How To Become a Successful Body-Part Model (Part I)
In case you were wondering, the body parts in this image belong to a body-part model (BPM). It’s not entirely clear to me whether this person is modeling her hand or her knee. Maybe it’s both but let’s not get sidetracked by minor details here. One thing is for sure: you need to have great skin to have a rewarding and successful career as a BPM. So, in this post I want to lay out the essential aspects of what it takes to have great skin and how that might impact your overall health too. If you want to take the bit in your teeth and take up body-part modelling, that’s up to you.
Meanwhile, this diagram of skin structure is a good way to frame the rest of the discussion:
There are three proteins that we need to talk about: keratin, collagen and elastin. Although they are found elsewhere throughout the body, they are particularly relevant for skin. Each differs in mechanical properties and amino acid composition. Depending on what animals and fish we consume, in youth we generally get enough amino acids, the building blocks needed to make all these proteins. As we age, many of us tend to eat less animal/fish protein for a variety of reasons: dental, social and economic. Consequently, our ability to repair and replace our structural proteins and maintain healthy-appearing skin diminishes. As the years go by, skin health can take it on the chin (pun fully intended) along with our bones, tendons, blood vessels and muscles.
Before I go any further, I want to emphasize that one of the hallmarks of aging for most folks is an impaired ability to extract and assimilate nutrients from food. Regardless of anything else I might say, part of your skin health strategy should probably involve support from digestive enzymes, betaine HCL and/or apple cider vinegar with meals and bitters to support bile production and release. Stool testing to assess colonic microflora might also be indicated in some cases if you are struggling with skin issues.
Per the figure, the very top layer of skin, known as the stratum corneum, consists of flattened cells containing the protein keratin. Keratin is also found in hair, nails, hoofs, feathers, rhinoceros horn, turtle shells and so forth. We’ll stick to human skin, where the keratin layer provides a barrier against water loss, infection and mechanical injury. The dermis layer contains collagen and elastin proteins, with collagen serving as the firm backbone to which the stretchy elastin fibers are attached. Last but not least, the dermis also contains water, so staying well-hydrated gives you the best shot at firm, smooth skin, with fewer wrinkles and a less crepe-like appearance.
To help our skin as we age, there are various hydrolyzed (predigested) and well-researched proprietary keratin and collagen formulations on the market, which supply more of the specific amino acids needed to target the synthesis of each skin protein. You can discuss these supplements with your Integrative Health practitioner. Note that Vitamin C is essential for healthy collagen formation: many of the physical manifestations of scurvy such as bleeding gums, poor wound healing, skin sores and arterial damage reflect poor collagen formation and degradation of collagen.
If you want good collagen and elastin, make sure you are getting enough copper: it is the cofactor for an enzyme called lysyl oxidase, essential for collagen-elastin crosslinking. Copper also stimulates fibroblasts in the dermis to secrete collagen, elastin and the growth factor, TGF‐β1 (Ogen-Shtern 2019). In a randomized, controlled trial conducted by Baek et al, participants who slept on copper impregnated pillowcases for 8 weeks were shown to have fewer Crowsfoot wrinkles and less roughness (Baek 2019). I swear on Tommy Copper`s underwear that I am not making this up and here is a figure from the paper to prove it:
Having the right amino acids in sufficient quantities is a necessary but not sufficient part of skin health. We also need other factors including hormones and many other nutrients. The amino acids provide the basic raw materials but the hormones and nutrients provide the key regulatory signals and cofactors that prompt/mediate protein synthesis and/or turnover and enable everything to work smoothly and efficiently.
It has long been recognized that hormones are important for healthy skin, especially estrogens (Schmidt 1996). The 2019 article by Borda is also a good overview. As soon as estrogen supplementation became widespread, beneficial effects on skin were noted, including more elasticity and thickness, fewer and finer wrinkles, less dryness and discoloration and better wound healing. This is true for both oral and topical (skin-delivered) estrogens. Note that skin-delivered estrogens have fewer systemic effects and dosing is much lower than oral.
Several decades ago, in his bestselling book: The Difference Between Narwhal Tusk and Rhinoceros Horn, John Lee MD noted that topical progesterone was equally marvelous for skin, after decades of recommending it to his patients. I’m kidding about the book title. It was actually called: What Your Doctor May NOT Tell You About Menopause.* Since you asked though, Narwhal tusk is made of ivory: rhinoceros horn is made of keratin.
*Dr. Lee wrote a follow up: book What Your Doctor May NOT Tell You About Premenopause. Either book relays the same information about the skin benefits of progesterone and does NOT mention narwhals or rhinoceros.
Where was I? Yes. Progesterone. More recently, Holzer et al conducted a randomized placebo-controlled trial of topical progesterone applied to the face (just 2 mg per application) affirming what Dr. Lee had been saying all along: the progesterone recipients had fewer, more shallow wrinkles and firmer, more youthful-appearing skin (Holzer 2005).
A primary mechanism of action for both progesterone and estrogens likely involves upregulation of the keratin, collagen and elastin synthesis pathways. DHEA, another hormone used topically to improve skin appearance, has been found to increase sebum production and decrease the dry, papery appearance of aging skin.
A little bit of hormone applied to the skin goes a long way toward smoothing wrinkles and improving appearance, without any significant side effects. (Side effects can appear with excessive dosing.) Years ago, some high-end over-the-counter night creams were found to have small amounts of estriol and progesterone added to them to enhance their effects. This was no doubt well-intentioned but also illegal. Medical grade skin products contain only the ingredients listed on their labels. An Integrative Health practitioner with experience in hormones can work with you and a Compounding Pharmacist to formulate hormone-containing topicals to augment other Medical-grade products you might be using, if so desired.
Some websites are selling topical skincare products containing essential fatty acids. The benefits of this approach are unclear. It’s always a good idea to ensure you have an adequate intake of essential fatty acids in your diet anyway, to maintain optimal membrane integrity for all cells, including skin cells. But avoid synthetic, partially hydrogenated fake oils such as margarine like the plague if you want healthy skin.
Although I mentioned copper and Vitamin C, there are three other nutrients that are very important for skin health but none of them get the airtime they deserve. These are Silicon, Nicotinamide and Methylsulfonylmethane. I am going to discuss these nutrients in Part II of this post, coming out in the next week or so.
Up to now, I’ve talked mostly about how to improve skin health by supporting protein synthesis with various strategies. I need to say a bit more about how to mitigate skin damage. The two main mechanisms of skin damage that I can think of are free radicals and glycation.
Free radicals are molecules that are hungry for an electron. They are created in the body routinely as our mitochondria react fuels with oxygen to make ATP. Intensive exercise will therefore create more free radicals than usual, as more ATP is needed for exercise. You may have heard the names of some free radicals: hydroxyl, superoxide anion, peroxynitrite, nitric oxide. These and others have the annoying tendency of attacking other molecules such as lipids to reclaim missing electrons, turning their targets into free radicals which attack other lipids in turn, creating a chain reaction. Free radicals can damage cell membranes, DNA, and structural proteins such as collagen and elastin, wreaking havoc on skin from within.
The main sources of free radicals outside the body include tobacco smoke, UV, air pollutants generated by fuel combustion, industrial chemicals and toxic elements such as cadmium and lead. We can go a long way toward avoiding these things, but our line of defense is antioxidants to mop up the free radicals we can’t avoid. The bodies premier antioxidant is glutathione which consists of three amino acids: cysteine, glutamic acid and glycine. You can support glutathione synthesis by supplementing with N-acetylcysteine or NAC along with selenium which is a cofactor for various enzymes associated with free radical scavenging. Methylsulfonylmethane is also a free radical scavenger and has a glutathione-sparing effect. More on this in Part II.
There are many other supplemental antioxidant nutrients you could take including quercetin, green tea extract, and curcumin to name a few. Honestly, the best way to amount a good free radical defense is to start with your food, trying to eat a wide variety of richly-coloured organic fruits and vegetables along with leafy greens and certain mushrooms that have strong free radical scavenging power. Minimizing your intake of packaged and processed foods can also help minimize exposure to free radical-forming pollutants. Here’s a list of just a few of the antioxidant chemicals found in foods:
- allium sulphur compounds – leeks, onions and garlic
- anthocyanins – eggplant, grapes and berries
- beta-carotene – pumpkin, mangoes, apricots, carrots, spinach and parsley
- catechins – red wine and tea
- cryptoxanthins – red capsicum, pumpkin and mangoes
- ergothioneine– red and black beans
- flavonoids – tea, green tea, citrus fruits, red wine, onion and apples
- indoles – cruciferous vegetables such as broccoli, cabbage and cauliflower
- isoflavonoids – soybeans, tofu, lentils, peas and milk
- lutein – green, leafy vegetables: e.g. spinach, kale, swiss chard
- lycopene – tomatoes, apricots, pink grapefruit and watermelon
- mushrooms – Reishi, Lion’s Mane, Porcinic, Maitake, Grey and Yellow Oyster
- polyphenols – herbs
- vitamin A – liver, sweet potatoes, carrots, milk, and egg yolks
- vitamin C – oranges, blackcurrants, kiwifruit, mangoes, broccoli, spinach, capsicum and strawberries
- vitamin E – vegetable oils (such as wheatgerm oil), avocados, nuts, seeds and whole grains
I think you get the idea. Don’t overlook butter from grass-fed cows (https://milkio.co.nz/out-to-pasture-how-grass-fed-cows-make-better-milk-for-butter/). This type of butter contains Vitamin A, beta-carotene and other compounds that help protect your skin from solar radiation. Don’t forget the oysters either. Their zinc is a cofactor for the enzyme that converts beta-carotene to Vitamin A.
So many nutrient-rich foods and so little time!
Eating this way will probably minimize damage from the second mechanism I mentioned: glycation. Glycation involves a complicated series of reactions between many common sugars and proteins, fats, DNA and RNA. Compounds called Advanced Glycation Endproducts or AGEs are formed and wind up attaching to the molecules that make up our tissues, altering their shapes and functions and binding to receptors that trigger inflammation. Note that AGE deposition in the skin may also be worsened by UV exposure.
You can fight AGE deposition by maintaining normal or low normal blood sugar levels by including lots of high-fiber low glycemic index carbohydrates and by avoidance of fried foods. When you’re eating lots of whole fruits and vegetables you’re usually not eating as many simple carbohydrates that quickly raise blood sugar. Keeping your uric acid low and your muscle mass high makes you more sensitive to insulin and helps keep the lid on blood sugar.
I’ve left you with plenty to think about for now but there is more coming in Part II. I’ll talk about the other supplements I mentioned, along with sunscreen, and the role of a healthy liver in keeping skin healthy. I promise not to mention narwhals.
Stay tuned!
Author: George Gillson, MD, PHD, CCFP
EvolveWell Medical Director
References
Baek JH, Yoo MA, Koh JS, Borkow G. Reduction of facial wrinkles depth by sleeping on copper oxide-containing pillowcases: a double blind, placebo controlled, parallel, randomized clinical study. J Cosmet Dermatol. 2012 Sep;11(3):193-200. doi: 10.1111/j.1473-2165.2012.00624.x. PMID: 22938003.
Borda LJ, Wong LL, Tosti A. Bioidentical hormone therapy in menopause: relevance in dermatology. Dermatol Online J. 2019 Jan 15;25(1):13030/qt4c20m28z. PMID: 30710894.
Holzer G, Riegler E, Hönigsmann H, Farokhnia S, Schmidt JB. Effects and side-effects of 2% progesterone cream on the skin of peri- and postmenopausal women: results from a double-blind, vehicle-controlled, randomized study. Br J Dermatol. 2005 Sep;153(3):626-34. doi: 10.1111/j.1365-2133.2005.06685.x.
Ogen-Shtern N, Chumin K, Cohen G, Borkow G. Increased pro-collagen 1, elastin, and TGF-β1 expression by copper ions in an ex-vivo human skin model. J Cosmet Dermatol. 2020 Jun;19(6):1522-1527. doi: 10.1111/jocd.13186. Epub 2019 Oct 11. PMID: 31603269.
Schmidt JB, Binder M, Demschik G, Bieglmayer C, Reiner A. Treatment of skin aging with topical estrogens. Int J Dermatol. 1996 Sep;35(9):669-74. doi: 10.1111/j.1365-4362.1996.tb03701.x. PMID: 8876303.