Transcript Management - ClubRunner

The Skin Why
Protect It
Associate Professor Geoff Sussman
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Protects
Transmits sensations: touch, pressure, pain
Regulates body temperature
Excretes wastes
Prevents excessive loss of body fluids
Synthesizes vitamin D
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15 sebaceous glands
0.9 metres of blood vessels
100 sweat glands
3,000 sensory nerve cells
3.7 metre of nerves
25 pressure apparatus for touch
2 receptors for cold
12 receptors for heat
300,000 epidermal cells
10 hairs
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Dermis loses 80% of its original thickness
40% less collagen
Sebum and sweat production is reduced
Epidermal layer separates more easily from the
dermis
Elastin fibres decrease in number but increase in
size, thus making the skin stiff
Decrease in Langerhan cells - thus the immune
system functions
Small blood vessels diminish by 40%
◦  vitamin D, collagen and moisture
◦  migration of capillary epithelial cells
◦  epidermal turnover
◦ fragility of capillaries
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SKIN Ph
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SKIN MOISTURE
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SUN DAMAGE
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USE OF SKIN ADHESIVES
It is essential to ensure as the skin ages that
appropriate measures are taken such as not
using soap or other alkaline pH products that
will increase the drying and therefore cracking
of the skin
The ‘acid mantle’ of the stratum corneum seems to be
important for both permeability barrier formation and
skin antimicrobial defense. Changes in the pH are
reported to play a role in the cause of skin diseases
like irritant contact dermatitis, atopic dermatitis, acne
vulgaris and fungal infections. Repeated washings
with soap may reduce the normal skin flora, leading to
an increased colonization of the skin with coagulasenegative staphylococci.
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The basic fat usually animal fat but may
include vegetable fat is mixed with Caustic
Soda to saponify the mixture and form the
base soap mill. This is then mixed with
additives, perfume, and other ingredients
and then pressed into moulds to form the bar
of soap.
The issue is that the Caustic Soda is not
neutralized so the final product is alkaline.
Most soaps and detergents are alkaline and
induce an increase in cutaneous pH, which
affects the physiologic protective “acid mantle” of
the skin by decreasing the fat content.
Disruption of stratum corneum and changes in
pH are key elements in the induction of irritant
contact dermatitis and pruritus by soaps.
These conditions are exacerbated in the winter
months in people with dry, sensitive skin.
Brand
pH
Neutrogena
9.5
Cussons Baby Soap
10.8
Cussons Imperial Leather
10.9
J & J Baby Soap
11.0
Palmolive Regular
11.0
Pears
10.8
Velvet
11.0
Simple Soap
11.2
Dove
Cetaphil Bar
QV Bar
Wash wounds with a pH 5-6 wash if basically clean
Using appropriate moisturising agents to ensure
suppleness and to minimise the drying effects
of the ageing process on the skin including.
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Skin creams e.g. Sorbolene {little value}
Skin ointments e.g. Wool Alcohols ointment
Bath oils
Barrier films
Sorbolene and other aqueous creams are of little value as
Moisturizers.
Recent published studies in the British Journal of Dermatology have
reported a significant increase in transepidermal water loss.
Another study reported Impacts on cellular and molecular level of
the skin. Increased desquamatory and inflammatory protease
activity. Changes in corneocyte maturity and size indicate an
accelerated skin turnover induced by chronic application of this
Emollient.
Danby ey al The effects of aqueous cream on the skin barrier in patients withy a previous history
of atopic dermatitis BJ Derm 201165,329-334
Mohammed D et al Influence of aqueous cream on corneocyte size, maturity, skin protease
activity, protein content and transepidermal water loss. B J Dermat 2011 1643,1304-1310
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Products
Products
Products
Products
from
from
from
from
Ego
Hamilton
Dermatech
Nivea
Simple products with few preservatives and
few ingredients.
Simple products with few preservatives and few ingredients.
Use of a Lactic Acid Foot Heel Cream
1. WOUNDS SHOULD BE KEPT CLEAN AND DRY
SO THAT A SCAB FORMS OVER THE WOUND
2. WOUNDS SHOULD BE EXPOSED TO AIR AND
SUNLIGHT AS MUCH AS POSSIBLE
3. WHERE TISSUE LOSS IS PRESENT THE WOUND SHOULD
BE PACKED TO PREVENT SURFACE CLOSURE BEFORE
THE CAVITY IS FILLED
4. WOUNDS SHOULD BE COVERED WITH A DRY DRESSING
1.THE SCAB (DEHYDRATED EXUDATE AND DYING DERMIS) IS A
PHYSICAL BARRIER TO HEALING THE DELAY BECAUSE EPIDERMAL
CELLS CANNOT MOVE EASILY UNDER THE SCAB THERE MAY BE
POOR COSMETIC RESULTS AND SCARRING.
2. EXPOSURE TO AIR REDUCES SURFACE TEMPERATURE OF THE
WOUND AND DRIES THE WOUND CAUSING FURTHER DELAYS
HEALING
3. GAUZE PACKING IMPAIRES THE QUALITY OF HEALING
4. THE DRESSING MAY ADHERE TO THE WOUND AND CAUSE TRAUMA
WHEN IT IS REMOVED.
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Intrinsic
- health status
- immune function
- age factors
- body build
- diabetes
- nutritional status
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Extrinsic
- mechanical stress
- debris
- temperature
- drying/maceration
- infection
- chemical stress
- other factors (e.g.
smoking, drugs)
Antisepsis
Acute injuries will often be contaminated by the
surroundings where the injury occurred e.g.
dirt, gravel, grass, clothing or other foreign
material. The risk of infection developing in
these wounds is high due to the inflammatory
nature of the wound as the tissue commences
the healing process.
Antisepsis
The thorough decontaminating of the wound with
a good surfactant product will help to remove
most of the foreign material and reduce the risk
of infection. It is also appropriate to apply a
topical antiseptic before dressing the wound.
This is usually left in place for 3-5 minutes and
then washed off with clean water.
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The use of alcoholic hand gels is superior to
washing.
Out with the Old
and in
with the New
What should a home First Aid kit contain
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Hydrogel for burns
Simple waterproof dressing
Simple non-waterproof dressing
Haemostatic for bleeding
Cohesive bandage (support)
Simple antiseptic (Betadine)
Swabs for cleaning
Steri-strips closure
Foam dressing (older people to cover skin
tears)
Simple non-waterproof dressing
Simple waterproof dressing
Strips
Antiseptic solution
Foam dressings
Haemostatic dressing
Hydrogel dressings
Bandages
Cleaning swabs
Conclusion
Looking after your skin is very important.
The skin plays a vital role in protecting
the body. Good hydration, moisturizers and
protection from damage are simple ways
to ensure good skin health.