SKIN RELATING PROBLEMS

PREPARED BY… SUSHMITA RANA M PHARM.

CONTENTS Structure of skin Dry skin Acne Pigmentation Prickly heat Wrinkles

STRUCTURE OF SKIN

DRY SKIN Dry skin has a low level of sebum and can be prone to

sensitivity. It usually feels "tight“ and uncomfortable after washing unless some type of moisturizer or skin cream is applied. Chapping and cracking are signs of extremely dry, dehydrated skin. It looks dull, especially on the cheeks and around the eyes. There may be tiny expression lines on these spots and at the comers of the mouth

CAUSESThe oil glands do not supply enough

lubrication to the skin. As a result, the skin becomes dehydrated.

Dry skin could be due to a genetic condition.

Poor diet. Nutritional deficiencies, especially deficiencies of vitamin A and the B vitamins, can also contribute to dry skin.

CONT….Environmental factors such as

exposure to sun, wind, cold, chemicals, or cosmetics, or excessive bathing with harsh soaps.

Conditions such as dermatitis, eczema, psoriasis, or seborrhea.

HOW TO CARE FOR DRY SKIN Dry skin needs plenty of thorough but gentle

cleansing, regular stimulation with massage and generous quantities of oil and moisture. It also needs extra careful protection. Washing dry skin with soap and water not only removes grime but also the natural oils protecting the skin. A moisturizer increases the water content of the outer layers of the skin and gives it a soft, moist look.

DIET RECOMMENDATIONS FOR DRY SKIN Eat a balanced diet that includes vegetables,

fruits, grains, seeds, and nuts. Drink at least 2 quarts of quality water every

day to keep the skin well hydrated.  Eat foods such as garlic, onions, eggs, and

asparagus that are high in sulfur, which helps to keep the skin smooth and youthful.

DEFINITION OF ACNE

Acne is an inflammatory skin condition that occurs when oil and dead skin cells block the pore opening, causing sebum (oil) to build up inside the pore.

ACNE LIFE CYCLE

Stage 1: Clogged Pores. Cells lining pores shed and mix with excess sebum produced by sebaceous glands, forming a plug, which leads to clogged pores.Stage 2: Bacteria. Accumulated sebum and dead cells attract the P. acnes (or propionibacterium) bacteria naturally found in skin, which feeds on oil and multiplies rapidly inside pores.Stage 3: Inflammation. This bacterial overgrowth triggers the natural inflammatory response causing swelling and redness. This can ultimately lead to discoloration and scarring.

CAUSES OF ACNE...1. Eat chocolate and greasy food (e.g. French

Fries) will case acne？ No scientific proof on the correlation

between the formation of acne and food.2. Will dirty skin cause acne?

Acne is caused by the excess production of sebum from skin.

3. Stress causes acne! Some studies have demonstrated there is

no relationship between acne and stress. .

STRESS CAN CAUSE ACNE

Stress can aggravate your skin by triggering the release of androgens and cortisol. These stress hormones can stimulate an overproduction of oil. When this excess oil mixes with dead skin cells, it promotes bacterial growth and can cause acne to develop or worsen.

1. I wash my face several times a day. Why do I still get acne? Too much washing will only irritate the skin further

and worsen their acne. Gently wash your face daily with mild cleanser or soap, pat dry and use appropriate acne treatment.

2. Just let acne run its course! Some acne scar will remain permanent, so patients

should use appropriate acne treatment as soon as possible.

FACTS ABOUT TREATMENT OF ACNE...

CONT…1. Is it essential to squeeze the acne?

Squeezing forces infected material deeper into skin, causing additional inflammation and possible scarring. If you have severe acne problem, consult the doctor as soon as possible.

2. If the acne cannot be cured in a month, then should try other drugs. Give acne products enough time to do their job.

Some medicines might take a few months to take effect. Ask your doctor how much time is needed for each particular product to work.

TREATMENTS Frequent washing with soap and water Anti-inflammatory drugs to inhibit P. acnes (bacteria) Use anti-biotic, for example tetracycline,

erythromycin or co-trimoxazole etc. to curb the growth of bacteria and reduce inflammation.

Use anti-androgen (e.g. oral contraceptive pills) to regulate androgen, to prevent excess sebum production. This method is only suitable for women.

PIGMENTATION Skin color is generally due to melanin Melanin is synthesised by melanocytes within

melanosomes and transferred to keratinocytes

Human beings come in a glorious spectrum of different colors: light,dark,plain or freckly skin;

Skin pigmentation has far –reaching social and psychological implications.

Melanin pigmentation disorders are important for medical and cosmetic reasons

OVERVIEW OF THE DISEASES

Pregnancy mask

Vitiligo

Hyperpigmentation

Melasma

Lentigo

Iatrogenic hyperpigmentation

Post-acneic or cicatricial

hyperpigmentation

Hypopigmentation Vitiligo

Lentigo

Melasma

CURRENT TREATMENTSOld bleaching agents

Hydroquinone (tyrosinase inhibitor) Azelaic acid Corticoïd

Associated with « peeling » / dermabrasion products Vitamin A Glycolic acid

Best treatment: Kligman trio Corticoïd (dexamethasone) Hydroquinone Retinoic acid

HYPOPIGMENTATION DISORDERS Vitiligo

High prevalence: 0.5 - 2% of the population

Unknown etiology

3 major hypotheses, not exclusive of each other: immunologic factors oxidative stress sympathetic neurogenic disturbance

VITILIGO

CURRENT TREATMENTS Puvatherapy (psoralen + UVA) no longer

used (known carcinogenic risk) UVB narrow band

For 10 years: unknown risk cancer Topical treatments

Tacrolimus (off label)Corticoïd

Surgery: too invasive technique If spot entirely healed, no relapsing

PRICKLY HEAT Commonly called heat rash or miliaria. It is

caused by obstruction to the sweat ducts. Skin care is the main treatment.

It is heat rash characterized by itchy red spots which develop on the chest ,under the armpits and between the thighs in the hot countries.

Basically caused by blocked sweat glands.

CONT… Occurs when sweat cannot freely evaporate

from the skin and sweat ducts become plugged.

This inflammation can cause a red rash. Can be prevented by wearing clothes that

allow sweat to evaporate as well as bathing regularly and drying the skin.

PREVENTION Drink plenty of cool water or electrolyte replacement

fluids even if not thirsty. (One small cup every 15-20 minutes)

Be able to recognize early signs & symptoms of heat-induced illness and take appropriate action to prevent serious heat disorders.

Spend as little time as possible in direct sunlight. Take frequent breaks in cool, shaded areas. Wear light, loose fitting, clothing. Avoid caffeine, which can make the body lose water.

WRINKLES Wrinkles are the lines and creases that form

in your skin. Some wrinkles can become deep crevices or furrows and may be especially noticeable around your eyes, mouth and neck.

CAUSES Age. As you get older, your skin naturally becomes less

elastic and more fragile. Decreased production of natural oils dries your skin and makes it appear more wrinkled.

Fat in the deeper layers of your skin diminishes. This causes loose, saggy skin and more-pronounced lines and crevices.

Exposure to ultraviolet (UV) light. Ultraviolet radiation, which speeds the natural aging process, is the primary cause of early wrinkling. Exposure to UV light breaks down your skin's connective tissue — collagen and elastin fibers, which lie in the deeper layer of skin (dermis).

Without the supportive connective tissue, your skin loses strength and flexibility. Skin then begins to sag and wrinkle prematurely.

CONT…. Smoking. Smoking can accelerate the normal aging

process of your skin, contributing to wrinkles. This may be due to changes in the blood supply to your skin.

Repeated facial expressions. Facial movements and expressions, such as squinting or smiling, lead to fine lines and wrinkles. Each time you use a facial muscle, a groove forms beneath the surface of the skin. And as skin ages, it loses its flexibility and is no longer able to spring back in place. These grooves then become permanent features on your face

TREATMENTS Topical retinoids. Derived from vitamin A,

retinoids — such as tretinoin (Renova, Retin-A) and tazarotene (Avage, Tazorac) — that you apply to your skin may reduce fine wrinkles, splotches and skin roughness.

Because retinoids can make your skin burn more easily, you'll need to use a broad-spectrum sunscreen and wear protective clothing daily. Retinoids may cause redness, dryness, itching, and a burning or tingling sensation

CONT… Nonprescription wrinkle creams. The

effectiveness of anti-wrinkle creams depends in part on the active ingredients. Retinol, antioxidants and some peptides may result in slight to modest improvements in wrinkles.

With nonprescription wrinkle creams, your results, if any, are limited and usually short-lived because these creams contain less of the active ingredients than do prescription creams.