Acne

Acne is a condition of the pilosebaceous gland. Mild acne affects the majority of teenagers at some point, but in one study only 14% of girls and 9% of boys actually consulted their GP and of these 0.3% were referred to see a dermatologist (Rademaker et al., 1989). However, acne is not just a condition affecting teenagers, it can persist into adult years and for a number of people it appears for the first time after teenage years are left well behind. There are also instances in which babies show signs of acnetype lesions (Cunliffe et al., 2001). Acne is a condition which can be effectively treated. In order to make the most of the treatments available, it is helpful for nurses to understand the underlying pathology of the condition. There are a range of treatments available; however, patients need support to ensure that they are used appropriately and effectively.

Psychological and social aspects of skin care

The interplay between the skin and the mind and individuals and their communities, is not in any way a new concept. Indeed, the nursing literature has made mention of it years before more scientific work examined the nature of the relationship between the brain and the skin. In an attempt to understand this relationship, this section will look at the pathophysiological changes that affect both the brain and the skin in what has become known as the brain–skin axis. Once these are understood, it is then helpful to gain some insight into the coping mechanisms that people employ to enable them to live with chronic skin conditions. At the same time, it is important to bear in mind that some people struggle to cope and as such, the section will look at some nursing interventions that can improve mental well-being and the ability to cope with adverse health experiences.

Laser Skin Resurfacing

The cutaneous application of laser technology was launched in 1959 with the development of the 694-nm ruby laser by Maiman. Over the next two decades, the argon laser, used to treat vascular lesions, and the carbon dioxide (CO₂) laser, used to vaporize epidermal and dermal lesions,became the focus of research and development. Because these lasers yielded a high rate of hypertrophic scarring and pigmentary alteration due to excessive thermal injury to dermal tissue, their use in dermatology was limited.

Skin cancer and its prevention

Cancer is the commonest cause of death in people aged 50–64; one in four people die of cancer (Office of National Statistics, 2009). Skin cancer is the most frequently diagnosed cancer in the UK, and rates of melanoma have risen faster than any other major cancer (Cancer Research UK, 2009a). The All Party Parliamentary Group on Skin (APPGS, 2003) enquiry into the treatment, management and prevention of skin cancer reports that the incidence of skin cancer has doubled within the last 20 years.

Oral Antioxidant Nutrients

In light of new research on the importance of these vitamins to overall health, the Institute of Medicine (IOM) in Washington, D.C., recently released new dietary guidelines for intake of the antioxidant nutrients vitamin C, vitamin E, carotenoids, and selenium. In addition, a variety of other nutrients are believed to be involved in antioxidant processes.According to the IOM, a dietary antioxidant is defined as “a substance in foods that significantly decreases the adverse effects of reactive species, such as reactive oxygen and nitrogen species, on the normal physiological function in humans”.

Sclerotherapy

Varicose veins and the subset of small varicosities referred to as telangiectatic and reticular veins are the most common vascular disorders of the lower extremities. Up to 60% of American adults are affected with varicose veins, and the incidence increases with age [1]. Many of these patients are affected not only by their appearance, but also by the quality of life that can accompany varicose veins. Varicosities can be associated with varying degrees of discomfort and pain, lipodermatosclerosis, venous ulcerations, thrombophlebitis, and deep vein thrombosis.

Disorders of Fat

Anetoderma » Focal dermal defect: localized areas of atrophic skin with laxity or herniated appearance over trunk, thighs and arms, ± overlying skin depressed or macular » Normal epidermis, ↓ or absent elastic tissue in dermis with special stain (may appear normal on H&E), ± perivascular lymphocytes » May be primary (idiopathic) or secondary (infection, inflammatory cutaneous disorder or tumor).

Biology of the skin

The skin is the largest organ of the body weighing between 2 and 4.5 kg (16% of body weight) and covering approximately 2 m² (Tortora and Derrickson, 2006). The skin is between 1 and 2 mm thick, depending on the part of the body that is being considered. It is dynamic and changing, capable of healing itself and responding to the external environment in such a way that ensures human survival.