A Complete Guide to Skin Health

Skin care is often synonymous with anti-aging and beauty procedures. But Dr. Deetta Gray, Bellevue Club member and Medical Director for Pinnacle Dermatology & Skin Rejuvenation, says there is an important distinction between skin aesthetics and health. She answered some of our questions and gave us the rundown for everything you need to know to keep your skin in optimal health.


The skin is the largest organ of the human body, and with that comes a lot of responsibility. Its primary tasks include regulating body temperature, preventing fluid loss and acting as a barrier to radiation (the sun). It’s also the first line of defense against infection and pollution. Meanwhile, Gray suggests we recognize the skin’s function in another way—for its ability to act as a window to 

underlying disease. “It’s a very important organ,” she says. “Pay attention to it; especially if it’s changing. For example, if you see new lesions or a rash, take it seriously, and seek attention by a dermatologist to diagnose what is going on.”


It’s no surprise Gray’s number one piece of advice for healthy skin is to wear sunscreen, sun-protective clothing and hats and to take other protective measures every day (such as avoiding the sun during its peak hours). “The sun is ultraviolet radiation. All it takes is one hit to a cell to cause a DNA mutation and eventually a skin cancer,” she says. For a long time, the gold standard was a minimum of SPF 30 applied every two to three hours when outside. This protocol provides 97 percent protection and was thought to be the best case. However, Gray adds the latest studies show the higher the SPF the better. “Investigators have found that the high SPF sunscreen, like 70, do protect for longer periods of time.”

In regard to picking a quality sunscreen, she suggests using formulas with zinc oxide and titanium dioxide; they are natural minerals and actually stay on the skin longer. There are now micronized products, too, so they rub in much better without leaving a thick white film on the skin. If you can’t find a mineral-based option, Gray stands by the opinion that “it’s much more important to protect the skin from the sun with chemical sunscreens than to go without.”

Care 101

Taking care of your skin for optimal health can seem overwhelming. There are hundreds of serums, masks, creams and supplements promising a variety of results. Dr. Gray says it doesn’t need to be quite so complicated. There are a few simple guidelines she follows. The first is to create cell turnover, sloughing off old cells that can accumulate. “Skin can build up, and it can start to itch and crack,” she says. For the face, she suggests a gentle peel that uses either alpha hydroxy acid (glycolic and lactic acids) or beta hydroxy acid (salicylic acid). She advises clients to stay away from harsh exfoliating tools that irritate and damage delicate skin.

Another suggestion for creating healthy skin is to use a variety of antioxidants, both topical and ingested. A diet rich in fruit, vegetables, whole grains, lean proteins and tea is a good base. “Red berries, mangoes, tomatoes are all high in antioxidants and promote healthy skin. Tomatoes, specifically, are known to reduce the effect of sun on the skin. Green tea, high in polyphenols, is also great,” Gray says. “Something I find very interesting right now is a fern called polypodium leucotomos that comes from South America. When it’s ingested it reduces the abil

ity of the sun to burn the skin.” To infuse the skin with even more antioxidants, which protect the skin from free radicals, Gray recommends finding products that incorporate vitamins C and A, both potent antioxidants.

Disorders & Diseases

Dr. Grey

Finding any area of the skin that is misshapen or discolored can be scary, and Dr. Gray is careful not to frighten patients unnecessarily. But the reality is skin cancer is on the rise and remains a pressing concern for dermatologists. She says the increase in skin cancer incidence is unclear, but  possibly due to  increased sun exposure over a lifetime, with people living longer life spans, increased outdoor recreation and possibly earlier recognition. Currently the numbers are as follows: one in five people will have basal cell carcinoma (a slow-growing, very treatable cancer); one in 24 people will develop superficial melanoma (more threatening but treatable); and one in 47 will develop an invasive melanoma (the most threatening). “To put it into perspective, when I was in residency a few decades ago, melanoma incidence was one in 90 people. That means the incidence has almost doubled.” See the sidebar to learn about how to identify problematic areas.

Some of the other common skin disorders Gray currently sees are acne, eczema and psoriasis. “Fifteen percent of people get eczema in their lifetime and about 3 percent get psoriasis,” she says, with most flare-ups occurring during the cold-weather months, when the skin is especially susceptible to drying out. While many cases are mild and localized, these conditions can act as a flag to underlying, more systemic problems. For instance, “Up to 30 percent of psoriasis patients develop psoriatic arthritis,” Gray says. “Some of the more systemic diseases can develop silently, so I always ask my patients if there is stiffness in the joints, or if it’s hard to feel like the joints are relaxed. Is there swelling or pain?” She adds, ““Psoriasis can also be at higher risk of major cardiac events and other diseases because the whole body is inflamed.”

For more information, visit https://pinnacledermatology.com/.

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