It’s important to remember that healthy glowing skin starts within. We are what we eat. It doesn’t matter how fabulous your skin care, it will not be a substitute for a poor diet or lifestyle. My top tips are to eat a healthy balanced diet full of fresh fruits and vegetables, a balance of healthy fats and protein and with plenty of fibre. Don’t underestimate the value of good sleep and stress management and of course a healthy gut microbiome.
What is the gut-skin axis?
There is a lot of interest currently around the so-called brain-skin-gut axis. This intimate link was identified as far back as 1930 when Stokes and Pillsbury attributed depression to altering the gut microbiome, leading to inflammatory skin diseases.
In 2016 O’Neil et al published a review looking at the mechanisms linking the gut and skin health. One of the associations is through the microbiome. Although not fully explored, the gut microbiome appears to influence the skin through its effect on immunity. There may also be a more direct effect, gut bacteria and their metabolites have been found in skin; a suggested mechanism that a disturbed intestinal barrier can allow gut bacteria to leak into the blood and directly accumulate in skin.
Stress directly affects gut health and increasingly we are aware of an intimate relationship between the gut, skin and brain. By optimising the health in these areas i.e. reducing stress, and promoting a healthy gut, we can optimise skin barrier function and skin health. There is increasing work being done looking at this symbiotic relationship.
Although there are a lot of animal studies looking at how changes to gut flora effect skin, there aren’t that many studies showing a change to the gut microbiome and the direct effect on skin. That said patients with psoriatic arthritis are at increased risk of developing IBD and have subclinical evidence of gut inflammation.
A study of 113 rosacea patients demonstrated that those with rosacea have a higher incidence of small intestinal bacterial overgrowth (SIBO) when compared to controls. Those with SIBO were treated with either antibiotics for 10 days or a placebo. Those who were treated with antibiotic therapy experienced an improvement in their symptoms for at least nine months.
How do you look after your skin over the summer?
Now that summer is here, you may notice some changes with your skin.
- Firstly, as the air tends to be less dry, moisturiser often goes further. It might be time to switch up skin care to use lighter more fluid moisturisers for example.
- As we start to show more skin we might start to notice moles, and if you are at all concerned that something has changed looks odd or is simply not healing, this is a good time to see a skin specialist to get a full skin check.
- Some individuals start to worry about bumpy arms or some blemishes on the chest or back. Starting with bumpy arms and thighs this might be keratosis pilaris, where dry skin can block follicles, this can sometimes become red and inflamed. I would look for ingredients such as ceramides and salicylic acid to help with keratosis pilaris. The ceramides help to support a healthy skin barrier, and the BHA salicylic acid can help to unblock pores. The key here is consistency.
- If you see blemishes on the chest and back look for ingredients such as salicylic acid, azelaic acid and niacinamide. Always wash skin after a sweaty gym session and wear breathable fabrics.
- The next most important point is to make sure you avoid sunburn. The pattern of 50 weeks of a year in an office and then 2 weeks of intensive summer sun with sunburn, is associated with the most serious skin cancer, melanoma. Sunburning in childhood is particularly dangerous.
My guide to SPF
Firstly, I always suggest a factor 50 sun cream. Although the protection between a 50 and 30 doesn’t seem a huge difference, the truth is by the time an SPF is applied in a cosmetically acceptable manner - almost always less than the manufacturers recommended amount - there is a significant reduction in protection. Very often an SPF 50 becomes a 25-30 SPF.
To achieve the recommended 2mg/cm2 it is usually too thick an application to be cosmetically acceptable. Remember also that SPF refers largely to protection against UVB, whereas UVA is an important wavelength that is present all the year and will penetrate glass. Therefore, making sure an SPF has excellent 5* UVA protection is also important. Some sun creams have filters that protect against longer UVA wavelengths so-called UVA-1. This wavelength works synergistically with pollution to damage skin and upregulate enzymes that breakdown collagen and elastin. So protection against UVA-1 is ideal.
If dyspigmentation is an issue protection against visible light is important, some mineral sun creams are seen as better protection against visible light with addition of filters such as iron oxide. Some antioxidants may also be added to sun cream to protect against the visible spectrum. Remember the most effective sun cream is the one that you can apply easily, that is cosmetically acceptable, one that will be re-applied frequently, the key to good ongoing sun protection.
What about skin care when travelling?
Travelling is often fun, however when we fly our skin may become dehydrated, especially on long-haul flights. Essentially the recycled air in the cabin is incredibly drying. This lack of moisture starts to affect our skin barrier, and we see an increase in trans-epidermal water loss. Skin becomes dry and sometimes also irritated and inflamed, especially if there is a history of dermatitis. When we fly the dry air that’s circulating dehydrates us when we breathe it in. As well as the direct loss of moisture from the skin.
My advice...
- The most important step is to ensure skin is super hydrated before flying. By ensuring your skin barrier is in a good place before taking off, you’ll minimise the impact of in-flight dehydration. In the days leading up to your trip ensure you are using gentle, hydrating skincare and drinking plenty of water. Try to layer hydrating serums beneath moisturiser and remember to apply extra cream to your hands and feet.
- On the day of the flight, apply extra moisturiser before leaving. If possible, take a small pot of rich moisturiser and a water spray in your hand luggage too. Applying the water beneath the cream will allow you to trap the moisture in, sealing it in the skin. If you only apply the water, or a serum formulated with water-attracting humectants, like glycerine or hyaluronic acid, without topping with moisturiser, skin can actually become drier than before. This is with no humid external air to attract water from (cabin air is notoriously dry), the humectants may instead draw water from the deeper layers of your skin.
- If you are someone who always develops dry scaling skin around the nose and eyebrows and scalp, so-called seborrheic dermatitis, often exacerbated by long haul flights, I advise the following: As well as moisturising skin, apply an anti-yeast cream a few days before flying as this can really help control the yeast element of this condition.
- Finally, laying off in-flight alcohol will help with your skin’s appearance too. Tempting as it is, try to avoid excessive alcohol consumption. If you do have a glass of wine, match it with a large glass of water.
Summary
Summer can be a great time for skin as long as it is carefully protected from UV exposure. Sun is good for us, it gives us vitamin D, lowers blood pressure and enhances our feeling of wellbeing. Like any medicine however, it’s how you take it. Enjoy the sun sensibly without sunburn. Wear a hat, keep hydrated and avoid that harsh midday sun that may not be safe. Use the summer to boost sleep, reconnect with nature and spend time with family and friends. Have fun.
Join us as we uncover how you can feel your best inside and out this summer.
Sources
Microbiome in Inflammatory Arthritis and Human Rheumatic Diseases. Arthritis Rheumatol. (2016). Link.
Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication. Clin Gastroenterol Hepatol. (2008). Link.
