Skin Relating Problems: Prepared by Sushmita Rana M Pharm

SKIN RELATING PROBLEMS
PREPARED BY… SUSHMITA RANA

M PHARM.
CONTENTS
 Structure of skin
 Dry skin
 Acne
 Pigmentation
 Prickly heat
 Wrinkles
STRUCTURE OF SKIN
DRY SKIN
 Dry skin has a low level of sebum and can be prone to
sensitivity. It usually feels "tight“ and uncomfortable
after washing unless some type of moisturizer or skin
cream is applied. Chapping and cracking are signs of
extremely dry, dehydrated skin. It looks dull,
especially on the cheeks and around the eyes. There
may be tiny expression lines on these spots and at the
comers of the mouth
CAUSES
The oil glands do not supply enough
lubrication to the skin. As a result, the
skin becomes dehydrated.
Dry skin could be due to a genetic
condition.
Poor diet. Nutritional deficiencies,
especially deficiencies of vitamin A and
the B vitamins, can also contribute to dry
skin.
CONT….
Environmental factors such as
exposure to sun, wind, cold,
chemicals, or cosmetics, or excessive
bathing with harsh soaps.
Conditions such as dermatitis,
eczema, psoriasis, or seborrhea.
HOW TO CARE FOR DRY SKIN
 Dryskin needs plenty of thorough but gentle
cleansing, regular stimulation with massage
and generous quantities of oil and moisture. It
also needs extra careful protection. Washing
dry skin with soap and water not only
removes grime but also the natural oils
protecting the skin. A moisturizer increases
the water content of the outer layers of the
skin and gives it a soft, moist look.
DIET RECOMMENDATIONS FOR DRY SKIN
 Eat a balanced diet that includes vegetables,
fruits, grains, seeds, and nuts.
 Drink at least 2 quarts of quality water every
day to keep the skin well hydrated.
 Eat foods such as garlic, onions, eggs, and
asparagus that are high in sulfur, which helps
to keep the skin smooth and youthful.
DEFINITION OF ACNE
Acne is an inflammatory
skin condition that occurs
when oil and dead skin cells
block the pore opening,
causing sebum (oil) to build
up inside the pore.
ACNE LIFE CYCLE
Stage 1: Clogged Pores. Cells lining pores

shed and mix with excess sebum produced
by sebaceous glands, forming a plug, which
leads to clogged pores.
Stage 2: Bacteria. Accumulated sebum and
dead cells attract the P. acnes (or
propionibacterium) bacteria naturally found
in skin, which feeds on oil and multiplies
rapidly inside pores.
Stage 3: Inflammation. This bacterial
overgrowth triggers the natural
inflammatory response causing swelling and
redness. This can ultimately lead to
discoloration and scarring.
CAUSES OF ACNE...
1. Eat chocolate and greasy food (e.g. French
Fries) will case acne？
 No scientific proof on the correlation
between the formation of acne and food.
2. Will dirty skin cause acne?
 Acne is caused by the excess production
of sebum from skin.
3. Stress causes acne!
 Some studies have demonstrated there is
no relationship between acne and stress. .
STRESS CAN CAUSE ACNE
Stress can aggravate your

skin by triggering the release
of androgens and cortisol.
These stress hormones can
stimulate an overproduction
of oil. When this excess oil
mixes with dead skin cells, it
promotes bacterial growth
and can cause acne to
develop or worsen.
FACTS ABOUT TREATMENT OF ACNE...
1. I wash my face several times a day. Why do I still get

acne?
 Too much washing will only irritate the skin further
and worsen their acne. Gently wash your face daily
with mild cleanser or soap, pat dry and use
appropriate acne treatment.
2. Just let acne run its course!
 Some acne scar will remain permanent, so patients
should use appropriate acne treatment as soon as
possible.
CONT…
1. Is it essential to squeeze the acne?
 Squeezing forces infected material deeper into
skin, causing additional inflammation and
possible scarring. If you have severe acne
problem, consult the doctor as soon as possible.
2. If the acne cannot be cured in a month, then should
try other drugs.
 Give acne products enough time to do their job.
Some medicines might take a few months to take
effect. Ask your doctor how much time is needed
for each particular product to work.
TREATMENTS
 Frequent washing with soap and water
 Anti-inflammatory drugs to inhibit P. acnes (bacteria)
 Use anti-biotic, for example tetracycline,

erythromycin or co-trimoxazole etc. to curb the
growth of bacteria and reduce inflammation.
 Use anti-androgen (e.g. oral contraceptive pills) to
regulate androgen, to prevent excess sebum
production. This method is only suitable for women.
PIGMENTATION
 Skin color is generally due to melanin

 Melanin is synthesised by melanocytes within
melanosomes and transferred to
keratinocytes
 Human beings come in a glorious spectrum of
different colors: light,dark,plain or freckly
skin;
 Skin pigmentation has far –reaching social
and psychological implications.
 Melanin pigmentation disorders are
important for medical and cosmetic reasons
OVERVIEW OF THE DISEASES
Melasma
Lentigo
Hyperpigmentation
Iatrogenic Pregnancy mask
hyperpigmentation
Post-acneic or
cicatricial
hyperpigmentation
Hypopigmentation Vitiligo
Vitiligo
Melasma
Lentigo
CURRENT TREATMENTS
 Old bleaching agents
 Hydroquinone (tyrosinase inhibitor)
 Azelaic acid
 Corticoïd
 Associated with « peeling » / dermabrasion products

 Vitamin A
 Glycolic acid
 Best treatment: Kligman trio

 Corticoïd (dexamethasone)
 Hydroquinone
 Retinoic acid
HYPOPIGMENTATION DISORDERS
 Vitiligo
 High prevalence: 0.5 - 2% of the population
 Unknown etiology
 3 major hypotheses, not exclusive of each other:

 immunologic factors
 oxidative stress
 sympathetic neurogenic disturbance
VITILIGO
CURRENT TREATMENTS
 Puvatherapy (psoralen + UVA) no longer
used (known carcinogenic risk)
 UVB narrow band
 For 10 years: unknown risk cancer

 Topical treatments
 Tacrolimus (off label)

 Corticoïd
 Surgery: too invasive technique
 If spot entirely healed, no relapsing

PRICKLY HEAT
 Commonly called heat rash or miliaria. It is
caused by obstruction to the sweat ducts.
Skin care is the main treatment.
 It is heat rash characterized by itchy red spots
which develop on the chest ,under the armpits
and between the thighs in the hot countries.
 Basically caused by blocked sweat glands.
CONT…
 Occurs when sweat cannot freely evaporate
from the skin and sweat ducts become
plugged.
 This inflammation can cause a red rash.
 Can be prevented by wearing clothes that

allow sweat to evaporate as well as bathing
regularly and drying the skin.
PREVENTION
 Drink plenty of cool water or electrolyte replacement
fluids even if not thirsty. (One small cup every 15-20
minutes)
 Be able to recognize early signs & symptoms of heat-
induced illness and take appropriate action to
prevent serious heat disorders.
 Spend as little time as possible in direct sunlight.
 Take frequent breaks in cool, shaded areas.
 Wear light, loose fitting, clothing.
 Avoid caffeine, which can make the body lose water.

WRINKLES
 Wrinkles are the lines and creases that form
in your skin. Some wrinkles can become deep
crevices or furrows and may be especially
noticeable around your eyes, mouth and neck.
CAUSES
 Age. As you get older, your skin naturally becomes less
elastic and more fragile. Decreased production of natural
oils dries your skin and makes it appear more wrinkled.
 Fat in the deeper layers of your skin diminishes. This
causes loose, saggy skin and more-pronounced lines and
crevices.
 Exposure to ultraviolet (UV) light. Ultraviolet radiation,
which speeds the natural aging process, is the primary
cause of early wrinkling. Exposure to UV light breaks down
your skin's connective tissue — collagen and elastin fibers,
which lie in the deeper layer of skin (dermis).
 Without the supportive connective tissue, your skin loses
strength and flexibility. Skin then begins to sag and
wrinkle prematurely.
CONT….
 Smoking. Smoking can accelerate the normal aging
process of your skin, contributing to wrinkles. This
may be due to changes in the blood supply to your
skin.
 Repeated facial expressions. Facial movements and
expressions, such as squinting or smiling, lead to fine
lines and wrinkles. Each time you use a facial muscle,
a groove forms beneath the surface of the skin. And as
skin ages, it loses its flexibility and is no longer able to
spring back in place. These grooves then become
permanent features on your face
TREATMENTS
 Topical retinoids. Derived from vitamin A,
retinoids — such as tretinoin (Renova, Retin-
A) and tazarotene (Avage, Tazorac) — that
you apply to your skin may reduce fine
wrinkles, splotches and skin roughness.
 Because retinoids can make your skin burn
more easily, you'll need to use a broad-
spectrum sunscreen and wear protective
clothing daily. Retinoids may cause redness,
dryness, itching, and a burning or tingling
sensation
CONT…
 Nonprescription wrinkle creams. The
effectiveness of anti-wrinkle creams depends
in part on the active ingredients. Retinol,
antioxidants and some peptides may result in
slight to modest improvements in wrinkles.
 With nonprescription wrinkle creams, your
results, if any, are limited and usually short-
lived because these creams contain less of the
active ingredients than do prescription
creams.

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SKIN RELATING PROBLEMS

PREPARED BY… SUSHMITA RANA

Stage 1: Clogged Pores. Cells lining pores

Stress can aggravate your

1. I wash my face several times a day. Why do I still get

 Use anti-biotic, for example tetracycline,

 Skin color is generally due to melanin

 Associated with « peeling » / dermabrasion products

 Best treatment: Kligman trio

 High prevalence: 0.5 - 2% of the population

 3 major hypotheses, not exclusive of each other:

 For 10 years: unknown risk cancer

 Tacrolimus (off label)

 If spot entirely healed, no relapsing

 Can be prevented by wearing clothes that

 Take frequent breaks in cool, shaded areas.

 Wear light, loose fitting, clothing.

 Avoid caffeine, which can make the body lose water.

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