Skin Conditions

Family Health Diary

What about skin?
The condition of your skin can tell you a lot about your state of health, even your state of mind. Most skin problems happen either when this defensive barrier is damaged from contact or exposure to various things, or from internal problems relating to allergy or disease.

Common skin conditions:

  • Acne is very common in adolescence afflicting many teenagers with unsightly spots on their face, chest and back. It is triggered by the hormone surge of puberty, which causes overproduction of sebum by oil glands in the skin, resulting in blocked pores, which can easily become infected and form spots.
  • Dermatitis is a rash caused by inflammation of the skin in response to an allergy (nickel in jewellery, latex in gloves) or an irritant (detergents, solvents, shampoo).
  • Eczema is similar, with “atopic” eczema being a red itchy rash in places like elbow creases, behind your knees, face and neck. Its cause is not always obvious but frequently related to food or environmental factors.
  • Psoriasis is an inherited immune reaction of the skin, which appears as raised patches of inflamed, red, flaky skin.
  • Drug allergy: some medications, particularly some antibiotics, cause an allergic skin rash which may range from simply a red rash through to blistering and more internal symptoms like breathing or fainting problems.
  • Rosacea is a common red facial rash in middle-aged women which can be triggered by anything that causes flushing, like exposure to sunlight and/or wind, and some medications (vasodilators).
  • Hives or urticaria: is a skin reaction which appears as raised itchy bumps and white/red patches. While sometimes the cause can be identified, such as an allergic reaction to a medication, plant or food, often it simply just occurs without rhyme or reason.

Dry, itchy skin
Dry skin is usually caused by environmental factors such as low humidity; high or low temperatures; air conditioning; excessive exposure to water; and using harsh soaps, which washes away natural oils. It is also a common problem as we age when skin loses its natural lubrication. As it dehydrates, skin often becomes itchy, which is also a common symptom of many rashes like eczema or psoriasis. Itching can also indicate an internal problem such as liver disease or an under-active thyroid gland. The inherited skin disorder ichthyosis vulgaris (or fish scale disease) is an extreme form of dry skin, where dead skin piles up like scales.

Skin infections

  • Impetigo is a bacterial infection of the skin that is more common in children
  • Ringworm is caused by a fungus which forms an itchy red rash; forming an expanding ring as the infection spreads
  • Chicken pox is a common childhood infection with a virus (varicella), causing itchy spots all over the body that blister and eventually crust over. This is the same virus that can reappear later in life as shingles, which also appears as a rash but is more localised. There are a variety of other similar viral rashes.
Prevention and treatment
If you take good care of your skin you can avoid many skin problems, however there may be an underlying cause, so you should never ignore an unusual or persistent rash.

1. Look after your skin

  • Only use soap if your skin is obviously dirty. Other similar cleansers will also strip your skin of its natural oils, increasing the risk of dermatitis.
  • Avoid contact with irritants.
  • Protect your skin from the sun.

2. What is causing the rash
If you have a persistent skin problem you should seek medical help. To help with a diagnosis, some testing (blood, skin patch) may be necessary or perhaps a referral to a dermatologist.

3. Keep your skin hydrated
As skin dries out, cracks form destroying its barrier function. Moisturisers are creams, lotions or ointments that add water to the skin or keep water in the skin; emollients are a form of moisturiser that soften skin by adding back fats, also lost from dry skin.

4. Treatment options

  • Antibiotics – topical (applied on skin) or oral for bacterial infections
  • Anti-fungal creams – for fungal infections
  • Antihistamines – pills/tablets used to treat allergic reactions. Topical antihistamines can sometimes actually cause dermatitis and are generally avoided
  • Corticosteroid creams – for inflammation; mild creams can be obtained from your pharmacy but you will need a prescription for a stronger steroid cream
  • Phototherapy – use of UV light to treat severe rashes like psoriasis
  • Acne treatment – depends on the severity; some cases can clear up by regular gentle washing or using a medicated face-wash available from your pharmacy. In severe cases the most effective treatment to stop acne from causing permanent skin damage is vitamin A based medication, which is only available on prescription and may take several months to work.

5. Living with sensitive skin

  • Keep your fingers away from irritated skin and don’t scratch as this makes it worse
  • Avoid harsh detergents; use mild unscented laundry detergents
  • Avoid hot baths or showers
  • Use soap substitutes like aqueous (water-based) creams. They are also moisturisers
  • Apply moisturisers often, particularly after bathing or showing
  • Add oatmeal to your bath to reduce itching
  • Cover affected areas with a cold compress to reduce itching and help healing
  • Wear natural fibres next to your skin like cotton instead of synthetics, but not wool as this can cause irritation.

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