Skin Care Excerpt: 'You: Being Beautiful'

"It's not the shape of your eyes or the width of your nose that defines beauty," Dr. Mehmet Oz told "Good Morning America" today. "It's the texture of the skin."

After Oz shared the secrets to beautiful hair last month, he returned to "Good Morning America" today, along with colleague Dr. Michael Roizen, to share some tips on how to determine the age of your skin and reverse the aging process.

One way to check the age of your skin, Oz said, is to take the simple Scotch tape test.

To do this, put 1½-inch piece of tape above the eyes and above the lip.

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"You look at it. If it's got no flakiness or no lines, it's skin of a 30-year-old," Oz explained. "Lines and flakiness, the skin of a 50-year-old."

The good news, Oz said, is that aging can be reversed. Check out an excerpt of Oz and Roizen's book, "You: Being Beautiful" below.

The Skinny: How Your Skin Works

Your skin can do more than get you arrested. -It's able to do many things—some good and some -we'd rather live without. It Sweats: In a way, our skin acts as our third kidney, detoxifying our bodies. When we exert ourselves, not only do we sweat to cool our bodies, we also increase blood flow, which releases toxins. Though it may not be so great on silk blouses and stair climbers, sweating is something you need to do regularly—not just because of the cardiovascular and fat--frying benefits of exercise, but also because of its body--cleansing function.

It Tans and Burns: Exposure to sun causes an immediate release of stored melanin and stimulates the cells designed to protect you from too much sun, the melanocytes, to produce a protective pigment, melanin. But that process takes several days, by which time you have left the beach with Santa--suit--colored flesh. The sun, unbuffered by melanin, is your -skin's cancer--causing deep fryer.

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).

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.

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).

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 your dermatologist can use to compare yearly changes. Put a dime next to any growths that you photograph to provide an estimate of size. By the way, in case you think -you're safe just because you stay out of the sun, realize that skin--damaging ozone levels increase in the afternoon, which can affect skin whether -it's sunny or not. That underscores the point that you need to try to keep your skin healthy even if you have the best sun--protecting habits. Following are some other health issues that have beauty implications. These are irritating conditions that can influence your appearance and self--confidence.

Acne and Rosacea: While people often like to think that things like chocolate are responsible for pimples, -there's no proof that what pops up on your dessert plate influences what pops up on your nose the night before a big presentation. What we do know is that 80 percent of U.S. teens and 40 percent of U.S. adults complain of pimples. But in Papua, New Guinea, the figure is nearly 0 percent, so -it's a fair guess that something is going on with our lifestyle. One culprit is inadequate intake of omega--3 fatty acids (as opposed to saturated or trans fats or omega--6 fats from corn and soybean oils). Get adequate amounts of these good fats by consuming walnuts, avocados, freshly ground flaxseed, canola oil, fish oils, or DHA supplements from algae. Another culprit? Stress. In studies of college kids during exams, researchers found them to have many more bouts of acne while under pressure. Paradoxically, the steroid medication triamcinolone can be injected to calm a severe form of pimples called cystic acne, but -there's a cost—it also thins the skin, often leaving a depression months later.

And -don't squeeze—you'll damage the skin by increasing inflammation and risk spreading the infection. Instead, wash your face with a coarse washcloth and mild soap to break open any pimples. Salicylic acid, benzoyl peroxide, azelaic acid, and vitamin A creams or gels are all simple and effective methods for reducing acne. You can also try an ancient Chinese remedy—seabuchthorn oil, which has been used for a few millennia in China for a variety of medicinal benefits. More recently, the rich fatty acid mixture has been used topically as a natural treatment for acne and rosacea. Try the soap form. For rosacea—a form of adult acne -that's a fairly common problem—certain antibiotics tend to work not only because they kill bacteria but because of their anti--inflammatory effect. Our recommendation: Ask your doc if an ointment that combines antibiotics and a low--potency steroid cream such as hydrocortisone is right for you. Lasers that target the visible capillaries can have a dramatic immediate effect, and daily topical vitamin C and twice daily topical niacin more subtly reduce the redness in about a month.

Eczema: If your -skin's looking as if you just did the hubba--hubba in a bed of mashed strawberries, it might be a case of the common skin condition eczema. This is a type of allergic reaction, and -it's easily treated with inexpensive skin moisturizers. -It's especially common during the winter, when the dry air causes little breaks in the skin, letting in chemicals that rake over your skin, particularly your hands. Treat your skin like an athlete working out in the heat—keep it hydrated. After your daily shower (don't dry yourself first), immediately apply Vaseline or cream (Eucerin, Keri, Nivea) so the moisture is locked in—and the rash--irritating dryness is kept out. If you have stubborn eczema, you might use a moisturizer with lactic acid or a steroid or a prescription drug called tacrolimus. If all else fails, have an allergist get to the bottom of your problem—in many cases the culprit is the metal nickel or one of the preservatives or fragrances in skin care products.

YOU Test

What's Your Type?

All that time in front of the mirror, in the shower, and at the nude beach has likely given you some pretty good insight into what type of skin you have. But -there's more to skin intelligence than just knowing whether -you're happier exposing it or concealing it. Take this test to determine your skin type.

1. Does your skin look dull or flake like a snow globe?

2. Does your skin look like a bathroom floor with a shiny, slippery texture?

3. Does your skin feel itchy and taut like sausage casing?

4. Do you have pores that are enlarged like craters, or clogged pores, or acne?

5. Does your skin react to cosmetics containing alcohol, synthetics, fragrances, and artificial colors?

6. Does your skin appear consistently moist, vibrant, and plumper than a squishy cantaloupe?

7. Does your forehead, nose, or chin appear oilier than a fast--food kitchen, while the skin around your cheeks, eyes, and mouth is normal or dry?

If you answered yes to 1 or 3, you have DRY skin.

If you answered yes to 2 or 4, you have OILY skin.

If you answered yes to 5, you have SENSITIVE skin.

If you answered yes to 6, you have NORMAL skin.

If you answered yes to 7, you have COMBINATION skin.

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