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 acneAge 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 SKINThe 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.
ECZEMAEczema, 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.
PSORIASISThis 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.
PIGMENTATIONUnbalanced 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.