Skin care

For other uses, see Skin care (disambiguation).

Skin care is the range of practices that support skin integrity including nutrition, avoidance of excessive sun exposure, and appropriate use of emollients; that enhance appearance such as use of cosmetics, botulinum, exfoliation, fillers, laser resurfacing, microdermabrasion, peels, retinol therapy; and that remediate skin break down and relieve skin conditions.[1] Skin care is a routine daily procedure in many settings, such as skin that is either too dry or too moist, and prevention of incontinence-associated dermatitis and prevention of skin injuries.[2] Skin care is a component in wound healing, neonates, elderly, stomas, radiation treatment and with some medications.

Background

Skin care sits at the interface of what is commonly thought of as personal care products, some of which are cosmetics,[3] and dermatology, traditionally a medical discipline in which medical doctors diagnose and treat skin diseases;[4] there is some overlap with each of these topics.

The Federal Food, Drug, and Cosmetic Act defines cosmetics as products intended to cleanse or beautify (for instance, shampoos and lipstick). A separate category exists for medications, which are intended to diagnose, cure, mitigate, treat, or prevent disease, or to affect the structure or function of the body (for instance, sunscreens and acne creams), although some products, such as moisturizing sunscreens and anti-dandruff shampoos, are regulated within both categories.[3][5]

Skin care differs from dermatology, as traditionally practiced, by its additional but less medical scope and by its inclusion of non-physician professionals, such as estheticians and wound care nursing staff.[1][6] Skin care includes modifications of individual behavior and of environmental and working conditions.[6] Nevertheless, dermatology has co-opted some aspects of skin care, particularly in the U.S., and to a significantly lesser extent elsewhere, such as the U.K.[1] Add from[1][2][7][8] [9]

Neonate

Guidelines for neonatal skin care have been developed. Nevertheless, the pediatric and dermatologic communities have not reached consensus on best cleansing practices, as good quality scientific evidence is scarce.[10] Immersion in water seems superior to washing alone, and use of synthetic detergents or mild liquid baby cleansers seems comparable or superior to water alone.[10] Add from [11][12]

Sunscreen

Sun protection is an important aspect of skin care. Though the sun is beneficial in order for the human body to get it's daily dose of vitamin D, unprotected excessive sunlight can cause extreme damage to the skin. Ultraviolet (UVA and UVB) radiation in the sun's rays can cause sunburn in varying degrees, early ageing and increased risk of skin cancer.[13] UV exposure can cause patches of uneven skin tone and dry out the skin.

This can reduce the skin's elasticity and encourage sagging and wrinkle formation. Sunscreen can protect the skin from sun damage; sunscreen should be applied at least 20 minutes before exposure, and should be re-applied every four hours. Sunscreen should be applied to all areas of the skin that will be exposed to sunlight, and at least a tablespoon (25 ml) should be applied to each limb, the face, chest, and back, to ensure thorough coverage. Many tinted moisturizers, foundations and primers now contain some form of SPF.

Sunscreens may come in the form of creams, gels or lotions; their SPF number indicates their effectiveness in protecting the skin from the sun's radiation. There are sunscreens available to suit every skin type; in particular, those with oily skin should choose non-comodegenic sunscreens; those with dry skins should choose sunscreens with moisturizers to help keep skin hydrated, and those with sensitive skin should choose unscented, hypoallergenic sunscreen and spot-test in an inconspicuous place (such as the inside of the elbow or behind the ear) to ensure that it does not irritate the skin.

Elderly

Skin ageing is associated with increased vulnerability.[14] Skin problems including pruritus are common in the elderly but are often inadequately addressed.[15] A literature review of studies that assessed maintenance of skin integrity in the elderly found most to be low levels of evidence[14] but the review concluded that skin-cleansing with synthetic detergents or amphoteric surfactants induced less skin dryness than using soap and water.[14] Moisturizers with humectants helped with skin dryness, and skin barrier occlusives reduced skin injuries.[14]

Acne

Main article: Acne

According to the American Academy of Dermatology, between 40 to 50 million Americans suffer from acne each year.[16] While many associate acne with adolescence, acne can occur at any age. Causes of acne can include heredity/genetics, hormones, menstruation, food, and emotional stress.[16]

There are a few ways to help reduce the effects of acne. Use a gentle exfoliating product, such as a scrub that contains sea salt or jojoba beads instead of one that uses sharp seeds, granules, or husks. Some anti-acne creams contain drying agents such as benzoyl peroxide, which can help ease acne in certain cases — particularly among teenagers. However, many adults can't tolerate the intense drying effects and might experience cracked skin and red blemishes the longer they use the product.

Pressure sore

Main article: Pressure ulcer

Stoma

Add from [17][18]

Wound healing

Wound healing.[19]

Nutrition

Add from

Radiation

Radiation induces skin reactions in the treated area, particularly in the axilla, head and neck, perineum and skin fold regions.[20] Formulations with moisturising, anti-inflammatory, anti-microbial and wound healing properties are often used, but no preferred approach or individual product has been identified as best practice.[20][21] Soft silicone dressings that act as barriers to friction may be helpful.[20] In breast cancer, calendula cream may reduce the severity of radiation effects on the dark spot corrector.[21][22] Deodorant use after completing radiation treatment has been controversial but is now recommended for practice.[22] Add from[23][24][25][26]

EGFR

Epidermal growth factor receptor (EGFR) inhibitors are medications used in cancer treatment. These medications commonly cause skin and nail problems, including rashes, dry skin and paronychia.[27] Preventive intensive moisturising with emollient ointments several times, avoidance of water-based creams and water soaks (although in certain circumstances white vinegar or potassium permanganate soaks may help), protection the skin from excessive exposure to sunshine, and soap substitutes which are less dehydrating for the skin than normal soaps, as well as shampoos that reduce the risk of scalp folliculitis, are recommended. Treatment measures with topical antibiotic medication can be helpful.[27][28][29]

Related products

Main articles: Cosmeceutical and Nutricosmetics

Cosmeceuticals are topically-applied, combination products that bring together cosmetics and "biologically active ingredients". Products which are similar in perceived benefits but ingested orally are known as nutricosmetics. According to the United States Food and Drug Administration (FDA), the Food, Drug, and Cosmetic Act "does not recognize any such category as "cosmeceuticals." A product can be a drug, a cosmetic, or a combination of both, but the term "cosmeceutical" has no meaning under the law". Drugs are subject to an intensive review and approval process by FDA. Cosmetics, and these related products, although regulated, are not approved by FDA prior to sale.

Procedures

Skin care procedures include use of botulinum;[30] exfoliation; fillers; laser medicine in cosmetic resurfacing, hair removal, vitiligo, port-wine stain and tattoo removal; photodynamic therapy; microdermabrasion; peels; retinol therapy.[1]

References

  1. 1 2 3 4 5 Penzer R, Ersser S. Principles of Skin Care: A Guide for Nurses and Health Care Practitioners. John Wiley & Sons, 2010. ISBN 9781405170871
  2. 1 2 http://www.ncbi.nlm.nih.gov/pubmed/26165590 PMID 26165590 Evidence-Based Skin Care: A Systematic Literature Review and the Development of a Basic Skin Care Algorithm. - PubMed - NCBI
  3. 1 2 Kessler R. More than Cosmetic Changes: Taking Stock of Personal Care Product Safety. Environ Health Perspect; DOI:10.1289/ehp.123-A120
  4. ↑ Random House Webster's Unabridged Dictionary. Random House, Inc. 2001. Page 537. ISBN 0-375-72026-X.
  5. ↑ FDA. Cosmetics: Guidance & Regulation; Laws & Regulations. Prohibited & Restricted Ingredients. [website]. U.S. Food and Drug Administration, Silver Spring, MD. Updated 26 January 2015.
  6. 1 2 Schwanitz HJ, Riehl U, Schlesinger T, et al. (2003). "Skin care management: educational aspects". Int Arch Occup Environ Health 76 (5): 374–81. doi:10.1007/s00420-002-0428-z. PMID 12719982.
  7. ↑ Handbook of Cosmetic Skin Care Second Edition AVI SHAI, HOWARD I. MAIBACH, and ROBERT BARAN Published August 2009 ISBN 9780415467186 Edition Second Pages 308 226 http://informahealthcare.com/isbn/9781616310004
  8. ↑ Antioxidants and skin care: The essentials Graf J - Plastic and reconstructive surgery, 2010
  9. ↑ Draelos ZD Active agents in common skin care products - Plastic and reconstructive surgery, 2010
  10. 1 2 Blume-Peytavi U, Hauser M, Stamatas GN, Pathirana D, Garcia Bartels N (2012). "Skin care practices for newborns and infants: review of the clinical evidence for best practices". Pediatr Dermatol 29 (1): 1–14. doi:10.1111/j.1525-1470.2011.01594.x. PMID 22011065.
  11. ↑ PMID 10633681 Lund C, Kuller J, Lane A, Lott JW, Raines DA (1999). "Neonatal skin care: the scientific basis for practice". Neonatal Netw 18 (4): 15–27. doi:10.1891/0730-0832.18.4.15. PMID 10633681.
  12. ↑ PMID 22988452
  13. ↑ PMID 26208767
  14. 1 2 3 4 Kottner J, Lichterfeld A, Blume-Peytavi U (2013). "Maintaining skin integrity in the aged: a systematic review". Br. J. Dermatol. 169 (3): 528–42. doi:10.1111/bjd.12469. PMID 23773110.
  15. ↑ Beauregard S, Gilchrest BA (1987). "A survey of skin problems and skin care regimens in the elderly". Arch Dermatol 123 (12): 1638–43. doi:10.1001/archderm.1987.01660360066014. PMID 3688904.
  16. 1 2 AAD. Acne facts.. [website]. American Academy of Dermatology. 10 November 2015.
  17. ↑ Skin care management of gastrointestinal fistulas JL Dearlove - Surgical Clinics of North America, 1996 - Elsevier* Peristomal skin care: an overview of available products P Black - Br J Nurs, 2007 - silesse.com
  18. ↑ PMID 15632457 Nix D, Ermer-Seltun J (2004). "A review of perineal skin care protocols and skin barrier product use". Ostomy Wound Manage 50 (12): 59–67. PMID 15632457.
  19. ↑ Flanagan M. Wound Healing and Skin Integrity: Principles and Practice. John Wiley & Sons, 2013. ISBN 9780470659779
  20. 1 2 3 Herst PM (2014). "Protecting the radiation-damaged skin from friction: a mini review". J Med Radiat Sci 61 (2): 119–25. doi:10.1002/jmrs.46. PMC 4175840. PMID 26229646.
  21. 1 2 McQuestion M (2006). "Evidence-based skin care management in radiation therapy". Semin Oncol Nurs 22 (3): 163–73. doi:10.1016/j.soncn.2006.04.004. PMID 16893745.
  22. 1 2 McQuestion M (2011). "Evidence-based skin care management in radiation therapy: clinical update". Semin Oncol Nurs 27 (2): e1–17. doi:10.1016/j.soncn.2011.02.009. PMID 21514477.
  23. ↑ PMID 16927902 The validity of skin care protocols followed by women with breast cancer receiving external radiation J Aistars - Clinical Journal of Oncology Nursing, 2006 - search.proquest.com
  24. ↑ Bolderston A, Lloyd NS, Wong RK, Holden L, Robb-Blenderman L (2006). "The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline". Support Care Cancer 14 (8): 802–17. doi:10.1007/s00520-006-0063-4. PMID 16758176.
  25. ↑ PMID 20598015
  26. ↑ PMID 25901591 Trueman E (2015). "Management of radiotherapy-induced skin reactions". Int J Palliat Nurs 21 (4): 187–92. doi:10.12968/ijpn.2015.21.4.187. PMID 25901591.
  27. 1 2 Califano R, Tariq N, Compton S, et al. (2015). "Expert Consensus on the Management of Adverse Events from EGFR Tyrosine Kinase Inhibitors in the UK". Drugs 75 (12): 1335–48. doi:10.1007/s40265-015-0434-6. PMC 4532717. PMID 26187773.
  28. ↑ Thatcher N, Nicolson M, Groves RW, et al. (2009). "Expert consensus on the management of erlotinib-associated cutaneous toxicity in the U.K.". Oncologist 14 (8): 840–7. doi:10.1634/theoncologist.2009-0055. PMID 19679688.
  29. ↑ Kiyohara Y, Yamazaki N, Kishi A (2013). "Erlotinib-related skin toxicities: treatment strategies in patients with metastatic non-small cell lung cancer". J. Am. Acad. Dermatol. 69 (3): 463–72. doi:10.1016/j.jaad.2013.02.025. PMID 23602600.
  30. ↑ http://www.allergan.com/assets/pdf/botox_cosmetic_pi.pdf
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