In this section I discuss what it takes to keep our skin looking young and healthy—what we can do for it, what to avoid, and some dietary guidelines and supplement suggestions. Many aspects of lifestyle, including stress, cigarette smoking, and sunbathing or ultraviolet (UV) tanning may lead to premature aging of the skin. I also review some of the many acute and chronic skin disorders that occur at various ages or throughout life. Fortunately, most of these problems eventually heal on their own. I will briefly examine these with a focus on nutritional influences and treatment, trying to be a bit more helpful than the lighthearted maxim of the Dermatologist: "If it’s dry, wet it; if it’s wet, dry it out. If that doesn’t work, use cortisone."

The skin is our largest organ. It functions as a protective covering, a key sensing organ, an oil producer, and an important organ of elimination. Through regular evaporation and perspiration, the skin can clear all kinds of toxins to help maintain internal balance. The skin must be well nourished to stay healthy. It needs good circulation through its millions of tiny capillaries, good nerve function, and a ready supply of nutrients to aid its rapid growth.

Our skin surface is the intermediary between the external and internal environments and reflects the health of the underlying organs and our internal body function. By looking at the skin, tongue surface, eye tissue, and hair quality, I can get a good idea of an individual’s general health, vitality, and internal balance. In Chinese medicine, the skin coloration or hue around and under the eyes reflects the subtle balance among the Chinese five elements. For example, a greenish hue may suggest a liver/gallbladder imbalance. In this system, the colors are related to different organs as shown in the following chart.

The condition of the skin and tissue around the eyes can suggest certain other problems. Signs of fatigue and increased aging lines or dark circles under the eyes may indicate stress; the Chinese would diagnose weak adrenal-kidney energy. Water or kidney imbalance may show up as puffiness, while colon congestion or imbalance might be represented by wrinkled bags under the eyes or a white coloration.

Allergies may be revealed by slightly puffy or pitted dark circles, even looking like black and blue "shiners" under the eyes when severe. As the skin is an eliminating organ, the general skin health may tie into functions of the lungs, colon, kidneys, and liver. In Chinese medicine, many skin problems are treated by strengthening the function of these organs.

To keep our skin healthy, it is most important to take good overall care of ourselves, as the skin’s well-being is dependent on the health of the rest of our body. Drinking adequate amounts of water may be the single most important factor in healthy skin and good eliminative functions. Two quarts of quality drinking water per day is the suggested average, but this may vary for different individuals, according to a number of factors. More water is needed with a rich, fatty diet than with a lot of fruits and vegetables; with a high activity level than with a sedentary lifestyle; with hot, dry weather than with cold and damp; in summer than in winter; and with constipation than with normal bowel function. We must each find our own balance of fluid intake. It is wise to drink regularly upon awakening, between meals up to about a half hour before eating (it keeps the appetite down, too), and whenever thirsty. Water is the best liquid for us, followed by herb teas, fruit juices, and mineral waters; we should avoid caffeinated beverages, sugary drinks, and soda pops.

NO SMOKING! for healthy skin. The smoke and chemical irritation, besides causing a variety of serious medical conditions, causes rapid aging of the skin, especially around the mouth and eyes. Smokers notoriously have many more age lines around those areas than nonsmokers of the same age. The effect of tobacco smoke on the aging process is due mainly to an increase in free radicals, which are damaging to the skin cells in the dermis as well as to the cells in our inner organs and tissue linings. Smoking has a drying effect and also exposes smokers and others to many toxic chemicals (such as carbon monoxide) and metals (such as cadmium), which may cause more chronic irritation internally. For similar reasons, avoiding or protecting ourselves from other chemicals, at home, at work, and especially in foods and pharmaceuticals is also important to healthy skin.

Ultraviolet (sun) light is known to be damaging to the skin and results in more rapid aging and dryness of the skin, as can be seen in many a farmer, construction worker, or sun worshiper. The changes in the ozone layer make sun exposure more dangerous than ever. Care must be taken with sunbathing or using sun lamps, because excessive ultraviolet light exposure can eventually reduce skin elasticity and tone. Along with dehydration or nutrient deficiencies, this may lead to rapid skin aging.

Skin care with moisturizing and beauty products requires a fine balance between nurturance and chemical exposure. I recommend natural products whenever possible. A number of companies now produce natural skin care products that can help rehydrate dried skin, relubricate skin with oils, and protect the skin from heat, cold, chemicals, and the sun. Sunscreens are very popular now with the current knowledge of the sun’s chronic damaging effects on the skin. Beauty creams with aloe vera, clay packs, herbal wraps, honey or egg white facials, and dry-brush massaging are some ways to clean, detoxify, and nurture our epidermis. Saunas and sweats are also helpful in clearing impurities through the skin.

Diet and Supplements
The diet that supports healthy skin includes high-nutrient, high-water-content foods such as fresh fruits and vegetables. These important foods should be consumed daily, as fresh fruits eaten alone in the morning and vegetable salads at lunch or dinner. Cooked vegetables with proteins or starches are also recommended. The essential fatty acids found in the vegetable oils, seeds, and nuts are also necessary to nourish our skin and keep the texture and vitality strong. Cold-pressed olive oil and flaxseed oil are, I think, the best sources of essential fats. Olive oil is stable to heat; however, flaxseed (linseed) should only be used uncooked. Some of the cold-pressed polyunsaturated oils, such as safflower, soy, and sunflower, can also be used in moderation but should not be used for frying or cooking; sesame oil can be used in cooking, sparingly. Some cholesterol-containing foods, such as eggs, poultry, and occasionally even meat, may be used. Fresh fish is one of the better, slightly lower-fat animal foods.

Water is very important to help carry nutrients throughout the body and to flush out toxins. Adequate protein intake, along with good protein digestion and assimilation, is essential to make available the amino acids vital to tissue building and rapid cellular turnover in skin. Two amino acids, L-cysteine and L-proline, are especially important here. A high-fiber diet consisting of whole grains, legumes, and vegetables is helpful to detoxify the colon regularly and prevent accumulation of colon toxins going through the body causing tissue toxicity, which can lead to problems in the skin. Vitamin A and beta-carotene foods are helpful to skin health, as are zinc and silica-rich foods.

Supplements for healthy skin include a multivitamin and mineral, antioxidant nutrients to counteract free-radical damage, and the essential fatty acids. Water intake, as stated, is essential to healthy skin tissue. Fiber, such as bran or psyllium seed husks, helps prevent colon stagnation and general body toxicity which easily affects the skin. Vitamin A and beta-carotene are important to fat-soluble vitamins that play a role in preventing acne, blemishes, and dry skin and may help to prevent skin cancer. Vitamin A deficiency can lead to all kinds of skin problems. The antioxidant function of beta-carotene is useful as well. Ascorbic acid (vitamin C) provides more antioxidant free-radical protection in the blood and body fluids, and helps to reduce some of the aging effects of smoke or chemicals. Vitamin E and selenium also perform this function, especially with regard to fats. Selenium may also reduce the risks of skin and other cancers. Zinc is needed in cell repair, for DNA, RNA, and enzyme production, and to keep the immune function strong. Silica is thought to strengthen the skin, hair, and nails; after all, it is highly concentrated in the coverings (skins) of most fruits, vegetables, and grains. The B vitamins are essential to healthy skin. Niacin, pyridoxine, riboflavin, and thiamine deficiencies are all associated with skin disorders. Biotin supports skin health as it helps our body synthesize fats and proteins, and utilize carbohydrates. Vitamin B6, or pyridoxine, is needed for cell division and protein synthesis, both important skin functions. Essential fatty acids (EFAs) are vital to skin tissue health; these are found in many oils, such as olive and linseed oils. Cod liver oil is high in vitamins A and D and other nutrients, but it also may concentrate impurities. Eicosapentaenoic acid (EPA), the main omega-3 fish oil, also has some nourishing qualities for the skin, besides protecting against cardiovascular disease. Gamma-linolenic acid (GLA), as found in evening primrose oil, does the same and has also been used successfully for some cases of eczema and as a mild anti-inflammatory. The amino acids are essential to protein building, cell division, and tissue health and repair and are certainly important to functioning skin. The sulfur-containing amino acids, such as L-cysteine and methionine, are especially important skin amino acids. Tyrosine (and copper) help in skin and hair pigmentation.