“[Wound Care Nurse]…heal thyself:” Facial Skin Care

Karen Farid, RN, MSN, CWCN

I’ve always been interested in promoting healthy skin, especially facial skin. As a child, I remember going to the local beach club with my mom and my brothers and sisters and passing the Noxema (Unilever, London, UK; yes, it is still manufactured!) around at night to soothe the sunburn on every sunny day! We were not aware of sun damage that would come back to haunt us when we were older.

When I was in my 40s, I noticed a small area of abnormal puckered skin on my collarbone. My surgeon laughed at me  (it was less than half a centimeter) but humored me and removed it. It was my first basal cell carcinoma. I’ve had two more small carcinomas removed from my face, but luckily close to my hairline where the scars went unnoticed. But that first basal cell lesion on my collarbone drove home the concept of critical skin care for my face, not just for the purpose of preventing skin cancer. I had plans for working well into my 70s and 80s after retiring from my acute care facility position: I had already started planning to do consultations for wound care in a private practice. I also wanted to do research on pressure ulcer evolution. I had specialized for so long and was convinced there was more to deep tissue injuries than what meets eye. In short, I wanted to project an image of an active person who was meeting her career head-on and driving it forward by fueling it with a strong understanding of the system behind the disease and the disease behind the skin lesions.

After that first skin cancer, I also worried about skin damage that would age me unnecessarily faster. I had older neighbors who had been going to Florida every winter for endless sunbathing and golfing, and I recognized that sun damage had a horrible aging effect on the skin. That first skin cancer brought me up short and drove me to the Internet, searching for answers on keeping my skin supple and young looking with minimal wrinkles and certainly no more cancer operations. Of course, sunblock was the ultimate protection from the sun, but what about other effective anti-aging secrets?

My studies in systemic diseases and conditions had put me in good stead with the concept of “wellness” and anti-aging. I started a regular exercise program: resistive exercises for my upper body (arm, chest, and shoulder exercises with weights - no more than 8 lb and 30 reps to avoid bulk), sit-ups to strengthen my core abdominal muscles, and walking the dog 1 to 2 miles a day, even in the rain (the dog makes me do it. There’s no shirking with him ridingg herd on me!), as well as taking the stairs at work. I also swim laps in our pool all summer after work and walking the dog; it’s a great way to cool down. I’m no size 6, or even 12, but exercise keeps me proportioned and gives me energy all day, essential for projecting mental fitness and competence.

My mission also had me searching fashion magazines for the latest skin care tips and products. They are a good source for the latest dermatological advances. I learned that retin-A was one of the few treatments that actually penetrated the skin and stimulated collagen production. I read that eye creams and moisturizers could actually make the skin around the eyes sag from too much moisture and eye irritation if they got in the eyes. I learned from my friend, whose teenage daughter had a stubborn case of blepharitis (inflammation of the eyelid edges including the lashes) that castor oil helped reduce the redness and it didn’t irritate the eyes.

I obtained an prescription for retin-A gel .025% (not covered by prescription plans); it dries well and disappears into the skin. I use on the skin around my eye orbit 1 to 2 times a week at night to build collagen. I use a tiny bit of castor oil on my fingertips and blot it around my eyes as a make-up base for shadow and concealer. Over the years, this routine has kept my eye skin tight and almost wrinkle-free. As my eyesight deteriorated with age, I chose to wear glasses (progressives) and one of my friends’ daughter taught me how to order on-line (great savings. I rarely pay more than $200 a pair unless I get designer frames). I chose glasses instead of Lasik surgery or contacts because the glasses provide great UV/UA protection for my eyes and the surrounding skin. Sunblock is contraindicated to use around the eyes because it is so irritating to the eyes, but I use it on my facial skin. I always finish my eye makeup before proceeding to the rest of my face.

The journey to establish a good facial routine (ie, cleansing, subcutaneous collagen protection and building, diminishing wrinkles, and promoting a healthy glow to complement the health and vitality provided by exercising) was a long one. As wound care nurses, we have so many products that we use for patients that can contribute to our own skin health. Mt favorite barrier cream is Ameriderm peri-cream skin barrier (Ameriderm, Paterson, NJ). It’s not sticky and prevents those awful cracks on my fingertips in winter (I never forget my gloves, either). I also use the peri-cream to protect my lips from cracking during the winter, especially at the corners. I realized that it’s actually moisture from saliva that causes the cracking and what better than a moisture barrier?! I put it on and blot off the excess then apply my lipstick. Ameriderm body cleanser (in a spray bottle, which saves time) is great for removing makeup. It doesn’t dry out the skin; instead s it leaves the skin moist, not stripped, and not greasy. Okay, you may laugh, but these little tricks will make you feel and look better!   

Every magazine article on the latest discoveries in facial creams and moisturizers, like Enzyme CoQ10, caffeic acid (caffeine), peptides, SPF, green tea extract, and so on, sounded like stuff I’d like to use, but when shopping for preparations, I found that there was only one “skin perfecting” ingredient per product. Finding something to wear “naked” (alone without additional makeup) or wear under makeup was a frustrating search. I researched some items like peptides and decided on L-arginine. L-arginine is the key ingredient in “Healthibetic” cream (Healthibetic, Port Coquitlam, BC, Canada), an over-the counter product that has been shown in studies to increase skin circulation when it is applied to diabetic legs. I also bought Neutragena (Johnson & Johnson Consumer, Inc, Princeton, NJ) firming lotion with CoQ10 and sunblock with 40 - 50 SPF. I washed out an 8-oz face cream jar with a wide screw on top opening that I could use the hand-blender in and filled the jar half way with the sunblock and another quarter way with the CoQ10 lotion. In a small frying pan, I combine one-quarter cup of distilled water, 1/2 teaspoon of instant regular coffee, and a green tea bag, brought the mixture to a boil, and slowly boiled off the water until only one tablespoon (approximately) was left  (I didn’t want to water down the resulting face cream). I squeezed out the tea bag and, before adding the mixture to the SPF/CoQ10 cream, I added 1/2 teaspoon of L-arginine powder (bought online) and dissolved it in the coffee solution. I poured the coffee, green tea, L-arginine solution into the SPF/CoQ10 cream. Then in the same frying pan I melted 2 tablespoons of coconut oil (less if your have oily skin or still have acne) and added that to the jar of cream. The last ingredient is hyaluronic acid (I will talk more about this powerful molecule in “Part 2” of “…heal thyself…” in the next blog). Then, using the hand blender, I blended the cream for 15 to 20 seconds. The result is a very light face cream that does not separate. I apply this mixture morning after cleansing my skin and before makeup or even if I do not plan to apply makeup. It absorbs right into the skin with no greasy film. I’m on my third jar of homemade moisturizer in 4 years. I’ll never use anything else for daily moisturizer and time has stood still for my face as far as fine lines go.

A note of caution: ALWAYS DO SKIN TESTS ON INNER FOREARM SKIN FOR POSSIBLE ALLERGIES TO INGREDIENTS YOU HAVE NEVER USED: lightly scratch the forearm skin before applying the “green tea, coffee, L-arginine” solution. Check over a period of one day for redness and swelling. Also, many people are allergic to sunblock, so always check products, as well as coconut oil, on your forearm skin.

On a personal note; I still have to deal with deeper expression lines, especially laugh lines. But there’s always Botox if it really starts to bother me. I love to whistle (because I can’t sing) and I use straws when I drink my iced decaf, so I guess I’ll always have those lines around my mouth, but the barrier cream has made them less noticeable.

As much as skin care is important to our persona, inner health status is important to our vigor and glowing skin. Adequate sleep is probably the most important contribution to a healthy mind and body. In my case, after several months of feeling like I was always tired, I had a T3-T4, TSH done and found out I had hypothyroidism. I also had a diagnostic sleep test and found I was seriously obstructive sleep apneic. After determinedly using a prescribed CPAP machine at night, I now will not travel without it; it has changed my life. Enjoy exploring what will bring you inner health and outer beauty!