Wednesday, November 23, 2011

Thankfulness Linked to Positive Changes in Brain and Body

Grateful? Write it down. Think about it. Talk about it. 'Tis the season of thanking, and not only will you spread those positive vibrations to those around you, your health will benefit, too.
For those who tend to be more Grinch-ish than grateful, there's some hard evidence that might make you want to turn that frown upside down. A positive outlook and feelings of thankfulness can have a direct and beneficial effect on the brain and body.
"If [thankfulness] were a drug, it would be the world's best-selling product with a health maintenance indication for every major organ system," said Dr. P. Murali Doraiswamy, head of the division of biologic psychology at Duke University Medical Center.
While the act of being thankful is not a substitute for a proper medical diagnosis and treatment, Doraiswamy said it's certainly a strategy that can be used to enhance wellness.
Studies have shown measurable effects on multiple body and brain systems, said Doraiswamy. Those include mood neurotransmitters (serotonin, norepinephrine), reproductive hormones (testosterone), social bonding hormones (oxytocin), cognitive and pleasure related neurotransmitters (dopamine), inflammatory and immune systems (cytokines), stress hormones (cortisol), cardiac and EEG rhythms, blood pressure, and blood sugar.
"When my coaching clients ask me why gratitude exercises work, I let them know that humans have something called a negativity bias where "bad stuff" in our life outweighs the good by a measure of about 3:1," Renee Jain, a certified coach of positive psychology, wrote in an email.
"This bias developed over millions of years help us survive threats in our environment," said Jain. "Fortunately, we no longer have to worry about a saber-toothed tiger attacking us on the way to work. Unfortunately, we still have this bias, which makes us home in on negative events, emotions, and interactions in our lives."
The brain's fundamental organizing principle in life is to avoid threat and maximize rewards, said Mitch Wasden, CEO of Ochsner Medical Center in Baton Rouge, who holds a doctorate in human and organizational learning. Because of this, the "chemical cocktail surging through the body allows humans to feel rewards and threats," he said.
"The brain's primary reward chemical is called dopamine," continued Wasden. "The interesting thing, however, is that we can't feel rewards and threats unless we focus attention on them. Many good and bad things happen in our life every day, but until they come to our own attention, we don't get the neurotransmitter release that allows us to feel good or bad."
But there's a twist. The brain doesn't know the difference when it's reacting to reality, fiction or even past events, which explains why people feel scared while watching horror movies even though they know it's not real or they cry when reading a sad novel. Feeling thankful for things that have happened acts as a "mental movie," Wasden explained. The brain releases dopamine, which, in turn, has a positive effect on mood and emotional well-being.
"I find positive psychology strategies can be particularly helpful for some people with mild depression and for those with poor psychosocial coping styles," said Doraiswamy. "Clearly if someone has severe depression or is suicidal they need urgent medical management for acute care but even there positive psychology strategies may reduce their risk for relapse or increase compliance with their treatments."
"Gratitude helps us counteract the negativity bias by focusing our attention on the "good stuff," Jain said. "A little focus can go a long way to improving one's psychological, social, and physical health."
If it's tough to get out of a negative-thinking rut, Wasden suggested keeping a journal of things, big or small, that you are grateful for. Write letters of gratitude and meditate on positive emotions.
"One of the most well-known practices uncovered from this research is known as the Three Blessings exercise," said Jain. "Each night before going to bed you write down three good things (ordinary or extraordinary) that happened to you during the day. Studies reveal those who continue this exercise for one week straight can increase their happiness and decrease depressive symptoms for up to a six-month period."

Friday, November 18, 2011

Trying to stay warm can make skin dryness worse

You don’t know what you’ve got until it’s gone. The old adage usually refers to lost love, but the same holds true for the skin’s protective lipid layer. 
You might not even know your skin has a protective lipid layer, but when the temperatures drop and your skin dries out, you can tell it’s gone. 

Winter weather and the things we do to stave off the cold make dry skin worse.

When it’s cold outside, we run the furnace, which removes humidity from the air. We take long, hot showers to warm up, and hot water saps moisture. We wear wool clothing, but it can cause friction and itching, which further irritate already-dry skin.

Dr. Elizabeth Small, a Springfield Clinic dermatologist with 31 years of experience, said treating dry skin is “quite common” in the winter months. Once the protective lipid layer is gone, water evaporates from the skin, which causes it to dry and crack.

Frequent hand washing and the use of antibacterial hand gels — both of which are promoted during cold and flu season to keep germs at bay — dry out skin. 

“Health care and child care workers are prone to dry skin because of frequent hand washing. I know from personal experience,” Small said. “I almost always have a finger crack by the end of the week, and it takes the weekend to heal.”

A simple solution is to find an antibacterial hand lotion and apply it after hand washing.

Michelle Schroeder, an early childhood teacher in Springfield, develops itchy, rough skin in the winter. Washing her hands countless times throughout the day only makes it worse. 

After trying a variety of products, most of which didn’t heal her dry skin, she discovered Herbacin, an over-the-counter lotion she applies frequently throughout the day. 

She also drinks ample water to stay hydrated. Small says a healthy person should try to consume 64 ounces a day. 

Signs of excessive dryness include itchy, flaky, red, scaly, cracked skin.

Amy Behrens, a registered nurse from Rochester, says winter is definitely the worst time of year for dry skin, and the first sign is usually the appearance of her hands.

The mother of two jokes that she knows she has dry skin when she looks down and sees her grandma’s hands at the end of her arms. Indeed, dry skin looked more aged than youthful, hydrated skin.

“My hands usually start looking scaly and feeling dry and scratchy,” Behrens said. “

"Working in health care means I am constantly washing my hands and applying sanitizer. It’s not easy on the skin, but it’s best for patients. At work, I use hospital-provided hand lotion that is compatible with latex gloves we wear.”

To repair the damage, Behrens uses Aquafor and Eucerin, both over-the-counter moisturizers, at home.

When desperate, Behrens uses an “overnight Aquaphor remedy” to hydrate hands or feet. Simply apply before bed, slip on old socks and sleep in them. 

“It is greasy,” Behrens said, “but it works.”

Heather Jordan, who works at the Springfield Developmental Center, says her hands “feel like sandpaper” when winter rolls around. 

She uses Gold Bond Ultimate skin lotion, the “only lotion that sustains the moisture for several hours.”

Personal preference seems to dictate which OTC moisturizer to use, but when the symptoms persist, it’s time to see a doctor.

“If you have cracked fingers that aren’t healing, inflamed, itchy skin that keeps you up at night or you have trouble walking because of cracked heels, you should see a doctor,” Small said. 

Doctors can prescribe cortisone creams that contain higher levels of cortisone and other steroids than OTC products. Low-potency steroid cream cuts down on the symptoms and allows skin to heal faster. 

Friday, November 11, 2011

The Skinny On Fat Versus Fillers

Patients coming in for surgery to make them look younger often will ask about fat injections.
There has been a lot of attention in the press about fat injections as a way to fill the grooves and troughs around the face. The areas most commonly affected by aging are around the mouth and lips. There are the nasolabial creases, the pair of which looks like parentheses, extending from the side of the nose down to the corners of the mouth. Then, there are the marionette lines, also somewhat parenthetic and parallel, running from the corners of the lower lip to the chin.
Another area that frequently tends to shrink and flatten out is the cheek bone area, particularly toward the nose under the eye. Finally, the area that shows hollowness with increasing age is below the cheek bone in the mid-cheek area.
What are the options? Today, we have more than ever. First, there is fat grafting. It begins with liposuction from the abdomen or the buttocks. It is filtered, prepared, and then injected into the areas that show shrinkage.  In excellent and in experienced and highly specialized hands, fat injections can be successful. The alternative is to fill with man-made fillers. This would include Restylane, Juvederm, Radiesse, Artefill and Sculptra.
Now, Radiesse and Juvederm are very similar – each is composed of hyaluronic acid – a natural occurring substance in human bone cartilage and skin. The product is bio-engineered in the laboratory and is considered pure and free of any possible rejection phenomenon. Complications from these injections are very, very rare. One unique property of Juvederm and Restylane, being hyaluronic acid, is that in case of overinjection, they can be dissolved using an enzyme called hyaluronidase.
While Restylane and Juvederm have a relatively short life within the tissues, typically 4-6 months or a bit longer, some of the other products are engineered to last longer. I have seen nice results from Sculptra injections done five years prior.
So, what about this competition between fat injections and what I will group together as the “non-fat injections”? The non-fat injections, which are laboratory made, allow a major advantage in that when the injections take place, one can see the result. Now, Sculptra is somewhat of an exception because it takes several months for the body to make new collagen and capitalize on the presence of Sculptra. The other products render an immediate, visible improvement. That is a huge advantage because the patient gets to make a decision when he/she is happy with the amount of filling. Further, one can fill a moderate amount and see how it looks in a few weeks, and go back and “top off.”  There is no need to puncture the body to obtain this as there is with fat injections.
I happen to like the concept of “testing the waters” with the non-permanent hyaluronic products, Restylane and Juvederm, almost as a ”demo”. Their immediate effect and shortened longevity also allows the patient to quickly decide if they are happy with the results. If they do not see the demonstrable improvement, and do not feel that it is a reasonable investment of their time and money, they can refrain from any further injections. There is economy of dollars there.
Now, let’s look at fat injections. I want to cite the recent discussion that took place on the pages of an excellent cosmetic surgery magazine for surgeons, Cosmetic Surgery Times. The publication interviewed two veteran cosmetic surgeons who faced off on fat injections. In the fat injection corner was J. William Little, MD, and in the “non-fat” injection corner was Val Lambros, MD.
I do not know Dr. Little personally, but he enjoys an excellent reputation nationally and internationally. I do know Dr. Lambros, and I have always admired the work that he has done, including his very unique tracking of individual facial aging using medically-consistent photographs. He has been a very good student of the subject of where the face ages, how it ages, and how, to the eye, the signs of aging can be reversed.
 Dr. Lambros made a very strong case for the unpredictability of fat injections. Frankly, I sit in that camp, also. I have always seen the unpredictability as the major disadvantage of fat injections. It does not mean that you cannot have a spectacular result, but it would take a very experienced practitioner, and somewhat of a “good day.”  Remember, not all practitioners are experienced enough to have a long track of patient observations, and Dr. Lambros referred to that.  I have selected certain quotes from his commentary because I think they are very on point.
“Injected fat can grow. This will be the longest long-term problem with fat.”  Dr. Lambros goes on to mention that, indeed, “the injected fat cannot be removed.  Then, you have the issue of symmetry. The surgeon may inject equal amounts into both cheeks, but maybe some of the fat will take on one side, and more will take on the other.  Another point made was that, in fact, due to a variety of anatomic factors, the fat takes better in younger people.  But, it is the older people that need the fat more because the hollowing of the face is a function of aging.”
Further, Dr. Lambros agreed with my observation that it takes quite a bit of experience and, what he calls, “finesse” and “esthetic sensibilities.”  While these are laudable and important characteristics in the cosmetic surgeon, we have to admit that not all will have this. If so, that is a negative.
Young surgeons are always taken with technology. In fact, it is a little more exciting to harvest the fat, treat it, and inject it.  It is more mechanical, more surgical than the mere injection of a syringe filled with a non-fat filler, such as Restylane, Juvederm, Radiesse, Sculptra or Artefill.

Read more:

Friday, November 4, 2011

Beat back the years while you sleep

We’re always hearing that one of the best beauty tips around is a good night’s sleep - and with the clocks going back yesterday, sleep is something we’ll all want a lot more of as winter sets in.

But if, like me, you woke up this morning feeling sleep-deprived and bemoaning the bags under your eyes, you probably don’t need convincing that how much sleep - and how good that sleep is - does make a difference to how you look.

But, surprisingly, given that dark circles are one of women’s biggest beauty bug- bears, science is still struggling to explain why we look so bad after a sleepless night.

“There’s a lack of evidence-based research into the relationship between sleep and appearance in the short term,” says consultant dermatologist Dr Nick Lowe. “There’s an increasing body of work suggesting that in the long-term, sleep deprivation could prematurely age skin.

“Chronic lack of sleep (consistently getting less than the seven to nine hours most adults need) has been shown, within weeks, to compromise the immune system, making it harder for skin to repair damage inflicted during the day,” he says.

“Other research has discovered a link between lack of sleep and increased levels of the stress hormone cortisol. At high levels, this can inhibit the formation of collagen, essential for healthy, youthful skin.”

Vogue’s former beauty director Kathy Phillips is so convinced of the importance of sleep that when she founded her aroma-therapy-based beauty company, This Works, she came up with an entire range of products designed to aid sleep, including a lavender bath soak and soothing pillow spray.

“If you don’t sleep well, everything suffers,” she says. “You eat the wrong things because you feel tired, you skip regular exercise and you work less efficiently.

“Some people are genetically programmed to get dark circles; others just feel listless and lacking in energy, have pasty skin and generally feel more fractious.” Let’s say, for argument’s sake, a good night’s sleep is the best beauty secret (no one would ever say too much sleep makes you look bad, would they?), but if you can’t get enough you at least want to make sure you’re using the most effective skincare products available while you are asleep.

The past few years have seen a huge growth in so-called “nocturnal” skincare, but do we really need an entirely separate regime for after dark?

Skincare expert Paula Begoun says no. “Day and night, skin needs the same ingredients to fight wrinkles, ageing, cellular damage and collagen breakdown.

“With the exception of sun protection, which for obvious reasons doesn’t need to be in a night cream, there’s no research showing that skin needs different ingredients or heavier formulations at night.”

But Dr Sian Morris, principal scientist with Olay, which recently launched its Regenerist Night Renewal Elixir, disagrees.

“Day creams have to prep skin for make-up, so most women prefer a light cream that’s quickly absorbed, but our research has found they like their night cream to be slightly richer and creamier.

“Science suggests it makes sense to have a more emollient cream at night. Skin at night is physiologically different from during the day; it needs more moisture and can be more receptive to certain ingredients.”

Her argument is supported by the growth of a field of medicine known as chronopharmacology, which has shown the efficacy of a drug is affected by the time at which it is taken.

This is because all of the biological systems in our bodies - digestion, brain, muscles, metabolism, capacity to sleep - run to certain patterns, known as circadian rhythms.

“Studies show the permeability of the skin’s barrier is lower at night and skin blood flow is higher than during the day.

“Practically, that means greater amounts of the active ingredients within skincare products are likely to penetrate to the dermis (the deeper layer of the skin) to help tackle issues such as wrinkles. Use products that include vitamin A derivatives (the most effective anti-aging ingredients) only at night, because they are unstable when exposed to sunlight.”

These vitamin A derivatives also boost the skin’s natural exfoliation process, which studies have shown to be less efficient at night.

Other research suggests that skin is more prone to water loss while we sleep, so if you really want to wake up glowing and fresh-faced, it makes sense to look for products that are rich in ingredients that draw water to the skin (such as hyaluronic acid and glycerin).