everyone’s skin. Sometimes the follicles (FALL-lick-els) in the skin, where hair grows, become clogged with oil and dead skin cells, and the bacteria thrive. Then that spot on the skin may hurt, become swollen, red, and hot. Eventually the walls of the follicle break down and spill the oil, skin cells and bacteria into the nearby skin, and a pimple forms.

There are many false ideas about what causes acne. Chocolate and greasy foods are often blamed, but foods probably don’t have much effect on acne in most people. Another common myth is that dirty skin causes acne. But blackheads and other acne lesions are not caused by dirt. Stress doesn’t cause acne either, but for people who have acne, stress might make it worse.

If acne really bothers you, ask your parents about going to see a doctor. If your acne is not very bad, your family doctor may be able to give you medicines that will help to improve it. Or you might want to see a doctor who treats just the skin. These doctors are known as dermatologists (dur-muh-TOL-uh-jists). Dermatologists have a number of good treatments for acne.

What it is:

Sometimes referred to as “photoaging,” premature aging is the result of unprotected UV exposure. It takes the form of leathery, wrinkled skin, and dark spots.

Why it happens:

Although the causes of premature aging are not always clear, unprotected exposure to harmful UV rays break down the collagen and elastin fibers in healthy young skin, and cause wrinkles and loosened folds. Frequent sunburns or hours spent tanning can result in a permanent darkening of the skin, dark spots, and a leathery texture.

Symptoms:

• Wrinkles
• Dark spots
• Leathery skin

Treatment:

A dermatologist or plastic surgeon can develop a treatment plan based on your needs. Treatments can include chemical peels, dermabrasion, and skin fillers.

The Bottom Line:

Premature aging is a long-term side effect of UV exposure, meaning it may not show on your skin until many years after you have had a sunburn or suntan. Avoiding UV exposure is essential to maintaining healthy skin.

Considering all the wear and tear skin gets—exposure to the elements, washing and drying, squinting and smiling—it’s remarkably resilient. However, an illness or external irritant can cause a bump, spot or rash to show up somewhere on the body. Usually harmless, changes in the skin sometimes require medical attention. This guide will show you what to look for and what to do about it.

Skin Smarts

Here are some tips to maintain healthy skin:

• Avoid the sun. sun exposure causes skin cancer, wrinkles and age spots. Wear a sunscreen with an SPF of 15 or more.
• Eat right. Make sure your diet has enough protein and is low in saturated fat and cholesterol.
• Drink plenty of water. Plenty means eight 8-ounce servings a day.
• Don’t smoke and avoid smoky areas. Breathing smoke is associated with wrinkles and poor circulation.
• Watch your skin carefully. a bump, crusted area, lesion or mole that has grown or changed in character could be a sign of skin cancer. if caught early, skin cancers are almost always curable.

Keep it clean

Washing your skin, especially your hands, is very important for keeping it healthy. Hand washing keeps you from spreading germs to other parts of your body. It also keeps you from spreading germs that could give others a cold or the flu. To help keep your skin from getting dry, use water that’s comfortably warm, not too hot, when you take a bath or shower. If your skin is dry or itchy, try a moisturizing cream or lotion.

Enjoy being in the sun—but protect your skin

Your skin produces vitamin D when it is exposed to sunshine. Vitamin D helps keep your bones and other body systems healthy. However, too much sun can damage your skin and increase your risk for skin cancer. It may make your skin look old years too soon and can make it less able to fight off infections. Whenever you’re outside, use a sunscreen with a sun protection factor (SPF) of 15 or above. Apply it evenly, and have a friend or parent help you with the hard-to-reach spots. Follow the directions that tell you how often to reapply it—one application won’t last all day!

What about tanning beds?

Tanning beds don’t offer a safe alternative to natural sunlight. Exposure to ultraviolet (UV) (uhl-truh-VYE-uh-lit) radiation damages your skin, whether the exposure comes from tanning beds or natural sunlight.

This damage increases the risk of skin cancer and premature skin aging just like too much sun. In fact, most tanning beds emit mainly UVA rays, which may increase the risk of melanoma (MEH-luh-NOH-muh), the deadliest form of skin cancer.

Physical activity

Being physically active is good for your skin! It increases the flow of blood to the surface of your skin and brings oxygen and nutrients to your whole body. Sweating helps to flush out impurities from your skin. Get 1 hour or more of physical activity every day. This will be good for your skin as well as your heart, lungs, muscles, and other parts of your body. Be sure to drink enough water to replace the fluids you lose when you sweat. If you have any concerns about your health, talk to your doctor or a physical therapist to find out what kinds of activities are right for you.

A healthy diet

You really don’t need a special diet to keep your skin in good health. Eating a balanced diet will help you maintain a healthy weight and provide a variety of nutrients for your skin and your overall health. A balanced diet:

• Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat dairy products like milk, cheese, and yogurt.
• Includes protein from lean meats, poultry, seafood, beans, eggs, and nuts.
• Is low in solid fats, saturated fats, cholesterol, salt (sodium), added sugars, and refined grains.
• Is as low as possible in trans fats.
• Balances calories taken in through food with calories burned in physical activity to help maintain a healthy weight.

See your doctor

If you find anything unusual on your skin, like a mole that changes size or color or a patch that looks red or itches, ask a parent or other trusted adult to take a look at it and arrange for you to see a doctor.

For skin diseases, it’s important to see a doctor as early as possible to prevent permanent damage to your skin.

Start now

Healthy skin will help you look your best and feel good about how you look. Start healthy habits now while you are young—they will help you keep your skin healthy for the rest of your life.

Healthy dietary choices are important for overall health. Anti-inflammatory or Mediterranean-style dietary approaches have been found to enhance many aspects of health especially in the setting of inflammatory diseases. Additionally, low glycemic index/low glycemic load diets have been shown to have significant benefitnot only for overall health, but for improving some skin conditions as well as for slowing signs of aging. Supplements can give an added boost to disease prevention and/or minimizing the effects of chronic conditions.

Omega-3 Fatty Acids

Omega-3 fatty acids have been shown to decrease the production of inflammatory compounds and of insulin and insulin-related compoundsall of which contribute to impaired function of the skin. These essential fatty acids have been shown helpful in specific skin conditions such as eczema, psoriasis, acne, and skin cancer. The inflammatory markers that are inhibited by omega-3 fatty acids impact collagen and other structural proteins that function to support the skin and underlying tissues. In this way, omega-3 fatty acids may help slow the appearance of visual characteristics of aging.

Ideally, omega-3 fatty acids would come from foods such as fatty fish (salmon, mackerel, and sardines), flaxseeds, and walnuts. When that is not possible, supplements can be helpful.

Gamma-Linoleic Acid (GLA)

GLA is an omega-6 polyunsaturated fatty acid that has anti-inflammatory properties. It is found in borage oil, evening primrose oil, hemp oil, and black current oil. It has been shown to be potentially helpful in atopic dermatitis (eczema). Research, however, has been conflicting. Overall, GLA is safe. Gastrointestinal side effects are the most common and are generally reversible. There may be increased risk of bleeding when taken along with other blood thinners.

Probiotics

Specific strains of probiotics have been shown to limit ultraviolet damage (Lactobacillus johnsonii) and to decrease skin sensitivity as well as increase recovery time after physical damage (Lactobacillus paracasei). Probiotics have potential benefits in several skin conditions including atopic dermatitis (especially when taken by the mother in the perinatal and nursing time periods), rosacea, and acne. Diet appears to play a significant role in supporting a healthy gut microflora, and effects of supplemental probiotics may be optimized by following a plant-based diet.

Probiotics have also been shown to improve would healing in both GI ulcers and in infected skin wounds through a variety of proposed mechanisms. Given the increasing rates of resistance, this is a promising area for development of new ways to treat skin infections.

There are many strains of probiotics, and comparing studies is difficult since the studies use different strains and different concentrations of probiotics. Additional research will help clarify the specific doses and strains that are most likely to be helpful for skin health.

Carotenoids

The carotenoids are pigmented molecules made by plants that have powerful antioxidant properties. Beta-carotene and lycopene are two that have been linked to skin health.

Beta-carotene is considered a provitamin because it is converted to vitamin A in the body. Several studies have found decreased rates of many types of cancer in people who regularly eat foods rich in beta-carotene, but studies looking at actual blood levels of beta-carotene and supplementation in people with skin cancer have not shown benefit. Supplementation may be risky in some people (heavy smokers), though it appears beneficial in generally healthy people. Foods rich in beta-carotene are a staple in anti-inflammatory and Mediterranean-style diets. These foods are high in other antioxidants as well as fiberboth of which are beneficial for many aspects of health.

Food sources: leafy greens, carrots, sweet potatoes, sweet peppers, dried apricots, peas, broccoli, squash, cantaloupe.

Lycopene is a powerful antioxidant and has been identified as having potent photoprotective properties. Tomatoes and tomato-based products have the highest concentrations of lycopene, and the concentration increases with cooking. Watermelon and pink grapefruit are also good food sources of lycopene. The Observed Safe Level (OSL) for lycopene indicates strong evidence of long-term safety with supplementation up to 75 mg/day.

Turmeric (Curcumin)

Curcumin is the major active component of turmeric. It has strong antibacterial, anti-inflammatory, and anticancer properties. Curcumin has been shown to improve wound healing, psoriasis, and skin cancer, and there is evidence that its anti-inflammatory properties could be helpful in any inflammatory skin disease. Turmeric has been studied in a wide variety of skin conditions and over half have shown benefit. There is still more work needed in this area to clarify appropriate application of the herb, degree of benefit that can be expected, and the mechanisms by which turmeric results in improvement in skin disease.

Currently, the ideal dose for skin health is unknown. Curcumin can be obtained through diet or by taking capsules of turmeric powder. Clinical studies have found turmeric powder safe at doses up to 8-12 gm/day with the primary side effect being reversible gastrointestinal problems (nausea and diarrhea).

Flavonoids

Flavonoids make up a large class of protective molecules that are synthesized by plants. They are powerful antioxidants and have the ability to regulate pathways involved in cell processes such as cell growth, differentiation, and cell death. Beneficial effects on cancer include limiting inflammation, inhibiting proliferation of abnormal cells, and blocking cancerous cells from invading normal tissue. Foods rich in flavonoids include red, blue, and purple berries; red and purple grapes; plums; red and yellow onions; green and black tea; apples; dark chocolate; fresh parsley; kale; broccoli; and citrus fruits.

Green tea contains the flavonoid epigallocatechin-3-gallate (EGCG). It has many anticancer effects as well as antioxidant and photoprotective effects. Topically, it may help with acne as well as overgrown scars. Clinical studies in humans are lacking, and an ideal dose for supplementation is not known. Green tea is easily accessible, safe, and inexpensive.

Suggestion: Drink 2 or more cups of green tea daily.

Soy isoflavones are also members of the flavonoid family. They have weak estrogen-like effects on human tissues. They also appear to inhibit enzymes that are involved in skin breakdown. Both oral supplementation and topical preparations may reduce wrinkling and other signs of aging. The use of these compounds in people who have breast cancer has been an area of considerable debate. Due to the confusing data, some experts recommend that women with a history of breast cancer (especially estrogen receptor positive breast cancer) avoid increasing soy isoflavones in their diets. Others feel that moderate consumption of soy protein will not likely be harmful and may be beneficial. It very well may be that natural food sources of these isoflavones may be helpful while concentrated supplements may be harmful.

Resveratrol

Resveratrol is a compound naturally produced by plants to protect them from infection by bacteria and fungus. It has exhibited inhibitory activity of transcription factors and enzymes involved in inflammatory pathways. It has also been shown to inhibit a variety of different human cancer cells including melanoma and to inhibit factors that allow cancer cells to spread to other tissues. Although human studies are limited, supplementation appears safe. Resveratrol is concentrated in the skin of grapes and is found in highest concentrations in wine and grape-based products. Other sources include berries (blueberries, bilberries, cranberries), peanuts (boiled have the highest levels, raw peanuts and peanut butter have lower levels), and the roots of Japanese knotweed (Polygonum cuspidatum).

Multivitamin

There is evidence that vitamin A, vitamin B complex, vitamin C, vitamin D, vitamin E, biotin, and the minerals chromium, iron, selenium, and zinc play important roles in maintaining skin heath. Additional supplementation may be helpful for specific skin conditions. While a detailed account of the impact individual vitamins and minerals have on the skin is beyond the scope of this document, it is wise to take a regular multivitamin that contains 100% of the daily value for most vitamins and minerals, particularly for those who have limited access to food sources of these important nutrients.

Collagen

Collagen supplementation has become popular in the last few years and anecdotal evidence abounds regarding its benefits. There are some good-quality studies looking at short-term collagen supplementation (between 8 and 24 weeks) that show positive impact on wound healing and reducing signs of aging particularly in the areas of elasticity, collagen density of the dermis, and skin hydration. Because this is an unregulated supplement, care should be taken when choosing a product. Consideration of sourcing and third-party quality control is important.

Acne (AK-nee). Acne is a disorder caused by P. acne bacteria on the skin. Commonly called pimples or zits, acne usually occurs on the face, neck, back, chest, and shoulders.

Capillaries (CAP-uh-ler-ees). The smallest blood vessels in your body. They branch through body tissues to deliver oxygen and nutrients and carry away waste products. Your body exchanges nutrients and fluids through the walls of these tiny blood vessels.

Dehydration (dee-hahy-DREY-shun). A condition that occurs when you lose more fluids than you take in. Your body is about two-thirds water. When you get dehydrated, it means the amount of water in your body has dropped below the level needed for normal body function.

Dermatologist (dur-muh-TOL-uh-jist). A doctor who specializes in the treatment of diseases of the skin.

Follicle (FALL-lick-el). The opening in the skin where the hair grows out. This opening also allows oil and dead skin cells to rise from under the skin to reach the surface where they can be washed away.

Melanoma (MEH-luh-NOH-muh). Melanoma is the deadliest form of skin cancer. It can be treated successfully if it is detected early.

Microbes (MYE-krobs). Tiny organisms that are too small to see without a microscope, yet they are abundant on Earth. These microscopic organisms are found in plants and animals as well as in the human body. Some microbes cause disease in humans, plants, and animals, while others are essential for a healthy life.

Propionibacterium acnes (P. acnes) (P. AK-nees). A bacterium (germ) that lives on the surface of the skin and can cause acne when the follicles become clogged with oil and dead skin cells.

Psoriasis (suh-RYE-uh-sis). A skin disease that causes itchy or sore patches of thick, red skin with silvery scales.

Ultraviolet (UV) rays (uhl-truh-VYE-uh-lit reys). Sunlight consists of two types of harmful rays: ultraviolet A (UVA) rays and ultraviolet B (UVB) rays.

• UVA rays (which pass through window glass) penetrate deeper into the dermis, the thickest layer of the skin. UVA rays can suppress your immune system, which interferes with the immune system’s ability to protect you against the development and spread of skin cancer. UVA exposure also is known to lead to signs of premature aging of the skin such as wrinkling and age spots.
• UVB rays are the sun’s burning rays (which are blocked by window glass) and are the primary cause of sunburn.

A good way to remember the difference is that UVA rays are the aging rays and UVB rays are the burning rays. Excessive exposure to both forms of UV rays can lead to the development of skin cancer.

Vitamin D (VYE-tuh-min D). The vitamin that helps your body use calcium. Your skin makes vitamin D when the sun shines on it, and it is often added to dairy products like milk and yogurt, fortified soy beverage, and some cereal and orange juice.