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Considering that each of us is covered in a dozen or more pounds of the stuff, it’s surprising how little thought we give to our skin’s essential role in the drama of our daily existence. Skin, after all, is where we meet the world. It’s the interface between our body and its surroundings. It’s our first line of defense against pathogens and sharp objects. It is the point at which we encounter sensation – pain or pleasure, heat or cold. Our skin is both the face we show the world and our most intimate means of physical connection.

But even if we seldom contemplate our skin in such deep and philosophical terms, we certainly do a great deal of dabbing, cleansing, buffing, spritzing – and even injecting – in an effort to perfect its outermost appearance. In 2004, the global demand for skincare products represented the second largest share of the estimated $200-billion-plus-a-year personal-care market.

And yet the fact remains that dollars alone can’t buy truly healthy skin. That’s because our skin is an intrinsic component of the health of our entire bodily organism. Meaning that unless we are optimally healthy, our skin won’t be either.

By understanding your skin as a vital organ and by smartening up about the factors that most profoundly affect its condition – from sun exposure, nutrition and hydration to internal and external skin stressors – you can optimize the look and feel of the skin you’re in, and also reap whole-body health benefits in the bargain.

The Anatomy of Your Skin

The skin of an average-sized human adult covers approximately 2 square meters and accounts for 12 to 15 percent of his or her total body weight. In some spots, like your eyelids, your skin might be as thin as 0.5 mm (similar to an empty envelope). In others, like the soles of your feet, it might be at least as thick as 4 mm (comparable to the thickness of the magazine you’re reading).

Composed of three layers (the epidermis, the dermis and the hypodermis), each industrious square inch of this skin tissue harbors millions of cells, more than 1,000 nerve endings, hundreds of sweat and oil glands, and nearly 15 feet of blood vessels. Together, they perform a series of everyday miracles on behalf of the entire body.

Sweat glands relieve the body of water, sodium and waste products.

Blood vessels help regulate body temperature and keep the skin nourished and oxygenated.

Oil, or sebaceous, glands keep the body’s outer surface resilient, protected and pliable.

Nerve endings in the skin communicate information to the interior of the brain and body. Machinery within the skin’s cells catalyze an astonishing array of biochemical effects – including the sunlight-assisted synthesis of vitamin D – essential to the body’s health.

Meanwhile, the skin also broadcasts all kinds of internal information, such as the presence of fever or an emotional response, through physiological reactions like blushing, blanching or creating a “cold sweat.” According to Christiane Northrup, MD, author of Women’s Bodies, Women’s Wisdom: “Because it is derived from the same embryonic layer as our brains and nervous systems, our skin acts as a kind of external brain – sensing our external environment and translating impressions to our inner selves, and then reflecting our response back to the world.”

To the trained eye, skin characteristics can communicate an astonishing array of information about a body’s physical and psychological state. Skin that’s flaky, rough, patchy, red, sallow, broken out, blotchy, jaundiced, ashy or weeping, for example, might reflect nutritional deficiencies, stress, disease, digestive disorders, toxicity, food allergies, hormonal imbalances, environmental irritations – and a whole host of other health challenges.

Many natural- and holistic-health professionals assert that the body tends to express illness “from the outside in,” and to heal “from the inside out.” So, in treating what appears to be an external skin condition, those practitioners may be just as likely to look to the body’s interior for clues about the condition’s origin and to treat the source of the problem accordingly.

That might mean removing a food allergen or improving the nutrition in a patient’s diet. It might mean prescribing detoxification and stress reduction, treating a digestive disorder or endocrine imbalance, or addressing a fungus,  parasite or low-level infection located deep within the body. According to Karen Edwards, ND, BSNH, an Indiana-based naturopathic practitioner, “Any skin disorder can be interpreted as a symptom of something going awry internally. It often means that toxins are being stirred up and are exiting through the skin – our largest organ of elimination.”

How to Protect and Defend Your Skin

In addition to being one of the body’s primary means of releasing wastes, the skin is also the body’s primary barrier against toxins, germs and other external contaminants – although it’s not a perfect line of defense. As a rule, the healthier your skin, the better protection it provides against unwanted invaders. But even healthy, unbroken skin is surprisingly permeable.

“The skin tends to absorb whatever you put on it,” Edwards says. “That’s why the transdermal [patch] method of administering medicine is so popular: It allows medicine to enter the bloodstream faster than having to go through all the organs of digestion.”

The same mechanisms that allow those prescription drugs to be absorbed through the skin, though, also allow in chemical compounds from skincare and hair-care products. Many of them aren’t good for your general health, and, ironically, some aren’t particularly good for your skin, either. The presence of petrochemicals, fragrances, detergents and other substances can cause irritations and allergic reactions that contribute to bumps and clogged pores. Overly harsh cleansers and exfoliants can disturb the skin’s pH balance and strip the skin of its natural mantle, resulting in dryness, flaking, dermatitis, excessive oil production and vulnerability to infection.

A good rule of thumb,: “If you wouldn’t eat it, don’t put it on your skin.”

For this reason, Edwards, who developed a line of natural skincare and medicinal-bathing products for her clients, encourages people to think twice about what they put on their bodies. A good rule of thumb, she says: “If you wouldn’t eat it, don’t put it on your skin.”

True, most of us might not be eager to ingest even the most natural lotions and cleansers. However, we would still do well, Edwards says, to consider whether any of the ingredients in our body-care products might be harmful if swallowed. (One way to evaluate the safety of your favorite skincare products: Check the Skin Deep online brand-by-brand comparison guide at It rates products by the known toxicity of their ingredients.)

The Damage Done

In a healthy body, skin-cell turnover is quite rapid: Through natural sloughing and cell regeneration, we typically replace our entire epidermis – the outermost layer of skin – every 28 to 30 days. So why don’t we keep the clear, healthy, baby-soft skin we were born with?

Because, over a lifetime, our skin takes a beating – and its regenerative capacity simply can’t keep pace. According to the American Academy of Dermatology (AAD), skin ages both intrinsically, because of the genetic instructions encoded in our DNA, and extrinsically, because of environmental and lifestyle factors. As a result, our skin is prone to becoming rougher, thinner, less elastic and less toned over time.

Of course, you can’t choose your genes (which dictate, to some degree, your skin’s character and resiliency). Nor can you avoid the fact that the cellular aging process is coded into all human DNA. But you can control a variety of factors that contribute to how your body’s DNA-level instructions play out and how quickly they take their course.

For example, you may have inherited delicate and sun-sensitive skin that’s vulnerable to damage. But there are plenty of things you can do – from avoiding excessive sun exposure to eating a diet rich in antioxidants and healthy fatty acids – that can help modify the impact of that genetic inheritance and preserve your skin’s health. And happily, many of the same steps you take to care for your general health also protect the DNA lodged in your skin cells, reducing your vulnerability not only to the visible signs of aging, but also to life-threatening melanoma.

The most widely accepted theory of both intrinsic and extrinsic skin aging is the free-radical theory. Free radicals – the suspected culprits behind everything from skin wrinkling and sagging to the origins of skin cancer – are the byproducts of our body’s process for turning food into energy and from our exposure to sunlight, smoke and pollution. These unstable oxygen molecules are missing one of their two electrons, and in seeking to “re-pair” themselves, they steal electrons from healthy cells, destabilizing them and setting off an intracellular inflammatory response in the process.

Inflammation, we now know, is a root cause of damage and disease in the body. It’s also implicated in a great many skin afflictions, such as dermatitis, rosacea, rashes, psoriasis, acne and premature aging. We can minimize the damage caused by inflammation and free radicals by making sure our bodies are properly nourished and by reducing the presence of pro-inflammatory substances (like processed sugars, refined carbohydrates and trans fats) in our diets.

Exercise, too, plays a part: Our cardiovascular system is responsible for circulating nutrients and repair compounds to the skin, for maintaining the health of capillaries that affect our skin’s appearance, and also for helping to maintain proper blood-sugar levels (too-high blood sugar contributes to body-wide inflammation).

That said, because both metabolizing food and exerting energy also produce free radicals, we stand to benefit most from moderation in both areas. By eating moderately (taking in just enough calories to maintain a healthy weight versus overeating and then attempting to “burn it off”) and exercising moderately (versus being sedentary or exercising at overly high intensities too often), you can help lighten your body’s inflammatory and free-radical burdens and enhance its self-repair capabilities. And that means healthier, more radiantly beautiful skin for you.

Good Skin Sense at Any Age

As research unveils the connection between a healthy, glowing complexion and a balanced mind and body, it’s becoming increasingly clear: Caring for your skin is really a matter of caring for your whole self. And it’s never too late to make the healthy, whole-body changes that will visibly improve your skin and sustain its vitality for years to come.

So, if you’re suffering from a skin condition – or a lack of skin quality – that concerns you, consider looking deeper than your skin’s surface for the possible causes and cures. As you take the nutrition, exercise and other healthy lifestyle steps necessary to improve your skin, you may be amazed at the positive results your entire body enjoys.

Caring for your skin is really a matter of caring for your whole self. And it’s never too late to make the healthy, whole-body changes that will visibly improve your skin and sustain its vitality for years to come.

Over time, it is true, our skin will change of its own accord. But a truly healthy skin remains a beautiful skin – at any age. For those who are concerned about the visible signs of aging, says Christiane Northrup, a change in perspective may be the best prescription of all. “A little wrinkling is inevitable,” she says, “so don’t feel discouraged by the wrinkles you currently have. When I first noticed some fine lines around my eyes, I decided to like them. They remind me of my father’s eyes, which were crinkled from laughter and smiling.”

Northrup says she’s also been inspired by the 100-year-old Queen Mother’s response to a request from publicists who wanted to retouch her photos to conceal her wrinkles. “I would not want it to be thought,” she said, “that I had lived for all of these years without having anything to show for it.”

Keep in mind that whatever your age, your skin has a knack for expressing not just your personal history, but also the current state of affairs in your body. So take stock of how your skin looks, how it feels, and how you’re treating it these days – both inside and out. Then do whatever you can to help your skin put its best and healthiest face forward.

What to Eat for Healthy Skin

Certain essential fatty acids (EFAs) found in the omega-3, omega-6 and omega-9 families play a crucial role in supporting strong skin structures, keeping skin soft and smooth, fighting inflammation, and maintaining good skin health.

Some, like gamma-linolenic acid (an unusually healthy type of omega-6), have been shown to be effective in the treatment of common skin ailments such as rosacea, psoriasis, eczema, dryness and acne. Because the body can’t make EFAs on its own, they must be obtained from food or supplements – but the key here is balance.

According to the National Institutes of Health, most American diets provide more than 10 times the amount of certain omega-6s (found in many processed foods, red meat, eggs and most vegetable oils) as omega-3s. That imbalance not only negatively affects your skin, it contributes to long-term diseases, including heart disease, cancer, asthma, arthritis and depression.

Avoiding processed foods and cooking oils like sunflower, safflower, corn and soybean, and eating red meat sparingly (no more than a couple of times a month) can help reduce your intake of unhealthy omega-6s. Good food sources of omega-3s and other healthy fatty acids include nuts, seeds, and cold-water fish like salmon, sardines, tuna and halibut. EFA supplements are available in liquid, ground-seed or capsule form.

Proper Hydration

“If I could teach my patients and students three things that would keep them forever young, they’d be ‘drink water, drink water and drink more water,'” quips skincare expert Nicholas Perricone, MD, author of The New York Times bestseller The Wrinkle Cure. So if you’re worried about a dull, dry or flaky complexion, you might be better off reaching for a water bottle than for the latest brand-name moisturizer (moisturizers do help skin retain water, but they can’t begin to counteract the symptoms of a dehydrated body).

“If I could teach my patients and students three things that would keep them forever young, they’d be ‘drink water, drink water and drink more water.'”

The amount of water you need to remain properly hydrated is highly individual. It depends on your diet (the more fresh produce you eat, the more water you’ll take in through your food), your activity level (the more you sweat, the more lost moisture you’ll need to replace) and your climate (very dry environments tend to draw the moisture out of your body).

Many health professionals still recommend the old standby of eight 8-ounce glasses of fluid a day, with limited caffeine and alcohol consumption. One skin-saving beverage definitely worth its small amount of caffeine: green tea, for its polyphenols, one of nature’s strongest natural antioxidants.

(See “Everything You Need to Know About Hydration” for more.)

Skin Support 101

Combine a nourishing diet with adequate hydration, appropriate exercise, good stress management and high-quality sleep and you’ve got the underpinnings for the systems that help build, nourish, protect and repair your skin. But when it comes to coaxing out the best skin your body has to offer, you’ll also want to keep the following key stressors and solutions in mind:

Stressor 1: The Sun

We need a certain amount of sunlight to support our general health. But experts agree: There is no such thing as a healthy suntan. A tan is your body’s response to exposure to ultraviolet (UV) light. Photoaging, the term used to describe the damage to skin caused by UV exposure, is responsible for 90 to 95 percent of extrinsic skin aging, according to the American Academy of Dermatology. Too much sun can cause free-radical formation and collagen breakdown. It can contribute to “age spots,” dark patches and other visible skin discolorations. It also can inhibit the immune system and interfere with DNA repair.

But before you slather on the sunscreen, consider the ingredients in your sun protection of choice. According to a 2001 study by the Institute of Pharmacology and Toxicology at the University of Zurich in Switzerland, common sunscreen ingredients like benzophenone-3 (BP-3), homosalate (HMS), 4-methyl-benzylidene camphor (4-MBC), octyl-methoxycinnamate (OMC) and octyl-dimethyl-PABA (OD-PABA) are estrogenic substances that may cause reproductive problems and endocrine disruption. Other evidence suggests that a variety of chemicals such as PABA and benzophenone present in commercial sunscreens may stimulate free radicals, damaging DNA and contributing to the very skin cancers they’re designed to protect us against.

Sun Smarts. Get in the habit of donning a hat when you go outside. And if you’re worried about chemical safety, consider natural sun-block products that use titanium dioxide and zinc oxide to block rays.

Vitamins C and E also counter the effects of sun exposure. In 2005, the Journal of Investigative Dermatology reported that people who supplemented with vitamins C and E significantly reduced their risk of sunburn from exposure to UVB radiation.

In addition, scientists saw a reduction of factors linked to DNA damage within skin cells, leading them to conclude that antioxidant vitamins help protect against DNA damage.

Stressor 2: Free Radicals

Free radicals are a byproduct of our body’s process for turning food into energy, and also the result of exposure to the stressors above and below. They are infamous for contributing to the oxidation (a rust-like weakening) of the body’s internal and external tissues and have been implicated in causing widespread inflammation and cellular damage throughout the body – including the skin. For example, free radicals damage collagen, one of the essential components of the connective tissue that keeps skin smooth, firm and wrinkle-free. Free radicals can also contribute to the formation of skin discolorations.

Antioxidant Allies. Commonly associated with the vitamins A, C and E, antioxidants are abundantly represented in the phytochemicals (e.g., carotenoids, flavonoids and polyphenols) of brightly colored fruits, vegetables and legumes. Red beans and brightly colored berries, according to a 2004 USDA study, top the charts for antioxidant activity.

In recent years, a number of high-powered antioxidants, such as alpha-lipoic acid (ALA), have been getting increased attention in the skincare industry. Believed by some researchers to be up to hundreds of times more effective at counteracting free-radical damage than vitamins C and E, ALA also has anti-inflammatory properties. It’s found in spinach, broccoli, and other plant and animal sources. It can be taken as a dietary supplement or applied topically.

It’s important to note, though, that while applying topical antioxidants directly to the skin may prove helpful in the long run, there’s no guarantee it will produce visible results in the short term. Limiting free-radical and inflammatory activity within the body is likely to have a further-reaching impact on skin’s health and appearance overall. Best of all, this same course of action also helps support the systems that protect the integrity of the skin’s cells while improving the vitality of the body as a whole.

Stressor 3: Smoke and Pollution

One of the skin’s most vicious enemies is cigarette smoke. “Past studies have shown that the skin of smokers ages twice as fast after the age of 30 as the skin of nonsmokers,” explains Christiane Northrup, MD. Smoking dehydrates, slows skin growth and rejuvenation, depletes essential nutrients, and contributes to decreased levels of estrogen, leading to collagen and elastin breakdown.

Air pollution takes its toll on the skin by causing irritation and inflammation, contributing to the body’s toxic load, eating away at the ozone layer (which protects us from the sun), and contributing to the presence of airborne volatile organic compounds (VOCs) that can cause allergic skin reactions. New furniture, carpet and building materials can also off-gas the VOC formaldehyde, which causes skin irritation in some folks.

Pollution Solutions. The obvious, and perhaps best, step to take to avoid smoke and pollution damage is to stop smoking, limit exposure to secondhand smoke and take whatever steps you can to avoid other environmental toxins. You can also emphasize good nutrition and proper hydration to protect your skin from damage, enable detoxification and optimize its repair mechanisms.

Vitamin D in the Crossfire

For decades, dermatologists have urged patients to scrupulously practice sun protection to prevent skin cancer, which, according to the American Cancer Society, is the most common cancer in the country, making up nearly half of all new diagnosed cases.

While the tried and true advice — seek shade, wear sunscreen, avoid direct sun exposure between 10 a.m. and 3 p.m. daily — hasn’t changed, recent research indicates that our hyper-vigilance about sun exposure may actually be compromising our body’s ability to maintain healthy levels of vitamin D.

We’ve long known vitamin D is essential to building strong bones, but a flurry of emerging studies is linking deficiencies of the sunshine vitamin to a growing list of serious health concerns, including hypertension, diabetes, depression and a variety of cancers. Despite vitamin D also coming from foods like eggs, cod liver oil, fatty fish and fortified products, many Americans, especially those living in cloudier climes, do not get today’s “adequate intakes” for bone health (set at 200 to 600 IU daily, depending on age, by the Institute of Medicine of the National Academies) — and essentially no one is getting the daily 1,000 IU that more researchers are starting to recommend.

“Many people are deficient in vitamin D. A glass of milk, for example, has only 100 IU. Other foods, such as orange juice, yogurt and cheese, are now beginning to be fortified, but you have to work fairly hard to reach 1,000 IU a day,” says Cedric F. Garland, a professor at Moores Cancer Center and the Department of Family and Preventative Medicine at the University of California, San Diego’s School of Medicine, and coauthor of a study linking vitamin D supplementation to a 50-percent decrease in colon, ovarian and breast cancers.

To supplement deficient dietary intake, Garland agrees with advice given by a growing number of doctors and researchers: Take in a moderate amount of daily sun exposure in the mornings and evenings, when the sun’s rays are less harsh. “We recommend no more than 15 minutes of exposure daily over 40 percent of the body, other than the face, which should be protected from the sun,” Garland explains. “Dark-skinned people, however, may need more exposure to produce adequate amounts of vitamin D, and some fair-skinned people shouldn’t try to get any vitamin D from the sun.”

If you’re concerned about a vitamin D deficiency, have your D levels tested by a nutritionally savvy physician, counsels Joseph Mercola, DO, an Illinois-based osteopathic physician who runs the natural healing site To ensure you’re receiving the gold standard in vitamin D testing, Mercola advises you request the 25 OH-D test, also called 25-hydroxy vitamin D.

This article originally appeared as “Skin Deep.”

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