The New York Times online health blog yesterday featured a fascinating article about tanning addiction, Addicted To Tanning?  One of the most interesting aspects of the article was a study showing that chronic tanners experienced withdrawal symptoms (jitters and nausea) when they were given the narcotic withdrawal drug called naltrexone, suggesting that pleasure-giving endorphins may be part of tanning addiction.

Well, I just had to post a comment on the New York Times!  I’m surprised at what memories came up for me when I read the article and wanted to share my comment with you.  Here is the comment I left on the New York Times online health blog concerning the article:

I’m a practicing dermatologist and was probably addicted to tanning as a teen and young adult. I was unable to stop tanning in spite of having surgery for a skin growth that was at first thought to be a very aggressive melanoma. In the end the growth was not cancer, I did not have the lower leg amputation recommended by my first dermatologist, but the scare did not deter me from tanning.

It wasn’t until my dermatology residency in San Diego that I found the resolve to stop; seeing sun damage and skin cancer in patient after patient was like the shock therapy used to help people stop smoking. For the last 25 years I’ve avidly sun protect my skin. Interestingly, my facial skin texture looks younger now than when I was in my 20’s and tanning. Also interesting is that my family now has a strong family history of melanoma and I’m convinced that if I had continued tanning I probably would not be here today.

As for vitamin D, fair skin makes all it needs in the first few minutes of sun exposure. Continued exposure actually starts to break the vitamin D down. Knowing that sun protection is never perfect, I recommend sun protecting your skin, and the ‘margin of error’ usually lets enough sun into your skin for vitamin D production. To really know what your vitamin D needs are, get it measured and ask your doctor for advice. I find there is very little correlation between patients that sun protect or tan and vitamin D levels. My specific advice and more information on vitamin D is available on one of my recent blog posts.

It’s funny that I didn’t go into dermatology because of this early near brush with cancer.  It’s also funny that it took my residency experiences to get me out of the sun, now I know why.

You may also want to read my sun protection advice:

5 Steps For Smart Sun Protection

If You Want A Nice Sunburn Use Last Year’s Sunscreen

How To Pick The Best Sunscreen

Are Your Summer Clothes Good Enough To Be Sun Protective Clothing

Photo Attribution:

Your nails don’t always stand up to the use you put them to, and when they don’t, they crack!

Just yesterday, an 80 year old patient asked me why his fingernails were dry, brittle and splitting on the ends.  He’d always had strong nails.  He wanted to know if I thought Knox Gelatin Capsules would work for him; it’s what his mother used when she had nail problem. They didn’t work for her, but he didn’t know what else to do.

Almost every day I’m asked by someone for advice to fix their brittle, splitting fingernails because the problem is so common. It can happen at any age, but it’s definitely one of those “as we age” stories. If your nails are splitting, there are things you can do to improve them, but there are also common ‘remedies’ that actually make the problem worse.

THE PROBLEM:

Your nails dry out as you age, losing their natural oils which act as a glue to hold the nail layers together. If you have thin fingernails and dry skin to begin with you can expect this to happen to you ‘sooner rather than later’.  Exposing your hands to harsh soaps, cleaning products, solvents and rough work makes things worse. At first your nails begin to ‘fray’ on the edges, becoming brittle. Eventually the layers split.  Nail hardeners make this worse because the alcohols, formaldehyde and other chemicals in the nail hardeners really dry out your natural oils. (Crazy fact: Nail hardeners actually contain more of these chemicals than nail polishes!  It’s these chemicals that make the nails feel harder at first, but- whammo- after a few weeks the splitting is worse than ever.)

THE FIX:

Dermatologist’s 3 Simple Tricks To Treat Cracked And Splitting Fingernails:

1. Hydrate and add oils.  Use creams, oils and ointments on your nails everyday after they’ve been wet. My favorite is good old Bag Balm with it’s wool alcohol (aka lanolin).  Some of my other favorite hydrating ingredients for nails are Shea Butter, Jojoba oil, avocado oil, or other rich natural oils.  The thicker the cream the better, and oils or ointments are best. The trick is to use something that stays put for awhile and doesn’t just rub off right away.  Plus, you always moisturize skin and nails immediately after water exposure; applying moisturizers to dry nails is a waste of time.  Put your moisturizer on within minutes after your bath or shower, or after washing your hands.  Do it as often as possible.  You can use a hand cream during the day (I love my Intensive Hand Cream, which is non-greasy), but use a thicker product like Bag Balm at bed time. If your nails are really bad, apply Bag Balm to them numerous times a day after washing your hands.
2. Clip and file your nails when they’re wet. Clipping and filing dry nails makes the splits worse so always do it after water exposure.  Towel off the water and then use sharp nail clippers to trim your nails, followed by gently filing the edges.  You can also very gently buff the nail edges to keep the splitting layers from catching on things and progressing down the nail.
3. Wear gloves when you do rough work or get your hands into harsh chemicals. Obviously you want to protect your brittle and splitting nails from the things that make them worse.

Gelatin capsules don’t work but vitamin supplements formulated specifically for nail growth may help. I’ve had patients who feel that their nails grew a lot faster and stronger once they started taking supplements. Nail supplement formulations appear to vary, though most contain biotin.  I tell patients to go to their favorite high quality natural food store and ask the vitamin specialist for their best nail formula.  It’s important to know that many of the ingredients in these supplements are lavishly present in whole foods like fruits, vegetables, whole grains, nuts, natural oils, beans and fish.  Eating a richly nutritious diet is key to supporting healthy nails and vitamin supplements should be used in addition to, not in place of a healthy diet.

Your fingernails grow slowly, about 1mm per month.  As you age, the growth slows down even more.  This means it will take several months for the dry and split portion of your nails to grow out.  Depending on the condition of the rest of your existing nails, it could take as long as a year for proper nail care, good diet and your vitamin supplements to stop the nail splitting, so hang in there and don’t give up.

Lastly, there are internal diseases that can affect your nails, the most common being thyroid problems and anemia.  Some skin diseases affect the nails as well and cause splitting.  If your nails don’t improve, see your doctor.

I’d love to hear any tricks or products you’ve found to improve your brittle and splitting fingernails.

If you found this information helpful you may also want to read:

Pandemic Of Dry Hands; Hand Sanitizers, The Swine Flu And Tips To Save Your Hands

Natural Skin Health; Dermatologist’s Diet Recommendations For Healthy Skin

Dermatologist’s 3 Simple Steps For Sandal Ready Feet By Spring

Photo:

http://www.flickr.com/photos/tonythemisfit/2432720887/ Tony The Misfit

It’s just been scientifically proven: A veggie and fruit diet gives you a better looking skin color that a sun tan. As a dermatologist and nutrition advocate, I’m thrilled!

You actually do look more beautiful to other people when your skin has the golden glow that comes from eating fruits and veggies. People find that color more appealing than the brown color that comes from a sun tan.

I’ve thought this for years and now it’s fact; in a scientific study, volunteers rated the golden skin of veggie eaters as more beautiful than the brown skin of sun tanners — and you can get your own ‘golden glow’ in as little as a month.

The take home message: If you want to look great, skip the sun tan and instead tank up on fruits and veggies!

Here’s the details:

Dr. Ian Stephen, an experimental psychologist at the University of Bristol in England, did a study where he showed volunteers a series of photographs of both men and women. Some were sun-tanned and others were on a prescribed fruit and veggie diet that was high in beta carotene. He asked the volunteers to rate the attractiveness of the people’s skin tone. The volunteers consistently preferred the skin tone of those people who were eating the fruit and veggie diet over the tone from people who were sun tanned.

To understand this, you need to know that skin color is produced by one of two skin pigments: melanin or beta carotene. Your skin’s melanin content is partly determined by your genes, but it also increases with sun exposure. Beta carotene is a yellow/orange pigment that you only get if you eat it. Foods with lots of beta carotene include certain fruits and veggies like carrots, winter squash, cantaloupe, and some green leafy veggies.

Beta carotene imparts warmth to skin color. Of course this shows up more in really fair-skinned people (Fitzpatrick skin types 1 to 3), but in my experience, even people with darker skin (Fitzpatrick 4 to 6) can warm up their skin color with a healthy diet. I’m a fair Fitz type 2 and I’ve always preferred my skin with the warmth of beta carotene instead of my natural color (a pasty and transparent blueish white). I eat a ton of veggies, which I’ve talked about in past blog posts. Now I’m going to make sure to always include the fruits and veggies with lots of beta carotene; heart attack, stroke, cancer, arthritis and weight control were motivating, but skin tone and beauty are real kickers! It’s undeniable, we are what we eat and everybody can see it in our skin.

Foods High In Beta Carotene

Good food sources of beta-carotene include:

• Yellow/orange vegetables: carrots, sweet potatoes, pumpkins, winter squash
• Dark green and/or leafy vegetables: kale, broccoli, spinach, collard greens, turnips and their green leaves, beet leaves, mustard and dandelion greens, watercress, cilantro, chicory, endive, escarole
• Yellow/orange fruits: apricots, cantaloupes, papayas, mangoes, nectarines, peaches
• Other good vegetable and fruit sources – summer squash, asparagus, peas, sour cherries, prune plums.

My advice to help you get get the most beta carotene out of your foods:

• Eat them with a little fat or oil because you’ll absorb beta carotene better with a little fat in your digestive tract.
• Chopped or juiced foods release more beta carotene than large chunks of food (carrot juice is a great source of beta carotene)
• Eating your fruits and veggies really fresh is key, because beta carotene is fragile and gets lost when the fruits or veggies are processed or stored

To Sum It Up: You can get a great skin color without the wrinkles, liver spots and premature skin aging that comes from sun tanning. Instead, eat fruits and veggies that are high in beta carotene for the best skin color of all…..

Skip the sun, have a salad, and look fabulous forever!

References:

Timesonline, May 23, 2010

Facial Skin Coloration Affects Perceived Health of Human Faces, Stephen ID, et. al., Int J Primatol, 2009 Dec;30(6):845-857.

If You Found This Post Interesting, You May Want To Look At:

The Alkaline Mediterranean Diet-A Dietary Magic Wand For Overall Health And Beauty

Are You Really Getting Vitamin D From The Sun Or Just Nuking Your DNA?

Use Self Tanners Like A Pro

Photo: Pink Sherbet

Flax seeds are the richest plant source of important health nutrients that do amazing things for your health. Expansive fields of blue flax flowers yield billions of these seeds-and you don’t have to eat a lot of them to reap the benefits. You do, however need to know how to correctly add them to your diet because the ‘magic’ health promoting ingredients in flax seeds are fragile and easily broken down in pre-made foods.  It’s easy, and tasty, to add a small amount of fresh flax seeds to your food every day. This simple addition to your diet will make a huge difference in how you feel now, and to what diseases you develop over the course of your lifetime.

Why Eat Flax Seeds:

The quick answer is that they contain huge amounts of things that can:

• Lower your cholesterol,
• Prevent clogged arteries and heart attacks,
• Reduce your risk of developing and dying from some of the more common, and horrible cancers
• Reduce your aches and pains
• Help you to be one of those people who look and feel younger than their age.

The longer answer is that flax seeds (and flax oil) are the richest plant source of the all important omega-3 fatty acid called alpha-linolenic acid which:

• Fights heart disease
• Reduces inflammation (The most obvious inflammation is arthritis and bone/joint pain. Inflammation, however is much bigger; it’s what makes pain, redness and symptoms form from all sorts of problems in your body. As a dermatologist, I treat the skin inflammation from acne, rosacea, psoriasis, eczema and other skin rashes.)
• Reduces your risk of cancers like breast, prostate, skin, colon, and lung
• Has been shown to slow the spread of existing cancers including ovarian and breast cancer

Flax seeds (but not flax oil alone) are also:

• The richest plant source of phytoestrogens, which have anticancer effects
• The richest plant source of something called plant lignans that fight belly fat, diabetes, high cholesterol, high blood pressure and clogged arteries.  These lignans are converted in your gut into enterodiol and enteroloactone, and it’s these compounds that do all this important work for you.  (Your gut bacteria actually do the conversion, which is one reason you also want to eat probiotic rich foods like kefir.)
• Packed with powerful antioxidants which help you stay youthful as you age.  You need good antioxidant defense systems for healthy aging because they protect you from free radicals and it’s free radicals that break down your body over time.  These same antioxidants help keep you mentally sharp as you age.
• Packed with fiber (we all know one reason why that matters) which is another way that they help to lower your cholesterol.
• Packed with vitamins, minerals and other nutrients that help keep you healthy

You reap the benefits of flax seeds by eating just 1 to 4 tablespoons per day of freshly ground flax seeds. I eat about ¼ cup of golden flax seeds (flax meal) every day and have for years. I grind my seeds every morning in a coffee grinder (that I don’t use for coffee). I throw the flax meal on my morning yogurt, sprinkle it with raw almonds and a little cereal or granola, add some fresh fruit, top it with soy milk and it tastes great.  Other options are to add the freshly ground flax meal to your morning cereal or a smoothie. Ground flax seeds have a soft, slightly nutty flavor that I think combines nicely with yogurt, fruit, cereals, oatmeal and other grains.

Golden Flax Seeds In The Grinder Before Grinding

Ground Flax Seeds (Flax Meal) After Grinding

The Breakfast That I Start Each Day With

It’s important to know that the magic nutrients in flax seeds break down quickly after the seeds are ground.  This happens because of exposure to air and light. If you’re not going to eat your ground flax meal immediately, store it in the fridge in a dark container to protect it from light and air, and use it as soon as possible. You can buy pre-ground flax meal but it’s expensive and you never know if it was prepared and stored properly.  It’s also possible that the fragile nutrients in flax seeds are broken down by heat, like during baking.  This means that baked foods with flax meal probably don’t have the same benefits as freshly ground flax meal.  Lastly, you can’t just eat the seeds without grinding them because the human digestive tract can’t break into the seed’s outer shell, you have to grind the flax seeds to release their powerful nutrients.

Someday drugs and supplements with extracts that concentrate the active components of flax seeds may be used to treat specific diseases.  For the present time, the best way to reap the benefits of flax seeds is to eat the seeds as freshly ground flax meal. I always prefer getting nutrients by eating whole foods rather than taking supplements; processing involves steps that can alter and destroy fragile nutrients.  It also separates the ‘active’ ingredient from all the other ingredients and often you need all the ingredients working together to get the health promoting magic.  My bias is that ‘you can’t outsmart mother nature’.  Plus, it’s easy to ‘over dose’ on an active ingredient in a supplement, but it’s hard to overdose on it if you’re eating it as a whole food.

Both animal and human studies provide evidence that eating flax seeds and their important nutrients are safe.  Only pregnant women need to exercise caution in the amount of flax seeds they eat.  If you have questions, of course ask your doctor.

To sum it up: Adding 1 to 4 tablespoons of freshly ground flax seed meal to your daily diet is a simple and inexpensive way to help you fight cancer, heart disease and inflammation…… and to age gracefully.

If you found this information helpful, you may also want to read:

Natural Skin Health; Dermatologist’s Diet Recommendations for Healthy Skin

The Alkaline Mediterranean Diet; A Magic Wand for Overall Health and Beauty

Are You Really Getting Vitamin D From The Sun Or Just Nuking Your DNA

References:

Health effects with consumption of the flax lignan secoisolariciresinol diglucoside, Adolphe JL, et. al., Br J Nutr, 2010 Apr; 103(7):929-38.

Experimental and clinical research findings on the cardiovascular benefits of consuming flaxseed, Bassett CM, et. al., Appl Physiol Nutr Metab, 2009 Oct;34(5):965-74

Decreased severity of ovarian cancer and increased survival in hens fed a flaxseed-enriched diet for 1 year, Ansenberger K, et. al., Gynecol Oncol 2010 May;117(2):341-7

Photo Attribution: Jim Linwood

Vitamin D update-

Almost every person that I talk to misunderstands vitamin D and sun exposure. Even physicians give incorrect advice. I see simple mandates telling people to go out and get sun for optimum health, but confusion surrounds how much sun, what time of the day, how many days a week, how long in the sun, and of course, should a person even use sun for vitamin D production in the first place. I’ve answered a lot of these questions about sun exposure and vitamin D in a previous post, but I want to give an update on some really good information I’ve found since I wrote that post.

People are rightly concerned about their vitamin D levels.  Scientists are learning more and more about how critical vitamin D is to health.  Everybody’s talking about it.  I was at my hair stylist just the other day and when another woman there found out I was a dermatologist, she sat down next to me, looked me directly in the eyes, worry written all over her face, and said,

“I just have to ask what do about my vitamin D.  I’m a cancer survivor, I’ve heard that cancer survivors have low vitamin D and that it’s dangerous.  I’ve been told to get sun, but how much? Will I get more sun damage? What do I do?  I want to be healthy.”

She’s right.  Cancer patients often do have low vitamin D levels and it’s frightening.  Vitamin D is known to be important for immune strength, including immune strength against cancer. Sunny weather is here and frightened cancer survivors, and anyone who’s health conscious, are searching for answers about the sun and what’s best for their vitamin D level.  Here’s what I told her:

Hot Off The Press Update On Vitamin D And Health

Fair-skinned people make the maximum amount of vitamin D3 possible within a few minutes of mid-day summer sun exposure. This occurs with less sun exposure than would cause skin redness.  Longer sun exposure adds nothing to vitamin D stores, but it does increase DNA damage.

The vitamin D3 that you do make from the sun breaks down if you keep getting more sun exposure, meaning you actually lose the vitamin D3 that you just produced in those first few minutes of summer sun.

Only UVB (middle of the day summer sun from about 11 to 3pm) makes vitamin D3, I mentioned this in the previous post.

Dietary vitamin D supplements should be vitamin D3, not D2.

You should eat foods that contain D3 including fish liver, fish liver oils, fatty fish including salmon (thank goodness), mackerel and bluefish, and egg yolks.  You also need to try to eat wild caught fish, not farmed; studies show that in the US, farmed salmon contains only ¼ the amount of D3 compared to wild salmon from Alaska.

2000 IU of Vitamin D3 may well end up being the new dosage recommended for prevention of vitamin D3 deficiency for people at risk of low levels.  Recommendations are currently being reevaluated by the medical community, but  it appears that 2000 IU is generally the latest recommendation.  This is the dose that I take.

Some final words about sun exposure and your vitamin D levels:

Simplified recommendations bounced around by ‘experts’ telling you to go in the sun are way too simple.  Ignore advice about how much skin you need to expose, how often and for how long.  Too many things affect how well the sun produces vitamin D3 in your skin, including:

• Where you are in the world (your location latitude and altitude)
• Time of the day
• Time of the year
• Ozone concentration above you
• Pollution in the air
• Clouds in the sky
• Reflective surrounding surfaces (water, cement, sand, etc.)
• Your skin pigmentation
• How much of the pre-vitamin your skin has in it at the time

And remember, what vitamin D3 your skin does produce is broken down if you stay in the sun after you’ve made that initial dose.

Forget simple recommendations.  Get your vitamin D level measured by your doctor.  Take supplements and eat foods with vitamin D3.  If that doesn’t keep your vitamin D level in the healthy range, then experiment with exposing your tummy for a few minutes like I mentioned in the previous post.  Get your level re-measured, your sun-produced vitamin D level peaks in 12 to 24 hours after exposure.  In summary, customize your approach to a healthy vitamin D level.  And remember, chances are, your level is just fine anyway and all that sun exposure is just nuking your DNA, making wrinkles, age spots and skin cancers.

If You Found This Helpful, You May Also Want To Read:

Making Sense Of The Vitamin D Dilemma

5 Steps For Smart Sun Protection

Cynthia Bailey MD’s Recommendations For An Alkaline Mediterranean Diet

References:
Bodo Lehmann & Michael Meurer, Vitamin D metabolism, Dermatologic Therapy, Vol 23, 2010, 2-12
Joseph W. Diehl & Melvin W. Chiu, Effects of ambient sunlight and photoprotection on vitamin D status, Dermatologic Therapy, Vol. 23, 2010 48-60

Photo Attributions: