Skincare update – includes related information
Each stage of life requires a slightly different skincare routine. During childhood, adolescence and young adulthood, dermatologists suggest washing with gentle soap and warm water — not hot or cold — and rinsing well to remove the soap. In young infants and the elderly, who have extra-sensitive skins, soaps should be used sparingly and washing should be less frequent.
The right skin cleanser depends on the skin type. Cleansing creams are not necessarily less drying than soaps. One University of Toronto dermatologist says that “any soap is fine unless you have dry skin, in which case mild, superfatted types (such as Neutragena, Dove, Caress, Petro-phylic, Allenbury’s and Lowila) are best, avoiding deodorant and antiseptic soaps, unless a physician prescribes them.”
Astringents containing alcohol can be useful for the oily-skinned but will further dehydrate dry skin. If used at all, they should be dabbed on lightly with cotton balls (not paper tissue, as it irritates the skin). Despite claims that various astringents “close the skin’s pores,” none fulfills this promise.
Creams should be sparingly used on oily skin. Most dermatologists consider expensive creams hardly worth the cost. Cheaper ones, or even plain mineral oil, do an equally good job. As one dermatologist puts it, “there’s no need to go any fancier than plain petrolatum or petroleum jelly. But petroleum jelly is sticky, which makes other products seem more appealing.” Any cream or oil that holds moisture in the skin will moisturize effectively if applied to damp skin. Cocoa butter, mineral oil and lanolin are as effective as expensive creams (although lanolin can cause allergies in some). Moisturizers, hand and body creams, face, eye and night creams all work by trapping water and providing a protective layer on top of the skin that prevents dryness and cracking.
Avoiding dry skin
While the combination of oil and sweat normally keeps human skin soft and supple, lack of humidity or overexposure to water, sun, chemicals and soaps can dehydrate it. Dry skin can lead to dermatitis (skin inflammation and irritation) and may develop into eczema, with soreness, inflammation, and perhaps bleeding and swollen, weepy, oozing, crusty patches. (Dermatologists often use the terms “dermatitis” and “eczema” interchangeably.) Once eczema is entrenched, it’s difficult to reverse except with topical steroids such as hydrocortisone creams.
The commonest causes of dry skin are centrally heated rooms; lack of moisture; cold, dry air; and too much bathing or showering. The best antidotes are to humidify the indoor surroundings and, as one dermatologist puts it, “moisturize well to trap water in the skin’s surface.” Showers are less drying than tub baths. Bubble baths and bath oils should be used sparingly as they can trigger skin irritation and can provoke urinary-tract infections in children (especially girls).
Deodorants and antiperspirants often irritate skin
Perspiration from the eccrine glands helps regulate the body’s temperature by evaporation from the skin’s surface. But if accumulated sweat stays on the body for a few hours, especially in the body folds or on clothing, a strong odour develops due to the bacterial breakdown of sweat. (Shaving underarm hair decreases the odour.
The earliest deodorants were merely perfumes used to mask body odour. The bacterial breakdown of sweat is mainly to blame for body odour, so modem deodorants are antibacterials in soaps, roll-ons, sprays, sticks and creams. Antibacterials used include benzalkonium chloride, hexachlorophene and salicylanilides, some of which can cause photosensitization (exaggerated response to the sun). One safe, inexpensive deodorant recommended by a University of Toronto dermatologist is Aqueous Zephiran, or benzalkonium chloride, a clear, colourless, odorless liquid. Although deodorants decrease body odour, they don’t reduce sweating, so many people prefer products containing both a deodorant and an antiperspirant.
Products labelled as antiperspirants must reduce normal sweating by at least 20 per cent. Many contain metals, particularly aluminum, but experts suggest avoiding aluminum-containing antiperspirants for fear of adverse health effects. Some antiperspirants also block the sweat glands and cause an irritation or rash. Antiperspirants containing perfumes, hexachlorophene and zirconium can also irritate the skin. (Those containing zirconium should be avoided because a few people develop small lumps, or granulomas, in their armpits from zirconium products.) Do not put antiperspirants on inflamed, wet or recently shaved skin as they may irritate it.
Tracing the causes of skin itchiness
Contact dermatitis is an inflammatory skin irritation, sometimes due to an allergy or to direct contact with a long list of substances, including dyes, metals (such as mercury or nickel, in jewelry), rubber, topical medicines (such as neomycin or streptomycin creams), commercial fabric finishes, laundry products, shoe leather, perfumes, shampoos, make-up, some local anaesthetics, sulphas and tars. The irritation produces inflamed, itching, red patches, and perhaps oozing blisters – especially on prolonged exposure. Occupational dermatitis is common among hairdressers, shrimp-peelers, furniture-makers, bakers and many others exposed to irritating chemicals.
For self-treatment of mild dermatitis, a 0.5 per cent hydrocortisone topical ointment, cream or lotion – now available without prescription – can relieve the itching, redness and scaling. If symptoms persist or worsen, a physician should be consulted.
Atopic dermatitis often arises from inherited allergies triggered by rapid changes in temperature, sweating, wool, polyester or nylon clothing, heavy and greasy ointments, soaps, detergents and emotional stress. In infants and children, atopic dermatitis can begin on the cheeks a few months after birth and spread to the elbows and knees, possibly provoked by crawling. In childhood, the dermatitis often moves to the creases of arms, legs, possibly also neck, scalp, wrists and ankles. The condition often clears up in adolescence.
Hives, or urticaria, with large red patches and severe skin itchiness, can result from triggers that release histamines in the body, for example, chemicals, foods, inhalants, fungi, bacteria, insect stings, dust, feathers, moulds, fumes, pollens, metals, heat and cold. The reddened, swollen skin blotches usually last only a short time in the same place but may occur elsewhere later on. Occasionally hives persist a month or more, a condition known as “chronic, urticaria.” Internal disorders such as thyroid disease, cancer or ulcerative colitis can cause hives, and emotional stress can aggravate the condition. Treatment means avoiding known triggers. Antihistamines and anti-inflammatory creams may help.
Impetigo, a contagious skin infection due to staphylococcal or streptococcal bacteria that enter the skin via small scratches, is common among young children. It typically begins as small red, itchy macula (spots) that turn into blisters that soon rupture and develop thin yellow, oozy crusts. Left untreated, the sores can last for weeks, may be passed on to others and occasionally lead to complications such as kidney disease (in children). Impetigo is easily managed once the causative bacteria are pinpointed – by gently removing the crusts, washing well with an antibacterial soap, applying topical antibacterials and/or taking antibiotics. Parents looking after children with impetigo should try to avoid catching or passing on the infection – by washing the hands after touching the child and making sure each person has a separate towel.
Watch for allergic skin reactions
Face creams rarely cause allergic reactions, but certain ingredients can provoke allergies, particularly perfumes, preservatives, salicylic acid, resorcinol, oxidizing agents and lanolin. Skinbleaching creams are likely to cause allergic reactions. They should not be used by dark-skinned people except with medical supervision, as they often cause an inflammatory reaction that permanently lightens skin in patches. Hair removers containing barium or calcium sulphide or calcium thioglycolate also cause allergic reactions. Nail polish can produce not only nail splintering and yellowing, but allergic reactions if it touches the skin. A trace of nail polish on the eyelids can make them red and swollen (yet many with an allergic eyelid reaction don’t blame the nail polish).
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