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Skin Care Lesson 20

With your partner come up with any skin issues you have ever experienced

Discuss with pupils the following skin complaints and how they can be treated.

ACNE

Birthmarks

Eczema

Facial disfigurements (including burnt skin)

Excessive sweating (to include smells that this can induce)

Psoriasis

Skin Cancer

Keep emphasising that the school nurse has leaflets and treatments for these conditions and a whole lot more

Discuss with partners jobs that could lead to rough or damaged skin eg

Physical labourer

Farmer

Dealing with chemicals/use of gloves to protect skin

How do you look after your skin on a day to day basis?

Not just for girls!!

Emphasis that many sportsmen are very careful about their skin and use lots of moisturisers, skin creams to protect themselves from effects of sun/harsh weather/harsh contact sports/daily training which ends in showers and loss of the bodies natural oils.

Why good skin care stops you from ageing as rapidly

Why good skin care involves being careful with the sun.

Skin quiz

Finish off by asking the pupils to ask their partner a question re the skin facts you have discussed in the lesson. The need to come up with 10 Q’s each and see who wins

Common Skin Conditions

ACNE


Acne is an inflammatory skin condition, commonly affecting the face, chest and back. It is one of the most common skin conditions, affecting up to 80-90% of adolescents. Acne may also occur during infancy due to the activation of sebaceous glands by maternal hormones in-utero. It can be a persistent problem, although it spontaneously resolves after a period of 4-5 years in about 70% of people. Approximately 30% of people continue with their acne into adult life. The incidence of acne at the age of 40 is reported to be 1% in men and 5% in women.

 

Causes

Acne is caused by the overactivity of the sebaceous (oil) glands. Sebaceous glands are active due to the hormone testosterone. Testosterone is produced in men from the testes and in women from the ovaries and the adrenal gland. Although testosterone levels are usually normal in people who develop acne, the sebaceous glands are overly sensitive to the hormone. Over production of oil leads to a greasy feel to the skin. In addition, there is a change in the growth of the cells lining the follicular canal (pore). Instead of dislodging normally and being carried away by the oil (sebum) when they die, these cells become sticky and stick to the inner surface of the gland and gradually build up a partial blockage.

Symptoms

The partial blockage of the pore is called a microcomedone and is the starting point of all inflammatory and non-inflammatory spots in acne. Bacteria start to multiply within the blockage, which leads to inflammatory lesions or red papules. As part of the healing process, the body recruits white blood cells which destroy the bacteria but lead to the formation of pus. In some cases the blocked pores remain full of this solidified pus and may never become inflamed, these are known as the blackheads and whiteheads. Some people may go on to develop painful swollen cysts which need urgent treatment as they are more likely to lead to scarring. There are many myths surrounding the causes of acne, which include:

. only teenage spots - you'll grow out of it.

. eating too much chocolate and too many chips.

. not keeping your skin clean enough.

Acne can be a devastating psychological disease commonly affecting the face, neck, chest, shoulders and back. The latest survey by the Acne Support Group shows that 12% of people with acne feel suicidal as a result of having the condition. Whilst it is a very common skin condition, it need not be left untreated and leave a person feeling so desperate that they want to take their own life.

 

Treatments

There are many treatments available, which need to be given at an early stage to prevent scarring. Treatments are generally longterm, however with encouragement and support a person can improve their skin substantially.

First line treatment for acne includes creams or gels containing the active ingredients benzoyl peroxide, nicotinamide or salicylic acid, all of which are available from chemists. Topical retinoid treatments can be particularly effective at reducing comedonal (blackhead) type acne. Antibiotics are a very popular treatment for acne as they target the inflammation associated with acne. They can be taken in tablet form, or used topically. Some topical antibiotic treatments are combined with other anti-acne ingredients such as zinc, benzoyl peroxide or retinoids. Other treatments include preparations containing the hormone therapy cyproterone acetate (females only).

For those who have not responded to systemic and topical therapies, isotretinoin, which is a synthetic vitamin A, can be very useful. This is a hospital-only drug and can achieve up to 95% positive results in patients. There are many potential side effects from this drug and hence the patient will need monitoring by their dermatologist.

Generally, treatments need to be taken for two months before any improvement is noticed and used ongoing if necessary. The aim of treating acne successfully is to stop new spots forming and avoid scarring which can be difficult to treat.

BIRTHMARKS (NEW ENTRY)

There is a wide variety of birthmarks but the most commonly occurring are either red, vascular  haemangiomas and port wine stains or brown, congenital melanocytic naevi (CMNs).

Haemangiomas are dynamic, proliferative and endothelial anomalies with their hallmark being rapid growth. They are not usually present at birth but  can appear within the first few weeks thereafter. Most haemangiomas do not need treatment and will disappear by school age, however, a few will cause problems such as bleeding, ulceration, deformation and disfigurement. For rapidly proliferating lesions that are at a site which will cause a problem (such as near the eye, nose, mouth or in the nappy area) early treatment with compression dressing, oral or intra-lesional steroids, alpha-interferon and laser therapy should be considered. Occasionally, combination therapy should be instituted.

Capillary Haemangiomas

The most common is the strawberry naevus with an incidence of 1:20 babies. Over 80% of these will regress spontaneously by the age of 7 years

 

Cavernous Haemangiomas

These are deep and bluish in colour. They are composed of possibly larger venules which are clustered together and located deeper into the skin and, hence, the blue colouration. Almost all will resolve naturally.

 

Mixed Haemangiomas

In these lesions there is a combination of superficial (red) and deep (bluish) vascular components. Most will disappear completely with time and no treatment is required.

 

Neonatal Haemangiomatosis

This is a rare condition which can be life-threatening. There are many miliary blood-filled circular individual lesions not only in the skin but also internally. Within the first 4 weeks of life the baby may present with congestive cardiac failure, liver failure and may succumb to multi-system organ failure. Steroids should be started following the diagnosis of internal lesions and age of the patient. Alpha-interferon may also be considered as part of the treatment regime.

 

Lymphangio-Haemangiomas

These are a mixture of lymphatic and blood vessel abnormalities all amalgamated together . They create difficult management problems because of the nature of the abnormalities involved.

Verrucous Haemangiomas

These are uncommon congenital haemangiomas present from birth where there is unilateral hyperkeratotic lesions mostly seen on the lower extremities. Clinically, they are warty, crusty and dry dark lesions; with age they can bleed and cause difficult management problems.

 

Pulse dye laser therapy may stop the bleeding, flatten the lesion, reduce hyperkeratosis and may lessen the pain and discomfort.

 

Multiple Haemangiomas

These are individual separate cutaneous capillary haemangiomas scattered all over the body. They sprout out at different stages in the first few weeks of life.  Usually they do not cause any problems unless internal lesions are also present. Babies should be investigated at an early stage with an abdominal ultra-sound scan, a cranial CT scan and echo-cardiogram, if appropriate, to look for internal manifestations.  In blue rubber bleb naevus syndrome there is angiomatosis characterized by numerous cavernous like haemangiomas that involve the skin, mucous membrane and other parts of the body like gastrointestinal tract, lips, oral cavity, glans penis, nasopharynx and, rarely, brain meninges and heart.

 

Haemangiomas associated with major blood vessel abnormalities

Capillary haemangiomas on the head and neck may have associated cardiovascular abnormalities, e.g.  coarctation of aorta, or they may present with subglottic haemangiomas; they should be investigated to exclude cardiovascular and subglottic involvement.

 

Port Wine Stains

This most common vascular malformation consists of dysplastic, ectatic vessels which persist throughout life; there is an incidence of 3:1000 births.  It is also known as naevus flammus and is defined as a vascular malformation of developmental origin characterized pathologically by ectasia of superficial dermal capillaries and clinically by permanent macular erythema. It is present from birth and is often present on the face. This type of birthmark becomes darker, thickens with age and forms progressive nodularity and blebbing, often resulting in major disfigurement. Recent advances have shown that pulse dye laser therapy is the main stay of treatment.  Experience supports the view that younger children age 6 months – 4 years tend to have a better response to laser treatment than older children with the aim to complete treatment prior to starting main stream education so that psychological and social interactions are as normal as possible. Port wine stains can be associated with other medical problems such as glaucoma, Sturge-Weber syndrome, Klippel Trenaunay Weber syndrome, Proteus syndrome.

 

ECZEMA

The word eczema comes from the Greek and means ‘to boil over’. The main features of eczema are dry, itching, red and inflamed skin. The words eczema and dermatitis mean the same thing. Eczema affects about one in every ten people in the United Kingdom and can be mild, moderate or severe. Eczema can be a disruptive and distressing condition and can affect all areas of personal and family life.

Types, Symptoms and Causes

Atopic eczema. This is the most common type of eczema. It usually starts in babies and young children and is thought to affect up to one in every five children. The main features are itching, redness, and inflammation. Dry, scaling skin is often seen in the creases of legs, wrists and neck as well as on the face and forehead. If the skin is weeping and crusting the skin may be infected.

Atopic eczema is an inherited condition, linked to asthma and hayfever. It is thought that people with atopic conditions are sensitive to things found in their environment (allergens) which people that are not atopic find harmless. Allergens may affect the skin by direct contact, or by being breathed in or swallowed. Eczema is not contagious – it cannot be caught from someone else.

Many people have mild to moderate eczema, which can be successfully managed. However, some people do have severe eczema, which may sometimes need hospital treatment. Three quarters of children with atopic eczema grow out of it by the time they reach their teenage years.

Contact dermatitis. There are two types of contact dermatitis: allergic and irritant. Both types have similar symptoms, though the hands are most often affected. It is sometimes referred to as occupational dermatitis due to the impact it can have on a person’s occupation.

Allergic contact dermatitis. This tends to appear where the skin is in direct contact with something, for example, the earlobes in nickel allergy (if wearing earrings). It is caused when the immune system overreacts to a substance that would normally be considered harmless, and creates an allergic response. Common allergens include nickel, chromates, and fragrances. It can be a painful and disabling condition with skin which is often dry, red, split, cracked, weeping, fluid-filled and intensely itchy, sore and stinging. If the condition is related to the person’s work, a change of career is sometimes necessary. Jobs that are at high risk include hairdressing, catering, cleaning, construction, engineering, printing, health care, agriculture and horticulture.

Irritant contact dermatitis. This has virtually the same signs and symptoms as allergic contact dermatitis but is caused by repeated contact with an irritant substance such as diluted acids, diluted alkalis, solvents, soaps, detergents, metallic salts, cement, resins and cutting fluids. The most common occupations at risk of irritant contact dermatitis are those that involve wet work, for example, chefs, bakers, bartenders, caterers, cleaners, hairdressers, metal workers, surgical nurses, printers, solderers, fishermen and construction workers.

Seborrhoeic eczema. This can occur in adults, children and babies. In babies it is often associated with ‘cradle cap’. It usually starts on the scalp as dandruff that can progress to redness, irritation and scaling which can spread to the face and skin creases. It is a reaction to the increased production of pityrosporum ovale, a yeast that occurs normally on the skin in those areas which generally produce a lot of oil such as scalp, face and chest and back in men. Candida (which causes thrush) can also be found on the skin of people with seborrhoeic eczema and can make the condition worse. 

Gravitational eczema. Also known as varicose or stasis eczema, this type appears on the lower legs and generally affects people in later life, particularly women. It is related to poor blood circulation and high blood pressure. Special care needs to be taken to make sure that legs are not knocked as the skin can become thin, fragile, shiny and flaky which can lead to leg ulcers.

Treatments

The main treatment for eczema is emollients (moisturisers) and an explanation of the condition and its treatments. Other treatments for mild to moderate eczema might include topical corticosteroids (applied to the skin), antibiotics, and bandaging. People with eczema might also be given advice on how to avoid allergens, the ‘triggers’ that make their eczema worse. Some people also find complementary medicines useful to treat their eczema. 

Severe eczema might be treated with stronger topical corticosteroids, ultra-violet light therapy, drugs which suppress the immune system, such as ciclosporin, and oral steroids taken by mouth. New treatments, known as topical immunomodulators, such as tacrolimus and pimecrolimus, are now available for people with atopic eczema.

 

FACIAL DISFIGUREMENT

About 400,000 people in Britain have disfigurements to their face, hands or body. These include birthmarks, scars, asymmetrical features, paralysis, skin grafts and conditions affecting the skin (such as psoriasis, vitiligo, acne, EB, Ichthyosis, and Neurofibromatosis). Disfigurement can be present at birth like a cleft lip and palate or caused by an accident, fire, cancer treatment, disease or illness.

Treatments

Surgical and medical treatment depends on the disfigurement/condition. Surgery /treatment can make a disfigurement less noticeable, but it can rarely be removed altogether. Indeed many conditions that affect appearance do not recede or disappear. Some skin conditions be unpredictable or fluctuate. This can be very distressing and hard to accept.

Psychological and social effects

Children, young people and adults who have a medical condition that affects their appearance may be treated unfairly and experience a number of common challenges socially. Whatever the underlying cause of the visual difference, individuals may be stared at, asked questions by strangers, called names, be bullied or rejected. This may happen at school, work or in other public places such as the pub or shops. Such reactions can lead to low self-esteem, lack of confidence, difficulty meeting new people and forming intimate relationships.

Activities that involve exposing ones body (e.g. swimming, sports, wearing summer clothes) can also add further to feeling self-conscious about appearance. In some instances social isolation may occur if adults or parents and their children start to avoid social situations for fear of what they entail and how others will react. Where skin conditions are concerned, there are also many existing myths in our society – that the condition is contagious or caused by poor hygiene or diet for example.

Individual’s ability to adjust and cope with the visual difference in their appearance is not predicted by severity, location or cause of the condition. Research has demonstrated people cope best when they have good quality support networks, a high level of self-esteem and good social (interaction) skills.

HYPERHIDROSIS - Excessive Sweating

 

Sweating is regulated by the sympathetic nervous system. In about 1.0% of the population, this system is revved-up, over-stimulating the sweat glands causing sweating to occur at inappropriate times in specific areas of the body. This is called hyperhidrosis.

Causes

While doctors don't know why hyperhidrosis starts, they have successfully linked it to over activity in the sympathetic nervous system, which runs along the vertebra of the spine inside the chest cavity.

This chain controls the sweat glands, responsible for perspiration throughout the entire body. Depending on which part of the chain becomes overactive, different parts of the body become affected.

Sometimes people will sweat excessively because of other illnesses. These causes must first be ruled out before primary hyperhidrosis can be diagnosed.

Symptoms

Hyperhidrosis can occur in many different areas of the body, but most commonly affects the hands and feet. Palmar and planter hyperhidrosis, as they are known, are probably the most troublesome, as they are difficult for the sufferer to hide. Shaking hands becomes uncomfortable and working with paper and metals are a problem, making business and day-to-day life a struggle. Often people report that they are even embarrassed to hold the hands of those they love.

Hyperhidrosis is also common in the armpits (axillae), causing staining of clothes and, together with an embarrassing odour, forces most sufferers to change their clothes several times a day.

Facial, back and groin sweating, although less common, affect a considerable number of people.

Regardless of where it is located, hyperhidrosis presents an embarrassing problem to those afflicted with it.

 

Treatment

 

Iontophoresis

A machine called an iontophoresis machine is now available in dermatology departments in most NHS hospitals and in some private hospitals and specialist clinics.

Until about five years ago, iontophoresis was mostly carried out in physiotherapy departments and achieved varying results. However, iontophoresis is now mostly performed by specialists and, with the use of the new iontophoresis machines, the results have been quite outstanding.

Nearly all sufferers have achieved a complete cessation of sweating after about four, 20 minute sessions. The absence of sweating tends to last from about two weeks to three months. Sufferers then undergo another course of treatment, which can be practiced at home if they want to buy their own machine. For those few sufferers who do not get a complete cessation of sweating using just tap water, a drug called Glycopyrronium Bromide which is available on prescription can be added to the water. This ensures good results.

The treatment is pain free, safe, cheap to run and can be done as often as is necessary; although a treatment protocol is recommended.

Although the results are good with iontophoresis, treatment generally has to be repeated often. Weekly or fortnightly is quite normal.

PSORIASIS

There are several forms of psoriasis, which usually appear as patches of silvery scales on top of areas of crimson skin. The scales are easily shed or scratched off. It is a distressing condition, which can lead to a reduced self-esteem. Over a million people in the United Kingdom and Ireland express the condition, equating to 2% of the population; with men and women being equally affected. Psoriasis usually occurs between the ages of 10 and 45 years, although there are exceptions. It is an inherited condition, which does not necessarily recur in successive generations.

Causes 
Psoriasis is caused by the over production of skin cells. The development of skin cells to replace those naturally sloughed off occurs at up to seven times the normal replacement rate. Hence, raised red patches are produced. These can be covered with scaly, dead skin. Trigger factors for a psoriasis flare-up include: infection; damage to the skin (burns, sunburn and scratching for example) and, certain medications (eg. anti-malarial, anti-depressant and beta receptor blocking drugs). Very commonly, stressful events such as death, divorce, examinations and work pressures may precipitate a flare-up or may exacerbate a mild flare-up. In women, hormonal changes can affect the condition. The basic cause of the condition remains unknown and is subject to ongoing research.

Types and Symptoms 
Chronic plaque psoriasis (psoriasis vulgaris) - This is the most common type, appearing on elbows and knees, or sometimes more extensively over the trunk and limbs.

Pustular psoriasis (palmar plantar) - Pustules on the soles of the feet and palms of the hand, which go brown and develop scales. The skin often cracks. More often seen in middle age.

Flexural psoriasis - This type appears in the armpits, groin and under the breasts. It is fiery, shiny red, with little or no scaling.

Guttate psoriasis - This is quite common in children and teenagers, often occurring after a streptococcal throat infection. Lesions appear as small ‘raindrop’ patches.

Psoriasis of the scalp and nails -Scalp psoriasis affects the majority of people who develop the condition. Scaling occurs, especially around the hairline. It is often itchy and can sometimes lead to a temporary loss of hair. Nail involvement is less common. Nails may show pitting, flaking and ridges. This can be an early indication of psoriatic arthritis (see section on Psoriatic Arthritis).

The lowering of self-esteem is one of the most profound aspects of psoriasis. With such an emphasis on appearance in society, the incidence of psoriasis can cause a great deal of distress. One of the most difficult aspects is its effects on everyday life. A reduced self-esteem can affect the freedom to sunbathe or swim, visit the hairdresser or try on new clothes in a store and sometimes the choice of career. Having to cover up in warm weather and feeling unable to pursue the activities of people who are unaffected by the condition, add to the debilitating features of living with psoriasis.

Temperature regulation is affected and people with the condition can feel hot when others feel cold, and vice versa. Sleep can be difficult. Itching and soreness can exacerbate the condition, leading to a general feeling of being unwell.

It is important to recognise that psoriasis is a non-contagious condition and cannot be spread by touch to unaffected areas of skin or to other people.

Treatments 
Mild to moderate psoriasis is treated with topical applications containing coal tar, dithranol, or the novel Vitamin A and D derivatives. Ultra violet light therapy and immunosuppressants are used in more resistant cases.

SKIN CANCER

. Skin cancers are extremely common with more than 73,000 new cases registered each year in the UK. Many cases are not reported so the real number of cases is actually much higher. 

. Over the last twenty-five years, the incidence of malignant melanoma has increased more than for any other cancer in the UK. The male rates of melanoma have quadrupled in the past 30 years in the UK.

. Malignant melanoma is more common in women than men. However, mortality is higher among men – most probably due to late detection.

. Around a third of melanomas occur in people aged less than 50 years and in the 15-39 year age-group malignant melanoma is the second most common cancer.

. Over 2,000 people die from skin cancer each year in the UK.

. There are now more deaths from malignant melanoma in the UK than in Australia, although more Australians than Britons are diagnosed with it each year.

 

Types of skin cancer 
There are two main types of skin cancer, malignant melanoma and non-melanoma skin cancer (NMSC).

 

Malignant Melanoma (MM)

Malignant melanomas are the least common, but most serious type of skin cancer with 8,000 new cases each year in the UK and 1,800 deaths. MMs are curable if found early, but can be very difficult to cure if they have spread into the deeper layers of the skin. MM develops in cells known as melanocytes, which are responsible for the colour of our skin.

 

Non-melanoma skin cancer (NMSC)

The majority of NMSCs are Basal Cell Carcinomas (BCCs), also known as rodent ulcers or Squamous Cell Carcinomas (SCCs).

 

Basal cell carcinoma arises from the cells in the base of the skin and is the most common skin tumour in the UK. It is usually seen in caucasians, particularly those with fair complexion, fair hair and blue eyes. The type of skin affected is almost always hair bearing skin, though occasionally basal cell carcinoma is found on the soles of the feet. Most basal cell carcinomas are slow growing and do not spread. However, if left, they can erode the skin and cause an ulcer, known as a rodent ulcer.

Squamous cell carcinoma starts in the surface cells of the skin and is the second most common type of skin cancer in the UK. This is a slow growing cancer but may spread to other parts of the body if left untreated. Like basal cell carcinoma, squamous cell carcinoma tends to occur in white skinned people, with more males than females being affected.

 

Both forms of NMSCs are highly treatable and survival rates for NMSCs are over 95%. However, if left untreated, these tumours can become destructive, invading local tissues and causing disfigurement. Whilst BCCs rarely metastasise, SCCs can, and in 2003, there were 514 deaths in the UK from NMSC. 80% of NMSCs occur in people aged 60 years and over and they constitute a substantial public health problem due to the very large numbers of cases each year.

 

What causes skin cancer?

 

The main cause of skin cancer is too much sun. Sunburn can double the risk of skin cancer. Lots of sun over your lifetime also increases your risk of certain skin cancers.

 

Using a sunbed increases the risk of skin cancer. The more you use sunbeds the greater the risk is likely to be and when the tan fades the skin damage remains. Sunbeds also cause premature skin aging, which means that skin becomes wrinkly, tough and blemished at a younger age.

 

Who is most at risk?

 

Some people are more likely than others to get skin cancer. These people tend to have one or more of the following…

• fair skin that tends to burn in strong sun

• red or fair hair

• lots of moles or freckles

• a personal or family history of skin cancer

• had sunburn, especially when young

 

As a general rule, the fairer your skin, the more careful you should be in the sun. Knowing your skin type will help you work out when you need to protect yourself.

 

Be SunSmart in the Summer Sun

 

Those most at risk are people with fair skin, lots of moles or freckles or a family history of skin cancer. Know your skin type and use the UV Index to find out when you need to protect yourself.

 

Spend time in the shade between 11 and 3

The summer sun is most damaging to your skin in the middle of the day.

 

Make sure you never burn

Sunburn can double your risk of skin cancer.

 

Aim to cover up with a t-shirt, hat and sunglasses

When the sun is at its peak sunscreen is not enough.

 

Remember to take extra care with children

Young skin is delicate. Keep babies out of the sun especially around midday.

 

Then use factor 15+ sunscreen

Apply sunscreen generously and reapply often.

 

Also…

Report mole changes or unusual skin growths promptly to your doctor.

 

Find out more at .uk

 

Where can skin cancer start?

 

The most common sites for melanoma are the leg in women, the back in men and the face in older people. But a melanoma can grow anywhere, sometimes on the sole of the foot, or on the buttocks. Other types of skin cancer often affect areas that catch the most sun such as the head, neck, shoulders or arms.

 

What are the signs of skin cancer

Check skin regularly for changes using the ABCD rule. This is especially important for people who are fair-skinned and have lots of moles or freckles.

 

The ABCD rule:

 

Asymmetry: The two halves of a melanoma may not look the same.

Border: Edges of a melanoma may be irregular, blurred or jagged.

Colour: The colour of a melanoma may be uneven, with more than one shade.

Diameter: Many melanomas are at least 6mm in diameter, the size of a pencil eraser.

 

Other signs of skin cancer:

·        a new growth or sore that won’t heal

·        a spot, mole or sore that itches or hurts

·        a mole or growth that bleeds, crusts or scabs

 

Any changes in a mole, freckle or patch of normal skin that occur quickly over weeks or months should be taken seriously.

 

Treatments 
Treatment options include: surgery; electrocautery; cryosurgery; lymph gland removal; radiotherapy; chemotherapy and, immunotherapy (for MM). These treatments may be used alone or in combination. Most people with non-melanoma skin cancer are cured, whilst the prognosis for malignant melanoma depends on the depth of the cancer in the skin. It is important to report a suspected melanoma early.

 

"Beauty Goes Skin Deep"

10 Minutes a Day, keeps those wrinkles at away

By Diana Dudas

Our skin like other body parts is not invincible, when it comes to being susceptible to damage. As it is necessary to get monthly haircuts and weekly manicures as part of your grooming regime it should also be a necessity and not a luxury to take care of the most important organ of your body, the skin.  And the time to start doing that is now.

Too young to care.

It may seem unimportant to  contemplate doing anything about your complexions before reaching your  thirties. However it is in our twenties that the effects of aging begin to be visible in our complexion. As we mature, biochemical changes occur in elastin and collagen, the connective tissues that give skin it’s firmness and elasticity. Genetics also play a part in this, which is why these changes occur at different times in different people. 

As skin becomes less elastic, it also becomes drier, and the fat padding begins to disappear. This causes the skin to sag and look less supple. Ultimately wrinkles will appear. Then one day, after glancing in the mirror  you  suddenly notice  those crows feet creeping in around the corners of your immaculately decorated eyelids, or you notice that your lip potions have sadly waded into the spider like crevices above the lips. It is normally then, when decisions are made to go out and get a miracle cream or maybe a facial. 

Aging can be slowed down, and you can do your part to promote a younger complexion even as you mature. All it takes is a little TLC, but start NOW! The sooner you start to nurture your skin the more chance you have of a age-less complexion. All it takes is a short monthly visit to  a skin care specialist, or a few minutes a day, taking care of your skin at home.

Skin care  starts at home

Enjoying a monthly facial is an excellent idea. Having your, face, neck and shoulders massaged for an hour and a half will most definitely put you into a state of euphoria and your skin will feel revitalized and renewed. And for those of you who haven’t got time for a full treatment, you will be pleased to know  that the New York style facial is now available,  which takes only 15 minutes, perfect for a quick lunch hour  treat. Making time for a facial is important, but more so it is of the utmost importance to maintain this caring act at home.  Your skin needs twice daily nurturing  to keep it clean, moist and protected and it only takes ten minutes a day.

Easy as ABC

A good skin care regime is neither complicated nor laborious. A quick 1, 2, 3 step is a great start. This means a twice daily cleansing, toning and moisturizing.  it only takes 5 minutes each time, that’s just 10 minutes a day.

Cleanse: Use a liquid, cream or foam cleanser. And gently massage your face to remove all dirt and make-up. Then rinse. Do not use soaps as they can be overly drying and also clog pores.

Tone: After cleansing saturate a cotton pad, and stoke over face and neck, this will work to remove the last traces of cleanser and also close your pores.

Moisturize: Apply your cream with upward motions to both the face and neck. Avoid eye area.

This is all you need to get you well on your way to a healthy and more radiant complexion.

Your only young once!

This might be the case, however there is absolutely nothing wrong from being in denial of your age for as long as you fell fit!

For those concerned about skin maturity or maybe suffer with  problem skin there are extra  steps that you can take to ensure healthy skin.

A weekly exfoliation will uncover fresh new layers of skin. Look for exfoliators that contain enzymes as these will dissolve dead skin cells without being too abrasive. This will give your skin a healthy glow.

For optimum results, immediately after using your exfoliator, apply a masque  . Check the ingredient lists for  anti-inflammatory agents such as cucumber or chamomile, these will work to calm and soothe your skin, so that it emerges, refreshed,, refined and revitalized.  Always a good thing!

Obviously the more you  care for our skin, the better you are going to look. And that alone will give you a new lease of life. There are also eye creams and gels that reduce fine lines and firm the area around the eye. Thus helping to prevent further wrinkles.

Doctor my Eyes!

Eye crèmes are a vital part of your skin care regime. The skin around your eyes is much finer than the rest of your face and body and cannot absorb a heavy moisturizer. If you were to compare the thickness of skin on the various parts of our body to paper. The delicate eye area, would be like tissue paper, the face like writing paper, and the neck and body like wrapping paper this is why it is important to use lighter crèmes that are specifically made for the delicate eye area. If you were to apply your usual facial moisturizer to the eye area, the moisturizer would have no where to go, and would in fact create puffy, baggy eyes.  Also for the same reasons never use eye crèmes on the eyelid before going to sleep. However you can use an eye gel sparingly under the eye area.

Going below and beyond

Once  you have achieved your basic skin care regime, your skin will be like a clean canvas ready to absorb all the nutrients found in anti-aging formulas. These include products containing liposomes, night crèmes and also serums.  When crèmes containing liposomes are applied to the skin, the liposomes are deposited on the skin and begin to merge with the cellular membranes and then release their active ingredients.  Serums go one step further, they are able to penetrate below the skin wall and attach themselves to emerging skin cells promoting healthy new skin cells.  Serums come in the form of droplets and are applied sparingly under your moisturizer.

What to look for

The thought of shopping for skin care items can tedious and knowing which ingredients to look is daunting, so  here are a few suggestions of what ingredients to look for when starting your skin care regime. When choosing your cleanser toner and moisturizer look for the following ingredients, which will vary depending on your skin type:

Dull dry skin…  oxygenating essential oils  including: Peppermint, Geranium, Rosemary, Cyprus, Thyme, Anise and Cinnamon

Oily or acne prone skin…anti-bacterial and oil blotting extracts including: Camphor, Eucalyptus Oil, and Witch hazel

Mature Skin…Liposomes, serums. Sunflower, jojoba and hazelnut are rich lubricants.

Exfoliators…ENZYMES are the gentlest and yet most effective  form of exfoliation. Papaya being the most effective

Once you start on the road to good skin care, your skin will crave it. Remember, a good diet, exercise and drinking lots of water will also help improve your complexion. With just ten minutes a day you will soon see results and others will also notice.

So start your twice daily skin care regime and , when you just don’t feel like it, remember just 10 minutes a day keeps those winkles away.

Skin Care

I am concerned about a funny patch of skin and wanted to know if you could give me advice?

Immediately see the school nurse/your own GP

In order to obtain an appointment with a consultant dermatologist within the UK – either on the NHS or privately – you must be referred by a GP.

I have itchy dry skin and have tried lots of treatments from my GP but nothing is making it go away. My GP says that all we can do is control the itching and does not seem keen to do any more about it, but I’m desperate for the horrible redness to go away.

Many conditions can cause itchy skin and some may even be environmentally driven through irritation or allergy to substances around you. If your itching is due to a skin disease such as eczema then it may be that your GP is right – it is currently only possible to control not cure many conditions although new treatments are coming through all the time. The best person to talk through your concerns with is your GP.

I am suffering bullying at school because of my skin condition. Please help me – it is affecting my whole life and I feel so desperate.

That is why telling teachers is so important. They know how to deal with your issues. They will help organize an appointment with the school nurse as well as deal with bullying issues

Someone told me that my skin disease is because I am dirty. I don’t think that I am dirty, but I am worried now that it might be true?

While personal hygiene is important, it is very rare indeed for lack of it to be the cause of a skin disease. Washing with soap can dry the skin and make a dry skin condition like eczema worse. Obviously, you should wash, bath or shower often enough to keep clean, and it is sensible to use a soap substitute if you have dry skin. Your pharmacist will be able to advise you about this.

Are any skin diseases curable?

There are treatments for some skin conditions including athlete’s foot, impetigo, ringworm, which make them curable. Some like eczema and psoriasis cannot be cured, but can usually be managed so that their effects are minimised. The best option is to consult your pharmacist or GP for more advice on your particular skin problem.

My friend has really spotty skin and she says it isn’t catching, but I’m really worried to touch her

Occasionally a small blister can be a cold sore but even this will only be transferred by direct skin contact with friction, for example, passionate kissing, not just touch. Take a look at to find out the real facts about spots.

I am so upset – I have just been told that I have a skin condition and that I will never be cured. Is this true? And why me? Is it something that I have done?

First have a look and see if there is a patient group, which will have in depth knowledge of the condition and experience in counselling people who have just been diagnosed. If there is no patient group then go back to your GP practice and speak to your practice nurse or GP again for more support. There are many reasons why skin diseases occur or recur. Many are not curable, but for most there are good treatments to limit the problems.

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