Want to stay young-looking? Save your skin!

In her "Today" series "Slow Your Clock Down" the show's medical contributor on women's health, Dr. Judith Reichman, offers strategies to delay the aging process. In this excerpt from her new book of the same name, Dr. Reichman discusses the importance of protecting the body's largest organ — the skin.

What to Do About Photoaging

Preventing further damage
There is no such thing as a safe tan. Even the slightest change in pigment is indicative of skin cell injury. The UVA rays from tanning booths ultimately inflict the same (if not more) damage to the skin as that caused by natural sunlight. If you want the bronzed-goddess look, it’s much safer to fake it. Use rayless self-tanning creams or sprays containing dihydroxyacetone (DHA), a substance that interacts with proteins in your outer (dead) skin layer, and stains it brown—for a few days, anyway. These creams do not penetrate the pores and don’t inflict any damage.

Limit exposure to rays — or wear protective clothing.
This first admonition is so commonsense as to be comical in this guide for the intelligent woman, but most of us don’t follow it. I call it the “ten to three” coverup rule. Why? Burning UV rays are out in greatest force at midday. Avoid spending time in the sun during these hours—or if you must, wear protective clothing: long sleeves, long pants, a hat, a scarf, or a collar around your neck.

I was recently in Australia, which has the world’s highest rate of skin cancer due to its latitude, depletion of the ozone layer, and the genetic makeup of its mostly light-skinned population. They sell marvelous sunprotective hats and lightweight clothing that can be worn in and out of the water.

Only on TODAY.MSNBc.com! Dr. Judith Reichman addresses your questions about women's health. LAST WEEK: Will removing my ovaries prevent cancer? GO TO ALL HEALTH TUESDAY COLUMNS

Clothing’s sun protection varies by style, fabric (tightly woven or thick ones block sun better), and whether and how much UV-protective chemical treatment is used on the fabric. A number of manufacturers now offer sun-protective clothing (Solumbra, REI, Sunveil, and UV Aquawear, to name a few); you can easily find outlets via an Internet search. Sunprotective fabrics are rated according to ultraviolet protection factor (UPF). Unlike sunscreen SPF ratings, the UPF considers both UVA and UVB radiation. A “very good” rating with a UPF protective factor of 25 to 35 is equivalent to SPF 25 or 30; “excellent” is UPF 40 to 50+, equivalent to SPF 30+. A UPF 50 is supposed to mean that only one-fiftieth of UV rays can penetrate it and reach your skin. (While these are U.S. government standards, compliance by manufacturers is voluntary.) By comparison, an ordinary polo shirt might rate a measly 6. Protective clothing is the best protection, but don’t forget sunscreen. Unless you’re wearing a total face mask, or a hat that comes down to your chin, your face will nearly always be exposed. Nor is the rest of your body safe; clothing moves, is shortened for style, and may not screen out all rays — or you may remove it to go in the water or just because you’re hot.

Always wear sunscreen.
Consider investing in three types for different sun-exposure scenarios:

1. Daily wear, even when you’re not planning to be outdoors in the sun. Apply sunscreen to your face, neck, and hands. It should contain zinc oxide, titanium dioxide, Parsol 1789, or another broad-spectrum sunscreen, and have a minimum SPF rating of 15. There are many excellent over-the-counter products, which include Cetaphil Facial Moisturizer SPF 15, Clinique City Block SPF 15, and Olay Complete UV Protective Lotion. Slightly stronger formulations are sold through dermatologists’ offices.
2. High-sun outdoor activities and sports mandate an SPF of 30 or more. Even though its description is not totally accurate (you have to reapply it after sixty to ninety minutes), choose a product labeled “waterproof” or “sweatproof” that contains 4 to 7 percent zinc oxide, Parsol 1789, or titanium dioxide. Brands include SkinCeuticals Sport SPF 45 and waterproof Coppertone Sport SPF 45.
3. If you’re not swimming or under intense equatorial sun, but are spending extra time outside, this is when you’re at greatest risk for casual sunburns. Go for the less expensive family-size bottles. Once more, an SPF of 30 to 45 is best. Examples include Coppertone Shade Sunblock.
   

Other In-Your-Face Insults

Smoking: This vies with UV radiation as a prime cause of accelerated skin aging. The thousands of chemicals in cigarette smoke wither the minute blood vessels that supply the skin with oxygen and nutrients. These toxins alter the function of fibroblasts, cells that regenerate the collagen in your skin. The free radicals in cigarette smoke (oxygen molecules in search of a lost electron) thicken and break the skin’s stretchy elastin fibers. This leads to a loss of tone, and wrinkles. Smoking literally embalms your dermis: The formaldehyde and ammonia in smoke fix and “preserve” it. Inhaling those toxins also deactivates the ovaries’ estrogen, further contributing to the loss of your skin’s collagen and fluid content.

When you purse your lips around a cigarette to inhale and exhale, you train your skin in wrinkle formation. Then, to shield your eyes, you squint and frown. Multiple fine creases appear around the lips, then fine lines around the eyes, followed by frown lines. These gradually deepen. Loss of water and elasticity causes sagging under the eyes, drooping lids, and fallen jowls. Add a tint of yellow, and you’ve created a ten- to fifteen-year advancement of your face’s clock. If you make surgical repairs while you’re still smoking, they take longer to heal because the skin is oxygen starved and the fibroblasts are unable to lay down collagen effectively. Finally, cigarette smoking is associated with psoriasis, squamous cell carcinoma, and an increase in death rates from malignant melanomas.

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These are more than superficial reasons to stop! And note that secondhand smoke inexorably, albeit more slowly, gives a similar hue and droop.

Weight changes: There is a French expression that translates to “Suffer your fanny for your face.” As you get older and lose elasticity, weight loss can leave you with stretched-out skin. Make every attempt not to gain weight in the first place — but if you do, take it off slowly and allow your skin time to get used to its less fat-filled form. If you’re considering plastic surgery after weight loss, give yourself at least nine months before doing it. Whatever you do, don’t yo-yo; it’s a fast route to stretch marks and folds.

Lack of sleep: Ever notice how much better your skin looks after a good eight or nine hours of sleep? Sleep is the ultimate mender, allowing your immune system time to repair the damage caused by daily activities.

For skin, it’s a time to regenerate collagen and ward off free radical attack. Fluid that is normally pooled in your lower body when you stand or sit can recirculate (no longer fighting gravity) and enter the vessels supplying your neck and face, and “fill up” the cells of your skin. This rehydration and improved blood flow temporarily diminishes the crevices that appear as fine wrinkles, and give you a glow that can last for hours (similar to that created by exercise). If you don’t let your body get the rest it needs, there are many telling signs: depression, fatigue, increased vulnerability to infection, achiness—but those on your face may be hardest to conceal.

Alcohol: For some women, even moderate amounts of alcohol create a crimson facial hue. Alcohol dilates blood vessels and increases blood flow to the skin; this is especially noticeable in fair-skinned women who tend to blush. Alcohol consumption can trigger hot flashes in perimenopause and menopause. An alcohol flush may also be due to an allergy to the sulfites in wine, or sensitivity to its tannic acid content, which is higher in red wine than in white. Finally, many women aged 30 to 50 develop a skin condition called rosacea, and alcohol consumption may make this worse.

Excerpted from “Slow Your Clock Down” by Judith Reichman. Copyright© 2004 by Judith Reichman. Excerpted by permission of William Morrow, a division of HarperCollins. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher

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