Evidence-Based Beauty
This started out as a post about not lighting a match and burning up your dollar bills on expensive beauty products, but that left out the guys (except for any tranny readers I might have), so that's at the bottom. First, there's the beauty of going by evidence instead of by hand-me-down nonthink. Tara Parker-Pope writes in The New York Times that even doctors believe in unproven crap:
Turkey makes you drowsy. Dim light ruins your eyes. Drink at last eight glasses of water a day. These are some of the medical myths that even doctors believe, reports the British Medical Journal.Researchers from the Indiana University School of Medicine made a list of common medical beliefs espoused by physicians and the general public. They included statements they had heard endorsed by doctors on multiple occasions. The result is a seven-item list of medical and health myths that are widely repeated by doctors and in the media, all of which either aren’t true or lack scientific evidence to support them.
The study authors, Dr. Rachel C. Vreeman and Dr. Aaron E. Carroll, said that while doctors realize good medicine requires them to constantly learn new things, they often forget to reexamine their existing medical beliefs. “These medical myths are a lighthearted reminder that we can be wrong and need to question what other falsehoods we unwittingly propagate as we practice medicine,'’ wrote Dr. Vreeman and Dr. Carroll.
The seven myths are:
1. People should drink at least eight glasses of water a day.2. We use only 10 percent of our brains.
3. Hair and fingernails continue to grow after death.
4. Shaving hair causes it to grow back faster, darker or coarser.
5. Reading in dim light ruins your eyesight.
6. Eating turkey makes people especially drowsy.
7. Cellphones create considerable electromagnetic interference in hospitals.
Details on each at the link. The best comment on the piece (at the NYT site) is the first one:
The real myth is that people use AS MUCH AS ten percent of their brains. Most people seem to use almost none. — Posted by ACW
You're especially in need of a brain when it comes to interactions with your doctor. While I am certainly not for going by the advice of gray-skinned people at the health food store, too many people operate on the assumption that the people in the white coats have the answers.
Recently, my doctor e-mailed me back (I have Kaiser, so I can e-mail her at any time and get a response back, usually within an hour) about a problem I'd been having, and asked whether I'd have a problem trying "western medicine" for it. I mean, I know doctors these days must deal with all these people who think anything by "Big Pharma" is evil, but please...me?
I told her I don't have a problem with "western medicine" (in fact, I'm pretty damn grateful for it), but I want my care to be directed by evidence-based medicine; meaning, we don't first give me a drug and see if it works, as she suggested, to figure out what's wrong with me. We test me to see if I have a problem, and then give me a drug. Well, I had tests, and they didn't show anything, but my symptoms persisted. I started to get upset and worry that there was something seriously wrong with me.
Luckily, because I'm articulate, pushy, and know how to do research and rough controlled experiments (eliminating stuff from my diet, etc.), I got her to send me to a specialist, who, to my relief, said my symptoms are those of "nothing serious," and then told me we'd do a super-invasive test to figure out what was wrong.
Uh...there's a less-invasive test, right, Doc? Yep. Well, how about we do the less-invasive test first, and then if it doesn't tell us I have what you think I have, we go on to the more invasive test?! And that's what we're doing. Arrrrgh!
And along the way, it seems I may get to Kaiser to change their procedure of handing out self-administered home tests, which they give out with no directions or confusing directions, which causes issues of what's called "access to care." If tests are confusing, people don't take the tests, they put off taking them, or they take them incorrectly.
I told the specialist, who seemed to get that I wasn't the average sheep of a patient who comes to see her, that they need to change their testing protocol at Kaiser. When I detailed how hard the tests were for me in the recent past, and how I held off doing them because of it, and probably did them wrong when I did take them -- and I'm obviously smart, articulate, speak English reasonably, and have beyond a sixth grade education -- she was horrified.
She asked me to report back to her on whether my test this time was equally hard to figure out. It was. Per her request, I'm going to write up what happened and suggestions of how it could be better after I finish this blog item. And it doesn't take a whole lot -- just clear written directions handed out with every test, perhaps coupled with verbal directions from people who know what they're talking about (meaning, the people at the patient interaction windows in the lab may have to be trained and/or moved around).
And nothing serious is wrong with me in case you're wondering. The doc thought I have GERD -- Gastro-Intestinal Reflux Disease. Except that it came on all at once -- the day I ate some cheese that made me violently ill -- and I have almost none of the symptoms of GERD: the pain, the backwash, etc. None of that. Should know in a few days if it's what I thought it was all along, and thought the first doctor had tested me for. Nope. She didn't!
The best was when she suggested I take steps to minimize the GERD; for example, change my diet and lose weight, cut back on drinking and smoking, and exercise. (I'm slim and I don't know how I could eat any healthier than I already do; when I order a glass of wine at dinner, Gregg often ends up finishing it; and I do 20 maniacal minutes on an exercise bike with moving arms every day.)
You know, you've got to monitor these people Every. Step. Of. The. Way.
On to a lack of evidence with less-serious side-effects, Natasha Singer writes in The New York Times that you should "rethink" beauty products that cost more than $30:
The Food and Drug Administration, which regulates cosmetics, does not require beauty manufacturers to publish rigorous studies on the efficacy of their products. So consumers do not have a proven, objective method by which to determine whether more-expensive beauty products work better — or whether they simply look fancier and emit more exotic perfume — than less-expensive items containing similar ingredients.(Manufacturers of prescription products must submit clinical evidence of their efficacy before receiving approval from the F.D.A.)
“Your chances of achieving good skin are not directly proportional to the amount of money you spend,” Dr. Sundaram said. “All too often, what you are paying for is the packaging, the advertising and the celebrity endorsements.”
My skincare regime: An economy-size pumper of Cetaphil face wash from Costco, a tube for the shower of St. Ives facial scrub (which they recently screwed up with some sickening fragrance "improvement"), and Anthelios #50+ sunblock cream "pour la visage" (for the face). Oh yeah, and an umbrella, not for rain, but for when I'll be out in the sun for any length of time. And I take vitamin D to make up for the vitamin D I'm not getting from sun exposure.
Here's the face of a woman a year younger than I am who smoked. (And who probably spent a good deal of time in the sun.) Whether or not her doctor has diagnosed her with GERD, I really couldn't say.
That last link didn't work - or am I just tech-challenged?
I'm with you on the sunscreen! I wear cheap-o Neutrogena moisturizer every day w/ SPF 45. I went to one of those traveling skin cancer awareness vans at an outdoor event. They scan your face and show you where the sun damage is. Good results - I think I'm doing right by my skin. I've noticed that your skin looks really great, too, based on the pics you've put up.
Amy - do you think you might have suddenly developed an allergy to cheese? I hope you feel better soon!
Gretchen at December 29, 2007 8:32 AM
8. Coffee and beer cause dehydration because it requires more water for the kidneys to purge the diuretics in them than they supply.
(Distilled alcohol does require additional water, as anyone who has suffered a hangover can attest; apparently folk wisdom generalized from spirits to beer. And coffee does cause people to urinate. So does water.)
Axman at December 29, 2007 8:43 AM
I'll go fix the link. I'd be very careful about investigating whether the new formulation of Neutrogena works. If memory serves me, the previous formulation was "photo-unstable," meaning...it breaks down when light hits it!
I think it's unlikely I developed an allergy to cheese overnight. It's possible, but unlikely. I've eaten that particular cheese -- Roquefort Societé #112 -- numerous times.
Amy Alkon at December 29, 2007 8:48 AM
While I agree that some doctors may believe some of the above-mentioned myths, I have never heard any ophthalmologist or optometrist in my 27 years of working in the biz espouse that reading in the dark will "ruin eyesight". We tell them that good lighting can help with their reading at near--with correction if they're presbyopic.
Lisa at December 29, 2007 8:54 AM
Amy, your "woman" link still isn't working. Assuming it's another pic of SJP?
I can almost always tell people who are or were smokers from their skin, as well as sunbathers and those who follow a rigorous lowfat diet...all three tend to have skin like parchment as they age.
deja pseu at December 29, 2007 10:46 AM
I've worked in the beauty business for over 15 years, and can say that many "herbal," "natural," and "amino-acid" ingredients do absolutely nothing to enhance product performance; they are added simply to attract the consumer to make a purchase. For instance, the industry has promoted the myth that hair is "alive" and can benefit from the topical applications of vitamins. Hair is not alive and will not benefit from vitamins the way living human tissue may.
Many products are purported to protect hair from damage due to ultraviolet radiation. While the ingredient responsible for this protection does block UV, it is not present in a high enough concentration to be effective.
Although shampoos and conditioners claiming not to be tested on animals have indeed not been so tested, the individual ingredients contained within these products have quite probably been tested on animals.
The public has been made to believe that soaps and shampoos must foam to clean, but this is not the case. Foaming agents are not only not necessary, some are harmful. For instance, Cocamide DEA has been banned from use in European (but not yet U.S.) hair care products for being carcinogenic. Other additives that promote foaming actually diminish the product's dirt-removing properties.
In my opinion, the most effective and healthy beauty products are those with the fewest, most basic ingredients. That means a slightly acidic shampoo (pH less than 7) with few if any man-made chemicals, and little or no fragrance. The goal should be simple as well: to remove the unwanted dirt and oil without stripping out so much as to make hair unmanageable.
FrankZ at December 29, 2007 11:49 AM
Thanks - swapped in another. Refresh and it should show up.
Amy Alkon at December 29, 2007 11:49 AM
Thanks so much, Franz. Leonor Greyl, the Paris hair expert Hillary Johnson sent me to for an LA Times Mag piece she was writing, told me Americans wash their hair too often, and also, that products that lather are not good for the hair. Dry it out, etc. Her shampoo, Creme Moelle de Bambou (For long hair) is THE shampoo that's made my hair look the best, but thanks to the euro, it's rather pricey. I found that Buddy Wash Shampoo for dogs, coupled with Buddy Wash conditioner, are good substitutes.
Amy Alkon at December 29, 2007 12:03 PM
"meaning...it breaks down when light hits it!"
Thanks for the information. That's bollocks. Luckily, my makeup has SPF 15 in it...so even if the sunscreen fails I have SPF 15 on. When I go to the beach I wear "real" sunscreen, not just moisturizer w/ SPF.
I was actually looking at the Anthelios (b/c it's a full spectrum protector) recently and was planning to buy it once the Neutrogena runs out. Change of plans: I'll be buying it *before* the Neutrogena runs out. Is it gentle? My skin is sensitive as hell.
I spend the money on some stuff and not on other stuff. I won't cut corners on foundation but I will on mascara. Weird tid bit: I've never had success w/ drug store nail polish. Sally Hansen, Revlon, L'Oreal, Cover girl...it's like throwing my money out. The stuff bubbles. Doesn't dry correctly and will stay goopy. OPI and Essie are a dollar or two more but are truly worth it.
I really like switching to blog entries like this every now and then to break up the heavy stuff.
Have I mentioned that, as a perfume addict (like, I need therapy), I've had AMAZING success w/ ebay?? Once you find the right seller you can save bundles. Even on Serge Lutens!
Gretchen at December 29, 2007 12:07 PM
Anthelios is only sold in the USA in SPF15. Maybe you're in Britain where they sell the higher SPF's? Our government likes to protect us from protecting our skin!
Personally, I wouldn't rely on sunblock in foundation. What's the concentration, and do you put on enough for it to be adequate protection?
Is Anthelios "gentle"? Don't know. It isn't harsh to me, but I don't have allergies or sensitivities -- unless I've recently developed one to Roquefort.
About the only perfumes I can wear are Opium and Chanel's Coco. I hate vanilla smells, and sweet smells, and too many perfumes make women smell like 13-year-old girls.
Amy Alkon at December 29, 2007 12:33 PM
Related to the topic of cosmetic manufacturers not publishing any useful objective facts about their products: the same can be said of manufacturers of batteries. I can spend three times as much for one battery than another, but the only difference I can see from the packaging is hype. Why are no figures given?
Norman at December 29, 2007 12:38 PM
Here's an online source for Anthelios in stronger concentrations. http;//www.feelbest.com
They ship to the US.
deja pseu at December 29, 2007 12:57 PM
I hate perfumed *everything*. Hearing me say this at our first meeting, a dermatologist replied that was a genetic marker. She then listed a bunch of fellow-traveling phenomena that were likely in my life, some of them quite intimate, and she was correct about all of them.
But anyway, give some props to Parker. She was never a top-tier beauty, and this ain't 1983 anyway... That's about what a woman her age is supposed to look like, cigarettes or no. She produced one of the most successful television ventures of her generation, and she got to keep the money! That's worth a wrinkle.
Crid at December 29, 2007 12:57 PM
...and then told me we'd do a super-invasive test to figure out what was wrong.
Uh...there's a less-invasive test, right, Doc? Yep. Well, how about we do the less-invasive test first, and then if it doesn't tell us I have what you think I have, we go on to the more invasive test?!
Billing, baby...billing!
Doobie at December 29, 2007 1:19 PM
It's an HMO. They're encouraged to keep costs down, I believe.
Amy Alkon at December 29, 2007 1:22 PM
I'm in Boston - and yes, all they have at the drugstore is the SPF 15. Not sure how protective foundations are which is why it's important for me to switch to a broad spectrum SPF...that works...in sunlight.
And I agree that most of today's "modern" fragrances are too fruity and sweet and juvenile. The vast majority are, in fact, aimed at younger audiences who don't have a nose for the heavier and more delectable notes. Trying to sell a bottle of Tabac Blond to one of my twenty-something counterparts would be like asking "would you like a root canal w/o Novocaine?" Based on what I know of you, Opium certainly befits you.
To me, fragrance is a required accessory and sometimes it's even the main feature. It's a craft and an art and adds to an experience. If I don't have on perfume I feel that I'm missing something important.
...Unless your Crid...or mother who will not get into a car w/ me if I've "sprayed something" recently. Criddo, what did the derm say? I'm enthralled as I've never understood people who are "anti smells." No need to include the intimate ones...unless you want.
Gretchen at December 29, 2007 1:25 PM
Gretchen,
I have a question about perfume (and it applies to men's cologne, also). How close should someone have to be to the wearer before they actually smell the perfume/cologne. I ask because of two incidents in the last month. In one, I worked with a woman, and I could smell her perfume from at least 20 feet away. In another, some cowboy looking yahoo came into our local tavern and the guy's cologne could be smelt in half the place.
Shouldn't a person have to get within, say, a foot or two before they smell the perfume/cologne? Our, am I just betraying myself as a stick-up-the-butt fragrance-hater?
(If you have any references/guides it would help. I may have to work with the perfume-wearing woman again, and I'd like to be able to talk to her calmly and sensibly. I tried the first time but got told that she'd only put on a drop or two.)
David Crawford at December 29, 2007 1:52 PM
I'm of the mind that somebody shouldn't smell you unless they're close enough to kiss your neck. Important to put on perfume enough in advance that it has time for that to be the case.
PS I NEVER wear perfume to the movies, on airplanes, or to the dentist or doctor's office. Hate to make somebody like Crid suffer. It's also why I got a dog with hair, not fur -- so as not to torture the allergic.
Amy Alkon at December 29, 2007 2:15 PM
>what did the derm say?
I remembered it wrong... I'd gone in for something unrelated (forgotten). She said "And of course, you also have transmodemerative flobulitis." (That's not actually what the genetic condition was called, but I've forgotten. It was about 1992. It's in the files around here somewhere.)
Oh yeah? How do you know that?
"Because of that crease under your eye." She walked me to the mirror and pointed it out. I'd never noticed. Even in the mid-30's, it was a (relatively) deep but narrow number, starting just under the tear duct and pointing towards the mandible joint, petering out just past the eye socket. Nowadays, the whole neighborhood is an unnavigable landscape of trenches and canyons, so you have to know what you're looking for.
Should I worry about this?
"No, a lot of people have it. But I bet you never wear cologne or aftershave..."
This was true. I'd always thought I was too short to wear cologne. Or too dignified. To me, hanging out with a woman who wears perfume --for a whole evening!-- is like being a child, staring at the world through a blue cleary. It's charming and novel for a few seconds, but it's too disorienting to try to concentrate on anything else through the distortion.
"...and all the products in your bathroom are unscented..."
Bingo!
"...and at night in bed, you start to feel intolerably warm next to your wife after falling asleep, so you unconsciously roll away from her, and she thinks you're being standoffish."
You mean my EX-wife.
"Right. You dissipate heat differently than other people. Your mom probably says you were a fussy baby. ["Absolutely!" -Mother] Do you hate white wine?"
Of course... All MANLY men drink reds!
There were a couple other things about food that I can't remember. All this from a woman who'd met me one hundred seconds earlier. But there aren't that many other conditions that have such obvious markers. The only one she could mention (back in 1993) was one I'd already heard of, the creased earlobe that foretells heart disease.
Meanwhile, the shallow, moderate seasons in West Los Angeles are very comfortable, and thanks for asking.
Crid at December 29, 2007 2:52 PM
I don't wear it on planes and whatnot either...
David C: you shouldn't smell it until you're about a foot away. Some frags are stronger than others; as we perfumistas say, they have better "sillage." Strong smells don't bother me but I realize I'm in the minority and limit the sprays. It's also going to be stronger right after you spray it.
The thing about most ppl is that they wear only one fragrance. Your nose adjusts to a smell in a minute or so...and after years of wearing a perfume most ppl stop being able to smell it completely. Thus, they overcompensate by spraying too much.
It's possible that she put on more than she realized and that she, truly, cannot smell how strong her scent is. Or, her frag was of strong sillage and it happened to affect you very negatively. The guy in the bar - ew. Hate those guys...
Fragrance is activated by the heat of your skin and works with your body's chemistry. If her strong odor truly offends you there is not a perfect way to tell her "lighten up on the perfume, lady!" She will be annoyed. Period. You could also try having a manager do it if that is possible. The manager could pull her aside and let her know that there were complaints in the office about her perfume. If you find out you'll be working with her you could mention ahead of time that you have severe allergies and strong smells give you a migraine...Amy's the advice lady here, she might have better ideas!
I'll look around on my favorite perfume blogs and see if anyone has ideas...or a printable page that you could anonymously drop in her briefcase :-)
Gretchen at December 29, 2007 2:55 PM
More, Crid, more!!!
I can't tell you how much that resonates with me and my experience. I tried to google some of the things you mentioned and couldn't come up with a medical name. I would be indebted to you if you would find those files for the condition's name. If it will help, I'll ask again in a sultry, moaning whisper.
adoringfan at December 29, 2007 5:54 PM
I was so so excited that my sister in law sent me my first tube of LOreal Ombrelle, spf 60 w/ the good stuff in it!! She is in Seattle, and they get it from Canada. I've never used a present so quickly before! And I asked for more, more.
Someone above asked if it is gentle. I don't have sensitive skin, but I wear contacts, and that's a good way to test products. (not that you get squirt it in your eyes, but when you touch your face then your eyes, even when you don't plan to...) I would have worn this no matter what, but I was delighted to find that it doesn't hurt my eyes AT ALL. Best sunscreen ever. It is a little sticky, almost like a coating, but makeup is fine over it - and it hasn't balled up so far. I do wash my face before I pull any top over my head, so as not to get any on my clothing.
My dermatologist at Kaiser kept touching me a few weeks ago. I don't know if she is the L word, but she kept saying that my skin is great. (I am not that confident, just thought I'd share.)
Donna B. at December 29, 2007 6:16 PM
If it will help, I'll ask again in a sultry, moaning whisper.
I love when the comments section gets all sexed up.
Amy Alkon at December 29, 2007 6:23 PM
The sultry part will go better if you have have your wife do it. Write to cridcrid at gmail dot com and you'll get an email know when it turns up. Meanhwhile, let's call it "transdermative criditosis," so that I can be famous if it catches on.
Crid at December 29, 2007 9:25 PM
Dear adoring, go ahead and email I think I found it on the net, but it's too gross and scary to comment about publicly.
(Basically, we're all gonna die someday!)
Crid at December 30, 2007 4:03 PM
I'm the opposite of Gretchen. I'm horribly, horribly allergic to perfume and avoid it like the plague. Unfortunately, it is not entirely possible to avoid it altogether. Fragance free products are damned tough to come by espcially if your $ are limited and, if like me, you've no patience for having to special order something or travel miles out of your way.
So I wind up buying the least offensive off the supermarket/drug store shelfs. Perfume free laundry soap (thank science, even a trace of it in my clothes makes me itch) is readily available anywhere. I don't use fabric softeners because my skin is more sensitive to the scents than it is from not soft as down cloth.
I buy either Dove free or Pure 'N Natural bar soap for the body but find so call 99% pure Ivory soap is more horrible than any perfume. Do they make this shit from ragweed or something? Perfume makes me sneeze nonstop. Ivory not only makes me do that but turns me red and blotchy too.
I can't find a readily available shampoo that's totally perfume free but find Suave Daily Clarifying fairly mild. It's gentle on my hair and fragance is down there on the list of ingredients and a mild scent and doesn't do too much harm.
Detergent for dishes is a freaking nightmare. I've given up doing dishes without sneezing and I live in cheap apartments. I've only had two over the years that supplied dishwashers.
I only wore make-up briefly in my 20's and even hypoallergenic itched a bit. I don't look 49 and I credit it in part to not wearing make-up because it takes its toll but I admit it's also genetics and the fact that I'm a real indoor kind of gal. I'm just not into any outdoor activities really except a nice walk once or twice a day. So the sun hasn't taken the normal toll either. I really learned to hate the sun in Denver. It's too freaking strong there. I didn't really actively avoid the sun until I lived in Denver but even now that I'm back in New York, I do. Those walks are pleasant early morning or late afternoon. You can keep the midday sun except on the mildest spring days or crispest fall days.
Donna at December 31, 2007 7:21 AM
It only happened that one time? Perhaps you ate some bad cheese? Molds make some nasty toxins, and the result could have irritated your upper GI for a while.
The invasive test done first is cheaper in the long run if it gives definitive results. None of that "The first test was inconclusive, so come back in two weeks ..."
Perfumes are chemicals that interact with receptors in you body. Another class of chemicals that react with receptors are called drugs. It doesn't surprise me that some people can be "sensitive" to some chemicals that have drug-like properties without being sensitive to them in a classic allergy sorta way.
Phil-Z at December 31, 2007 7:52 PM
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