Smoking and Its Effects on Skin

Tobacco smoke contains thousands of harmful substances, many of which are known mutagens and carcinogens. Smoking has been associated with heart disease, lung disease, and cancer. It is also linked to premature aging of the skin, increased amount of infections, and delayed wound healing. In addition, the majority of inflammatory skin diseases tend to more severely affect smokers than non-smokers, and smokers typically respond more poorly to therapy than non-smokers.

Short-term effects of smoking on the skin and mucous membranes include yellowing of the fingers and nails, discoloration of the teeth, and even a black hairy tongue. Long-term effects include dry skin, uneven skin pigmentation, baggy eyes, a saggy jawline, and deeper facial wrinkles and furrows. It is common for the skin of a 40-year-old heavy smoker to resemble that of a 70-year-old nonsmoker. The exact connection between smoking and these effects are unknown, but current theories include the breakdown of elastic fibers in the skin, narrowing of blood vessels, production of free radicals, and reduced levels of vitamin A in the skin.

Smoking slows the body’s ability to heal itself by decreasing blood flow and inhibiting inflammation. This can cause persistent wounds, increased risk of infection and illness, and increased risk of graft rejection in the skin. Smoking has been linked to increased severity in several dermatologic diseases including palmoplantar pustulosis, psoriasis, hidradenitis suppurativa, systemic lupus erythematosus, and various vascular and oral diseases.

The carcinogens in cigarette smoke greatly increase the user’s risk of developing a variety of cancers. Smoking doubles the risk of developing squamous cell carcinoma, a type of skin cancer. The majority of oral and lip cancer cases occur in smokers.

It is important to note that while nicotine replacement is safer than smoking, nicotine itself is toxic and causes narrowing of blood vessels, inhibits inflammation, delays wound healing, and quickens skin aging. 

Smoking has significant short- and long-term effects on the skin and mucous membranes, some of which can be life threatening. Consult with your doctor if you need assistance in stopping smoking.

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Are There Benefits to Walking Barefoot?

Walking barefoot has recently grown in popularity. Proponents say it benefits your body and mind. But walking barefoot has its time and place. And it's not suitable for everyone. Humans started wearing shoes around 40,000 years ago to protect their feet from the elements. Since then, our shoes have become highly engineered with arch support, cushions, and shock absorbers. But have they become too supportive? While there are benefits of walking barefoot, there are also risks. 

What are the benefits of walking barefoot?

Walking barefoot has been shown to have several benefits. Here are a few of the benefits;

1. Strengthens foot and leg muscles 

Research suggests that children who walk barefoot may have stronger feet and fewer toe deformities. They may also have a more developed arch than those who often wear shoes. 

As we age, the muscles in our feet weaken, increasing the risk of falls. So taking a break from wearing shoes could give your foot muscles –– 29 of them, to be exact –– a workout. 

But there's a need for more research on barefoot walking in people of different ages. And going shoeless isn't the only way to strengthen foot and leg muscles. Switching to less supportive shoes makes a big difference. A 2021 study had adults switch from supportive footwear to minimal footwear. After 6 months, they had a 57% increase in foot strength.

2. Improves foot mechanics and ankle range of motion

Walking barefoot lets your feet move freely, which could improve your movement (foot mechanics). Research has shown improved foot structure, including a more defined arch and better mobility, in children who don't wear shoes for extended periods. Better foot mechanics can also mean fewer toe problems, such as bunions.

Barefoot walking can also change your gait or walking pattern. A study found that people who regularly walk barefoot tend to have wider feet than those who wear shoes. They may also have a shorter stride and bend their knees more when they walk. These changes reduce the impact when their feet touch the ground. However, the researchers noted that when people who usually wear shoes go barefoot, it can increase pressure on the bottom of their feet. 

3. Improves balance and posture 

Walking barefoot activates foot muscles and nerves that control balance and proprioception. Proprioception allows you to sense where your body is in space. It helps both balance and posture. As we age, improving balance is an important part of preventing falls. 

But a 2020 study found that, for older adults, wearing minimalist shoes was better than barefoot walking. It strengthened foot muscles and improved balance, while protecting the feet. 

The bottom line? Younger populations may benefit from barefoot walking for balance. Older populations should wear minimalist shoes to get the benefits without the risk of foot injuries.

4. Reduces stress 

Walking barefoot in the grass, dirt, or sand may help reduce stress and even inflammation. Having direct skin contact with the earth's surface, known as grounding, may transmit electrical charges to the body and elicit positive results. 

A very small study found that grounding helped improve mood and energy in massage therapists. Another study found that grounding helped reduce pain and inflammation. It even promoted wound healing. But there's a need for more research.

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What Makes Arch Support So Important?

What Can Happen to the Arches of Your Feet

Ligaments and tendons along the bottom of the foot support and connect the metatarsal and tarsal bones, which form distinctly curved and weight-bearing arches. If malformed or hurt through repetitive motion, sprain, or other acute injury, arches cannot do their jobs, i.e., helping you walk, run and simply stand with minimal strain on the lower extremities.

Examples of foot arch problems that your podiatrist frequently sees and treats in people of all ages include:

• Fallen arches, or flat feet
• Plantar fasciitis is an inflammatory condition of the band of connective tissue stretching across the arch from the heel to the toes
• Overpronation is a gait defect in which the foot rolls toward the midline when walking or running
• Ankle sprains, an overstretching or tearing of connective tissues between bones
• Heel pain and swelling
• Cavus foot, a pronounced arch deformity caused by cerebral palsy, spina bifida, or other medical condition

How Arch Support Can Help

Arch support can help improve the pain, balance, and gait problems common to arch deformities and conditions. Available over the counter (for mildly symptomatic issues) or as custom-made orthotics from your podiatrist, arch support:

• Holds up the ligaments, tendons, and bones on the bottom of the foot
• Corrects biomechanical issues associated with how the person places the foot on the ground
• Provides impact cushioning
• Corrects balance
• Decreases pain and fatigue in the feet, ankles, and lower legs

Orthotics are customized by your podiatric team using amazing three-dimensional scans of the entire foot. Then, the data and images are analyzed to create arch supports that fit directly into footwear to deliver the support, cushioning, correction, and protection needed.

Podiatrists construct orthotics from high-quality, long-lasting materials such as carbon fiber, and while somewhat costly if health insurance does not provide coverage, the devices literally last for years. Source

What Causes Unhealthy Nails?

What Causes Unhealthy Nails?

According to Dana Stern, M.D., a board-certified dermatologist and nail specialist, unhealthy nails can be caused by using harmful ingredients, like formaldehyde. "Nail strengtheners that contain formaldehyde can cause the nail to become paradoxically brittle and can lead to onycholysis, aka separation," she says. 

Additionally, excessive exposure to acetone can significantly dehydrate the nail leading to fragility, peeling, splits, and breakage. "Avoid products that tout themselves as treatments, but require polish remover to remove them," warns Dr. Stern. "These are often glorified clear polishes and may make nail damage worse."

Other causes of unhealthy nails include damage caused by injuries, such as aggressively buffing the nails or removing cuticles. Genetic predispositions can also play a role in nail health. "There is a genetic component to brittle nails and a direct correlation with aging," says Dr. Stern. Nails derive their nutrients and oxygen from the bloodstream. However, if you're predisposed to poor peripheral circulation, Dr. Stern says your nails may not be able to get the nutrients they need to be healthy.

The overuse of artificial products like nail polish, gel, or acrylic, on nails make nails brittle and dehydrated, says Michelle Saunders, a celebrity nail artist. The process of getting and removing these nail enhancements can also remove layers of your natural nails.

Signs of Unhealthy Nails

"Visible signs that your nails are not healthy include ridges in your nails, nails that easily break, and discoloration," says Syreeta Aaron, a professional nail artist and LeChat Nails educator. According to the American Association of Dermatology (AAD), yellow discoloration can be a result of nail polish or smoking. However, yellow nails that are thick and stopped growing may be due to lung disease or rheumatoid arthritis in severe cases.

If you notice green-ish black discoloration, this may be a sign of a bacterial infection. However, a dark black streak on the nail can be a sign of skin cancer. The AAD recommends booking an appointment with a dermatologist at the sight of any discoloration on the nails to fully understand the cause and the right treatment.

Other visible signs of unhealthy nails include grooves, pitting, and nail clubbing. Deep grooves are divots in the nail bed, and nail pitting looks like someone stuck a toothpick in your nails. Nail clubbing is the appearance of curved nails that can also make the fingertips larger and sometimes suggest issues in the lungs. Grooves in the nails aren't typically a cause for concern, but can be a sign that something slowed (or stopped) your nails from growing for a while, says AAD. That said, nail pitting is common in people with psoriasis, which can also cause nail splitting (another sign of unhealthy nails).

"Nails that are becoming thicker or thinner are also signs of them not being healthy," says Aaron. When the nails become so thin, they can begin to dip in the middle and appear spoon-shaped, which might be due to an iron deficiency.

Remedies for Unhealthy Nails

"​​Healthy nails have a natural sheen to them, and they are flexible," says Saunders. They also have an even nail plate, a pink nail bed with a clean white tip, and intact cuticles, adds Dr. Stern. If your nails don't check off these boxes, it's best to see a dermatologist for a professional opinion and next steps.

To maintain healthy nails, Dr. Stern recommends taking a break from over-processed products like gels, acrylics, and polish. If you can't, make sure you're being gentle when removing nail enhancements and searching for products that have skin-benefiting ingredients. "Look for nail treatments that have scientific validity and are formulated with natural ingredients," says Dr. Stern.

Additionally, moisturizing your nails with cuticle oil can go a long way. "Nails love oil and conditioner," says Saunders. "Remember, nails are made of keratin protein, so you want to treat nails as gently as you treat hair and condition often." Aaron also recommends staying on top of your daily supplements, such as vitamin C, biotin, zinc, iron, and magnesium, to ensure your nails are getting the necessary nutrients to remain healthy and strong. Source

8 Simple Nail Care Tips to Banish Dry, Brittle Nails for Good

The best route to stronger, longer nails is mostly through simple lifestyle habits, not pricy nail tools. But getting healthy nails also means kicking some bad habits, such as using your nails as a built-in pocket knife. For doable, helpful nail tips, we talked to the experts about the everyday dos and don'ts of nail care. Follow these steps, and you'll have stronger, longer nails before you know it;

1.) Moisturize your nails

Moisturizing is a well-known secret to healthy skin, but it's often overlooked in nail care. While dry, brittle nails can be the result of many factors, they're ultimately a cry for moisture, so consider proper moisture the foundation of your nail care routine. When applying hand lotion, give your nails a little extra attention. There are plenty of moisturizing nail products on the market, but applying moisturizer is really only half the battle—there's more to strong nails than a fancy cream or serum.

2.) Leave Your Cuticles Alone

It's common practice to cut, push back, or try to get rid of cuticles altogether, but cuticles are not the enemy. In fact, the cuticle is "the nail's natural protective seal," according to Dana Stern, MD, a board-certified dermatologist, and nail expert. Messing with your cuticles can do far more harm than good—even if a nail technician is the one doing the handiwork. Dr. Stern says a compromised cuticle can leave the nails vulnerable and at risk of infection. Michele Green, MD, a cosmetic dermatologist, agrees that poorly kept cuticles can have a domino effect. "When your cuticles get dry or injured it can injure the nail bed and affect the way your nails grow out," Dr. Green says. She recommends moisturizing the cuticles with cream or cuticle oil (like Deborah Lippmann's Cuticle Oil) to help protect and strengthen your nails.

3.) Avoid Contact With Water

Don't stop washing your hands or shower with gloves on, but do pay attention to ways you can reduce the time your nails spend in contact with water because excessive water contact can weaken nail structure. (Wet hair is especially vulnerable, and the same caution-when-wet approach you take to handling wet locks can apply to nail care, too.) For example, consider wearing gloves while doing the dishes or other wet work.

Do you know how soft and bendy nails get after a long bath? Consider this: "The nail is like a sponge. It is 1,000 times more absorptive of water than the skin, for example, and so water can easily diffuse into the nail," Dr. Stern says. Excessive water exposure can put significant strain on delicate nail cells (called onychocytes), which can lead to brittleness, peeling, and breakage, she says. This is also why soaking nails before a manicure is a bad practice. Not only does this make your nails more vulnerable to infection, according to Dr. Green, but it also doesn't allow nail polish to adhere as well or last as long.

4.) Be Gentle

The best nail care is gentle care, according to Susan C. Taylor, MD, board-certified dermatologist, and expert in treating skin of color. For starters, Dr. Taylor advocates against invasively digging under your nails. "Sometimes people take the pointy end of a nail file and they dig underneath their nails to get the dirt out," she says. "You don't want to do that, because it can separate the nail plate from the underlying bed, and then you can develop a bacterial fungal infection."

For similar reasons, you should resist the urge to use your nails as replacement tools—no matter how convenient it may be. (There are plenty of other creative ways to open a can of soda.) And if you do indulge in an acrylic or gel manicure—which you should only do sparingly—correct removal is important. Look for a good gel nail polish kit for at-home manicures that include all the necessary tools to properly treat your nails. "When you peel [acrylic or gel nails] off, you're really peeling layers of the nail, the nail plate, and that's going to weaken your nails—so that's a no-no," Dr. Taylor says.

5.) Treat Your Nails Like You Treat Your Hair

It's the new golden rule. Hair and nails are both composed of keratin proteins, so it makes sense that many of the same rules for treatment apply. Dr. Stern says both hair and nails can become dehydrated and damaged from over-processing. Frequent polish removal, gels, and acrylics do to nails what dyes, chemicals, and heat application do to hair. Just as hydration can help repair hair issues such as frizz and split ends, it can help improve dry and brittle nails. There's no nail care equivalent to second-day hair, but operating as though there are hard and fast rules for how to wash, care for, and use your nails can help keep them in the same good shape as your hair.

It bears repeating: Hydration is the foundation. "Just as you would condition your hair with a leave-in or rich conditioner, I would condition your cuticles as well to promote healthy, growing nails," Dr. Green says.

6.) Watch the Weather

Winter can be a rough time for skin, hair, and nails alike. Not only can cool, dry weather cause nails to get extra brittle, but Dr. Stern says the extreme swings in temperature from going outdoors to indoors can cause additional damage. The shift from a heated home or office to the chilly open air can cause nail cells to contract and expand repetitively, resulting in a weakening between the cells, leading to breakage, she says. It's smart to always wear gloves in the winter and, you guessed it, moisturize, moisturize, moisturize to protect both the skin of your hands and your nails.

7.) Rethink Your Products

• Nail files: Instead of those old-as-time emery boards, which Dr. Stern says "create microscopic tears in the nail that lead to splits and peeling," opt for a glass or crystal nail file (like OPI's Crystal Nail File).
• Nail polish remover: In the best-case scenario, you would avoid nail polish remover altogether. But since most of us aren't going to entirely give up the joy of a nice manicure, it's better to instead use non-acetone removers (like ella+mila Soy Nail Polish Remover) that contain hydrating oils and ingredients.
• Nail brush: Instead of digging under your nails with tools such as a filer, which Dr. Taylor warns against, use a gentle nail brush (like the Luxxii Fine Handle Grip Nail Brush) to clean out the dirt. Or, for a resourceful alternative, use an extra toothbrush you have lying around.
• Nail growth products: Go ahead and pass on these. "So many of the so-called nail treatment or nail growth products on the market are in reality clear nail polishes with marketing additives that have no scientific validity," Dr. Stern says.

8.) Be Patient With Nail Growth

If you're a chronic nail-biter, you know the victory of finally growing your nails out past your fingertips. Healthy habits plus patience pay off in nail care. But the primary focus should be on figuring out how to strengthen your nails, not solving the puzzle of how to grow nails fast. Stronger nails can lead to longer nails if you practice good nail care, but it all takes time. If you battle brittle nails and constant breakage, it's smart to keep your nails clipped short until they regain strength; then they'll have the foundation they need to grow longer.

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Foot Care for Seniors: 10 Important Tips

Proper foot care is essential for older adults because it can help prevent injuries, falls and complications from chronic diseases like diabetes. 

1.) Be good to your soles. As you age, the muscle tissue in your feet can thin and your nerves may not work effectively. This can lead to loss of feeling in your feet (neuropathy). Use a long-handled mirror – it will extend your reach several inches – to see what you may not feel. Examine the soles of your feet and in-between your toes every day for cuts, blisters, sores or any areas of skin breakdown from moisture. This is especially important if you have diabetes.

2.) Choose the right footwear. Wearing the right footwear can help you keep your balance, prevent falls and reduce the risk of blisters and other injuries. Never purchase shoes that rub or slide around on your heel as you walk – this is a common way to develop blisters that can become more serious sores. Also avoid shoes that are too tight, slick on the bottom, have high heels or pointy toes. If you have diabetes or neuropathy, talk with your doctor about prescription orthotics (supports or devices worn in your shoes). You may be eligible for custom orthotics partially covered by Medicare.

3.) Get the right fit. Here are a few suggestions:

• Prop up your feet on a stool or couch when sitting down
• Wiggle your toes when you sit for long periods of time
• Stretch daily
• Give yourself regular foot massages

4.) Barefoot isn’t better. When going outdoors, always wear shoes (preferably closed-toe shoes) to prevent cuts, scrapes and falls. It’s also best to wear shoes as much as possible while indoors to protect your feet.

5.) Keep your toenails in tip-top shape. Trimming your toenails correctly (straight across and no shorter than the tip of your toe) is key for preventing ingrown toenails. If you have diabetes or trouble reaching your feet, see a podiatrist (a physician who specializes in foot care), not a nail salon technician, for regular medical pedicures and nail trimming.

6.) Get the blood flowing. As you age, you may have decreased blood circulation to your feet. To promote healthy circulation:

• Prop up your feet on a stool or couch when sitting down
• Wiggle your toes when you sit for long periods of time
• Stretch daily
• Give yourself regular foot massages
• And, if you smoke, now’s the time to quit. Smoking can affect good circulation in the body.

7.) Keep your feet dry … Change your socks regularly and make sure your feet aren’t damp from sweat or a shower before putting on your shoes.

8.) … But not too dry. Keep your feet moisturized to prevent cracking, itching and calluses. Stick with gentle soap and apply cream or lotion daily after your shower or bath.

9.) Fight fungal infections. Prevent athlete’s foot by wearing shoes that fit properly, changing your socks or stockings daily (or whenever they become damp) and applying foot powder each day. If you experience itching or burning, see your podiatrist for treatment.

10.) Visit your podiatrist regularly for foot checks. Your podiatrist can catch problems like bone spurs, hammertoe, neuromas, bunions, warts, ingrown toenails or wounds before they cause more serious problems.

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7 Pedicure Safety Tips for People With Diabetes

The forecast calls for sunny weather. You want to slip into sandals or open toe-shoes, but your feet have to look their best. A pedicure is an option. But if you have type 2 diabetes, a pedicure comes with some risks. One is the risk of infection from a poorly sterilized pedicure tool or a cut. Infection can raise your blood sugar levels, interfere with proper healing and put you at risk of more serious complications like ulcers and even amputation.

So before scheduling a visit to the nail salon, check with your physician to make sure it’s okay to get a pedicure.“People with poorly-controlled diabetes can develop foot problems, such as decreased circulation or nerve damage, which can lead to serious complications,” says Athena Philis-Tsimikas, MD, a clinical endocrinologist and vice president of Scripps Whittier Diabetes Institute.

“Poor circulation can make your feet less able to fight infection. Nerve damage can cause loss of feeling, so if you injure your foot, you may not know it,” says Dr. Tsimikas said. “This makes cuts and nicks in the nail salon something you really want to avoid if you have diabetes.” If given the green light for a pedicure, stick to a few basic precautions that can significantly reduce your risk of infection and lead to a safer, more pleasant experience.

Follow these tips if you have type 2 diabetes and are considering getting a pedicure;

1. Know when to skip a pedicure

If you currently have any infections, cuts, or open sores on your legs, feet, or toenails, avoid the salon and the many risks. This applies also if you have neuropathy, which is a type of nerve damage that can occur with diabetes. Instead, contact your physician for a referral to a podiatrist or other specialist who is medically trained to care for your feet.

2. Avoid shaving your legs for a day or two before your pedicure

Shaving can leave tiny nicks in your skin and increase the risk of infection. If you have neuropathy, it can lead to a loss of sensation to the affected areas. Without the ability to feel pain, people with diabetic neuropathy can allow small cuts or blisters on their feet to fester into larger sores or ulcers which can become infected.

3. Find a salon that is clean and practices impeccable sanitation

Tell the manager you have diabetes and inquire about their sterilization procedures. Reputable salons will work with you and show you how they operate. Foot baths should be cleaned and disinfected between customers. Clippers and other tools should be washed and sanitized in a disinfecting solution or a surgical autoclave, which uses pressurized steam to sterilize instruments.

4. Bring your own nail kit

Play it safe and bring your own pedicure tools if possible.

5. Mention you have diabetes before the pedicure begins

Ask the technician to avoid doing anything that can scratch or injure the skin. Speak up if you don’t like what the technician is doing.

6. Bring up protective practices

Ask the technician not to cut your nails too short, as this can encourage ingrown toenails and lead to infection. Make sure toenail edges are not sharp; they should be rounded off with a file.

7. Skip any services that can injure the skin

Never allow the technician to cut your cuticles or use any sharp instruments on your skin or under your toenails. Instead, after your feet have been soaking for a few minutes and the skin around your toes is soft, cuticles can be gently pushed back with an orange stick, which is the thin stick, typically made of orange wood that is used for manicuring. After your pedicure is finished, keep an eye on your feet and legs for any signs of redness or infection. If you notice anything unusual, call your doctor right away. Source