How Often Should You Really Exfoliate Your Skin?
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For some people: more often. For most people: less often. Here’s how to tell:
Is your routine up to scratch?
First, know this: how often you should exfoliate depends on your skin type, climate, skin concerns, and the other products and treatments in your routine. Some people do not need to exfoliate at all.
Next, be aware of how the different kinds of exfoliation work, for example:
- Mechanical exfoliation: scrubs, washcloths, exfoliating brushes, body mitts, shaving, dermaplaning, and microdermabrasion physically remove surface cells through friction.
- Chemical exfoliation: ingredients such as glycolic, lactic, mandelic, and salicylic acids loosen the bonds between dead skin cells. Salicylic acid is oil-soluble, allowing it to penetrate into your pores and help with blackheads, whiteheads, and acne.
- Retinoid (indirect) exfoliation: topical retinoids such as retinol and retinaldehyde don’t directly exfoliate, but they do speed up epidermal cell maturation and shedding, which can reduce the need for additional exfoliation (since your skin cells will be hopping off of their own accord).
Be wary of stacking exfoliants, especially of the same kind: shaving followed by glycolic acid and then salicylic acid, for example, can create excessive irritation. In other words, pay attention the cumulative exfoliation from everything you use.
The best thing to do with any exfoliant is to begin gently and assess whether your skin actually benefits. Once or twice a week can be enough if it gives you the desired results without irritation. And certainly, only introduce one kind at once.
Finally, watch for overexfoliation: burning, stinging, redness, flushing, increased sensitivity, worsening acne, or aggravated rosacea can indicate that you are exfoliating too much. It can be tempting to try to get rid of it by exfoliating more, but that’s not the answer.
What to do if you realize you’ve overexfoliated: stop exfoliating temporarily and simplify your routine. Focus on gentle cleansing, richer moisturizing or barrier creams, and moisturizing sunscreen during the day. Hydrating products containing ingredients such as niacinamide or licorice root can also help soothe sensitivity.
For more on all of this plus visual illustrations, enjoy:
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Want to learn more?
You might also like:
Body Scrubs: Benefits, Risks, and Guidance
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Parent Effectiveness Training – by Dr. Thomas Gordon
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Do you want your home (or workplace, for that matter) to be a place of peace? This book literally got the author nominated for a Nobel Peace Prize. Can’t really get much higher praise than that.
The title is “Parent Effectiveness Training”, but in reality, the advice in the book is applicable to all manner of relationships, including:
- romantic relationships
- friends
- colleagues
- …and really any human interaction.
It covers some of the same topics we did today (and more) in much more detail than we ever could in a newsletter. It lays out formulae to use, gives plenty of examples, and/but is free from undue padding.
- Pros: this isn’t one of those “should have been an article” books. It has so much valuable content.
- Cons: It is from the 1970s* so examples may feel “dated” now.
In addition to going into much more detail on some of the topics covered in today’s issue of 10almonds, Dr. Gordon also talks in-depth about the concept of “problem-ownership”.
In a nutshell, that means: whose problem is a given thing? Who “has” what problem? Everyone needs to be on the same page about everyone else’s problems in the situation… as well as their own, which is not always a given!
Dr. Gordon presents, in short, tools not just to resolve conflict, but also to pre-empt it entirely. With these techniques, we can identify and deal with problems (together!) well before they arise.
Everybody wins.
Get your copy of “Parent Effectiveness Training” from Amazon today!
*Note: There is an updated edition on the market, and that’s what you’ll find upon following the above link. This reviewer (hi!) has a battered old paperback from the 1970s and cannot speak for what was changed in the new edition. However: if the 70s one is worth more than its weight in gold (and it is), the new edition is surely just as good, if not better!
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Native Americans Have Shorter Life Spans. Better Health Care Isn’t the Only Answer.
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HISLE, S.D. — Katherine Goodlow is only 20, but she has experienced enough to know that people around her are dying too young.
Goodlow, a member of the Lower Brule Sioux Tribe, said she’s lost six friends and acquaintances to suicide, two to car crashes, and one to appendicitis. Four of her relatives died in their 30s or 40s, from causes such as liver failure and covid-19, she said. And she recently lost a 1-year-old nephew.
“Most Native American kids and young people lose their friends at a young age,” said Goodlow, who is considering becoming a mental health therapist to help her community. “So, I’d say we’re basically used to it, but it hurts worse every time we lose someone.”
Native Americans tend to die much earlier than white Americans. Their median age at death was 14 years younger, according to an analysis of 2018-21 data from the Centers for Disease Control and Prevention
The disparity is even greater in Goodlow’s home state. Indigenous South Dakotans who died between 2017 and 2021 had a median age of 58 — 22 years younger than white South Dakotans, according to state data.
Donald Warne, a physician who is co-director of the Johns Hopkins Center for Indigenous Health and a member of the Oglala Sioux Tribe, can rattle off the most common medical conditions and accidents killing Native Americans.
But what’s ultimately behind this low life expectancy, agree Warne and many other experts on Indigenous health, are social and economic forces. They argue that in addition to bolstering medical care and fully funding the Indian Health Service — which provides health care to Native Americans — there needs to be a greater investment in case management, parenting classes, and home visits.
“It’s almost blasphemy for a physician to say,” but “the answer to addressing these things is not hiring more doctors and nurses,” Warne said. “The answer is having more community-based preventions.”
The Indian Health Service funds several kinds of these programs, including community health worker initiatives, and efforts to increase access to fresh produce and traditional foods.
Private insurers and state Medicaid programs, including South Dakota’s, are increasingly covering such services. But insurers don’t pay for all the services and aren’t reaching everyone who qualifies, according to Warne and the National Academy for State Health Policy.
Warne pointed to Family Spirit, a program developed by the Johns Hopkins center to improve health outcomes for Indigenous mothers and children.
Chelsea Randall, the director of maternal and child health at the Great Plains Tribal Leaders’ Health Board, said community health workers educate Native pregnant women and connect them with resources during home visits.
“We can be with them throughout their pregnancy and be supportive and be the advocate for them,” said Randall, whose organization runs Family Spirit programs across seven reservations in the Dakotas, and in Rapid City, South Dakota.
The community health workers help families until children turn 3, teaching parenting skills, family planning, drug abuse prevention, and stress management. They can also integrate the tribe’s culture by, for example, using their language or birthing traditions.
The health board funds Family Spirit through a grant from the federal Health Resources and Services Administration, Randall said. Community health workers, she said, use some of that money to provide child car seats and to teach parents how to properly install them to counter high rates of fatal crashes.
Other causes of early Native American deaths include homicide, drug overdoses, and chronic diseases, such as diabetes, Warne said. Native Americans also suffer a disproportionate number of infant and maternal deaths.
The crisis is evident in the obituaries from the Sioux Funeral Home, which mostly serves Lakota people from the Pine Ridge Reservation and surrounding area. The funeral home’s Facebook page posts obituaries for older adults, but also for many infants, toddlers, teenagers, young adults, and middle-aged residents.
Misty Merrival, who works at the funeral home, blames poor living conditions. Some community members struggle to find healthy food or afford heat in the winter, she said. They may live in homes with broken windows or that are crowded with extended family members. Some neighborhoods are strewn with trash, including intravenous needles and broken bottles.
Seeing all these premature deaths has inspired Merrival to keep herself and her teenage daughter healthy by abstaining from drugs and driving safely. They also talk every day about how they’re feeling, as a suicide-prevention strategy.
“We’ve made a promise to each other that we wouldn’t leave each other like that,” Merrival said.
Many Native Americans live in small towns or on poor, rural reservations. But rurality alone doesn’t explain the gap in life expectancy. For example, white people in rural Montana live 17 years longer, on average, than Native Americans in the state, according to state data reported by Lee Enterprises newspapers.
Many Indigenous people also face racism or personal trauma from child or sexual abuse and exposure to drugs or violence, Warne said. Some also deal with generational trauma from government programs and policies that broke up families and tried to suppress Native American culture.
Even when programs are available, they’re not always accessible.
Families without strong internet connections can’t easily make video appointments. Some lack cars or gas money to travel to clinics, and public transportation options are limited.
Randall, the health board official, is pregnant and facing her own transportation struggles.
It’s a three-hour round trip between her home in the town of Pine Ridge and her prenatal appointments in Rapid City. Randall has had to cancel several appointments when family members couldn’t lend their cars.
Goodlow, the 20-year-old who has lost several loved ones, lives with seven other people in her mother’s two-bedroom house along a gravel road. Their tiny community on the Pine Ridge Reservation has homes and ranches but no stores.
Goodlow attended several suicide-prevention presentations in high school. But the programs haven’t stopped the deaths. One friend recently killed herself after enduring the losses of her son, mother, best friend, and a niece and nephew.
A month later, another friend died from a burst appendix at age 17, Goodlow said. The next day, Goodlow woke up to find one of her grandmother’s parakeets had died. That afternoon, she watched one of her dogs die after having seizures.
“I thought it was like some sign,” Goodlow said. “I started crying and then I started thinking, ‘Why is this happening to me?’”
Warne said the overall conditions on some reservations can create despair. But those same reservations, including Pine Ridge, also contain flourishing art scenes and language and cultural revitalization programs. And not all Native American communities are poor.
Warne said federal, state, and tribal governments need to work together to improve life expectancy. He encourages tribes to negotiate contracts allowing them to manage their own health care facilities with federal dollars because that can open funding streams not available to the Indian Health Service.
Katrina Fuller is the health director at Siċaŋġu Co, a nonprofit group on the Rosebud Reservation in South Dakota. Fuller, a member of the Rosebud Sioux Tribe, said the organization works toward “wicozani,” or the good way of life, which encompasses the physical, emotional, cultural, and financial health of the community.
Siċaŋġu Co programs include bison restoration, youth development, a Lakota language immersion school, financial education, and food sovereignty initiatives.
“Some people out here that are struggling, they have dreams, too. They just need the resources, the training, even the moral support,” Fuller said. “I had one person in our health coaching class tell me they just really needed someone to believe in them, that they could do it.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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The Orchid That Renovates Your Gut (Gently)
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The Orchid That Renovates Your Gut (Gently)
Dendrobium officinale is an orchid that’s made its way from Traditional Chinese Medicine into modern science.
Read: Traditional Uses, Phytochemistry, Pharmacology, and Quality Control of Dendrobium officinale
To summarize its benefits, we’ll quote from Dr. Paharia’s article featured in our “what’s happening in the health world” section all so recently:
❝Gut microbes process Dendriobium officinale polysaccharides (DOPs) in the colon, producing short-chain fatty acids (SCFAs) and oligosaccharides that alter gut microbial composition and improve human health.
DOPs have been shown to decrease harmful bacteria like E. coli and Staphylococcus while promoting beneficial ones like Bifidobacterium.❞
We don’t stop at secondary sources, though, so we took a look at the science.
Dr. Wu et al. found (we’ll quote directly for these bullet points):
- DOPs have been shown to influence the gut microbiota, such as the abundance of Lactobacillus, Bifidobacterium, Akkermansia, Bacteroides, and Prevotella, and provide different benefits to the host due to structural differences.
- The dietary intake of DOPs has been shown to improve the composition of the gut microbiome and offers new intervention strategies for metabolic diseases such as obesity and type 2 diabetes as well as inflammatory diseases such as chronic obstructive pulmonary disease and colitis.
- Compared to drug therapy, intervention with DOPs is not specific and has a longer intervention duration
This is consistent with previous research on Dendrobium officinale, such as last year’s:
❝DOP significantly increased benign intestinal microbe proportion (Lactobacillus, etc.), but reduced harmful bacteria (Escherichia shigella) (P < 0.05), and significantly increased butyric acid production (P < 0.05)❞
In summary…
Research so far indicates that this does a lot of good for the gut, in a way that can “kickstart” healthier, self-regulating gut microbiota.
As to its further prospects, check out:
Very promising!
Where can I get it?
We don’t sell it, but for your convenience here’s an example product on Amazon
Be warned, it is expensive though!
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Air Quality & Your Heart
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…and other items from this week’s health news:
Air considered “safe” per existing environmental standards, isn’t
Researchers (Dr. Kate Hanneman et al.) investigated how long-term exposure to fine particulate matter (PM2.5), commonly from vehicles, industrial sources, and wildfire smoke, is linked to heart damage in the form of myocardial fibrosis (a scarring of the heart tissue).
Importantly, damage was seen even at pollution levels below global air quality guidelines, indicating that some reassessment of that may be in order, and that air pollution may be an underrecognized risk factor for heart disease, contributing additional risk beyond (even more important, but already well-studied) factors like smoking and hypertension. And when we say “additional risk”, it is an addition, which meant that the strongest effects were still seen in women, smokers, and those with high blood pressure.
Read in full: Even low levels of air pollution may quietly scar your heart, MRI study finds
Related: Why Women Especially Should Watch Out For Chronic Obstructive Pulmonary Disease (COPD)
Know your own heart
A team of researchers (Dr. Judy Luu et al.) looked at 443 adults aged 35–83 with no diagnosed heart disease. Participants filled in a questionnaire that ultimately ranked their social status on a 10-rung ladder and cardiac MRI scans were used to detect signs of stress in the heart, such as cardiac inflammation, and fibrosis scarring like we talked about above.
Notably, only women with lower self-assessed status showed a correlation between that low self-assessed status and the adverse cardiac signs. Men with similarly low self-perceived status did not show the same signs, even when matched for income and education levels. The researchers hypothesize that this difference may be because women’s self-assessed social status may reflect real-life inequities better than how things look on paper, due to additional (systemically overlooked and hard-to-measure) challenges often faced by women.
Read in full: Perceived social status influences women’s cardiovascular risk
Related: Heart Health vs Systemic Stress
“Forest bathing”, without the forest
“Nature scenes are relaxing” may not be breaking news in and of itself, but researchers (Dr. Simone Kühn et al.) investigated the effect of multimodal vs unimodal forest virtual reality on stress levels.
You may be wondering: what’s multimodal vs unimodal?
- multimodal = involving multiple senses (which in processing terms, are called modalities)
- unimodal = involving just one (e.g. just visual, or just auditory, etc)
How they did it: 136 participants were first subjected to stress-inducing images (move over, Clockwork Orange), then shown a 360° VR video of a Douglas fir forest in one of four ways: sight-only, sound-only, scent-only, or all three combined.
What they found: it indeed reduces stress, and—as expected—more modalities is better than fewer. So, something to bear in mind, if experiencing VR nature scenes at home for relaxation purposes!
Read in full: Virtual forest bathing found to alleviate stress
Related: How Nature Provides Us With A Surprisingly Powerful Painkiller ← not just by relaxation, either; it interrupts the signal transmitting the pain!
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Early exposure to air pollution could affect brain development and mental health later in life
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Exposure to air pollution in early life could have lasting effects on child development and mental health in adolescence, according to our recent study.
We integrated air pollution data with existing longitudinal data from the Christchurch Health and Development Study (CHDS). The CHDS has followed more than 1,200 children born in the city in 1977, with a strong focus on developmental and mental health outcomes.
Our aim was to examine how exposure to air pollution shapes development and mental health in later childhood and adolescence. We found an increased risk of attention problems, conduct issues, lower educational attainment and substance abuse in adolescence associated with higher exposure.
Existing evidence often focuses on adulthood. However, by tracking air pollution exposure from the prenatal period to the age of ten, and linking this data to subsequent cognitive and mental health outcomes, we were able to highlight the long-term consequences of growing up in polluted environments.
Air pollution is one of the leading environmental contributors to disease, especially respiratory and cardiovascular conditions. Children are especially vulnerable to air pollution because their brains and bodies are developing.
A growing body of evidence suggests air pollution could affect brain development, educational attainment and mental health, contributing to depression, anxiety and conduct or attention problems. Despite this, few studies have tracked long-term exposure to air pollution from early childhood.
Getty Images Patterns of exposure
We chose to conduct this research in Christchurch because the city is a historical air-pollution hotspot, with a documented history of measurements, and because of its long-running birth cohort study.
The CHDS collects detailed information on participants’ health, development, education and family backgrounds from prenatal into adulthood.
The city of Christchurch now enjoys much better air quality, but it was an air-pollution hotspot in the past. Flickr/Larry Koester, CC BY-SA For this study, we linked historical air-pollution data, measured as the concentration of black smoke from 1977 to 1987, to residential locations of birth cohort members. This allowed researchers to estimate each child’s annual exposure to air pollution during key developmental periods.
We found four distinct patterns of air-pollution exposure across childhood (see graph below):
- consistently low (these children had the lowest levels of air pollution throughout childhood)
- consistently high (this groups had the highest levels of air pollution from birth to the age of ten)
- elevated preschool (exposure peaked between ages three to six and then declined)
- high prenatal and postnatal (high exposure before and immediately after birth, but declining later).
We then examined whether children in the higher exposure groups were more likely to experience adverse impacts on cognition, educational achievement and mental health in later childhood and adolescence.
We adjusted for a range potential confounders such as socioeconomic status, neighbourhood disadvantage and parental characteristics.
We found children with elevated pre-school exposure had poorer educational attainment and a higher likelihood of conduct disorders and substance abuse problems. High prenatal and postnatal exposure was linked to a greater risk of attention problems as well as substance abuse in adolescence.
Children with persistently high air-pollution exposure were more likely to develop attention problems and had higher odds of substance abuse issues in adolescence.
Researchers identified four different trajectory patterns of exposure to air pollution from the prenatal period through to the age of ten. Author provided, CC BY-SA What these findings mean
The effects of air pollution on several outcomes were small at an individual level, but they could be highly important at a population level.
This is because even small shifts in cognitive and mental health outcomes, when applied to entire populations of children exposed to poor air quality, could have major consequences affecting future educational achievement, workforce productivity and public health burdens.
These findings support previous research suggesting air pollution could affect brain function by causing inflammation, oxidative stress and affecting neurodevelopmental pathways. Importantly, they reinforce the idea that certain developmental periods, such as the prenatal period and early childhood, may be especially sensitive to pollution exposure.
We need further research to confirm our findings but potential considerations include reducing children’s exposure to air pollution and improving urban air quality by cutting emissions from vehicles, industry and residential heating.
We should also promote cleaner energy sources to decrease exposure to harmful pollutants such as nitrogen dioxide and fine particulate matter. Providing better access to green spaces may mitigate the impact of air pollution.
To strengthen public health and policy measures, we need stricter air quality regulations, particularly around schools and childcare centres. We should also implement air-quality monitoring in urban areas to identify high-risk zones for children.
Better public information is crucial to minimise indoor and outdoor pollution exposure. This could include the use of air purifiers for indoor activies or limiting outdoor exposure during peak pollution periods.
Further research and action
Our study highlights the need for more research on air pollution’s effects on children’s mental health and cognition, particularly in different environmental and socioeconomic contexts.
Policymakers, educators and healthcare professionals must consider air pollution as a potential risk factor for developmental challenges, not just a physical health concern.
Air pollution may not be visible in the same way as poor housing or inaccessible healthcare, but its impact on child development could be important at a population level.
Given the rising prevalence of mental ill health in young people and adults, tackling air pollution could be an overlooked but essential public health strategy for protecting future generations.
Matthew Hobbs, Associate Professor and Transforming Lives Fellow in Spatial Data Science and Planetary Health, Sheffield Hallam University; Joseph Boden, Professor of Psychology, Director of the Christchurch Health and Development Study, University of Otago; Lianne Jane Woodward, Professor of Child Developmental Psychology, University of Canterbury, and Susie (Bingyu) Deng, Postdoctoral Research Associate in Health Sciences, University of Liverpool
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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It’s now easier to get antibiotics for UTIs – but here’s what to do if your symptoms don’t go away
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You wake up with that familiar urgency to go to the toilet and burning when you pee – and no matter how many times you go, that urgency doesn’t let up. You know exactly what it is: a urinary tract infection, or UTI.
UTIs are common, affecting half of all women at some point. They occur when bacteria enter the urinary tract, causing symptoms such as burning, urgency, frequent urination and lower abdominal pain.
Now many women can go straight to the pharmacy and get antibiotics without having to wait to see a doctor. This will mean faster treatment and fewer delays, as well as less pressure on general practice.
But this approach is designed for simple, or “uncomplicated”, infections in otherwise healthy people. It excludes men, those with recurrent UTIs (usually more than two UTIs in six months), pregnant women, and those with more complex cases or underlying kidney or urinary conditions.
So how does prescribing work for simple UTIs? And what might you need for more complicated infections?
Courtney Hale/Getty Images What happens when you see a pharmacist for a UTI?
Pharmacists will ask a series of questions to check it’s safe to treat you, and if it is, they can provide a short course of antibiotics.
These services are limited to women because UTIs are less common in men and more likely to be complicated, often requiring further investigation.
The most common antibiotics used include nitrofurantoin and fosfomycin. These target the bacteria most often responsible, especially Escherichia coli, which causes around 75% of uncomplicated UTIs.
The antibiotics pharmacists give you without a GP prescription can help with straightforward UTIs, but not the ones that keep coming back.
If you have a fever, back pain, or feel unwell, the infection may have spread beyond the bladder – and the pharmacist won’t be able to prescribe to treat this type of infection.
If your symptoms keep coming back, or don’t improve, you need to see a GP.
Why some infections don’t go away
For most people, antibiotics clear the infection and symptoms settle within a few days.
But some bacteria are surprisingly good at surviving. Instead of staying in the urine, they can invade the cells lining the bladder. Here, they are harder to detect and harder to kill, effectively “hiding” from the antibiotics and the body’s immune system.
Other times, the antibiotic simply doesn’t work. This is known as antibiotic resistance. It means the bacteria have adapted in a way that makes the drug less effective.
There are also other factors that increase the risk of repeat infections. Hormonal changes, especially after menopause, can alter the urinary tract and make it easier for bacteria to grow. Sexual activity, certain contraceptives and incomplete bladder emptying can also play a role.
What are your options if it keeps coming back?
If infections keep coming back, a doctor may test your urine to identify the exact bacteria causing the infection. This helps guide treatment, rather than relying on best guess.
Treatment might include a longer course of antibiotics, or a low-dose antibiotic taken over a longer period to prevent recurrence.
For postmenopausal women, vaginal oestrogen can help restore the natural balance of the urinary tract and reduce infections.
Researchers are also exploring vaccines. One example, Uromune, targets common urinary bacteria and aims to train the immune system to respond more effectively.
Alongside medical treatment, simple strategies can help reduce the risk of a UTI: staying hydrated, urinating after sex, and avoiding harsh soaps or products that may irritate the area. These steps won’t eliminate the chance of getting a UTI, but they can make a small difference.
What happens if it’s not treated properly?
Most UTIs stay in the bladder. But sometimes bacteria travel upwards to the kidneys, resulting in a kidney infection. This is more serious. Symptoms can include fever, lower back or side pain and nausea. It often requires stronger treatment.
Repeated infections can damage kidney tissue over time, affecting how well the kidneys filter waste.
In rare cases, the infection can enter the bloodstream. This can lead to sepsis, a life-threatening condition in which the body’s response to infection damages its own organs.
While uncommon, this shows why ongoing symptoms should not be ignored.
What complicates UTI treatment?
People with recurring symptoms and chronic UTIs often need ongoing, coordinated care. This may involve a GP for ongoing management, urine testing and preventative treatment. Sometimes, you may need a referral to a urologist to investigate underlying causes. Coordinated care can be difficult to access, especially if doctors dismiss symptoms.
Testing is also a challenge. Standard urine tests don’t always pick up hidden infections, leaving some people without clear answers. On top of this, antibiotic resistance complicates treatment.
For people living with recurrent infections, this is not a minor inconvenience. It affects sleep, work, relationships and quality of life. The good news is that, with the right care, many people can get their symptoms under better control.
So if your symptoms don’t improve, or keep coming back, it’s important to see a doctor. And if you feel your concerns are dismissed, find another doctor who listens and takes your symptoms seriously.
You can also ask your doctor about further testing, such as a urine culture to identify the exact bacteria, whether a longer or preventive course of treatment is appropriate, and if referral to a specialist may be needed.
If you have fever, severe back or side pain, or feel very unwell, seek urgent medical care, as this may indicate a more serious infection.
Iris Lim, Assistant Professor in Biomedical Science, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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