Your skin, the largest organ in your body, protects inner tissues and organs from the outside environment. It’s important to take good care of your skin so it will continue to protect your insides and stay healthy as you age. Aside from time, the most damaging factor to your skin is the sun. Protect your skin from harmful UV rays by wearing sunscreen (at least SPF 15, but 30 is better) and protective clothing (brimmed hats, sunglasses, long-sleeved shirts, etc.). Other causes of skin damage and premature aging include smoke and yo-yo dieting. Not only do the chemicals in smoke dry and damage your skin, but wrinkles will form on your face from pursing your lips around cigarettes and squinting to keep smoke out of your eyes. Dieting affects the skin because losing and gaining weight causes the skin to stretch and lose elasticity, making it more vulnerable to wrinkling and sagging under the force of gravity. Moisturizing is important for healthy skin, but be sure to choose a moisturizer that won’t cause irritation. You may want to look for lotions that contain alpha-hydroxy acids to wash away dead skin cells, keeping pores clean and revealing new skin, and to reduce water loss and the appearance of fine lines. However, this product may be irritating to sensitive skin. Avoid creams or lotions with sodium lauryl sulfate which removes natural oils from the skin. You can also help eliminate dry skin by using a humidifier, bathing less frequently, drinking at least 8 glasses of water a day, and using moisture masks. Daily Skin Care Acne Athlete’s Foot Eczema Moles Poison Ivy, Sumac, and Oak Prickly Heat Skin Cancer Sun Protection Warts Daily Skin Care Wash your face with tepid, not hot water, and use a facecloth and mild soap to wash off dead skin cells. Choose a soap that’s suited for your skin type (oily, normal, or dry). People with oily skin may need to wash their faces two or three times a day. Don’t wash your body with hot water or harsh soaps that will dry and irritate the skin. If you have dry skin, only wash your underarms, genitals, face, feet, and hands with mild soap. Pat yourself dry with a towel, rather than rubbing, and apply moisturizer immediately. For men when shaving, soften your beard area with a warm washcloth and then cover the area with shaving cream. Use a sharp blade and pass the razor over your skin only once in the direction of hair growth. Shaving in the other direction may cause irritation. Acne Acne is the general term for pimples, blackheads, whiteheads, and cysts. About 85% of people between 12 and 25 experience acne, though to varying degrees. Resulting from clogged pores, acne typically appears on the face, neck, chest, back, shoulders, and scalp. A pore gets clogged when the sebaceous gland – responsible for lubricating the skin and connected to the base of the hair follicle – produces excess oil that combines with dead skin cells to form a soft, white plug. Within the clogged pore, bacteria that naturally live on the skin multiply, causing an infection. In response to bacterial growth, the immune system sends white blood cells to combat the invaders. The combination of oil, dead skin cells, bacteria, and white blood cells causes the wall of the plugged follicle to bulge, producing a whitehead or blackhead. The difference between these two is whether the plug remains below the skin or is pushed to the surface. When the pressure of the hair follicle pushes the oil and dead skin cells to the surface of the skin, a blackhead forms. A whitehead is a clogged pore below the surface of the skin. If the follicle wall breaks down and spills its contents into nearby skin, a lesion or pimple will form. Acne is the combined result of three factors: build-up of oil, abnormal shedding of dead skin cells, and bacteria growth. Scientists aren’t sure exactly what leads to these changes in the skin, but certain factors have been found to play a part. Hormones, heredity, bacteria, and medication are among the causes of acne. Additionally, environmental factors, such as pollution or high humidity, and touching your skin with your hands or other bacteria-laden objects can promote pimples. Some say stress causes acne, others disagree, but it’s a good idea to reduce stress for other health reasons anyway. Surprisingly, food has nothing to do with acne. The best way to treat and prevent mild acne is to wash your skin with a gentle cleanser in the morning, evening, and after heavy exercise. Astringents, scrubs, and masks are often harsh on the skin, producing irritation that will lead to more acne. There are many over-the-counter and prescription treatments, including lotions, antibiotics, and oral contraceptives. Look for lotions with benzoyl peroxide, resorcinol, or salicylic acid to dry excess oil and promote peeling. Do not pick or squeeze blemishes because you may push the infection deeper into the skin and cause scars. Avoid oily and greasy cosmetics, sunscreens, and hair products; only use products labeled “water-based” or “noncomedogenic.” More serious forms of acne may require treatment by a dermatologist. Athlete's Foot Athlete’s foot is a common skin infection caused by the fungus tinea pedis. Making skin itchy, red, sore, and dry, athlete’s foot usually starts between the fourth and fifth toes, and may spread to the sides and sole of the foot. To combat the invading fungus, skin cells multiply, leading to thick, cracked, and peeling skin. The infection frequently causes foul odor, blisters, and inflammation. Be careful when self-medicating because not all fungal infections of the foot are due to athlete’s foot. You may want to get your feet checked out by a doctor before you apply any medication. Like most fungi, tinea pedis thrives in warm, moist, dark places, like inside sweaty shoes and on shower floors. Thus, in order to avoid athlete’s foot, you should wear shoes in communal showers, bathrooms, and on pool decks. Keep your feet clean and dry. To prevent foot and toenail fungus: Wear protective footwear (flip-flops) when standing in the locker room or shower because fungal foot and toenail infections are contagious. Wash and dry your feet thoroughly everyday. Use cornstarch or medicated foot powder to absorb excess moisture. Wear clean socks made of natural material, such as cotton or wool, everyday. Avoid shoes made of synthetic material, such as rubber or vinyl. Keep toenails neatly trimmed. Don’t share pedicure tools or shoes with others. Don’t wear shoes that are too tight. It’s best to wear breathable shoes or sandals, if weather permits. Discard old sneakers or replace the insoles regularly. Eczema Eczema is a general term encompassing various inflamed skin conditions. One of the more common forms of eczema is atopic dermatitis, characterized by red, itchy, thickened, fissured skin. People who develop eczema have an overactive inflammatory response to irritating substances, causing their skin to itch. Eczema is not contagious – it is caused by certain triggers. Triggers vary, but may include rough or course materials, detergents, soaps, juices from fruit and meats, dust mites, and animal saliva and dander. Some people break out in rash when feeling too hot and/or sweaty. The rash typically arises on the face, neck, and the insides of elbows, knees, and ankles. Unfortunately, there is no cure for eczema, but avoiding substances that trigger outbreaks helps most patients. Here are more tips to avoid and/or treat outbreaks: Moisturize immediately after bathing to lock-in moisture Keep baths and showers short, and use lukewarm, not hot, water Pat yourself dry instead of rubbing Soothe irritated skin with a cool compress Apply corticosteroid creams and ointments to reduce inflammation Avoid sudden changes in temperature or humidity (cover as much skin as possible when going outside during the winter) Avoid sweating or overheating Reduce stress Avoid scratchy materials. Wear cotton instead of wool or synthetics. Avoid harsh soaps and detergents Avoid environmental factors that trigger allergies, like pollen, mold, mites, and animal dander Avoid foods that you have noticed trigger outbreaks. Moles Moles are spots on the skin where melanocytes (pigment-producing cells) have produced more melanin, darkening a localized area of the epidermis. Everyone has moles, which come in a wide range of sizes, shapes, colors, textures, and patterns. The appearance of moles is probably determined before birth, but they may increase in number or color during hormone changes and sun exposure. Most moles will appear by the time a person reaches 20, but others may not appear until later in life. Each mole has its own growth pattern, but in general, when moles first appear, they look like freckles – they are mostly flat and tan, pink, or brown. Over time, they usually enlarge and may develop hairs. Moles tend to darken with exposure to the sun, during puberty, with birth control pills, and during pregnancy. The life cycle of the average mole is 50 years, so they change very slowly, often becoming more raised and lighter in color. Many will disappear with age, either fading away or becoming raised from the skin and getting rubbed off. The majority of moles and other blemishes are benign, but spots that change appearance or cause pain warrant medical attention. A new or existing mole that exhibits ABCD qualities should be seen by a dermatologist. This includes any spot that changes in size, shape, or color, or one that bleeds, itches, or becomes painful. Other moles that increase your risk of skin cancer are large ones (bigger than a pencil eraser) that are present at birth or that run in the family, usually with dark centers and lighter, irregular edges. Poison Ivy, Sumac, and Oak The rash caused by the plants poison ivy, poison sumac, and poison oak is an allergic reaction to the sap of these weeds. The sap, called urushiol oil, is clear or pale yellow, and escapes from damaged areas of the plant, no matter what time of year or whether the plant is dead or alive. Certainly a durable substance, urushiol can remain toxic on clothes and other objects for up to 5 years. Contact with an intact plant will not cause harm, but this is rare because poison ivy is extremely fragile, especially during the spring and summer months. There are three ways to contact urushiol oil. You can touch a damaged plant directly, touch a contaminated object or animal, or expose yourself to airborne particles from burning or lawn mowing the plants. Urushiol oil is absorbed into the skin almost immediately, though washing with cold water and soap within 30 minutes of contact can help limit allergic reactions. Contrary to what many people have been told, the rash caused by poison ivy is not contagious. Only exposure to urushiol sap will cause skin irritation, not contact with the skin of an infected person. Symptoms After contact with urushiol, sensitive individuals (about 85% of the population) will develop a rash within 48 hours. However, because sensitivity to the allergen develops with exposure – you are not born with it – first time contact may take up to 10 days to cause a rash. Any area of the body can develop the rash, though it is more likely in areas where skin is thin, such as the face. Affected areas will initially itch, and then become red, swollen, and blistered. In severe cases, patients develop oozing sores. There is a common misconception that scratching the rash causes it to spread. This is not true, but you should avoid scratching because it may cause scarring or secondary infection. It may seem like your rash is growing, but this is likely the result of varying skin thickness or multiple exposures to urushiol. The sap will be absorbed more slowly by skin that is thick, such as that found on the forearms, legs, and trunk. After a few days, the rash may dry and begin to scale. Affected skin will not fully recover until all contaminated cells have been shed. This usually takes about 10 days. Treatment Fortunately, sensitivity to urushiol tends to decrease with age. But for those whose sensitivity causes them to suffer, here are some tips for treatment: Wash exposed areas with cold water and soap as soon as possible. If you can do this within five minutes, the water may keep the urushiol from seeping into your skin. Even washing within the first 30 minutes will limit the severity of the rash. Hot water may open the pores to let the oil in. Wash clothing and any objects that may be contaminated with urushiol, which can remain toxic for up to 5 years. Soak in a bath of colloidal oatmeal or baking soda solution. Cool compresses and ice can soothe itching temporarily Cover affected areas with calamine lotion. Over-the-counter hydrocortisone creams are not strong enough to treat poison ivy rashes. Take over-the-counter oral anti-histamines if itching is severe (if you do not experience adverse reactions from such medication). For extreme cases, doctors can prescribe prescription-strength cortisone cream or oral steroids. Prevention The best prevention measure you can take is to learn how to identify the poisonous weeds. Unfortunately, this task is not as easy as the popular saying, “leaves of three, let them be,” makes it sound. A leaf of poison ivy or poison oak contains three pointed leaflets, and the middle leaflet has a longer stalk than the two side ones. However, even on the same plant the size and shape of the leaflets can vary. The edges of the leaves can be smooth or jagged, but are rarely lobed. Poison sumac, on the other hand, has leaves that contain 7-12 leaflets. The leaves of these plants tend to turn yellow or red in the fall even when other plants are still green. The berries of female plants change from green to off-white, and the leaves fall off before winter. Another factor that makes identification difficult is the variety of forms poisonous plants may take. Poison ivy grows as a vine, climbing vine, or a low shrub; poison oak can be a short or tall shrub; and poison sumac is found as a tall shrub or small tree. In North America, the plants (in combination) are confined neither by geographical location nor by ecological community. Poison ivy likes fertile, well-drained soil; poison oak can grow in dry areas; and poison sumac prefers standing water. The weeds can be found anywhere in the continental U.S. (aside from some desert areas of Nevada). Some tips to prevent developing a rash from poison ivy: Learn what poison ivy, oak, and sumac look like so you can avoid them. Destroy the weeds with herbicides in your own backyard, but be careful with dead plants because they still contain dangerous urushiol sap. Wear long pants and long sleeves, boots, and gloves in areas where there might be poison ivy. Do not let pets run through wooded areas, and wash them thoroughly if they might have touched poison ivy. Do not burn plants you suspect are poisonous. Barrier skin creams containing bentoquatam provide some protection by physically blocking the resin from reaching the skin. They are available over-the-counter. Prickly Heat Prickly heat is a type of heat rash that causes small pink bumps that itch and may have a “prickly” sensation. The rash occurs when the pores of sweat glands get clogged and often appears on areas that are covered by clothing, especially if there is friction. Prickly heat most commonly occurs on the chest, neck, and arms. Most common when it’s hot and humid, oils and ointments makes prickly heat more likely (and less likely to heal faster). Don’t avoid using sunscreen, but choose one that’s oil free and hypoallergenic. The first and most important step you should take to treat the rash is to get into cooler, dryer air. Gently cleanse the affected area. Try medicated acne pads for sensitive skin – the salicylic acid will help unclog pores. You can relieve itchiness with hydrocortisone cream (not ointment) and bath water treated with baking soda or an oatmeal product (Aveeno Bath Treatment). For severe prickly heat, you may even use an antihistamine, especially if you have trouble sleeping. With treatment, prickly heat should disappear within 2-3 days. Skin Cancer Skin cancer is the most common form of cancer in the United States. There are three types: basal cell carcinoma (cancer that develops on the covering of an organ), squamous cell carcinoma, and melanoma. The names refer to the type of epidermal cell where the cancer develops. Squamous cells are flat and scale-like, covering the round basal cells, and deeper melanocytes, which are responsible for producing melanin (the skin’s pigment). Basal and squamous cell growths (non-melanoma cancers) account for over 90% of skin cancer cases. They are superficial, slow-growing, and easily treatable if caught early. Melanoma, on the other hand, is very serious, sometimes fatal, because it affects deeper layers of the skin and has the most potential to spread to other parts of the body. Skin cancer may develop as an entirely new growth, or it may cause changes in an existing mole. Danger signals include growths or sores that bleed, crust over, heal, and then bleed again. Basal and squamous cell carcinomas usually appear on areas that get the most sun – scalp, face, lips, ears, neck, chest, shoulders, and arms. Around the head and neck, basal cell appears as a pearly or waxy bump, while on the back or chest it typically develops into a flat, flesh-colored or brown scar-like lesion. Squamous cell carcinoma can appear as a firm, red nodule, or a flat lesion with a scaly, crusted surface. Melanoma can occur anywhere on the body, and is typically found in large brownish spots with darker speckles. Cancerous growths may appear suddenly or develop gradually. You should regularly check your skin (about once a month) for growths and changes that could indicate cancer. Although most people do not worry about cancer until middle age, skin cancer is increasingly common in younger patients and it’s important to know what’s normal for your skin. In fact, you can help prevent skin cancer by having suspicious-looking moles removed. When doing a self-examination, you should remember the acronym “ABCD.” These letters stand for qualities of dangerous moles. A = Asymmetry. One half of the mole does not look like the other half. B = Border is irregular. The borders of the mole are scalloped or poorly defined. C = Color is varied. The mole has varying shades of tan, brown, and black, and sometimes even red, white, or blue. D = Diameter. The mole is larger than the size of a pencil eraser. Risk Factors: light colored hair, either blonde or red blue or light colored eyes family history of skin cancer living in an area with high levels of UV blistering sunburns freckles working or playing outside Sun Protection Minimizing the amount of UV rays absorbed by your skin is one of the most effective ways of preventing skin cancer. Sun damage is cumulative, meaning it builds up during your lifetime and cannot be reversed. It’s extremely important to protect your skin when you’re young because it’s estimated that most people receive 80% of skin-damaging UV exposure before they reach 20. Remember that certain medications, like antibiotics and birth control, will make you burn more easily. Burned skin is weakened, and will not provide as strong a barrier to the outside environment. In other words, burned skin is more permeable to chemicals applied to the skin, and water will evaporate faster from burned skin, so be sure to drink plenty of water. Sometimes a fever will accompany a burn. You should see a doctor if you have extreme blistering, nausea, fever above 102 degrees, or signs of heat stroke (dry, flushed skin and confusion). If you really want tan skin, opt for self-tanning lotions because artificial sources of UV, such as sunlamps and tanning booths, damage your skin and increase your risk for skin cancer. The most sell-known culprits of skin cancer are UVA (Ultraviolet-A) and UVB (Ultraviolet-B) rays. UVA has a long wavelength that penetrates the skin more deeply than UVB rays. It’s responsible for “photo ageing” – leathering and wrinkling of the skin – and for melanomas. UVB rays have shorter wavelengths, and are considered more harmful than UVA rays in producing sunburn. They are the main cause of basal and squamous cell carcinomas, as well as a major factor in the development of melanomas. Sunblocks and sunscreens with SPF (Sun Protection Factor) above 30 block most harmful UVA and UVB rays. The difference between these two methods of protection is the way they block harmful light waves. Sunscreen chemically absorbs UV rays while sunblock physically blocks the rays. Look for broad-spectrum sunscreens (meaning they protect against most UV rays) of an SPF 30 or higher. Even if you apply the ideal sunscreen, some UV rays can still penetrate the skin, making it important to take other precautions, such as wearing protective clothing and avoiding midday sunlight. Tips for protection: Minimize sun exposure between 10am and 2pm when ultraviolet rays are the strongest. Use sunscreen. Sunscreen with a sun protection factor (SPF) of 8 blocks 86% of UV rays; SPF 15 blocks 92% and SPF 30 blocks 96%. Use plenty because studies show the average person wears half the amount used by the manufacturer when testing the SPF value. Apply sunscreen about 20 minutes before heading outside, and reapply after bathing, sweating, or toweling off, or about every 2 hours. Wear sunglasses with UV-blocking filters because the eye is the second most common place for developing melanoma. Wear protection everyday because even on cloudy days, up to 80% of UV rays from the sun can reach your skin. Remember that harmful UV rays are reflected from the water and light surfaces like sand, snow, and cement; they can also penetrate the surface of the water. Warts Warts are caused by the human papillomavirus (HPV), of which there are at least 60 subtypes. The virus stimulates rapid growth of skin cells on the top layer of skin, usually on the hands and feet, but possibly anywhere on the body. Warts are skin colored, feel rough to the touch, and may have black dots at the center. These black dots are clotted blood vessels. Attacking a local area of the skin, HPV enters the skin through minor breaks or abrasions, which explains why they frequently arise around fingernails that are picked at or bitten. Two of the most familiar types of wart are common and plantar warts. Common warts may occur anywhere, but most often arise on the fingers, around the nails and on the backs of the hands. Plantar warts grow on the soles of the feet, sometimes causing pain as the patient walks, and often grow in clusters, known as mosaic warts. Although plantar warts may look embedded in deeper skin after they have been walked on, they remain infections of the epidermis (top layer of skin). Warts aren’t usually a serious health concern, and most disappear on their own in two years. However, if you find them bothersome, you can remove warts by over-the-counter treatments or by visiting a dermatologist. Salicylic acid is one of the most effective topical treatments available in drug stores, but you may find it necessary to see a dermatologist, especially for plantar warts. Doctors can remove warts by freezing them with liquid nitrogen (cryotherapy), cutting them off with a knife or laser, or injecting cancer drugs into the wart to kill the virus. If the body’s immunity is not sufficient to prevent regrowth, warts will return no matter how they are removed initially. Even though warts are contagious, passed through touching infected skin or an infected surface (e.g. shower floor), the risk of catching warts (other than genital warts) from another person is small. Additionally, each person’s immune system deals with HPV differently, so not everyone will develop warts. The incubation period is typically about 3 months, but warts may lie dormant for years. Once HPV has entered your body, whether you develop warts or not, the virus will live in your system forever, which explains why children are more likely to have warts than adults.