Horse Rescue and Sweat—what?!

I have been happily volunteering at Colorado Horse Rescue (CHR) since February 2013. I am in the sun for most of my 2-3 hour shift. Because I’m around horses I have on jeans and cowboy boots, and I also wear a long-sleeved shirt under my CHR T-shirt to keep my arms from burning. And to protect my all-important hands, I have on thick leather gloves. (I know—hot, right?!)

Along with the obligatory sunscreen, I always wear a bandana around my neck. I do this to protect the skin on my neck from sun damage. In the summer, I’ll wet the bandana before I put it on; this helps to keep me cooled off a bit. At the end of my shift and after a lot of sweating, before the sunscreen and sweat start to dry, I splash rinse my face and use the bandana to wipe and dry off my face.

Wearing a bandana—or something like it—is a good idea, even if you’re out walking. (With other exercising activities, like running and cycling, it’s a bit harder to pull off wearing one.) In the winter months at the rescue, the bandana adds an extra layer between my skin and the cold winter air.

If you’re in the Boulder/Longmont area and are looking for a really satisfying volunteer opportunity, consider Colorado Horse Rescue. Many of the horses who arrive at the rescue have sad backstories, but after a short time, whether a horse is eventually adopted or stays at CHR, the healing power of love is apparent in each and every equine. Seeing these transformations is truly heartwarming and makes this “job” so fulfilling and worthwhile. 

For more ideas on keeping your skin safe in the sun, see:

• Hats, Hats, Hats! Protect your skin in the sun
• NO SWEAT: What happens when sweat dries on your skin? 
• Colorado Horse Rescue website

If you look closely, you can see my red bandana poking out around my neck.

“I don’t eat much sugar”—really?

I came into the facial room to meet a new client, Cheryl. I went over her current skin care routine and any medications she might be on, especially the birth control pill. I asked if she took vitamins or herbs, did she exercise, drink water, and wear sunscreen? As soon as all the questions were answered, I began the facial.

After cleansing her skin, I brought my magnifying lamp over and peered through it at her face. The lamp magnifies about seven times, but in Cheryl’s case I really didn’t need the lamp. I could see from pretty far away that her skin was very broken out. She didn’t have pustules; her breakout consisted of those hard, red, deep-under-the-skin places. I could also see she was causing some damage from picking at her skin.

“Clean food”—good for skin

Instantly I knew she was ingesting way too much sugar, but I held myself back and proceeded to ask about her eating habits. I told her not to tell me what was good in her diet, but that I was interested in what she was eating regularly that wasn’t so good. The good, clean, healthy foods aren’t the troublemakers. Someone can tell me repeatedly about how much grilled chicken and vegetables they eat. Those foods are not causing their skin to break out, but something is.

I asked if she had much sugar in her diet. She responded the way most people do, “No, not really. Sure, I’ll have the occasional bite or two of a dessert I’m sharing with someone, but generally the only sugar I get is from fruit, like apples and oranges.” I asked about her menstrual cycles. Perhaps Cheryl’s skin problems were indicative of a hormone imbalance. “No, everything is normal,” she said in regard to her periods. So I was back on the sugar hunt.

To me, it seemed so simple: sugar was the culprit, yet she insisted she had very little in her diet, and in fact she ate very similarly to me—simple, clean foods. I explained to Cheryl that something was causing her breakout; it isn’t just happening for no reason and without explanation. And it is my job (and Cheryl’s) to decipher her lifestyle habits and figure out what was the offending edible substance.

All breakouts are hormonal. Hormones are little chemical messengers that tell your glands what to do. And in this case, it is the oil or sebaceous glands that are overproducing and causing problems. So to say that her breakouts were hormonal was true, but I wanted to find out why the hormones felt the need to exceed their normal and balanced dosage within her body.

Years ago a biochemist friend of mine told me that sugar can sometimes be a precursor to certain hormones in the body. I have absolutely no substantiated studies or clinical trials to back me up on this; I only have hundreds of clients who have been in my care for years who have stopped eating sugar and cleared up their skin. If the precursor theory is true, I would imagine it would be the androgens or male hormones that are being activated by eating sugar.

Sugary shots are not so great for skin

Since her periods were fine, I didn’t think it was a hormone imbalance causing her breakouts, so I went into my sugar speech. I started telling Cheryl about my own sugar addiction. I told her that I am so sensitive to sugar that if I ate just a small amount of sugar, but ate it every day, I would have a lot of breakouts consistently. Bingo. When I said the words “every day” it hit her. Every morning (or almost every day) Cheryl gets a coffee drink with a shot of vanilla in it. There it is. That vanilla syrup is essentially highly refined sugar—with vanilla flavoring. I told Cheryl that if I had one of those coffees with only one shot of vanilla every day for just one week, my skin, even in that short amount of time, would be a disaster.

According to myfitnesspal.com, 2 tablespoons of Starbucks vanilla syrup contains 19 grams of sugar. That is about as much sugar as you want in a day. It’s doubtful that 19 grams or so is all the sugar Cheryl was getting day to day. But even if it was, for sugar-sensitive people, that is enough to tip the scale and cause skin issues. For those (lucky people) who aren’t as sensitive, this coffee drink or its equivalent may not cause any problems.

We’d finally hit gold! We had something to work with, and now Cheryl could start taking control of her problem skin. I recommended she cut the vanilla shot out completely for at least one month to see if her skin did a turnaround. And it did. Admittedly, she also went on the products I recommended for her. But I know it was the sugar that in the end was causing her problems and that it was the avoidance of sugar that ultimately cleared up her skin.

Cheryl’s is a case where she really wasn’t ingesting a whole lot of sugar (if the coffee drinks were the only appreciable sugar she was getting daily); sometimes I do have clients who say they aren’t eating much sugar and, with further investigation, they really are. However this client does illustrate how sensitive to sugar some of us are—some more than others—and how taking out even small amounts of the sweet stuff can make a big difference in your skin.

For some eye-opening information, see: 

• Sugar in your precious Frappuccinos!
• I’m sensitive to sugar—are you? 
• Caffeine does more than just wake you up

Skin Cancer ABCs

The title of this post should really be Skin Cancer ABCDs. I recommend you memorize and use the following information to help you determine some preliminary information about questionable moles or spots on your skin. Please remember this: When in doubt, get checked out!

A stands for asymmetry. A circle is symmetrical; it has an evenness to it and is perfect in its round shape. Therefore asymmetry is a circle that isn’t fully and completely whole. One half doesn’t mirror the other half. It is uneven.

B stands for border. The border or outline of the mole has irregularities, either a ragged edge or notched—not smoothe.

C stands for color. Moles and spots on your skin should have an even color to them. If they are two-toned, for instance, having one shade of brown mixed with a darker shade of brown or even black, that is generally not a good sign. Along with differing shades, sometimes there are patches of red, white, or blue present. Color differences within one spot means it’s time to get your mole checked out by a dermatologist—now.

D stands for diameter. In the American Cancer Society’s literature they describe the diameter of anything bigger than a pencil eraser (wider than 6 millimeters or about 1/4-inch) is cause for concern. From my own personal experience, I had a precancerous mole removed that was less than a quarter of the size of a pencil’s eraser. But this mole also had color variation (“C”), so it was biopsied and removed. Size alone is not necessarily a negative, but if a smaller mole has any of the other ABCDs, don’t wait to have it checked out.

Next is a different set of ABCs used by permission from the American Academy of Dermatology. I am including it because it offers just that much more information that can help you remember how important protecting yourself in the sun is.

• Avoid the sun especially during midday between the hours of 10 a.m. and 4 p.m.

• Block the sun by applying sunscreen with Sun Protection Factor 15 on children 6 months or older.

• Cover up with long-sleeved shirt, sunglasses, and wide-brim hat if going outdoors.

• Shade: infants younger than six months need special protection because their skin is so delicate.

• Infants should be kept out of direct sunlight as much as possible.

• Sunscreens that contain para-aminobenzoic acid (often shortened to PABA on labels) or oxybenzone are not recommended for infants. Sunscreens that contain zinc or titanium oxide are a possibility, but check with your baby’s doctor before using them.

The main thing to remember when it comes to sun exposure and your skin is don’t wait until it’s too late to get checked out by your dermatologist. Skin cancer is preventable and curable if caught early enough.

For more information, see:

• My Skin Cancer Story: Please read this!
• Sun Exposure & Skin Cancer: It all adds up!
• Melanoma—the deadliest skin cancer

Rashy breakout around your mouth? A client’s question

I have this red, rashy breakout around my mouth, but it’s only on one side. What is causing this?

Believe it or not, I see this quite often. Whenever there is breakout on one side of the face, it’s time to ask yourself a few questions. First, do you talk on the phone a lot? If so, on which side of your face do you hold the phone? And further, do you let the phone rest on your face?

Telephones get dirty quickly. Even if you are the only person using a particular phone (a land line, for instance), oil and debris collect on the receiver, and especially if you rest the phone on your face, this will easily get transferred to your skin. Sometimes the oil will cause breakouts, and sometimes constant handling of the phone can cause contact dermatitis, a skin inflammation that is caused by contact with offending materials. If your “rash” is indeed dermatitis and not a true breakout (congested oil that has become infected), I will be posting an article specifically for help with all types of dermatitises at a later date.

Cell phones are contributors to irritations on the skin. They are almost always resting on your face and therefore can create problems, especially if you talk on a cell telephone throughout the day. I continue to see clients who have this one-sided breakout/irritation from using their cell phones.

• Step one in solving your problem is to keep the phone off your face. This won’t be easy, but without stopping contact, I’m afraid your problem will continue.
• Step 2, clean your phone (repeatedly if necessary). One of my clients was experiencing contact dermatitis caused by her cell phone. I recommended she keep baby wipes handy to clean her phone with. You’ll be amazed at how much junk gets piled up after just one day of using the telephone.
• Step 3, keep your hands off your face. Constantly feeling the breakout with your fingers will just encourage it to stay there.

For the time being, don’t use an abrasive scrub on this area, but do use a clay mask to help encourage any congestion to vacate the premises. Keeping the area clean, which includes keeping the phone off your face, is your best bet for helping the problem go away.

If the phone doesn’t seem to be the culprit, what is your body position when you sleep? Do you lie on your right or left side, on your back, or even face down? I have found some people can get a small amount of breakout if they sleep on their side—especially always one particular side. It is the side that is crushed against the pillow all night long that suffers. Changing how you position your body to sleep may be a huge leap, but if you are sure this is what is causing your breakouts, the true solution is to change your habits.

The only explanation I have come up with for this type of pillowcase breakout is that lying with your face against the pillow all night inhibits elimination. If you have always slept on your side and just now think this is causing some skin problems, perhaps it is simply new laundry soap.

To help with the breakout around your mouth, no matter the cause, use clay mask on the area at night. Be sure to let the clay dry before you get into bed, otherwise the clay will stick to your pillowcase instead of your skin. Do this for several consecutive nights and see if it clears the problem.

I can hear you saying, “But you said to always keep the clay mask moist on my face.” Yes, that is true when you are applying clay to your entire face, you don’t want that much surface area to become dried out. However, when dotting the clay mask on small spots or blemishes then going to bed, you have no choice but to let the clay dry. Because you are only applying the mask on tiny spots, this shouldn’t cause your skin to become excessively dry.

One more note: If you tend to go to bed without removing your makeup, this can always cause problems with congestion and breakout, around your mouth or wherever.

For more information, see:

• Dermatitises (skin inflammations) explained 
• Eczema anyone?
• Help for Breakouts

Requirements for taking Accutane

Unlike many drugs, before getting a prescription for Accutane, several requirements must be met. Why? Because Accutane carries with it significant risks. For male patients, the concerns are fewer. But for females, the potential for severe birth defects is probably the number one concern while on this medication. Because of this, no female patient is allowed to begin Accutane therapy if she is currently pregnant (no matter how far along) and definitely no pregnancies should occur while a woman is taking this potentially harmful medication.

There is strict monitoring for pregnancy during these treatments. Any female about to take Accutane must first take one, and in some cases two, pregnancy tests to ensure there is no possibility of a birth before going on this drug.

If a female patient is or might become sexually active during the course of treatment, she is required to:

• use two different forms of birth control at least one month prior to treatment
• throughout the entire course of treatment
• and then for at least one month following the discontinuation of Accutane treatment

Regardless of sexual activity, female patients must take birth control pills for the duration of treatment. There are even strict policies that require a negative pregnancy test before a female patient can pick up her next month’s supply of Accutane at the pharmacy.

A formal consent form must be signed before initiating treatment with this drug. It mentions the obvious and most notable potential for severe birth defects and the patient’s agreement to take birth control for the duration of treatment. It also goes into great detail about depression and the possible signs of a depressive mental state while on Accutane.

Please continue to read about Accutane use to help you understand the risks (and possible benefits) associated with taking this powerful drug. For more information, see:

• Accutane and Depression
• Going on Accutane—right or wrong? 
• Accutane—side effects