SPECIAL FROM Next Avenue
By Gina Roberts-Grey
Signs of brittle bones, diabetes and vitamin deficiencies may surface on your skin before you notice other symptoms
Your skin can say a lot about you: Laugh lines could indicate perennial good cheer, a winter tan hints at a relaxing vacation and blisters may tell of a weekend spent gardening.
But if you pay closer attention, doctors say, your skin has important things to say about your health, too -- it can be a crucial early-warning system for a range of concerns.
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When you're in the shower, getting dressed or preparing for your next checkup, take a look and consider some of the signals your skin might be sending you or your doctor:
Bone fracture risk A study of 114 recently postmenopausal women found that deep wrinkles on the face and neck could indicate an increased risk for broken bones. The reason: women with such wrinkles were more likely to have lower bone density in areas like the hips, spine and heels.
Estrogen promotes the production of the protein collagen, which your skin and bones both rely on to maintain density. So as a woman's level of estrogen declines in menopause, says Dr. Ronald Young, co-director of the Menopause Center at Texas Children's Pavilion for Women in Houston, "collagen in the skin is depleted, which means the skin isn't as firm and elastic, and wrinkles develop."
Deeper, worsening wrinkles are a sign that the body is producing less collagen which often means bone density is decreasing as well. "The worse the wrinkles, the lesser the bone density," lead researcher Lubna Pal, a Yale School of Medicine associate professor, said in a statement. "This relationship was independent of age or of factors known to influence bone mass."
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Dr. Ruth Freeman, a co-author of the study and a bone density specialist at Montefiore Medical Center in New York City, adds: "There isn't a one-to-one relationship between a wrinkle and the bones. It was just that the more wrinkles a person had, the lower their bone density was."
To gauge the depth of wrinkles, researchers used photography and a device known as a durometer, which measures skin rigidity. Bone density was determined with X-rays and ultrasound, but the scientists emphasized that physicians should be able to recognize women potentially at risk without scans. "Our findings that the appearance and physical properties of the skin can reflect the quality of the skeleton are noteworthy," Pal said, "because this may allow clinicians to identify fracture risk in postmenopausal women at a glance without depending on costly tests."
If you notice what appear to be deep wrinkles, Freeman says, ask your physician if you should get a bone density scan. In the meantime, if you're at risk for osteoporosis, take action to ward off bone loss through exercise and, if recommended by your doctor, calcium and vitamin D supplements or prescription bisphosphonates.
Diabetes If you discover thick, dark, velvety patches on folds of skin on your neck, armpit or groin, your doctor might want to arrange a blood test to check for diabetes. These patches, known as acanthosis nigricans, could be benign or a normal side effect of obesity, says dermatologist Janet Lin of Baltimore's Mercy Medical Center. But they also could be a sign of diabetes.
The patches, which sometimes appear on the face and hands as well, may itch or smell bad, "but most people only complain about the appearance of their skin, saying that it's 'dirty,'" Lin says.
It's not clear why these patches develop in some diabetics and not others, Lin says, nor do they appear to be correlated with the severity of the disorder. But if you notice such patches on your skin, Lin says, call your doctor to set up a fasting blood glucose test.
Thyroid Concerns Located at the base of your neck just above the collarbone, the thyroid gland is responsible for hormones that, among other functions, regulate your body temperature, metabolism and nervous system as well as the health of skin, hair and nails.
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Signs that your thyroid isn't performing properly -- it can be either overactive or underactive -- tend to appear first on your skin, typically on the back of your upper arms and the back of your fingers. "At first the skin just seems rough or bumpy, like a mild rash," says naturopath Alan Christianson of Phoenix. But if the thyroid continues to be out of whack, other areas can be affected, he says, such as the legs, scalp and neck. An underactive gland could result in hair loss, brittle nails or dry, flaky skin.
If you've noticed any such issues, schedule a physical with your internist and ask for a thyroid function test.
Omega-3 Deficiency Not only do omega-3 fatty acids, found most readily in oily fish like salmon, sardines and tuna, support brain function and reduce inflammation, they can also help lower the risk of heart disease, cancer and arthritis. In addition, omega-3s play a vital role by strengthening skin cells and helping to ensure hydration.
Dull, dry skin or complexion could indicate an omega-3 deficiency, Christianson says, because its absence can slow your natural exfoliation cycle, also potentially leading to dryness or dandruff.
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Supplements are one option to restore omega-3, but the best way to correct the deficiency is through diet. The American Heart Association recommends eating a 3- to 4-ounce serving of oily fish twice a week. Flaxseeds, walnuts and soybeans can also help maintain omega-3 levels.
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