From almost magical tricks to innovative treatments, on the internet we can find a lot of information about the skin care, but is everything we read on our screens reliable? To solve our doubts, with clarity and scientific basis, Dr. Lorea Bagazgoitia, dermatologist at the Ramón y Cajal Hospital in Madrid and author of What the science of skin care says (Ed. Editorial Platform), responds to issues that we all worry about how to protect the largest organ of our body on the outside, but also on the inside, and what treatments are best suited to pamper it depending on our age or the stage in the one that we meet. The time has come for you to know in depth the needs of your dermis and secret formula to avoid premature spots and wrinkles, something that, according to Dr. Bagazgoitia, inevitably passes through an optimal protection of the skin against solar radiation.

Your book is about skin care based on scientific evidence. Do you think that we are a little lost in the care of our dermis due to the amount of little information that is found on the internet?

I think that the information that we can find on the internet is very abundant, and is not always entirely reliable. In this sense, and according to the sources that we consult, we will be more or less lost. I believe that the recommendations should be based on solid arguments and scientific studies, and this is what I intend to convey in this book.

Basic care needed by the skin

What should we do to keep our skin healthy? What kind of products are best suited for each type of dermis?

The basic thing to maintain all healthy skins is a good hygiene, accompanied by sun protection during the day. Hygiene can be done with micellar water or a syndet -synthetic detergent-, which are products made artificially, specific to the skin, and less aggressive than natural soap. An exfoliation twice a week may be adequate in general terms.

During childhood, sun protection is very important, since sun damage accumulates and can remain throughout life

Unfortunately, there are no universal standards for choosing the right product, because it may not even exist. One of the most important things you have to pay attention to when buying a product of this type is that it is pleasing to you; for example, people who have dry skin will feel more comfortable with more fatty products, such as a thick cream or an ointment, while those with acne-prone skin will surely opt for a cream that provides hydration, but without an excess of lipids, such as gels or emulsions.

How can we know what our skin type is?

In the book I dedicate a chapter precisely to explain this. Dermatologists do not study the type of skin in the career of Medicine, or during the specialty. There is no serious scientific classification of the skin type. To label it as 'fat', 'mixed' or 'dry' enters more in the terrain of subjectivity, than in the purely scientific.

The basic thing to keep all healthy skins is a good hygiene (with micellar water or a syndet), accompanied by sun protection during the day

The type of skin depends on the balance between desquamation, reepithelization, hydration and sebaceous secretion, and can be modified depending on the ambient temperature, humidity, possible external aggressions and, of course, by age. Although it is true that the manufacturers of cosmetic products divide the skins in dry, mixed or normal.

Dr. Lorea Bagazgoitia

Men usually have oily skin, just as it happens in teenagers because of the hormonal changes they face, which increase androgens, sebum stimulants. However, dry skin usually occurs at older ages and in people who have abused the sun. We must bear in mind that the main factor that determines our skin type is genetics, as it happens with the color of hair or eyes.

The type of diet also influences the skin, how can we ensure that our skin is cared for and healthy through food? What foods should we avoid?

A balanced diet, with plenty of vegetables and fruits, and low in free sugars, trans and saturated fats helps us to be healthy and, therefore, our skin will be healthy. There is no particular food that makes our skin shine more or stay younger, unfortunately.

A tanned skin is the result of contact with some UV, which indicates that the epidermis has suffered

In the case of foods to be avoided, except in very specific cases of certain well-defined diseases, such as dermatitis herpetiformis-a skin disease caused by gluten sensitivity, although only one in 365 celiac sufferers suffer from it-, or People allergic to cow's milk protein, in general, there is no reason not to eat some food. The exception to this is people with acne, which can get worse if we carry a diet rich in high glycemic load foods such as sweets, refined flour or white bread, as well as dairy products.

And depending on the age, what specific care do you have to have?

In addition to what I have said, during childhood is very important sun protection, since sun damage accumulates during these years and can remain throughout life, increasing the risk of developing melanoma. In terms of hygiene, you have to choose products that have little or no alcohol and perfumes. In adolescence, where pimples or acne usually appear, you can support the treatment of cream or pills prescribed by a dermatologist with a good diet, with little glycemic load and few dairy products.

If you are in the age of fine wrinkles and blemishes, in addition to a good photoresist, you can use creams with retinoids, vitamin C or hydroxides. But if your wrinkles are more marked the creams will not be enough, and you will have to opt for techniques such as Botox or hyaluronic acid.

Dermatologists always recommend applying maximum sun protection (SPF 50+) throughout the year

As for the skins of the elders, this is especially fine, so it is easy to appear bruises with the minimum blow. It is also usually drier, which can cause itching, so you should not miss a daily moisturizer. Finally, we must know that during pregnancy the skin changes and may appear more pigmentation in some areas of the body or face, called melasma, which you can avoid by protecting yourself well from the sun.

Are anti-wrinkle or anti-stain products really effective? What ingredients should be included in the label to know what they are, and which ones should be avoided?

The best anti-wrinkle product is sunscreen against UVB, UVA, infrared and visible light, because the sun is the main cause of skin aging. The creams with retinoids, hydroxy acids and vitamin C can be a good complement, because by different mechanisms they can increase the synthesis and the quality of the collagen of the dermis and, likewise, they can equal the tone of the skin.

The assets that have shown a certain anti-wrinkle effect are retinoids, hydroxy acids and vitamin C

The treatment of the spots depends very much on the specific type of pigmentation, but there are some products capable of depigmenting the skin, and they can be identified because the labeling shows retinoids -like retinoic acid, retinal or retinaldehyde-, hydroxy acids -like glycolic acid and lactic or salicylic acid; and vitamin C, as ascorbic acid.

The assets that have shown some anti-wrinkle effect are retinoids, hydroxy acids and vitamin C. But the most important thing is that the photoresist is the best element for its prevention. European regulation makes the creams marketed safe in our environment, so there is no reason to explicitly avoid any of the components, unless we are allergic to one.

The importance of good sun protection for the skin

As you say, sunscreen is key every day of the year, not only in summer, but ... In what order should be applied on the skin with regard to moisturizer, serum and others?

The correct order would be first a good cleaning, the use of a moisturizing product and, after it, the sun cream. If some type of makeup is used it should be a posteriori. As with body protection in summer, the application must be repeated after a few hours, and if it is being made up, there are specific products for this, in the form of mist or dust.

Is it correct to use a high sun protection during the first days of sun exposure in summer, and then move to another with a lower protection factor?

Of course not. Dermatologists always recommend applying maximum sun protection (SPF 50+) throughout the year. The sun, through UV rays, causes skin cancer, and there is no reason not to use the optimal means to protect ourselves from it.

A recent study indicated that some dermatologists recommend applying 2 mg of cream per cm2 of the body so that the skin is fully protected. How can we measure well the amount of sunscreen we put on?

It is considered that the amount cited in the study is what allows us to obtain the protection indicated by the photo-protection label we are using. This measure can be calculated using coffee spoons:

  • Face and neck: ½ teaspoon of coffee.
  • Arms: ½ tablespoon of coffee per arm.
  • Legs: 1 spoonful of coffee per leg.
  • Chest: 1 spoonful of coffee.
  • Back: 1 tablespoon of coffee.

The application will have to be repeated approximately every two hours, or after episodes of heavy sweating or after a bath.

There is a popular belief that solar protection factors indicate the time after which the application should be repeated. This is so? Does it prevent you from getting bronzed?

The sunscreen factor indicates how many times more the skin resists before burning with the protective cream, at equal intensity of the sun, compared to the skin without cream. It is not a measure of time. Sunscreen does not prevent you from tanning, because the SPF measures the protection capacity against UVB, and not the UVA, which is the one that tans us; Even so, if what you want is a tanned skin makeup and self-tanning products are excellent resources to achieve without damaging the skin, because a tanned skin is the result of contact with a UV, which indicates that the epidermis has suffered.

Another common doubt in this regard, can makeup lead to the appearance of spots?

No. Exposure in general, without sun protection, makes the appearance of stains easier, while make-up can even provide us with extra protection.

In the book you say that it is not sensible to take the sun to get vitamin D ...

Vitamin D is essential for life, specifically for our body to absorb calcium from food. We obtain it through diet, ingesting fish such as salmon or sardines, milk, cereals or yoghurts, and through synthesis in our skin, caused by UVB radiation. That UVB radiation is exactly the same that causes skin cancer.

The cases in which doctors recommend their patients to put themselves in the sun without protection to obtain this vitamin are not rare, however, dermatologists advise the opposite. It makes more sense to protect yourself from the sun and, in case someone has low vitamin D, take it in oral supplements.

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