NZDSI Blog

Collagen..to supplement? that is the question..

19 Oct, 2020

Looking healthy is a common desire.   We are flooded with images of beauty and tips on achieving this.  Collagen supplements are a current enticing tool.  Are they worth the expense?  Watch NZDSI president Dr Louise Reiche in the collagen debate on Fair Go’s programme tonight on TV One or on TVNZ On Demand.

The skin is the largest organ in our body.  Our general health, daily habits and lifestyle impact on our skin’s quality and appearance.  Visible ageing changes such as wrinkling and dry skin are partly determined by our genetics and our age.  Diet and the environment are also major factors.  

Food we eat is broken down by our gut into small molecules that can be absorbed through the gut wall into the bloodstream and distributed throughout the body.  Cells absorb those building blocks to construct what the body needs. Collagen protein is a rope-like structure which provides strength to our skin, muscles and bones.   Collagen is rich in glycine, lysine, proline and hydroxyproline, but is an incomplete food protein because it lacks tryptophan which our bodies cannot make and thus require from the diet.  Collagen in our diet or in supplements can be broken down and reused for making new collagen or other proteins.  Manufacturing strong collagen in our body relies on additional nutrients (“cofactors”) such as Vitamin C and various minerals.  Consuming lots of collagen could create a nutrient imbalance and without other necessary cofactors the collagen production could either fail or be poor.

Having a balanced diet by eating a wide range of foods, ensures we will get plentiful nutrients, such as proteins, vitamins and anti-oxidants and are less likely to suffer imbalances, which can be the risk from taking supplements.  The Mediterranean diet - predominantly fresh vegetables and fruit, nuts, legumes and seafood, some white and smaller quantities of red meat, is the diet associated with best health outcomes and delayed ageing. Transport and storage reduces fresh food quality so choose locally grown and seasonal vegetables.  They are cheaper, and better for our environment and support our local communities economically.

Sun exposure is the biggest environmental factor contributing to visible skin ageing.  So habitually protecting your skin from the sun is key: seek the shade, wear a broad brim hat, wraparound sun glasses, high ultra-protective factor (UPF) clothing and a broad spectrum SPF50+ sunscreen to all exposed skin when going outdoors.   Regularly having a good night’s sleep, regular exercise, drinking plenty of water, avoiding smoking, and minimising alcohol consumption are additional ways to keep healthy and have healthy looking skin.


Spring school holidays..time to be Sun Smart

3 Oct, 2020

This weekend really is one to enjoy the outdoors in many parts of Aotearoa.  With almost summer temperatures in eastern areas the beach will lure the hardier swimmers. Crazy spring changeable weather given it was snowing at a few southern beaches last week that are reaching over 20 degrees today.  The spring school holidays are a time to take sun protection more seriously whatever the temperature.  The UV index is indicating sunburn risk - hitting 4s in the south and in the high range - 8 - in the north.  Invest in good wider brim hats and clothing for the beach and pools and consider working sun protection into the day’s plans well before the sunscreen goes on. Plan to be indoors or in the shade during the middle of the day. Some parents will find a midday siesta can work well for a break from the highest UV conditions.  Aim for SPF 50 long sleeve rash tops and SPF 50 sunscreen.  Remember to keep up the hat and sunscreen habit once back at school for Term 4.  If you are blessed with a pool at home it’s likely sited in a high UV position, don't wait for summer, add some effective shade now and limit exposure to that midday sunshine.

 


Here comes the sun… it’s been a long cold lonely winter… Kia ora George Harrison

30 Aug, 2020

 

In a year of uncertainty we have a welcome constant coming up on the earth’s calendar.  Spring has arrived in the Southern Hemisphere. Our increasing daylight hours are welcome following Matariki. In northern Aotearoa the kowhai flowers are bursting, koanga, time for planting.

It’s almost spring equinox – officially 1.30am NZ time on September 23, 2020.

The equinox occurs twice a year when the earth’s axis is tilted neither toward nor away from the sun.  After this date we will be thrown into strengthening sunlight as the earth slowly tilts and brings the south pole closer to the sun.  The UV index will be creeping up.  NIWA’s Leigh UV station is recording 4-5 during the middle of the day, Wellington is also just starting to reach UVI 3-4 and southern NZ will not be far behind.  Three plus is where the UV level has burning potential and slip, slop, slap is recommended during the stronger sunshine hours of the day.   It can still be cold and windy but don’t underestimate the spring sun on skin that has been hidden over winter.

Remind yourself of your level of risk – fair skin, your activities, past sunburns, family history, medicines you take, medical conditions - talk to your dermatologist about these factors. Our spring blogs will cover some of these.  Meanwhile get out your hat, keep the long sleeves, renew your sunscreen and enjoy the spring.

 


Vitamin D and the skin

22 Jul, 2020

As I write this blog, I am looking out of my office on to a cold, wet, blustery and overcast Auckland day. The UV index is about 2.5 so I am not so concerned with sun exposure but what about vitamin D?

Vitamin D is an essential vitamin. It is important for bone health and has other functions. New Zealand has one of the highest rates of skin cancer in the world but 90% of vitamin D is made by exposure of the skin to sunlight. Some foods contain natural sources of vitamin D and some have it added. How can we make enough vitamin D and at the same time minimise the risk of skin cancer?

Most New Zealanders have adequate levels of vitamin D. However, New Zealanders with skin of colour can develop deficiency especially when combined with clothing that covers a lot of the skin. Other New Zealanders may need to avoid the sun because they have skin conditions that are made worse by sunlight, for example systemic lupus erythematosus. Those who are at risk of skin cancer or who have had skin cancer are advised to protect against excessive sun exposure. Some medications can make you more sensitive to the sun, for example the antibiotic doxycycline.

The New Zealand Ministry of Health offers excellent advice on how to manage the problem of too little vitamin D and too much sun exposure, balancing benefit and risk. Different circumstances demand different solutions. This advice is easily accessible at the Ministry of Health website. If needed your doctor can prescribe a vitamin D tablet for you.

 

Level 1 and chilblains

11 Jun, 2020

Level 1 and what a relief to return to an “almost normal” normal. New Zealand dermatologists will fully open their clinics and you can book to see them.  For some of you, there may have been skin conditions for which you have not been able to seek an opinion because of the different lock down levels but now is the time to have them assessed and treated.

While being wary of Covid 19 it is possible to begin to turn away from this virus back to dermatology and consider dermatology in the winter. Can the cold cause rashes? Yes, several in fact including chilblains also known as pernio. Chilblains are a nuisance in winter. They are caused when the cold is sufficiently severe to damage the skin and cause painful, burning red or purplish bumps. Common sites are the hands, feet and occasionally other areas including the nose and ears. They can take a long time to resolve. Farmers sometimes get them on the hands driving quad bikes without gloves on cold days. Rarely there are other illnesses associated with chilblains and your dermatologist may need to check you for these conditions. A blood test or biopsy may be needed. Preventing them with warm clothing is important. Thermal gloves will help. Smoking makes the problem worse. A medication called nifedipine helps to open the small blood vessels in the skin and can be useful.

So stay warm while enjoying the new normal!