You and your skin

The only times we really give any thought to our skin is when some of us moisturise after a bath/shower or when we put sunscreen on in the summer. But even then most of us forget and neglect this vital part of our body. We take our skin for granted, but believe it or not, your skin is the largest organ in your body, and is also one of the hardest working.

Skin varies in thickness, with the parts of the body that receive the most wear and tear having the thickest skin, i.e. the soles of the feet and the palms of the hands.

Skin continually renews itself, with old skin cells shed and replaced by new ones; most cells are replaced every 28 days.

What does our skin do?
The skin has many vital functions:

Regulation of body temperature
The skin helps to regulate body temperature, keeping it at a constant temperature of 37.0 degrees C (98.6 degrees F). It does this by responding in different ways to hot and cold environments.

• When you're hot: Sweat evaporates to cool you down.
• When you're cold: Hairs on the skin stand on end, trapping air, which acts as an insulator.

Protection against…
One of the main uses of the skin is to protect the body against various environmental factors.

• Bacteria
• Physical damage
• Ultra Violet rays
• Evaporation

What happens when we develop problems with our skin?
Skin problems are very common can vary from minor complaints such as dry skin, to more serious complaints such as eczema. If you do have any queries about the condition of your skin, visit your pharmacist, who can advise on a whole range of preparations that are available over-the-counter to help remedy the problem.

Below, the Consumer Health Information Centre (CHIC) advises on some common skin complaints and offers practical advice and how to treat them.

Dry skin
Like most of the body, skin contains a high percentage of water. The skin is exposed to all the elements, and excess water loss (due to sun, warmth or wind) can cause the skin to dry out and start to crack. If you notice that you skin is looking flaky there are treatments you can buy from your pharmacy called emollients, which form a seal/barrier between the skin and the air, helping to seal moisture in the skin.

How can I treat dry skin?

• Emollients are safe to use as often as is necessary and are available in various forms: ointments for very dry skin, creams and lotions for mild to moderate or 'wet' eczema. Some are applied directly to the skin, whilst others are used as soap substitutes or can be added to the bath
• Ask you pharmacist which emollient would be best suited for you. You may also want to test a small amount on the skin first, as emollients contain substances to which some people are sensitive.

There are more practical things you can do to help prevent your skin drying out:

• Drink plenty of water: your body needs at least 8 glasses of water a day to keep it functioning properly. Without this water, skin starts to dry out.
• Moisturise your skin first thing in the morning and last thing at night
• In the colder months, wear gloves on your hands to prevent the cold and wind from stripping away the moisture.

Eczema (Dermatitis)
Eczema, or dermatitis as it is sometimes called, is a group of skin conditions, which can affect people of all ages in varying severities.

What causes eczema?
The causes of eczema are many and varied (from environmental allergens to problems with our immune system), and depend on the particular type of eczema that a person has. Your pharmacist of doctor can explain which type of eczema you have, but symptoms vary from dry, hot and itchy skin in mild forms, to broken, raw and bleeding skin in more severe forms. Although it can sometimes look unpleasant, eczema is not contagious.

There is currently no cure for eczema, but there is a wide range of treatments available over the counter at the pharmacy, that can help to minimise the discomfort that eczema can bring. These include the following:

• Emollient bath preparations: by preventing excessive water loss from the skin, emollients can help prevent itchiness due to dry skin
• Emollient soaps: as above
• Moisturising creams or ointments: as above
• Steroids: these act by reducing inflammation. Two steroids are available without prescription: hydrocortisone and clobetasone, which come as creams applied to the skin. Your pharmacist or doctor can advise on which to use for the various types of eczema or dermatitis. Neither can be used for children without a prescription.

More importantly, there are several things you can do yourself to help reduce symptoms and prevent flare-ups:

• Take frequent baths but do not use perfumed oils or soaps. Use emollients. Water should be warm but not too hot
• Use only non-biological washing powders and always use fabric softener
• Avoid known allergens such as dust mites and animal hair. Special vacuum cleaners, sprays and bedding can help reduce exposure
• Seek advice from a dietician on your diet as one in ten eczema sufferers can link their condition to diet
• Learn how to manage stress, which can cause flare-ups
• Keep finger nails short to prevent damaging the skin if you tend to scratch

Athlete's Foot
Athlete's foot is a skin disease caused by a fungus, usually occurring between the toes. The fungus most commonly attacks skin on the feet because shoes create a warm, dark, and humid environment, which encourages fungus growth. It is commonly picked up from showers and changing room floors in gyms, swimming baths, etc. Because the infection was common among athletes who used these facilities frequently, the term "athlete's foot" became popular.

Symptoms: Itchy, sore skin between the toes that will eventually crack and peel. Sometimes appears white, inflamed and weepy.

How can I prevent Athlete's Foot?
It is not easy to prevent athlete's foot, but good foot hygiene will help reduce the risk of infection:

• Avoid walking about barefoot, especially in changing rooms and communal showers
• Wash feet daily with soap and water; drying carefully, especially between the toes
• Change your socks and shoes regularly to decrease moisture and help prevent the fungus from infecting the feet
• If you tend to be a sufferer, try using an anti-fungal foot powder, which can be purchased from the pharmacy.

What treatments are available for Athlete's Foot?
Antifungal preparations for shoes and socks are available at the pharmacy. Ask you pharmacist to recommend the best one for you. They come as creams, sprays, ointments and dusting powders. Some preparations also contain hydrocortisone to stop the itching quickly.

Acne
Acne is an inflammatory skin disease affecting the tiny pores (and attached oil glands) that cover the face, arms, back and chest. Acne is an abnormal response to normal levels of the male hormone, testosterone, present in the blood of both men and women. As part of this abnormal reaction, pores in the skin become blocked causing blackheads, whiteheads, and even deeper lumps (cysts or nodules).

This abnormal response is self limiting and eventually acne does get better without treatment, but there is no way of predicting how long this can take: it may take a year or even a decade!

What acne treatments are available?

• Benzoyl peroxide is the best treatment, although some others are available. It acts as an antiseptic and an anti-inflammatory, and is available as a cream, gel, lotion or wash from your pharmacy, benzoyl peroxide acts as an antiseptic and an anti-inflammatory. Ask your pharmacist to recommend the most appropriate form for you.
• If your acne is severe, consult your doctor, who may recommend more powerful treatments such as antibiotic tablets, lotions and hormone treatments.

Is there anything else I can do to help acne?

• Frequent washing helps to reduce levels of sebum that is the cause of acne. Take care though, as excessive use of soaps will remove the protective skin layer and may make things worse.