Anti-Aging Interventions

by, James J. Romano, M.D.

CLOTHING AND SKIN PROTECTION FACTS

• A light T-shirt has a sun protection factor (SPF) of only 6 or 7, not even close to the 15 or 30 in a good sun screen.
• Bleached cotton clothing offers less protection than unbleached cotton, wool, or polyester.
• Darker colors block more sunlight than lighter colors.
• Loose-fitting apparel is more protective than stretch fabrics that hug the skin.
• Consider using an excellent hat designed specially to protect against the sun. This is available at: www.sundayafternoons.com.

Skin Cancer Facts

• There are three different types of skin cancer: basal cell, squamous cell, and melanoma. Each is easily recognized on the skin surface.
• Basal cell carcinomas are the most common and present as crusty, scaly lesions that bleed easy and never seem to heal and grow very slowly. They are easily treated and cured if removed in the early stages. It is very, very destructive if allowed to spread into the surrounding tissues.
• Squamous cell carcinomas are the second most common and are similar to basal cell carcinomas at times but usually start off as a red painful area and grow much more rapidly. Unlike basal cell carcinomas, it can break off and spread into the bloodstream and then can become fatal.
• Melanoma is the least common but most deadly. It arises in the pigment bearing cells and for this reason is usually colored. See the typical photos and ABCD warning signs below. Any suspicious areas should be biopsied.

• Non malignant lesions can be suspicious looking and deserve evaluation by your doctor. These include actinic keratoses and seborrheic keratoses. These are sun spots and age spots and raised areas that usually can be treated by shaving, peels, or creams.
• For more information on skin cancer visit the Skin Cancer Foundation at www.skincancer.org.

SKIN CARE

Proper care and maintenance of the skin parallels much of the same things we do for our body as a whole. These are our basic recommendations which are customized to your skin and lifestyle and expectations during a full hour intensive consultation with our skin care specialist.

• First is the avoidance of environmental pollutants especially the sun, cigarette smoke, and improper diet.
• Skin cancer surveillance.
• Emphasis on hydration with 2 quarts of water intake daily.
• Cleansing of the skin. This is not only with specific medical grade products but through periodic hands-on treatments with our specialists for deeper cleansing.
• The skin care specialist. Skin cleansing, care and maintenance definitely requires the skill and expertise of a dedicated highly qualified specialist who can squeeze the pores, treat the skin, and educate you in ways we simply cannot do ourselves.
• Topical products. There are many products and nutraceuticals and cosmeceuticals which provide specific medical grade benefit to the skin and should be used under the supervision and recommendation of your doctor or skin care specialist and include:
  • Vitamin C
  • Bleaching creams
  • Topical growth factors
  • Retin-a
  • Copper peptides
  • Aloe vera
• Textural interventions. This relates to the procedures designed to treat smoothness, light scars, wrinkles, blemishes, pigmentation, blotchiness, and mild skin laxity.
• Chemical interventions such as peels. These can be light (glycolic or alpha hydroxy peels), medium (TCA or Blue peel), or deep (Phenol). The healing time, permanancy, and level of improvement increases as you go up the scale.
• Mechanical interventions. This includes microdermabrasion and dermabrasion. An abrasive substance or rotary device is used to remove the upper skin cell layers usually after a period of skin care pre-treatment or in combination with other interventions.
• Systemic products. Most of the nutrients, supplements and dietary interventions you utilize in our program will have a direct effect on improvement and maintenance of the skin.
• Education. There are many products and interventions and this needs to be an ongoing evaluation, recommendation, and treatment process with constant learning by the patient and education by your supervising doctor and skin care specialist.

EXERCISE

Do not think of this just as a means to loose weight which effects the least. It is mostly beneficial in protecting the heart, strengthening bones, improving sleep and memory, reducing cancer risk and retaining muscle mass.

• Obtain a consultation from a personal trainer to know what exercises to do and develop a program that is safe and fun and will not harm your body.
• Exercise at least 20 minutes as day with the endpoint of raising your heartbeat (breaking into a sweat).

SPIRITUALITY AND RELATIONSHIPS

Do not ignore or underemphasize this. A sound marriage is one of the strongest positive factors in prolonged life and longevity. These place great emphasis on your basic human and loving needs and need for fulfillment. The approach is very personal but can be evaluated and improved greatly with reading, resources and professional evaluation and interventions.

STRESS

Management of stress and relaxation is important.

• Learn relaxation techniques and spend 10 minutes daily purposely and consciously doing nothing in an effort to rest your brain activity and relax your mind.
• Meditation is very powerful. Your brain is a very active organ that needs relaxation and rest besides just sleep. Learn these techniques and use them daily.
• Consider yoga, tai chi or other practices.
• Relaxation treatments work on your body and your mind and state of well being. Massage, hydrotherapy, and sauna are excellent examples of this. Personal nail and hair treatments can contain many of these relaxing elements.

RISK FACTOR AND ENVIRONMENT POLLUTANT ANALYSIS

• No cigarette smoking. Also avoid second hand cigarette smoke which is more harmful that actually smoking. This is because the pollutant and unfiltered, unlike when you are smoking.
• Be careful of the sun especially through it role of conversion in the skin of pre-Vitamin D to its active form. Sunlight can be an important factor in the prevention of rickets (vitamin D deficiency). For all this essential good, sunlight can be our enemy especially to the skin and vitality of the skin. It is the sigular harshest aging factor to our skin. We need some sun but do not over do it.
• Avoidance of sun exposure. Not just sun-tanning. This also means excess in casual sun activities like biking, hiking and gardening.
• Use sun screens. This means using the proper product and using it properly. Use at least an SPF 30. Make sure it contains a physical sun block such as zinc oxide and titanium dioxide. Use at least a generous two tablespoons on sun exposed areas every 2-4 hours while in the sun and after getting wet or sweating.
• Proper clothing. Not all clothes shield damaging sun rays.
• Consider using a bronzing or tanning cream for your color.
• Minimize alcohol intake.

PLASTIC SURGERY EXAM

These are all features which can be improved with plastic surgery and can decrease the appearance of aging:

• Skin exam. Look for loose skin, folds, wrinkles, crease, pigmentation, skin lesions, blotchiness and spots.
• Facial exam. Look for drooping eyebrows, excess skin and fat of the eyelids and face. Notice if the eyelids are loose and lack elasticity. Note jowls, drooping to the corners of the mouth and nose. See if there are loose hanging folds of skin and muscles in the neck.
• Breast exam. Notice if there are stretch marks and looseness of unevenness from one side to the other or an unusual shape (tubular) to the breasts. Noe that sagging is defined by nipples below the level or the fold beneath the breast. Note if the breasts are enlarged and uncomfortable, numb or painful and associated with rash and deep bra strap grooves. See if the nipple are inverted, enlarged or uneven. Notice if the areola are large or puffy.
• Body exam. Note abnormal large fat accumulations especially those unresponsive to diet and exercise. Note excess skin and looseness in the arms, thighs or abdomen. Note if there is an abdominal pouch or protuberance or weakness (hernia). Notice the contours of the calves ankles and knees.