Skin in Health and Disease

Some Topics

Skin Care Products

Skin care products are a popular form of entertainment for women and unfortunately, serious discussions of skin health interfere with the recreational aspects of skin care. When a real skin problem arises, skin-care products on store shelves are disappointing and some become harmful. A significant percentage of skin problems that an allergist sees are solved by stopping the use of cosmetics and skin care products. Low allergy products are marketed but do not always live up to their claims. The best skin care products have the least ingredients, carefully chosen to do one job well. There are six basic categories of skin care products:

1. Moisturizing lotions and creams based on mixing oil and water with emulsifiers.

2. Soaps and detergents.

3. Drying and peeling lotions and creams based on hydroxyl acids, salicylic acid, and vitamin A analogues.

4. Barrier ointments, creams and lotions.

5. Sunscreens.

6. Disinfectants and antibiotics

Paula Begoun provided detailed reviews of skin care products and cosmetics for many years. Her assumptions are that skin care product advertising routinely misleads hopeful customers and that good skin care products are uncommon. She states: “The huge number of things we are told about skin care and other beauty concerns is nothing less than astounding. That's why, when you begin thinking in terms of reality, facts, and balanced information, it is important to ignore the baseless, unfounded claims that are constantly bandied about in the guise of serious information. You may have run into the following terms and sales pitches for myriad skin-care and makeup products. These come-ons entice purchasers, even though they are vague or illogical. Among the doubtful assumptions made at the cosmetics counter is that different people have one of three or four different “skin types.” Usually, the classification includes normal, oily, dry and oily-dry. There are obvious differences among individual and ethnic groups in skin color, skin texture and hair growth. There are obvious differences in skin response to sun, contact irritants, allergens and infections. Some people’s skin is highly reactive and others never have allergic symptoms. Some people have skin infections routinely and others seldom are bothered. I am not aware of any skin classification that accounts for the great variation in skin condition and reactivity. ”

Begoun suggests: “As far as the cosmetics industry is concerned, every woman can and should have normal skin. Yet acquiring normal skin is like trying to scale a peak with a slippery, precarious slope. Like the rest of our bodies, skin is in a constant state of change. Even women with perfect complexions go through phases of having oily, dry, or blemish-prone skin. In reality, no one is likely to have normal skin for very long, no matter what she does. Chasing after normal skin can set you up on an endless skin-care buying spree, running around in circles trying everything and finding nothing that works for very long.”

Natasha Singer reported that Coleman, the vice president of the American Academy of Dermatology advised consumers that moisturizers and wrinkle creams are superficial treatments -- decorative and hygienic, not products that will change your skin; a $200 cream may have better perfume or packaging, but will not out perform a well-selected $10 cream.

Wrinkles and Skin Products

The interest in anti-aging skincare products increased with the introduction of alpha hydroxy acids, the first ingredients to have modest. temporary benefits demonstrated by clinical studies at concentrations of 5% and higher. The alpha hydroxy acids (AHA)38 are acids common in many plants and peel the surface layers of the skin, acting like a chemical version of a luffa sponge. The most potent AHA agent is glycolic acid and its anti-wrinkling effect starts with a concentration of 5%. Lower concentrations are probably of little or no value. Concentrations up to 20% are used in skin clinics to achieve “chemical dermabrasion.”

Vitamin A analogues have many effects on skin growth and some have been used to reduce wrinkling. Retin-A was the first popular agent intended for acne treatment but widely sought as a cosmetic agent. The main vitamin A analogue, retinoic acid, does smooth superficial wrinkles and offers modest short term benefits, but no major long-term change in the aging process. Vitamin C, collagen, beta hydroxy acids, vitamin E, elastin and liposome have appeared in numerous skin products with claims that have not been substantiated.

Other skin products featured anti-oxidant vitamins A, C and E. If you add up all the benefits available from hydroxyl acids and vitamin A analogues, the best results are still disappointing. In the best case, the skin smoothing effects are minor and temporary. The subtle benefits cannot begin to compete with powerful skin aging influences such as sun exposure, bad diets and smoking. The addition of nutrients to skin care products is just a marketing ploy with little chance of benefit.

The net effect of most surface treatment with agents of any type is that little or nothing changes. The magic rejuvenating cream has not yet been discovered. Vitamin C and E are promising for long-term anti-aging effects but they are best taken orally rather than applied to the surface, although there is room for both to be added to sunscreen lotions to reduce photo-damage from sun exposure.

Skin Cleaning

The flourishing microbial population that lives on and in the skin cannot be controlled easily. We have to accept that as hosts to many creatures, we must use prudent and rational methods of skin cleansing and also attempt to control the proliferation of skin related microbes in clothing, bed sheets, carpets and upholstery.  The cosmetic industry sells an unreasonable amount of skin cleansing products that are not very useful. Traditional soaps are also limited. Soaps are made by combining some sort of fat with alkali. With soft water, soaps create suds and are moderately effective cleansing agents. With hard water, soaps are rendered useless by the minerals in the water. If the soap you are using does not create obvious foamy suds, switch to a mild detergent soap. I use inexpensive liquid "sopas" or shampoos with a minimum of additives as a body cleanser since they contain detergents that are better than soap in cleaning the skin. Most shampoos contain the detergents, sodium lauryl sulfate and sodium laureth sulfate. The problem with detergent shampoos is that most of them contain a number of ingredients that are un-necessary and increase the risk of contact dermatitis. Cetaphil is a skin cleanser that combines sodium lauryl sulfate as the detergent with mild alcohol disinfectants that can be used on the face.

Hand cleansing in hospitals is considered to be the most important method of infection control. Different products and methods have been studied. Alcohol-based hand rubs are most effective in controlling bacterial growth on the skin. Antiseptic detergents with chlorhexidine such as Hibitane are also effective. Hand and face lotions containing anionic surfactants neutralize the antibacterial effect of chorhexidine and should be avoided when bacterial control is important (i.e. almost all skin diseases). Surgical scrubs require vigorous scrubbing of the hands and forearms with a stiff bristle brush, antimicrobial detergent and thorough rinsing. The scrub is usually repeated three times. Even with intense scrubbing with strong antibacterial agents, bacteria cannot be eliminated from the skin.

Skin in Health and Disease is a book about skin health, skin care that offers solutions to specific skin disorders through diet revision an improved nutrition. The good news for many suffers some chronic skin disorders is that complete diet revision will often improve and sometimes resolve skin symptoms. This book focuses on the most common skin disorders that can be controlled by changes in skin care, diet and the environment. Eczema, for example, is sometimes an expression of food allergy, or allergy to contact materials. Dermatologist may deny the food allergy causes, so that their patients often have to make independent decisions. In all aspects of medicine, we advocate responsible self-management and offer this book as primer and reference for self-managers with skin problems.


The book, Skin in Heath and Disease is intended to be used with the Alpha Nutrition Program. This text provides background knowledge, helpful in understanding skin disorders and the relevance of diet revision. Often a food holiday on Alpha ENF is the best way to begin recovery and the Alpha Nutrition program is an ideal way to design a safer, healthier long-term diet. If diet revision is appropriate to solve your Skin Disorders, you can order the the Starter Pack Option.

Starter Packs bundle the Alpha Nutrition Program, with other books and formulas to help you get started solving your health problems. The starter packs are sold at discounts to make it easier and affordable for you to learn more and try our nutrient formulas. If you are not ready for the starter pack, Order Books Separately.

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Alpha Online is a hub for twenty five Medical Information Centers. Each center acts as its own web site with a home page and a list of links to relevant topics. Take advantage of 800 pages of text which describe common medical problems and introduce you to innovative solutions such as Alpha ENF and the Alpha Nutrition Program.

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