TAKING CARE OF YOUR BODY

Your face is exposed and the very first thing people notice, so it generally receives a lot more attention than the rest of your body. And when the focus is shifted to your body, it is usually about losing weight and trying to cover up flaws, rather than celebrating it. But to feel good in your skin, you need to shower as much attention on your body as you do on your face - protecting and caring for the skin, which reacts and changes just as facial skin does.

It is also a good idea to listen to your body. Aching muscles, tiredness and stiff joints may be an indication that your body is run down and needs attention. A healthy diet and a fitness regime are essential to keep in shape, but caring for your body is just as much about keeping the skin smooth and glowing with energy.

Taking a brisk walk, treating yourself to a long bath or a massage, regular exfoliation, nourishing lotions, keeping an eye on posture, proper breathing and taking time to relax all have a direct impact on your body and its appearance. In this blog we look at how to keep the body's skin smooth, supple and healthy.

Detoxifying, firming body wraps relieve water retention, making the skin appear smoother. The effect lasts about 8-12 hours.

Body Basics

EXFOLIATION
Dry skin is simply the accumulation of dead skin cells. By removing them through exfoliation, skin looks smoother and more youthful; it also helps prevent ingrown hairs. You can either use an exfoliating scrub or a body brush, rubbing gently in a circular motion, towards the heart.

MOISTURIZING
The skin on your body is generally drier than the skin on your face, so daily moisturizing is essential. When choosing a product, remember that the heavier the consistency, the more moisturizing it is. If you suffer from spots on your chest or back, look for a body lotion that contains salicylic acid. Many lotions also contain AHAs, retinol, antioxidants and sunscreens, so you really can give your body the same attention as you do your face. Apply it immediately after bathing to seal in the moisture.

HAIR REMOVAL

Shaving, waxing or depilatories ... how you remove unwanted hair depends on personal preference - and your pain threshold.

Unwanted hair can be removed in a variety of ways depending on your time and pain threshold! And, various lotions can be applied after your method of hair removal to inhibit growth.

• Depilatories are creams and lotions that contain chemicals to dissolve hair. They can irritate the skin whose outer layer is made of keratin protein similar to that of hair. They are also very alkaline and so can disturb the skin's natural pH balance. Always do a patch test first, and never leave on longer than instructed.
• Shaving is quick and convenient in the bath or shower. First wash the area with warm water to avoid razor burn and soften hairs. For minimal irritation, change the blades regularly and use the fewest possible number of strokes. Shaving creams, gels and lotions provide a layer of protection by increasing lubrication so the blade glides smoothly. Most of them also contain soothing and moisturizing ingredients. If you do suffer skin sensitivity, do a patch test before using one of these products. Despite popular belief, shaving does not make the hair grow back thicker - it's merely the blunt edge as it grows out that makes it appear a little thicker.
• Waxing pulls the hair out from the root. Hairs grow back slower than with shaving and become finer with repeated use. For optimal results, hair needs to be quite long and the process can be painful. Like shaving, waxing can cause ingrown hairs, so exfoliate the area.
• Electrolysis, when it is performed properly, can permanently remove unwanted hair. Electrical impulses are directed into hair follicles where they shock the hair's root an inhibit growth. The procedure is time consuming and expensive because multiple treatments are required. It can also be quite painful, but an anaesthetic cream can be used to ease any discomfort. It is important to have it done by a professional as it can leave brown marks or scars if done incorrectly.
• Laser hair removal temporarily inactivates the hair follicle. Once the follicle is destroyed, it usually stops producing hair. As with electrolysis, more than one treatment is required and it is the most expensive procedure. A session leaves the area free of hair for four to six weeks. Eventually hair becomes finer or disappears altogether.

Why do ingrown hairs form?
An ingrown hair is a hair that has grown sideways, forcing the tip of the hair into the follicle wall. It can also occur if the hair is too weak to push through the follicle. Regular exfoliation will help reduce the occurrence, while a cream containing benzoyl peroxide, salicylic or glycolic acid can be dabbed on to clear it up.

All about Cellulite

Medium stiff brushes and loofahs are great exfoliants and are also ideal for improving circulation and drainage. Be gentle and stop using them if your skin is irritated.

Cellulite is the dimpling of the fatty tissue under the skin and anyone can have it, no matter how over or underweight you are. Some experts believe it is a result of genetic, circulatory and metabolic factors, and say there are ways to at least improve its appearance. Others say it is purely an accumulation of fat and no amount of body brushing or expensive potions will disperse it.

Another line of thinking is that it is a build-up of fat and toxins like lymphatic fluids, acidic waste and water, due to bad habits such as a sedentary lifestyle, poor diet, alcohol and smoking. This school of thought advocates massage or some other form of stimulation to flush out the nasty stuff.

The most accepted explanation is that cellulite is a woman's condition that is related to oestrogen, the female hormone, which kicks in at puberty and creates curves by enlarging the fat cells, especially on the hips and thighs. The appearance of cellulite is caused by the way a woman's fat cells are packaged underneath the skin: standing chambers of fat separated by fibrous membranes.

As we age, the connective tissue between these chambers thickens, causing a mattress-like effect. As the skin thins and fat deposits increase, so the 'mattress' is more exposed. Although it is difficult to get rid of cellulite completely, there are four types of treatments that have been shown varying degrees of success:

• Creams and lotions are being produced in the thousands, with all sorts of claims to reduce and remove cellulite. The ingredients in these creams, such as caffeine, avocado oil, seaweed and yeast extracts, may work temporarily to some extent, but they would need to be used continually for a permanent effect. A number of women report an improvement in cellulite using over-the-counter creams, but at the same time, many do not. Most of them do help to improve the texture and tone of the surface of the skin.
• Mechanical massage like Endermologie, a suction massage treatment, has been shown to minimize cellulite. It works by pulling the skin upwards into a set of rollers under a low-pressure vacuum. This is thought to stretch the vertical connective tissue fibres, resulting in a smoother appearance of the skin. Manual massages such as lymphatic drainage can also help.
• Diet, it seems, does not have a direct impact on the formation of cellulite, although crash dieting is a sure way to aggravate cellulite. Every time you restrict calories your body stores fat and reduces muscle and the less muscle you have, the worse your cellulite will be. When you start eating again, it is more likely your body will gain the weight back as inactive fat, rather than active muscle. A balance diet and six small meals a day is recommended for general health benefits. Eat the smallest meal in the evening when your metabolism and ability to burn calories is at its lowest. Minimize intake of fatty and refined foods, sugar, dairy, alcohol, caffeine and red meat.
• Exercise can also play a role in reducing the appearance of cellulite as it improves your circulation, which in turn burns fat and helps strengthen the connective tissue structure under the skin. The effects of exercise, however, will vary from person to person.

Dry body brushing is one of the cheapest and most effective methods of stimulating circulation, which is essential for normal body functioning. If your circulation is impaired, insufficient oxygen and nutrients are delivered to the cells, toxins are not removed efficiently and lymph fluid is not drained correctly. All this encourages fat and toxin build-up. When body brushing, brush firmly towards the heart, but be careful if you have any problem skin conditions.

Why don't men get cellulite?
There are a few reasons why women are the unlucky recipients of the orange peel effect. Firstly, the basis of cellulite is believed to be the female hormone, oestrogen. Secondly, fat is distributed differently in men and women. In women, it is stored mainly in the buttocks and thighs - where cellulite is generally located - and in men in the belly. Thirdly, men and women's fat sacs are packed differently in the skin.

A woman's fat cells are standing chambers with the connective 'ropes' pointing up towards the surface, thus creating the dimple-like effect. Men's fat sacs, on the other hand, lie horizontally. The connective tissue is also horizontal and therefore does not show on the surface.

Vein removal
Spider veins are small, dilated blood vessels that appear red or blue under the skin. Until recently, most spider leg veins were treated with sclerotherapy, which involves injecting a solution directly into the vein, causing it to close up and disappear within a few weeks. Though a successful treatment, side effects include skin ulceration, the formation of very fine blood vessels that appear as pink patches, brown staining of the skin, and rarely, blood clots or allergies to the solution.

Laser technology now allows dermatologists to zap these veins with good results. Several sessions of 10 to 15 minutes each at one to two month intervals are needed in order for the damaged blood vessels to be cleared away by the body's immune system.

Varicose veins are much thicker than spider veins and have a purplish tinge. They usually occur on the legs and are caused by a malfunction of the vein's valves, which can be stretched during pregnancy, or as a result of obesity, blood clots or even a genetic defect. If the valve cannot close normally, the blood flows backwards and pools in the vein.

There are various ways of treating varicose veins. A saline solution can be injected to restrict expansion of the vein, the vein can be closed at the valve or, in severe cases, the vein can be removed completely. New procedures include include a laser fibre that is inserted like a catheter directly into the damaged vein; the laser energy heats and seals the vein from within. Another treatment option uses radio frequency technology to destroy the vein by heating it from within.

If you have a tendency to develop leg veins, avoid sanding for long periods, wear support hose for varicose veins and exercise regularly. Exercise tones the calf muscles which help propel the blood back to the heart, thus avoiding pooling in the lower legs.

Stretch marks

Vitamin E is a perennial skincare favourite and many swear by its healing properties, particularly with regards to preventing and treating stretch marks.

If skin is seriously overstretched, such as when the body grows faster than the skin can handle (during pregnancy, sudden weight gain, quick muscle-building), collagen fibres in the middle layer can rupture and deep scars can be seen through the epidermis. These are commonly known as stretch marks. While they do face with time. there is little you can do to get rid of them altogether.

Microdermabrasion, laser resurfacing and intense pulsed light treatments may help. Generally, the longer you have had them, the less chance there is of reducing them. Some people swear by vitamin E. It is a good idea to apply vitamin E throughout a pregnancy or if you are trying to lose weight, as it helps keep the skin supple and may therefore help reduce the incidence of stretch marks. Fake tan can help disguise them.

Straighten Up
No matter what your shape or size, standing up straight will make you look and feel better. In fact, you can look as though you have lost five pounds simply by standing and walking correctly.

Not only does a good posture help to make you look stronger, taller and more graceful, it is also very good for your health as it lessens the chances of back and neck problems, weak stomach muscles, tiredness and poor circulation. To determine if your posture is good, stand as you usually do, with your heels against a wall. Your calves, buttocks, shoulders and the back of your head should touch the wall and you should just be able to slip your hand between the small of your back and the wall.

If, after doing this little test, you decide that your posture is not what it should be, then here's what you can do to improve it:

• When you are sitting, pull your navel in towards your spine and stretch the torso so it is upright.
• When standing for long periods of time, remember to check that your abdominal muscles are pulled in tight towards your spine, your hips are tilted slightly forward and your knees are relaxed.
• Exercise is a good way to improve your posture. Make sure you are doing exercises correctly, especially if it involves equipment at a gym.
• If you spend a lot of time sitting at a desk, find a chair that supports your lower back and keep your feet flat on the floor.
• To strengthen your back , squeeze your shoulder blades together and hold for 10 seconds. Repeat 10 times. Do this regularly throughout the day.

Good (A) versus Bad (B).
Not only is a sloppy posture unattractive, it also restricts your circulation and limits your breathing.








Bath Time

A relaxing bath can be a real treat for face and body. To get the most out of it, try these tips:

• The heat of a bath helps to open pores and relieve congestion. If you suffer from spider veins, broken capillaries or flush easily, avoid very hot baths and Jacuzzis.
• Add a few drops of essential oil to the water. You can choose the oil according to the effect you would like to create; relaxing, soothing or invigorating. Focus on the smell of the oil and enjoy it.
• Climb into the bath and take a few moments to unwind. Start by relaxing your neck muscles, then your shoulders, arms, chest, back, tummy, hips, thighs, knees and finally, your feet.
• As you relax, concentrate on your breathing. Inhale deeply through your nose to a count of four, letting the air fill your chest an work its way down into your abdomen. Hold for a count of eight and then exhale slowly through your mouth. Repeat a few times.
• Once you have soaked (keep it to 15 minutes - more than that and your skin will become puffy), wash by rubbing with long, smooth strokes towards the heart.
• When you get out of the water, dry yourself and apply a generous dollop of moisturizing lotion. Alternatively, apply essential oils while the skin is still damp, this will help to seal in moisture.

AGE REFINING TECHNOLOGY

As we age, our faces begin to show the effects of gravity, sun exposed and years of facial muscle movement. Despite the slew of products and advanced technology available today, there is only so much we can do to curb this. Dramatic results can be achieved with face-lifts and reshaping, but there are less-invasive rejuvenating techniques like freezing, filling and polishing. While one needs to accept the inevitable changes tat come with age, there is no reason why one should not make use of the sophisticated cosmetic procedures and techniques available.

There are so many options, however, that you will need to do some homework. All surgery carries some risk and even less-invasive techniques can have side-effects. Use reputable, certified professionals. Get recommendations or contact the dermatological or plastic surgeons association in your country. Know what can and cannot be improved and allow for recovery time. There are quick procedures such as 'lunch-time peels', while other treatments leave your skin red and inflamed for a few days and will require some time off.

Though surgery can have dramatic results, remember that beauty really does start within. Look after what you have and celebrate your uniqueness.

Whatever method you choose to rejuvenate your face, you should aim to create natural-looking results. Always consult a registered dermatologist or plastic surgeon, and be realistic about what the procedures can and cannot achieve.

There are three types of wrinkles. Static wrinkles are with you all the time, even when your face is at rest. Dynamic wrinkles are created by your facial expressions, and folds are lines that develop when the skin folds are lines that develop when the skin loses its youthful elasticity and begins to sag. Examples of the latter include droopy eyebrows, bags below the eyes, jowls and nasolabial folds (between the corners of your mouth and the sides of the nose). Various non-invasive techniques can help to improve these and they can be used in conjunction with surgery.

Botox injections have become a popular lunch-time fix; other than the possibility of some redness and very slight swelling at the site, patients can immediately resume their activities.

FREEZERS
Botox has become the treatment of choice to get rid of expression lines - those that form when you frown, smile or laugh. Botox is a neurotoxin produced from the botulinum bacteria. When injected into a muscle, it acts as a nerve impulse blocker, temporarily paralyzing the muscles and so keeping them from contracting.

Because it 'freezes' the expression muscles, your ability to move the muscle temporarily disappears along with the wrinkles. Botox is most effective on frown lines, forehead lines and crow's feet (on the outer corners of the eyes). The procedure is painless - just a needle prick, but a topical anaesthetic cream can be used if the client prefers or if multiple sites are planned.

The procedure takes about 10 minutes and the effect takes about four days to a week to kick in. It lasts from three to six months and must be repeated to maintain results. Injections can cause redness and swelling at the injection site and it's advisable not to do anything too strenuous on the day of treatment; nonetheless you can go about your business almost immediately. In rare cases, Botox injections too close to the eyelid muscles can cause the eye area to droop temporarily.

FILLERS
Soft-fillers are injected into the skin to fill lines and wrinkles and build or plump up areas like the lips and cheeks. There are temporary and permanent fillers, as well as exogenous (foreign substances such as collagen) and autologous (one's own tissue or fat) implants. The fat-injection procedure involves extracting fat cells from the patient's abdomen, thighs, buttocks or elsewhere, and re-injecting them beneath the facial skin. This method is usually used to fill in cheeks and lips or to fill laugh lines between the nose and mouth or on the forehead. As the fat is taken from the person's own body, there is no reaction because the immune system immediately recognizes the tissue.

The disadvantages of foreign collagen implants (extracted from cow skin or human cadaver) are that they only last for two or six months, and that skin testing is required in order to avoid possible allergic reactions.

The more popular temporary filling method is with hyaluronic acid (such as Restylane, Hylaform, Perlane). Hyaluronic acid is a substance that occurs naturally in the skin, so allergic reactions are rare. Injected into the skin in tiny amounts with a very thin needle, the gel adds natural volume under the wrinkle. The product is biodegradable and so will gradually be absorbed. As the gel breaks down, water takes its place and when it is totally absorbed, the gel disappears unnoticed from the body. The procedure takes up to half an hour.

After the treatment you could experience some swelling, tenderness and redness, but these symptoms will disappear in two to four days. How long the effect lasts depends on the individual, but it is generally effective for up to six months after lip augmentation, and up to 12 months after facial contouring.

Invasive rejuvenation treatments can tax the body. Regard them as you would minor surgery and allow your system enough time to recuperate.

Other filler materials being used include Fibril, a gelatin powder compound that's mixed with the patient's own blood and is injected to plump up the skin; GORE-TEX®, a thread like material that is implanted beneath the skin to add soft-tissue support; and Zyderm (a bovine collagen) and Zyplast (a cross-linked form of collagen), which are used to improve the appearance of wrinkles, scars and to add volume to the lips. Injectable fillers are not permanent and the body will eventually process the injected material. How long it lasts differs from person to person.



All invasive skincare procedures carry same risk. It is vital to consult a registered skincare professional and ensure you are getting the right treatment for your particular concern.



MICRODERMABRASION
Often referred to as the 'lunch time peel', microdermabrasion is a skin polishing technique that uses microparticles to abrade and rub off the top skin layer, removing the particles of dead skin to give i t a smoother appearance. The operator uses a handheld device that blasts fine particles of sand-like crystals (aluminium oxide or table salt) against the skin and vacuums away the used crystals, dirt and dead surface skin. It takes only 20 to 30 minutes for a full-face treatment and can also be used on the neck and chest.

There may be mild redness, which can be covered up with make-up and fades after a couple of hours. This procedure is not painful (there may be a slight tingling) and won't lighten or darken black skin as some strong exfoliating treatments do. It is recommended for smoothing away roughness, fine lines, sun-damaged or pigmented skin, age spots, scarring from acne, accidents or previous surgery, and even precancerous growths. Microdermabrasion exfoliates skin faster and more efficiently than any salon facial and penetrates the skin more deeply than a glycolic acid peel. It is not recommended as a treatment for crow's feet because, if used too close to the eyes, the crystals can cause eye irritation and the delicate eyelid skin can be damaged by the machine's suction.


INTENSE PULSED LIGHT THERAPY (IPL)
A fairly new, convenient and thus increasingly popular alternative to laser skin resurfacing and chemical peeling is the use of intense pulsed light. With this type of therapy, an intensive light source is directed towards the surface of the skin. It spreads in all directions and there is no danger of burning or scarring as there is with regular laser.

This therapy is particularly effective for rejuvenating the skin, not just superficially but in the deeper levels, too. The light pulses are adjustable in wavelength and duration so that a variety of tasks can be performed and objectives achieved.

Intense pulsed light therapy helps to improve redness (it's particularly effective in the treatment of rosacea); reduce broken capillaries, brown spots, UV damage, fine wrinkles and large pores. It can even out skin tone and firm the skin. One of its biggest advantages is that there is no down time. Each treatment takes approximately 20 minutes and patients can return to their daily activities immediately afterwards. There is also minimal discomfort - no anaesthesia or topical anaesthetic cream is needed.

This, coupled with an absence of scars and ease of treatments, makes an attractive number of advantages over laser skin resurfacing, chemical peeling, or microdermabrasion. Aftercare is customized to each patient's individual skin sensitivity. This rejuvenation technology is certainly cutting edge and very exciting. As with all of these procedures, it must only be administered by a skilled and qualified professional and a series of treatment is recommended to get the best possible results.

Age, gravity, sun exposure, smoking and stress changes the way a face looks. Creases form and it begins to lose its youthful definition.

CHEMICAL SKIN PEELS
These peels use a chemical solution to smooth the texture of the skin by removing the damaged outer layers. There are various kinds available. Alpha hydroxy acids are usually the mildest of the formulas. They can be used to remove the top layer of skin to treat fine lines, even out skin tone and uneven pigmentation and smooth acne scars. They also stimulate cell metabolism, increasing the skin's natural functions. The process takes about 10 minutes. The cons: it can irritate the skin, and you have to undergo a series of treatments to reap the benefits.

Trichloroacetic acid (TCA) is most commonly used for medium-depth peeling to smooth out fine surface wrinkles, blemishes and uneven pigmentation problems. The treatment takes 10 to 15 minutes and can be used on the neck and body. Although healing is quicker than a phenol peel, the results are usually less dramatic and not as long lasting. Repeated treatments may be needed to maintain results.

Phenol is the strongest of the chemical solutions and is used mainly to treat patients with deep wrinkles, sun-damaged skin or precancerous growths on the face. It is more suitable for fair skins as there is a high risk of loss of pigment. A full-face treatment may take an hour or more.

Recovery is slow, complete healing sometimes taking several months. Although the results are dramatic and can last for decades, your skin will never tan again and extreme caution must be taken in the sun.

LASER RESURFACING
Laser facial resurfacing (laser peeling) can be used to smooth skin at almost any age. The top layer of skin is peeled away while the collagen underneath is thickened and reformed. When your skin heals, it looks brighter and plumper. Laser works well on sun-damaged skin, brown spots, fine lines and veins. It does not improve sagging and so is often recommended in conjunction with a face-lift. Laser resurfacing works by directing an intense beam of laser light back and forth over the area being treated. Each pass of the light vaporizes the upper layers of damaged skin and causes the skin to contract. This result in tightening of the collagen and elastic fibres of the dermis, producing a new skin layer that is tighter, firmer and more youthful looking. There are many types of lasers: CO2 and erbium are among the more popular ones. The CO2 is the most aggressive (and effective) treatment for skin that is severely aged or scarred. It is essentially a powerful beam of light that vaporizes the top layers of the skin on contact, prompting it to rebuild itself from the bottom up. It can take from 10 minutes to more than an hour, and must always be performed by a qualified surgeon.

Recovery takes about 10 days, during which time the skin is very swollen, raw and oozing. Crusts form that will eventually fall off. There will be pain, similar to that of severe sunburn, for a few days. Because of the risk of hyperpigmentation, this type of laser treatment is not recommended for darker skin.

The erbium also vaporizes the outer layers of skin, but it resurfaces with less heat, so healing takes place in about a week, with most redness fading within 7-14 days. This type of laser is good for wrinkles, acne scars, sun damage, and irregular pigmentation, but not quite effective as the CO2. It is, however, much gentler, has fewer side effects, requires a shorter recovery period and can be used on dark skins.

IS SURGERY FOR YOU?
There is no doubt that a face-lift or liposculpture can make an enormous difference not only to a person's face, but also to their self-esteem. If you choose plastic surgery, then follow this advice:

• Be sure of your decision.
• Go to a qualified and reputable surgeon with whom you feel comfortable.
• Be realistic in your expectations. Resurfacing and Botox will improve the overall appearance of your skin's quality; surgery deals with skin quantity and can be used to elevate and reshape sagging contours.
• Get clear answers to all your questions.
• Be aware of the risks associated with surgery.
• Know the full cost and be aware of all the implications before you commit.
• Look after your face and body prior to surgery and follow all post-operative instructions.

PROBLEM SKIN

Most of us are born with perfect skin. While a lucky few manage to maintain a clear complexion over the years, most of the rest have experienced a few unwanted changes. For some it may be small irritations such as breakouts, dark patches after a pregnancy or enlarged pores. For others, it may be a more severe skin condition, like eczema or acne. Everyone experiences marks and blemishes on their skin at some point.

Some are permanent, others tend to come and go. Most will be of no importance , while some may require a professional opinion. While you can never regain the skin you were born with, there are many things you can do to improve your lot and treat a problem. The key is getting to know and understand your skin, so that you are able to identify what needs to be done. Make a habit of checking your skin regularly. If you tend to problem skin, be aware of your diet and lifestyle choices - they may well be the underlying cause. Also realize and accept that your skin is constantly changing and that you may need to adapt your skincare routine accordingly.

Histamines are chemicals in your body's tissues. When released, they cause an allergic reaction, which is your body's way of trying to expel a perceived invader.

CROSS SECTION OF A BLACKHEAD









If left alone, blackheads will simply stay in the skin. Remove them by gently steaming the area and then 'easing' the plug out.


All about acne
Age is not a sure guarantee against pimples or acne. In fact, many people only experience acne for the first time in their adult years; recent studies show that 40-50% of adults between the ages of 20-40 are diagnosed with low-grade persistent acne.

The exact cause of acne cannot be pinpointed. A number of factors seem to have an effect, including genetics, hormones, physiology, stress and the use of certain cosmetics. This type of acne ranges from a few isolated spots to severe breakouts, which can leave unsightly scars. Acne results when the sebaceous (oil) glands secrete too mush sebum into the hair follicle, which is lined with dead cells. The combination of excess sebum and dead cells clog up the pores, which are the pipelines for the natural flow of oil to the skin's surface. As a result bacteria build up, the area becomes inflamed, and spots or pimples may appear.

Acne most commonly occurs where the sebaceous glands are most active - on the face, neck, chest and back. A variety of blemishes result:

• Whiteheads form when oil and dead cells accumulate and block the pores from opening onto the surface of the skin.
• Blackheads are similar to whiteheads, except the blocked material protrudes above the skin, dilating the pore. The black colour is due to the oxidization process that occurs within the follicle.
• Papules are inflammations under the skin. When the sebum build-up becomes too much, the follicle expands and eventually bursts, releasing the sebum and dead cell build-up onto the surface of the skin. White blood cells then attack this material, forming pus, and a pustule results.
• Cysts occur when inflammation spreads deep into the skin. To contain it, the cells automatically form a fibrous capsule around it. Cysts can continue to grow slowly under the skin and usually need to be surgically removed.
• Scars result when damaged sin tries to heal itself. Naturally, scars can be severely aggravated by picking or squeezing.

Do not be tempted to remove skin impurities such as blackheads by harsh squeezing or without preparing your skin first.

FACT OR FICTION?
Chocolate and fatty foods cause acne. There is no scientific evidence to indicate that diet plays a determining role. The 'westernized' diet is high in preservatives, colourants and processed foods and supports the most acne-prone populations. The Asian and Mediterranean populations, however, generally eat more fatty acids and far less processed foods. Although acne is less common in these areas, the role of genetic factors is unclear.

Acne is due to poor hygiene. The blackheads we see are a result of an oxidization process that turn the sebum and dead cells black in colour. It is not dirt. In fact, over-cleansing can aggravate acne.

Sunlight improves acne. The sun can seem to improve the complexion, but it also suppresses the immune system. That is why acne often seems to get worse a few weeks after sun exposure. The sun also stimulates sebum secretion. It is more advisable to wear an oil-free sunscreen.




Although more common in teenagers than any other age group, acne can occur at any time in life. The causes are still not completely understood.


WHAT CAUSES ACNE?
Hormones
Throughout your life, hormones will play a very important role in determining the ups and downs of your skin. Oestrogen is an important skin regulator, and an excess of male hormones can cause acne. Men and women both produce male hormones (androgen and testosterone) and female hormones (oestrogen and progesterone) - only the ratio of these hormones differ between the sexes. When the levels of androgen increase - during puberty, ovulation, menstruation and childbirth, for example - the skin produces more oil and acne can result.

Diet
There is not enough evidence to suggest that acne and diet are related, but some people find that certain foods make their acne worse. Common culprits include chocolate, caffeine, nuts, high-fat and spicy foods, citrus fruits, refined foods, dairy products, and foods with a high iodide content, such as artichokes, seaweed, spinach and shellfish. Certain medications can also cause a flare-up.

Stress
Stress triggers the adrenal glands to release the hormone cortisol, which increases the secretion of sebum. Stress inducers include skimping on sleep, skipping meals and ingesting too much caffeine. All these factors trigger the adrenaline in your body to mobilize stored nutrients, which in turn slows down natural exfoliation processes. The remedy? Get enough sleep, follow a balanced diet, drink plenty of water, and cut down on caffeine and high-fat foods. In severe cases or if there is no change, consult a skincare professional.

Did you know?
Skin that is irritated by a cleanser or moisturizer reacts by forming a protective layer by adhering more skin cells onto the surface.

TREATING ACNE-PRONE SKIN
The best way to treat acne is by preventing new spots while treating existing ones. It can often be treated effectively with nonprescription, over-the-counter products.

• A regular purifying and cleansing routine will help remove excess sebum on the skin's surface, a breeding ground for bacteria. Try using a daily gentle antibacterial wash to help cleanse bacteria from the skin, combined with a beta hydroxy acid such as salicylic acid, which stimulates the skin's natural exfoliation process. As dead cells become 'unstuck', there is less chance of clogged pores. Salicylic acid also helps to curb an oily shine.
• Even oily skin needs daily moisture. If your skin is very oily, choose a lightweight lotion to replace moisture without adding oil. Make sure the product you buy is oil-free or noncomedogenic, which means it won't block pores. If you wear make-up, look out for foundations that 'mattify' or control oil, as they will help eliminate shine.
• Remember that fingers dipped into shared products increase the risk of contamination. If possible, opt for products that are specially sealed or have pump dispensers.
• Benzoyl peroxide is a fast-zapping, nonprescription ingredient that is particularly effective at speeding up the drying up and peeling of spots. It is available in varying strengths and should be introduced at low concentrations as it can be very drying and may cause allergies.
• If your acne does not respond to nonprescription remedies (give it at least six weeks), it is best to go for a medical diagnosis with a dermatologist who can prescribe a stronger formulation. Antibiotics can be taken orally (erythromycin and tetracycline are commonly used) or applied topically. The two other proven acne treatments are Retin-A and Roaccutane. Retin-A is an imitation of retinoic acid, the naturally occurring form of vitamin A found in the skin. Its main action is keratolytic, which means it acts as a peeling agent that loosens dead surface cells. Retin-A is a very powerful drug that only needs to be applied to the acne areas in very small doses. The problem is that retinoic acid can be irritating and drying, and causes increased sensitivity to the sun and any other products applied to the skin. Retinoid isotretinoin (Roacccutane) is a synthetic version of vitamin A that is taken orally once or twice a day for four months. It is extremely effective, but the side effects include dryness and increased skin sensitivity. Very strict birth control need to be practised while taking Roaccutane as it can cause major birth defects.

Medication is reserved for more persistent cases of acne and should always be taken under supervision.

Common Problems
ROSACEA
Rosacea is often referred to as 'acne rosacea' but is not the same as acne. Characterized by red and inflamed skin, particularly on the cheeks, nose, forehead and chin, it may begin as a tendency to blush or flush easily and progresses to persistent redness. Small blood vessels and tiny pimples may also occur. It is most common in women between the ages of 30 and 50 and some cases have been associated with menopause. The exact cause in unknown, although it is believed to be due to a disorder of the blood vessels, which become oversensitive to stimulation.

Heat and sunlight may aggravate it as they stimulate the release of chemicals that encourage the blood vessels to enlarge. Rosacea is not caused by excessive alcohol, but can be aggravated by it as alcohol causes the blood vessels to dilate. Severe cases are sometimes accompanied by burning of the eyes. Treatment includes oral and topical antibiotics, good sun protection practices and avoiding extreme temperatures and spicy food.

Cortisone creams may reduce the redness of rosacea, however, they must only be used under the supervision of a dermatologist and for no longer than two weeks at a time as they can thin the skin. Red wine, oranges and caffeine may also aggravate rosacea, as do scrubbing or rubbing the face and irritating facial products. It can become worse without treatment.








Eczema generally causes dry and itchy patches of skin.






ECZEMA
Eczema, also called dermatitis, describes a family of itchy, red skin conditions. Atopic eczema is an illness (usually an allergy) that runs in the family. It is the most common form of eczema and is characterized by chronic dryness, redness, chapping and itching. It usually appears firs during childhood and most patients recover before the age of 25, although some live with it their entire lives. It generally runs in families who also suffer from other allergies such as hay fever and asthma. In teens and young adults, the spots usually break out where the elbow bends, on the backs of the knees, ankles, wrists and on the face, neck and upper chest.

It is important not to scratch as this can lead to infection. Atopic eczema can be partly relieved by avoiding irritants like feathers and wool blankets; dogs, birds and cats; harsh detergents; and certain foods such as wheat, dairy and chocolate. Stress can also exacerbate the condition. Some over-the-counter products can relieve the itching, while topical steroid creams help soothe and calm the skin. It is best to consult a dermatologist for the correct diagnosis and treatment.


If, unlike this woman, you suffer from atopic dermatitis, you should wash newly bought clothes before wearing them and keep your pets outdoors. Children should avoid fuzzy toys and blankets.

PSORIASIS
This chronic skin disease is caused by an overproduction of cells in the epidermis and ineffective desquamation (shedding of these cells), the combination of which causes cells to accumulate and form red, scaly patches, especially around the elbows, knees, and scalp. Psoriasis tends to run in families and is not contagious. Mild or average cases can be treated with a prescription cream or lotion. If it is severe, your dermatologist may prescribe medication or light therapy. Although psoriasis can be contained, it is unlikely to be permanently cured.

DID YOU KNOW?
Viruses that sit on the skin's surface and penetrate the stratum corneum when it is damaged cause warts. They can be passed from person to person and are most common on the fingers and feet.

VITILIGO
This skin disease manifests as white patches on the surface of the skin. The patches are due to a loss of pigment, but dermatologists are not entirely sure what causes this. Vitiligo usually appears on the face, lips, hands, arms, legs and genital areas, but can appear anywhere on the body. The amount of colour a person loses varies: people with a light-coloured skin usually see the difference between patches of vitiligo and tanned skin in summer. For people with darker skin, vitiligo is quite visible all year round.

The most common way to treat it is with light therapy and medicine. It is also possible to hide the marks by using special cosmetic camouflage products. Very often, such products are also water-resistant.

PIGMENTATION
Unbalanced pigmentation is very common and may be a result of years of sun-worshipping or skin trauma. As discussed previously, the skin has pigment-producing cells called melanocytes that determine skin tone. Dark skins have larger melanin granules, which means more in-built protection, and so are more resistant to sun damage. Fairer skins have less melanin and thus are more likely to develop brown patches from sun exposure. However, skin with more melanin tends to have more hyperpigmentation related to scarring.

While pigmentation can largely be avoided by staying out of the sun, many women experience hyperpigmentation during pregnancy due to hormone activity, even if they avoid the sun. Chloasma or the 'mask of pregnancy' consists of brown patches that appear on the forehead, cheeks and above the lip.

A variety of topical treatments is available that can lighten blemishes, and chemical skin peels, microdermabrasion and laser resurfacing will brighten the skin

Pregnancy causes severe hormonal changes in a woman's body that may also affect her skin.

HORMONES AND SKIN
When a woman is pregnant, the additional hormones can cause many changes in the skin. While a beautiful rosy glow is associated with the first trimester an is a result of an abundant supply of oxygen, various sensitivities are likely to appear due to increased hormone activity. Conditions such as rashes, dryness, acne and allergies to your normal skincare products are common.

It is important to be extra conscientious with sun protection during pregnancy, as hormonal changes make the skin more susceptible to pigmentation damage. Vitamin supplements are also very important for the maintenance of your skin during this time: vitamin E and zinc have been shown to help reduce stretch marks, and vitamin C aids in collagen production. Always consult your doctor before taking any tablets during pregnancy and while breastfeeding.

Oral contraceptives have similar effects, leading to many of the same skin problems. Although different from person to person, many women on oral contraceptives are more sensitive to sunlight and can develop uneven skin tone and hyperpigmentation if they do not protect themselves adequately. Oral contraceptives can also lead to increased oil production or dehydration.

PHYSICAL AND CHEMICAL SUNSCREENS

Sunscreen formulations rely on physical or chemical agents to provide protection. Physical sunscreens contain inert mineral particles that reflect or block UV rays (Think of the white zinc dioxide layer that the cricketers use). The molecules cannot break down or be absorbed by the skin and are therefore less likely to irritate the skin. This type of sunscreen is generally better for sensitive skin types.

Physical sunscreens of the past tended to be thick, white and greasy, but modern preparations contain ultrafine titanium dioxide crystals that do not leave that white residue and actually help to absorb oil. Chemical sunscreens, on the other hand, contain synthetic chemical substances that absorb UV radiation. Some o the ingredients can be absorbed through the skin, so these sunscreens may cause irritation. PABA (paraaminobenzoic acid) is one of the most common sensitivity triggers in chemical sunscreens. When choosing a sunscreen, look for ingredients like titanium dioxide or Parsol 1789 (also known as avobenzone; the most effective ingredient for absorbing UVA) and do a patch test to check for sensitivity.

Make sure any product you choose offers UVA and UVB protection. It is also essential that your sunscreen contains antioxidants such as vitamin E, flavonoids, and ascorbic acid to neutralize free radical damage and trigger the repair process. Always choose a product that suits your skin type. For example, gel is best for oily skin, and creams and lotions are most suitable for dry skin.





Low levels of melanin make light skin much more susceptible to photo ageing. Yet black skin, which has quite a high-melanin content, is not immune to sunburn.



Sunburn and sunbeds can add 20 years to your face.


FAUX GLOWS
What we are hearing from dermatologists is that the only safe tan is one that comes in a tube. The good news is that this is the golden age for bottled tans; the modern formulas can give a natural looking glow without the orange streaks and bad smells of past formulations. Self tans us DHA (dihydroxyacetone), colourless sugar that reacts with dead skin cells to create a tanned effect. The reaction is not immediate; it usually takes three to four hours for the colour to develop fully. As your skin constantly renews itself, fake tans only last five to seven days. It is very important to remember that fake tans do not provide any sun protection, so you till need to apply a sunscreen.

WHAT ABOUT SUNBEDS?
If you are all concerned about your skin, you should never lie on a sunbed. The ultraviolet light used by indoor training systems is as dangerous as that of the sun and although they usually filter out the burning UVB rays, they let the UVA rays in even deeper. Sunbeds are, in essence, automatic ageing machines and increase your risk of melanoma.

If you burn in the sun, you can partially alleviate the unpleasant sting by applying cool compresses or adding oatmeal to a lukewarm bath. Creams containing menthol can be very soothing too.

Primary damage is done to your skin while you are in the sun. However, there is a secondary burst of free radical damage for another 24 hours after exposure. To counter this damage, you must get enough antioxidants and make repair part of your skincare routine.

SHOULD I APPLY A DAILY SUNSCREEN?
Yes! Eighty percent of all sun exposure is incidental - in other words, walking, driving to work (the side of your face closest to the window will exhibit more signs of premature ageing), or taking a break outdoors. In fact, sitting outside at noon for your lunch hour is worse than being on the beach between 9-11:00 or 14:00-17:00. For this reason, it is generally accepted that everyone should be using some sort of daily sun protection.

This is especially important if you are at risk for skin cancer or are on antibiotics, antimalarials, Retin-A, Roaccutane, antidepressants, or some hormone replacement therapies, as they can all increase photosensitivity. So, even when it is overcast, be sure to apply a sunscreen every morning. If you have sensitive skin, rather use a lower SPF and be careful to avoid the sun.




There is no doubt that sunshine makes us feel good. It is essential, however, to learn how to enjoy it without putting your skin at risk.

WHY VITAMIN A IS SO VITAL?
Vitamin A supports the natural health of the skin. Melanocytes, keratinocytes, fibroblasts and Langerhans cells all depend on vitamin A, and a deficiency will also result in a depletion of vitamin C. Although vitamin A protects the skin from the sun, UVA destroys it. If you send the weekend tanning next to the swimming pool, for example, the levels of vitamin A in your skin will be depleted and it will take about seven days to restore those levels. Ten minutes in the sun will cause the vitamin A level in the skin t o drop to about 10%. To maintain a high enough level of vitamin A in the skin to protect it, it is essential to apply vitamin A topically. and to supply the skin with antioxidants that protect your vitamin stores from attack by free radicals.

AND NOW FOR THE GOOD NEWS....
Although for many people the rate of damage is higher than the skin's inherent ability to repair itself, there is a lot of potential for self-repair. The key is to start taking the proper precautions now, if you have not being doing so already. Always protect yourself from the sun. By simply applying a daily sunscreen, you are giving your skin a chance to 'rest' and conserve some of the energy it would otherwise expend on protection during the day. As these energy reserves grow, your skin has a better chance of carrying out the crucial roles of repairing and rebuilding itself; ensuring long term healthy functioning.










Always remember: how you look after your skin as a child (parents, take note!) will determine your appearance 20 years down the line.

How do I know if I am at risk for skin cancer?
Every person runs some risk of developing skin cancer; a lighter skin tone and unprotected sun exposure increase that risk. It is crucial to protect young skin because a severe burn before the age of 18 almost doubles the risk of skin cancer and premature ageing. After years of sun exposure, basal cell carcinoma are the most common types of skin cancer and often appear on exposed areas of the skin. Melanomas are the most widely known type of skin cancer and the deadliest. Remember the ABCD of warning sings for changes in a mole, which may indicate melanoma:

A is for asymmetry: has its shape changed?
B is for border: have the edges increased or become irregular?
C is for colour: has the mole darkened or is the colour not uniform?
D is for diameter: has it become larger than 6mm (¼in)?
Speak to a dermatologist immediately if you answer yes to any of the above questions, or if you are concerned by any suddenly appearing skin lesion. Early detection can make all the difference between successful removal and long-term illness.

PREMATURE AGING

Despite all warnings to the contrary, come summer, the beaches are packed as we bare our bodies to get a tan. While a small amount of early-morning sun is good for you (15 minutes is sufficient to provide you with natural vitamin D, and occasional exposure is believed to improve psychological wellbeing), too much sun is dangerous. Besides the fact that sun dramatically ages your skin, it is also the cause of several kinds of skin cancer, including solar keratoses (wart-like growths) and malignant melanoma - and just one bout of harsh sunburn may be all it takes. Photo ageing - which can make up to around 85% of the overall appearance of ageing - is a slow process and only becomes visible after a few decades. And then it is too late to do anything about it.

Unfortunately, although people are now waking up to the dangers of overexposure and the horrors of skin cancer, only about half of the world's population takes adequate precautions to protect themselves from the sun. Sun safety should be a vital part of your life and one that you must instill in your children from an early age.

Wrinkles and other sun-related signs of premature ageing begin to form up to 10 years before they actually appear.

Your best ally against premature ageing is the daily use of a good sunscreen. The higher the SPF (Sun Protection Factor), the oilier the cream generally is. So if you are prone to breakouts stick to SPF 15 or lower or try a gel formula.


Photo ageing, a result of sun exposure. is a slow process. It may take several decades before it becomes fully noticeable. In fact, 90% of sun damage occurs by the age of 20, only becoming visible in your early thirties and onwards. The degree of photo ageing is mainly determined by your skin type and total lifetime sun exposure, and the degree of damage to different areas of the body is directly proportional to the amount of sunlight received (your hands and neckline for example, are more likely to have sun damage and age spots than your stomach).

Seriously sun-damaged skin has a thickened outer layer, making it feel day, rough and leathery. There are often darkly pigmented areas or whitish spots where levels of pigment are higher or lower than normal. Pores may be dilated and small blood vessels become more obvious, sometimes forming broken or spider-like veins, and the skin may be mottled red or inflamed. Within the dermis, the elastic fibres increase in quantity and thickness, manifesting as deep, fixed wrinkles and less pliable skin.

THE SCIENCE OF SUNBURN
The sun energy that reaches the Earth can be divided into three kinds of light: infrared and visible light, and ultraviolet radiation (UVR). UVR, in turn, consists of three different wavelengths: ultraviolet A, B and C.

• Ultraviolet C is the shortest wavelength and potentially the most damaging. DNA and proteins absorb UVC due to their molecular structure. Fortunately for us, UVC is mostly absorbed in the atmosphere by ozone layer. However, the current 'thinning' of this layer has increased the amounts that reach our planet, especially in the Southern Hemisphere.
• UVB is the most potent wavelength as it can penetrate into the epidermis where it affects the DNA and can create lipid peroxides, precursors of free radicals. It is believed to generate most of the photo damage to skin. UVB is the wavelength responsible for sunburn, and is at its most dangerous in the middle of a summer day, when transmitted through a blue sky. Less UVB is transmitted in the early mornings and late evenings; when the sun is lowest in the sky.
• UVA is about 1 000 times less damaging to the skin than UVB, but it is far from harmless. UVA tays are longer than UVB rays, and 90% of the sunlight reaching the earth is made up of UVA rays. They are the 'ageing' rays, which penetrate deeper into the skin (the dermis) and are responsible for the damage to your collagen and elastin, and causing freckles, blotchiness and pigmentation problems. While UVB peaks at high noon in summer, UVA is fairly constant throughout the day and year and can penetrate cloud cover, tinted glass and clothing relatively easily. UVA also causes immune suppression, resulting in increased susceptibility to skin infections and even skin cancer.

HOW SUNLIGHT PENETRATES THE SKIN

SUNBURN VS SUNTAN
There is no such thing as a safe tan. A suntan is actually the body's defence mechanism against too strong sunlight and the visible evidence of damage to the skin. Sunlight stimulates the skin to increase melanin production. As the melanin supply is activated, it moves up towards the surface of the skin where it helps prevent burning and reduces the penetration of the sun's rays. The side effect is skin of that golden colour that sun worshippers crave. Although dark-skinned people have more melanin in their skin and thus have a higher level of natural protection, they still need to use a sunscreen to avoid skin damage.

Sunburn, on the other hand, can be equated to 'cooking' your skin. If you do not apply sunscreen, or accidentally fall asleep in the sun, the surface blood vessels dilate (hence the redness), and an inflammatory response is induced to fight the damage,often causing blisters in the process. The redness occurs tow to eight hours after severe sun exposure and blistering can occur after 12 to 24 hours. A frightening fact is that our skin 'remembers' this burn, and the DNA may not repair perfectly. These 'errors' in DNA can lead to skin cancer years later. So when you make your way to the coast for your next summer holiday, remember that although a tan fades quickly, your skin carries a permanent memory of the damage.

Overexposure to the sun at an early age will result in premature wrinkling between the ages of 25 and 40. The dangerous rays are not just from the sun's light - they are also reflected off water an the earth.

PROTECTING YOUR SKIN
The time it takes for unprotected skin to turn red in the sun is known as the MED (minimal erythema dose). Your skin type determines your MED. Very fair skin, for example, will have a MED of about six minutes; olive toned skin can tolerate about 10 to 12 minutes; and black skin usually has a MED of 18 to 20 minutes. SPF (Sun Protection Factor) is a standardized measure that indicates how much additional time above your MED you can spend in the sun without getting burned. For example, if you can usually spend 10 minutes in the sun before burning, an SPF15 sunscreen will multiply that time by fifteen (10 minutes x 15 = 150 minutes of 'sun time').

Note that a person with fair skin can spend far less time in the sun than someone with darker skin, even if they both apply the same level of SPF. Once your time is up, you should ideally get out of the sun. Reapplying sunscreen only means that you will 'cook' more slowly, a bit like cooking your Sunday roast in the oven - once it is done you are simply crisping it! You should, however, always reapply sunscreen after swimming, perspiring and drying yourself off. The key is to use enough sunscreen (one to two ounces) for an even and full coverage. Double application is also important: apply the first layer 20 to 30 minutes before you go to the beach, and apply another layer as your 'coat of armour' when you get into the sun.