Skin careorskincareis a range of practices that supportskinintegrity, enhance its appearance, and relieve skin conditions. They can include nutrition, avoidance of excessive sun exposure, and appropriate use of emollients. Practices that enhance appearance include the use ofcosmetics,botulinum,exfoliation,fillers,laser resurfacing,microdermabrasion,peels,retinoltherapy,[1]and ultrasonic skin treatment.[2]Skin care is a routine daily procedure in many settings, such as skin that is either too dry or too moist, and prevention ofdermatitisand prevention of skin injuries.[3]
Skin care is a part of the treatment ofwound healing,radiation therapyand some medications.
Background
Skin care is at the interface ofcosmetics[4]anddermatology.[5]
The USFederal Food, Drug, and Cosmetic Actdefines cosmetics as products intended to cleanse or beautify (for instance, shampoos and lipstick). A separate category exists for medications, which are intended to diagnose, cure, mitigate, treat, or prevent disease, or to affect the structure or function of the body (for instance, sunscreens and acne creams), although some products, such as moisturizing sunscreens and anti-dandruff shampoos, are regulated within both categories.[4][6]
Skin care differs fromdermatologyby its inclusion of non-physician professionals, such asestheticiansand wound care nursing staff.[1][7]Skin care includes modifications of individual behavior and of environmental and working conditions.[7]
Skin care by age
Neonate
Guidelines for neonatal skin care have been developed. Nevertheless, the pediatric and dermatological communities have not reached a consensus on best cleansing practices, as goodquality scientific evidenceis scarce.[8]Immersion in water seems superior to washing alone, and use of syntheticdetergentsor mild liquid baby cleansers seems comparable or superior to water alone.[8]
Children
Dermatologists normally recommend that children wash their skin with a mild cleanser, use moisturizing lotion as needed, and wear sunscreen every day.[9]
Adolescents
Adolescents may be influenced bysocial media marketingto buy expensive skin care products, which are often not appropriate for their age (e.g.,"anti-ageing" serums,which are for middle-aged and elderly people).[9]
Elderly
Skin ageing is associated with increased skin vulnerability,[10]and the texture and colour of the skin can change over time. Although wrinkles occur naturally due to ageing, smoking can intensify the appearance of wrinkles. Sunspots, dryness,wrinkles,andmelanomascan occur fromUVexposure over time, whether it be through thesunor throughtanning beds.Exposure to UV can make skin less elastic. Skin problems includingpruritusare common in the elderly but are often inadequately addressed.[11]A literature review of studies assessing the maintenance of skin integrity in the elderly found most studies to have lowlevels of evidence,but the review concluded that skin-cleansing with syntheticdetergentsoramphotericsurfactantsinduced less skin dryness than using soap and water.[10]Moisturizerswithhumectantshelped with skin dryness and skin barrier occlusive reduced skin injuries.[10]When taking baths or showers, using warm water rather than hot water can aid with dryness.
There is limited evidence that moisturizing soap bar; combinations of water soak, oil soak, and lotion are effective in maintaining the skin integrity of elderly people when compared to standard care.[12]
Research
Asystematic reviewexamined the benefits and clinical efficacy of routine skin care activities, such aswashing,bathing, and applyinglotions,in acute and long-term care adult settings. The study led to a proposed 2-step program targeting adults with intact or preclinically damaged skin.[13]
Sunscreen
Sun protection is an important aspect of skin care. Though the sun is beneficial in order for the human body to get its daily dose of vitamin D, unprotected excessive sunlight can cause extreme damage to the skin.Ultraviolet(UVA and UVB) radiation in the sun's rays can cause sunburn in varying degrees, early ageing and an increased risk of skin cancer.[14]UV exposure can cause patches of uneven skin tone and dry out the skin. It can reduce skin's elasticity and encourage sagging and wrinkle formation.
Sunscreencan protect the skin from sun damage; sunscreen should be applied at least 20 minutes before exposure and should be re-applied every four hours. Sunscreen should be applied to all areas of the skin that will be exposed to sunlight, and at least a tablespoon (25 ml) should be applied to each limb, the face, chest, and back, to ensure thorough coverage. Many tinted moisturizers, foundations and primers now contain some form of SPF.
Sunscreens may come in the form of creams, gels or lotions; theirSPFnumber indicates their effectiveness in protecting the skin from the sun's radiation. There are sunscreens available to suit every skin type; in particular, those with oily skin should choose non-comedogenic sunscreens; those with dry skins should choose sunscreens with moisturizers to help keep skin hydrated, and those with sensitive skin should choose unscented, hypoallergenic sunscreen and spot-test in an inconspicuous place (such as the inside of the elbow or behind the ear) to ensure that it does not irritate the skin.
Skin care by health concern
Acne
According to the American Academy of Dermatology, between 40 and 50 million Americans develop acne each year.[15]Although many associate acne with adolescence, acne can occur at any age, with its causes including heredity, hormones, menstruation, food, and emotional stress.[15]
Those with inflammatory acne should exfoliate with caution as the procedure may make conditions worse and consult a dermatologist before treatment.[15]Some anti-acne creams contain drying agents such asbenzoyl peroxide(in concentrations of 2.5 - 10% ).[16]
Pressure sore
Pressure sores are injuries to the skin and underlying tissue as a result of prolonged pressure on the skin. A known example of a pressure sore is a bedsore called a pressure ulcer.
Stoma
When cleaning the stoma area, plain warm water should be use and dry wipe to gently clean around the stoma. Pat gently and make sure not to rub the area. Put all used wipes in a disposable bag and wash your hands after.
Wound healing
Wound healing is a complex and fragile process in which the skin repairs itself after injury. It is susceptible to interruption or failure that creates non-healing chronic wounds.[17]
Radiation
Radiation induces skin reactions in the treated area, particularly in theaxilla,head and neck,perineumand skin fold regions.[18]Formulations with moisturising, anti-inflammatory, anti-microbial and wound healing properties are often used, but no preferred approach or individual product has been identified as best practice.[18][19]Soft silicone dressings that act as barriers to friction may be helpful.[18]In breast cancer,calendulacream may reduce the severity of radiation effects on the dark spot corrector.[19][20]Deodorantuse after completing radiation treatment has been controversial but is now recommended for practice.[20]
EGFR side effects
Epidermal growth factor receptor(EGFR) inhibitors are medications used in cancer treatment. These medications commonly cause skin and nail problems, including rashes, dry skin andparonychia.[21]Preventive intensive moisturizing with emollient ointments several times, avoidance of water-based creams and water soaks (although in certain circumstances white vinegar or potassium permanganate soaks may help), protection the skin from excessive exposure to sunshine, and soap substitutes which are less dehydrating for the skin than normal soaps, as well as shampoos that reduce the risk of scalp folliculitis, are recommended. Treatment measures with topical antibiotic medication can be helpful.[21][22][23]
Related products
Cosmeceuticalsare topically applied, combination products that bring togethercosmeticsand "biologically active ingredients". Products which are similar in perceived benefits but ingested orally are known asnutricosmetics.According to the United States Food and Drug Administration (FDA), the Food, Drug, and Cosmetic Act "does not recognize any such category as" cosmeceuticals. "A product can be a drug, a cosmetic, or a combination of both, but the term" cosmeceutical "has no meaning under the law". Drugs are subject to an intensive review and approval process by FDA. Cosmetics, and these related products, although regulated, are not approved by FDA prior to sale.
Elaborate skin care routines are promoted on social media platforms such asTikTok.[9]This has led to children and teens using harsh and inappropriate products, such asanti-aging products,which provide no benefit to young skin and may be harmful.[9]It has also encouraged children and teens to wearsunscreenevery day.[9]
Procedures
Skin care procedures include use of botulinum;[24]exfoliation; fillers;laser medicinein cosmetic resurfacing,hair removal,vitiligo,port-wine stainandtattoo removal;photodynamic therapy;microdermabrasion; peels; retinol therapy.[1]
References
- ^abcPenzer R, Ersser S.Principles of Skin Care: A Guide for Nurses and Health Care Practitioners.John Wiley & Sons, 2010.ISBN9781405170871[1]
- ^Rodulfo, Kristina (2018-04-06)."Ultrasonic Face De-Gunking Spatulas Are a Thing and You're Going to Want One".ELLE.Archivedfrom the original on 2019-02-03.Retrieved2020-03-08.
- ^Lichterfeld A, Hauss A, Surber C, Peters T, Blume-Peytavi U, Kottner J (2015)."Evidence-Based Skin Care: A Systematic Literature Review and the Development of a Basic Skin Care Algorithm"(PDF).J Wound Ostomy Continence Nurs.42(5): 501–24.doi:10.1097/WON.0000000000000162.PMID26165590.S2CID3841975.Archived(PDF)from the original on 2023-04-30.Retrieved2019-12-13.
- ^abKessler R. More than Cosmetic Changes: Taking Stock of Personal Care Product Safety. Environ Health Perspect; DOI:10.1289/ehp.123-A120[2]Archived2015-09-08 at theWayback Machine
- ^Random House Webster's Unabridged Dictionary.Random House, Inc. 2001. Page 537.ISBN0-375-72026-X
- ^FDA.Cosmetics: Guidance & Regulation; Laws & Regulations. Prohibited & Restricted Ingredients.[website]. U.S. Food and Drug Administration, Silver Spring, MD. Updated 26 January 2015.[3]Archived2019-04-23 at theWayback Machine
- ^abSchwanitz HJ, Riehl U, Schlesinger T, et al. (2003). "Skin care management: educational aspects".Int Arch Occup Environ Health.76(5): 374–81.Bibcode:2003IAOEH..76..374S.doi:10.1007/s00420-002-0428-z.PMID12719982.S2CID41740856.
- ^abBlume-Peytavi U, Hauser M, Stamatas GN, Pathirana D, Garcia Bartels N (2012). "Skin care practices for newborns and infants: review of the clinical evidence for best practices".Pediatr Dermatol.29(1): 1–14.doi:10.1111/j.1525-1470.2011.01594.x.PMID22011065.S2CID27763545.
- ^abcdeGecker, Jocelyn (2024-08-31)."Which skin care products should young girls use? Dermatologists recommend this simple routine".AP News.Retrieved2024-09-06.
- ^abcKottner J, Lichterfeld A, Blume-Peytavi U (2013). "Maintaining skin integrity in the aged: a systematic review".Br. J. Dermatol.169(3): 528–42.doi:10.1111/bjd.12469.hdl:1854/LU-8691723.PMID23773110.S2CID42191236.
- ^Beauregard S, Gilchrest BA (1987). "A survey of skin problems and skin care regimens in the elderly".Arch Dermatol.123(12): 1638–43.doi:10.1001/archderm.1987.01660360066014.PMID3688904.
- ^Cowdell, Fiona; Jadotte, Yuri T; Ersser, Steven J; Danby, Simon; Lawton, Sandra; Roberts, Amanda; Dyson, Judith (2020-01-23). Cochrane Skin Group (ed.)."Hygiene and emollient interventions for maintaining skin integrity in older people in hospital and residential care settings".Cochrane Database of Systematic Reviews.1(1): CD011377.doi:10.1002/14651858.CD011377.pub2.PMC6996088.PMID32006460.
- ^Lichterfeld A, Hauss A, Surber C, Peters T, Blume-Peytavi U, Kottner J (2015)."Evidence-Based Skin Care: A Systematic Literature Review and the Development of a Basic Skin Care Algorithm"(PDF).Journal of Wound, Ostomy and Continence Nursing.42(5): 501–524.doi:10.1097/WON.0000000000000162.PMID26165590.
- ^Clark A, Hessler JL (Aug 2015). "Skin Care".Facial Plast Surg Clin North Am.23(3): 285–95.doi:10.1016/j.fsc.2015.04.002.PMID26208767.S2CID32542642.
- ^abc"Acne clinical guideline".American Academy of Dermatology. 2018.Archivedfrom the original on 2019-05-18.Retrieved2019-09-26.
- ^"Topical Acne Drug Products".CFR - Code of Federal Regulations, Title 21, U.S. Food and Drug Administration. 1 April 2018.Archivedfrom the original on 23 December 2016.Retrieved23 December2016.
- ^Flanagan M.Wound Healing and Skin Integrity: Principles and Practice.John Wiley & Sons, 2013.ISBN9780470659779
- ^abcHerst PM (2014)."Protecting the radiation-damaged skin from friction: a mini review".J Med Radiat Sci.61(2): 119–25.doi:10.1002/jmrs.46.PMC4175840.PMID26229646.
- ^abMcQuestion M (2006). "Evidence-based skin care management in radiation therapy".Semin Oncol Nurs.22(3): 163–73.doi:10.1016/j.soncn.2006.04.004.PMID16893745.
- ^abMcQuestion M (2011). "Evidence-based skin care management in radiation therapy: clinical update".Semin Oncol Nurs.27(2): e1–17.doi:10.1016/j.soncn.2011.02.009.PMID21514477.
- ^abCalifano R, Tariq N, Compton S, et al. (2015)."Expert Consensus on the Management of Adverse Events from EGFR Tyrosine Kinase Inhibitors in the UK".Drugs.75(12): 1335–48.doi:10.1007/s40265-015-0434-6.PMC4532717.PMID26187773.
- ^Thatcher N, Nicolson M, Groves RW, et al. (2009)."Expert consensus on the management of erlotinib-associated cutaneous toxicity in the U.K."Oncologist.14(8): 840–7.doi:10.1634/theoncologist.2009-0055.PMID19679688.S2CID2455128.
- ^Kiyohara Y, Yamazaki N, Kishi A (2013)."Erlotinib-related skin toxicities: treatment strategies in patients with metastatic non-small cell lung cancer".J. Am. Acad. Dermatol.69(3): 463–72.doi:10.1016/j.jaad.2013.02.025.PMID23602600.
- ^"BOTOX® Cosmetic (onabotulinumtoxinA)"(PDF).