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The term "Healthy Skin" did not exist until 1981, when Dr. Zein Obagi introduced the concept, the definition, and the steps needed to restore skin to its originality and vitality. Clinically, skin exists in two opposing states, the healthy state, and the damaged or altered state. The healthy state is defined by seven specific criteria. Utilizing each of these criteria when evaluating skin assists in formulating a diagnosis, creating a treatment plan, monitoring treatment progress, and evaluating the result. Skin Health Criteria includes skin that is: - Smooth
- Even in color tone
- Tight and firm
- Full, with proper volume
- Free of active disease
- Tolerant
- Hydrated
Skin in a Life Cycle Skin, more than any other organ in the body, experiences continuous changes throughout life. These changes start at the cellular level and later are reflected on the skin surface in texture, and in the skin's ability to renew itself after injury or procedures. In a life cycle, skin exists in two different states: Active and Inactive. The Active State The active state is represented in the definition of skin health; skin that is smooth, tight, firm, even color tone, free of active disease, tolerant, and hydrated. Clinically, healthy skin is full of vitality due to active and effective cellular function. The active state is seen throughout infancy and adolescence as long as there is no disease or genetic conditions that affect the functioning of the skin. After adolescence, male skin differs from female skin, with males sustaining healthier skin for a longer period, as compared to females. After adolescence, females have a tendency to mimic behaviors of their role models or peers and begin using a variety of skin care products, such as moisturizers and make-up, as well as begin to visit salons and spas for facial treatments. Early and habitual usage of moisturizers, and other skin care products, weaken the skin and eventually alter the skin's barrier function, making the skin weak. As the skin weakens, the skin becomes intolerant, leading to perceived "skin sensitivity". In attempts to self-treat their skin sensitivity, females seek out potent moisturizers, specialty products for sensitive skin, or over-the-counter cortisone products, which lead to more damage and eventually, the inactive state. The Inactive State Around the age of 30, skin vitality and cellular functions are gradually lost, leading to an inactive state. Most of the changes occurring are a result of natural intrinsic aging and variable degrees of extrinsic aging. Extrinsic aging stems from environmental damage (ultraviolet radiation, pollution, smoking). In aging skin, the epidermis is thinner; the barrier function is weakened; the melanocytes work irregularly by either over producing melanin as in melasma or aggregating together as in lentigines; and, the fibroblasts begin to produce less collagen, elastin, mucopolysacharrides, and necessary growth factors. With less collagen and elastin being produced, wrinkles and laxity creep in. When mucopolysacharrides are altered and not renewed, the skin is unable to retain water leading to skin dryness and altered texture. Chronic sun exposure results in damage to keratinocyte DNA, the appearance of precancerous and cancerous lesions, solar elastosis, and dyschromia. Other factors also lead to an inactive state, such as genetic factors that play a role in suppressing the skin's ability to renew itself, general health and nutritional status, use of hormones, and history of skin disease. Clinically, inactive skin appears dull, discolored, wrinkled, thin, and lax. Patients presenting with inactive skin often complain of dryness, skin sensitivity, and aged appearance. The objective in skin health restoration is to restore skin to an active state with use of appropriate topical agents; adding procedures when necessary. Sensitivity Most women claim that their skin is sensitive. Unless there is active disease, or genetic problems, this sensitivity is acquired as a result of early usage of products and moisturizers that weaken the skin as a result of disturbing the barrier function. It is interesting to note that men and children do not complain of skin sensitivity; mainly it is women who complain of skin sensitivity. Skin sensitivity should be corrected through conditioning, with proper use of essential and supportive topical agents. It takes six weeks (one maturation cycle) to repair the barrier function and restore normal skin tolerance. No procedures should be performed on patients who complain of skin sensitivity unless the skin has been properly conditioned. Likewise, correction of medical skin problems, such as acne, rosacea, or melasma, should occur before performance of procedures, as many procedures can aggravate existing medical conditions. Author information: At Obagi Skin Health Institute, we have a handle on your skin and explain it to you in a way that you can understand. Furthermore, we work with you to help treat it with proven methods that focus on healthier skin for you. The initial consultation with one of our medical professionals is the start of a journey towards your skin's transformation. For more information, call our Institute at 310-275-3030.
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