April 4, 2016

By Virender Sodhi, MD (Ayurved), NMD, and Priya Walia, MS (Ayurveda), NMD

Healthy Skin

“Swasthyavrit: Circle of Health”

In continuation of this series on “Swasthyavrit,” we are going to take a look at what the ancient wisdom of Ayurveda has to offer for skin health.

Ayurveda & Skin

Each dosha withholds characteristics that help define the various “skin types.” These qualities further predetermine what potential “problems” one may experience in his/her skin.

Vata (ether & air) Pitta (fire & water) Kapha (earth & water)
Skin Characteristics Dry, rough, cracked, thin, quick to age Oily, sensitive, prone to redness, itchy Naturally thick, rich, soft, full of moisture, oily, plump, slow to age

Ayurveda’s Division of the Layers of Skin:

While Western medicine identifies three layers of skin, ancient Ayurvedic wisdom has further distinguished each layer of skin into seven different layers. The founding father of surgery, Sushruta, described each layer as having its own distinct structure and function. Each layer provides support to the layer above.

  1. Avabhasini: outer layer of skin
    • Provides complexion
    • Reflects the quality of rasa dhatu (nutrition aspect of blood).
    • During imbalance, we find acne, pimples, and dandruff.
  2. Lohita: second layer
    • Has a connection to rakta dhatu (blood)
    • During imbalance, we find an increase in pigmentation and mole formation.
  3. Shweta: third layer
    • Described as being white and helps to provide balance to the color and tone of the skin.
    • During imbalance, we find eczema and other allergic responses.
  4. Tamra: fourth layer
    • Involved in skin immunity and provides a barrier to protect from pathogens.
  5. Vedini: fifth layer
    • Connects the sense of touch with the rest of the body through various signal transmissions.
    • During imbalance, we find conditions such as neuralgia or re-activation of herpes.
  6. Rohini: sixth layer
    • Responsible for regeneration
    • During imbalance, the healing ability and scar formation is weakened.
  7. Mamsadhara: innermost layer
    • Provides support to all 7 layers
    • During balance, we see stability, firmness and youthfulness in the skin.
    • During imbalance, the skin sags and the aging process becomes more visible.

Healthy Nutrients:

Nutritional status impacts the health of skin. Key nutrients are outlined below.

Glucose

  • Primary source of energy for cells, including skin cells.[1]
  • Deficiency can cause structural and barrier function changes.[2,3]
  • Glucose is found in fruits, vegetables, and carbohydrates (such as: breads, rice, pasta, sugar, etc).

Amino Acids: Proline, Glutamate, Arginine, and Ornithine

  • Promote collagen synthesis in skin cells.[4]
  • Provide protection against UV damages, including skin aging and enables optimal wound healing.
  • Food sources of arginine include: peanuts, almonds, sunflower seeds, walnuts, hazelnuts, lentil, Brazil nuts, cashews, pistachios, flax, kidney beans, pecans, pumpkin seeds, soybeans, turkey, tuna, chicken, salmon, shrimp, egg, and spirulina.[5]
  • Proline is also produced by the body, and is sourced from meat, dairy, eggs, asparagus, avocado, beans, broccoli, spinach, legumes, and soybeans.[6]

Vitamin A (Retinoids, Carotenoids, β-carotene)

  • Retinoids are mostly found in animal sources, whereas provitamin A carotenoids, including β-carotene, are found in plant products.[7] Other examples include: liver, cod liver oil, cream and butter from pastured cows, and egg yolks from chickens.[8]
  • An antioxidant that helps provide optimal skin turnover and growth, protect from damage, and promote wound healing. Vitamin A has also been used in treatment of acne, psoriasis, ichthyosis, and skin cancer.[9,10,11,12,13]

Vitamin C

  • Provides antioxidants to support structure and function of the skin, promote collagen synthesis,protect from UV damage, helps promote wound healing, and provides hydration to the skin.[14,15,16,17,18,19]

Food sources of vitamin A and C include: Dark, green, and leafy vegetables, and colorful fruits.[20 ]Amla, or Indian Gooseberry, serves to be the most potent source of vitamin C and antioxidants.

Vitamin E

  • Acts as an antioxidant and anti-inflammatory to help prevent premature aging of skin.[21,22,23,24,25]
  • Food sources of vitamin E include: wheat germ oil, sunflower seeds, almonds, sunflower oil, hazelnuts, peanut butter, peanuts, corn oil, spinach, broccoli, soybean oil, kiwi.[26]

Vitamin D

  • Improves the inflammatory response and is helpful in wound healing.[27,28]
  • Vitamin D receptors are actually found on the skin and is best absorbed by sun exposure.
  • Vitamin D is found in limited amounts of food: skin fat flesh of salmon, tuna, and mackerel, and fish liver oil.
  • Most individuals are deficient in vitamin D and need to take a supplement.

Zinc

  • Protects from sun damage, promotes wound healing, and provides antibacterial properties.[30]
  • Food sources of zinc include: oysters, beef, crab, lobster, liver, pork, chicken, yogurt, cashews, cheese, oatmeal, milk, almonds, beans, peas, flounder, sole, nuts and seeds.[31]

Copper

  • Is an antioxidant that helps collagen production, and helps promote the color of skin.[32,33]
  • Food sources of copper include: organ meats, nuts and seeds, chocolate and shellfish.[34]

Selenium

  • Provides protection to the skin from damage from UV exposure.[35,36]
  • Useful for the prevention and treatment of psoriasis.[37]
  • The most potent food source of selenium is Brazil nuts, with a daily recommended allowance of 25-50mcg daily (depending on age and gender).[38]

Healthy Diet:

Each dosha should focus on certain types of foods, which will help maintain the health of skin. Such foods are outlined below:

Vata Pitta Kapha
Diet
  • Aggravated with astringent, bitter, and pungent tastes.
  • Encourage sweet, salty, and sour tastes.
  • Focus on warm, cooked, fresh, oily, moist, heavy, and soothing food.
  • Oils: sesame, ghee
  • Aggravated with pungent (spicy & oily), salty, and sour tastes.
  • Encourage bitter, sweet, and astringent. Focus on moderate temperature, not too spicy, not too oily foods.
  • Oils: coconut, ghee, sesame
  • Aggravated with sweet, salty, sour (rice, bread, noodles).
  • Encourage pungent (spicy & oily), astringent, bitter tastes.
  • Focus on light, dry, warm foods. Drink warm water.
  • Oils: olive, ghee, sunflower

In general, fresh, seasonal fruits and vegetables are ideal. Aim for 4-5 servings of vegetables and 2 seasonal fruits daily.

Skin Care and Cleansing:

Ayurveda prescribes body massage (Abhyangha) for maintaining the health of skin. Many benefits are outlined in the traditional scripture of Ayurveda, the Charaka Samhita. Abhyangha brings the doshas back into balance, enhances complexion and luster of the skin, tones muscles, and moisturizes the skin. Other benefits include: increased circulation, calming the nerves, lubricating the joints, increasing mental clarity, enabling elimination from the body, increasing stamina, and promoting sleep. As such, it purifies and nourishes at a deeper level.

Skin supporting Herbs:

  • Amla, Phyllanthus amarus, extract powder can be added to any oil. This particular herb has long been used in Ayurveda due to its collagen supportive and skin healing properties. This potent antioxidant and vitamin A and C containing herb helps to establish and maintain the luster or young, healthy skin. Research has supported its skin protective, healing, and anti-aging effects.39-42
  • Gotu kola, Centella asiatica, extract powder may also be added to any oil. Centella has long been touted and studied to be the wound healing, collagen supporting, and strength promoting herb for skin.[43,44]
  • Seabuckthorn seed, Hippophae rhamnoides L., extract powder is another herb that can be added during massage. Seabuckthorn seed has been used for many years for its skin healing, collagen support, and protection from UV damage and photoaging.[45,46]

Traditionally, the massage is done daily, before a shower in the morning with warm oil that is suitable according to the individual’s predominant dosha. By doing this before the shower, one stimulates healthy circulation, lymph drainage, and allows for the pores to be opened and cleansed once in the shower. One begins the massage at the feet and works his/her way up the legs in long strokes, while going in circular motions around joints (ankles, knees, hips), then to the hands and up the arms to the shoulders. From there, the buttocks and stomach is massaged in a circular, clockwise motion, the upper chest and breasts are massage in a circular outward motion, allowing for the internal fluid/lymphatics to flow in the direction of drainage. Vertical strokes should be made over the breastbone and solar plexus. The back is massaged with long upward strokes as well. The neck and face should be massaged with long strokes. The starting point for the face should be at the base of the chin and one should work upwards and to the sides finishing at the center of the forehead with both hands. The cheeks, mouth, and eyes are massaged in a circular motion. Each stroke and circular motion should be done 3-5 times.

Each dosha uses specific oils, while sesame is considered to be tridoshic:

Vata Pitta Kapha
Oil for Skin Sesame, castor, ghee, olive, almond Coconut, sesame, sunflower Olive, mustard, sesame

Massage technique according to each Dosha:

Vata Pitta Kapha
Massage Technique Mild, gentle, slow Relaxing, cooling in a calm environment Dry, warm, stimulating, rough

After the massage is complete, one can begin to cleanse the skin. A gentle cleanser that will not strip the natural oils from the skin is ideal. One example is to use chickpea flour, ground turmeric, and yogurt to make a paste that can be massaged all over the body with a loofah brush.

Once the cleanse is complete, the individual can finish with a light oil massage that is appropriate for his/her dosha. This will be of particular use for the vata dosha, as the vata skin tends to be dry and cracked.

Breathing and Skin Health:

Prana, or life force, is provided with each breath we take. Many of us walk around without realizing that we are not breathing properly. Some breathe shallow, moving only the upper chest, while some hold their breath without noticing. A full breath enables every cell and tissue in the body to be nourished with not just oxygen, but also nutrients. In the case of skin, the breath enables healthy movement, nutrition, and oxygen to reach the outermost layer and largest organ of the body. One such breath practice includes:

So Hum “I am” Breath:

  1. Inhale through your nose, filling your lungs to full capacity.
  2. Hold the breath for 3 seconds, then slowly exhale through your mouth.
  3. Repeat this exercise 16 times, twice a day.

Conclusion:

As such, maintaining the health of the skin comes from within the body, not just with outer skin care. There are many factors that make up the health of our skin and each should be considered.

In continuing with the “Circle of Health,” our next topic will discuss the promotion and maintenance of oral health.

References

  • [1] Spravichikov, N., Sizyakov, G., Gartsbein, M., et al. (2001). Glucose effects on skin keratinocytes: implications for diabetes skin complications. Diabetes 50, 1627-1635.
  • [2] Halprin, K., M. and Ohkawara, A. (1966) Glucose and glycogen metabolism in the human epidermic. J. Invest. Dermatol. 46, 43-50
  • [3] Van Hattem, et al. (2008). Skin manifestation of diabetes. Cleve. Clin. J. Med. 75, 772, 774, 776-777
  • [4] Karna, E., et al. (2001). The potential mechanism for glutamine-induced collagen biosynthesis in cultured human skin fibroblasts. Comp. Biochem. Physiol. B Biochem. Mol. Biol. 130, 23-32.
  • [5] “L-arginine: food sources high in arginine amino acid content” (2015)
  • [6] “Proline”.
  • [7] Goodman, D.S. (1984). Vitamin A and retinoids in health and disease. N. Engl. J. Med. 310, 1023-1031.
  • [8] Kresser, C. (2012). Nutrition for healthy skin: Vitamin A, zinc, vitamin C.
  • [9] Jean, J. et al. (2011). Effects of retinoic acid on keratinocyte proliferation and differentiation in a psoriatic skin model. Tissue Eng. Part. A 17, 1859-1868.
  • [10] van de Kerkhof, P.C. (2006). Update on retinoid therapy of psoriasis in: an update on the use of retinoids in dermatology. Dermatol. Ther. 19, 252-263
  • [11] van Steensel, M. A. (2007). Emerging drugs for ichthyosis. Expert Opin. Emerg. Drugs 12, 647-656.
  • [12] Niles, R. M. (2002). The use of retinoids in the prevention and treatment of skin cancer. Expert Opin. Pharmacother. 3, 299-303.
  • [13] Kligman, A.M. (1997). The treatment of acne with topical retinoids: one man’s opinions. J. Am. Acad. Dermatol. 36, S92-95.
  • [14] McArdle, F., Rhodes, L.E. et al (2002). UVR-induced oxidative stress in human skin in vivo: effects of oral vitamin C supplementation. Free Radic. Biol. Med. 33, 1355-1362.
  • [15] Stewart, M.S. et al (1996). Antioxidant nutrients protect against UVB-induced oxidative damage to DNA of mouse keratinocytes in culture. J. Invest. Dermatol. 106, 1086-1089.
  • [16] Fisher et al (1996). Molecular basis of sun-induced premature skin ageing and retinoid antagonism. Nature. 379, 335-339.
  • [17] Campos, P.M. et al (2008). In vitro antioxidant activity and in vivo efficacy of topical formulation containing vitamin C and its derivatives studied by non-invasive methods. Skin Res. Technol. 14, 376-380.
  • [18] Michels, AJ (2011). Vitamin C and skin health. Linus Pauling Institute.
  • [19] Telang, Pumori Saokar. (2013). Vitamin C in dermatology. Indian Dermatology Online Journal 4.2: 143–146. PMC
  • [20] Nutrition and Hair Health. The Hair Trichological Society. .
  • [21] Bissett et al (1990). Photoprotective effect of superoxide-scavenging antioxidants against ultraviolet radiation-induced chronic skin damage in the hairless mouse. Photodermatol., Photoimmunol. Photomed. 7, 56-62.
  • [22] Jurkiewicz et al (1995). Effect of topically applied tocopherol on ultraviolet radiation-mediated free radical damage in skin. J Invest Dermatol. 104, 484-488.
  • [23] Burke et al (2000). Effect of topical and oral vitamin E on pigmentation and skin cancer induced by ultraviolet irradiation in Skh:2 hairless mice. Nutr Cancer. 38, 87-97.
  • [24] Meydani et al. (1990). Vitamin E supplementation enhances cell-mediated immunity in healthy elderly subjects. Am. J. Clin. Nutr. 52, 557-563.
  • [25] Wu et al (2008). IL-8 production and AP-1 transactivation induced by UVA in human keratinocytes: roles of D-alpha-tocopherol. Mol. Immunol. 45, 2288-2296.
  • [26] “Vitamin E- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
  • [27] Frohm et al. (1997). The expression of the gene coding for the antibacterial peptide LL-37 is induced in human keratinocytes during inflammatory disorders. J. Biol. Chem. 272, 15258-15263.
  • [28] Koczulla et al (2003). An angiogenic role for the human peptide antibiotic LL-37/hCAP-18. J. Clin. Invest. 111, 1665-1672.
  • [29] “Vitamin D- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
  • [30] Mitchnick et al. (1999.) Microfine zinc oxide (Z-cote) as a photostable UVA/UVB sunblock agent. J. Am. Acad. Dermatol. 40, 85-90.
  • [31] “Zinc: Fact Sheet for Health Professionals” National Institutes of Health: Office of Dietary Supplements.
  • [32] Pickart, L. (2008). The human tri-peptide GHK and tissue remodeling. J. Biomter. Sci. Polym. Ed. 19, 969-988.
  • [33] Menkes, J.H. (1988). Kinky hair disease: twenty years later. Brain Dev. 10, 77-79.
  • [34] Ma, J and Betts, NM. (2000) Zinc and copper intakes and their major food sources for older adults in the 1994–96 continuing survey of food intakes by individuals (CSFII) J. Nutr. 130:11, 2838-2843.
  • [35] Balagopalakrishna, C et al (1997). Minimally modified low density lipoproteins induce aortic smooth muscle proliferation via the activation of mitogen acitavted protein kinase. Mol. Cell. Biochem. 170, 85-89.
  • [36] Rafferty et al (1998). Differential expression of selenoproteins by human skin cells and protection by selenium from UVB-radiation-induced cell death. Biochem. J. 332 (pt 1), 231-236.
  • [37] Juhlin, L. et al (1982). Blood glutathione-peroxidase levels in skin diseases: effect of selenium and vitamin E treatment. Acta Derm. Venereol. 62, 211-314.
  • [38] “Selenium- Dietary Supplement Fact Sheet”. National Institutes of Health: Office of Dietary Supplements 2016.
  • [39] Datta, H and Paramesh, R. (2010). Trends in aging and skin care: Ayurvedic Concepts. Journal of Ayurveda and Integrative Medicine 1.2, 110-113.
  • [40] Fujii T, Wakaizumi M, Ikami T, Saito M. (2008). Amla (Emblica officinalis Gaertn.) extract promotes procollagen production and inhibits matrix metalloproteinase-1 in human skin fibroblasts. J Ethnopharmacol. 119(1):53-7.
  • [41] Majeed M, Bhat B, Anand S, Sivakumar A, Paliwal P, Geetha KG. (2011). Inhibition of UV-induced ROS and collagen damage by Phyllanthus emblica extract in normal human dermal fibroblasts. J Cosmet Sci. 62(1):49-56.
  • [42] Adil MD, Kaiser P, Satti NK, Zargar AM, Vishwakarma RA, Tasduq SA. (2010). Effect of Emblica officinalis (fruit) against UVB-induced photo-aging in human skin fibroblasts. J Ethnopharmacol 132(1):109-14.
  • [43] Hashim P (2014). The effect of Centella asiatica, vitamins, glycolic acid and their mixtures preparations in stimulating collagen and fibronectin synthesis in cultured human skin fibroblast. Pak J Pharm Sci. 27(2):233-7.
  • [44] Bylka W, Znajdek-Awiżeń P, Studzińska-Sroka E, Brzezińska M. (2013). Centella asiatica in cosmetology. Postepy Dermatol Alergol. 30(1):46-9.
  • [45] Hwang IS, Kim JE, Choi SI., et al. (2012). UV radiation-induced skin aging in hairless mice is effectively prevented by oral intake of sea buckthorn (Hippophae rhamnoides L.) fruit blend for 6 weeks through MMP suppression and increase of SOD activity. Int J Mol Med. 30(2):392-400.
  • [46] Jadoon S, Karim S, Bin Asad MH, et al. (2015). Anti-Aging Potential of Phytoextract Loaded-Pharmaceutical Creams for Human Skin Cell Longetivity. Oxid Med Cell Longev. 2015:709628.