Omaha District UMC » Skin problem

Skin Anatomy

admin — Tue, 17 Feb 2009 15:29:19 +0000

The skin is the largest organ of the people. Depending on body size and body weight of their surface 1,5-2 m2. The skin has a mass of 3,5-10 kilograms and makes about 16 percent of body weight from.
While the skin on the feet and hands as a bar skin, is the rest of the body of the so-called skin covered fields. Together with the skin appendages such as hair, nails, sweat and sebaceous glands characterized by skin, the genetic unique appearance of the people and also met a number of tasks:
* Protective, shielding the interior of the body as mechanical, thermal and chemical barrier
* Temperature regulation by constriction or enlargement of the skin blood vessels
* Regulation of water, for example by supply of fluid and salts (sweating)
* Defined function, for example, by perception of thermal stimuli, touch, pain
* Immune function, for example in the context of infectious diseases and allergies
* Communication, for example, by blushing or testator
The knowledge of Finals of the skin is an important prerequisite for their function and disease understanding.

Urea and arginine hydrochloride in skin dryness

admin — Tue, 10 Feb 2009 08:44:46 +0000

At the age it is very important to Feuchtigsverlust of the skin by moisturizing creams and emulsions offset.
Dry skin is one of the typical changes of aging skin, so be retroactive greasy creams (for example, urea 5-10%) and water retention Externa used to the water to stabilize the skin . Dermatokosmetischen Many products can be not only the visual appearance, but also a number of dermatoses prevention. It is important to the dehydration of the skin at the age offset should be moisturizing creams and emulsions are used regularly. The gels containing urea Externa requires special attention, because urea has a very high water retention capacity in the skin. Gels containing urea creams have soothing effect on itching and scaly skin. With increasing age reduces the natural proportion of urea in the epidermis as a consequence of the strong keratinisation of keratinocytes and sebaceous glands are less active. In connection with the moisture in the skin is Arginin ones. From arginine by means of the enzyme Arginase urea off.
Consequently, the external application of arginine chloride to an increased urea synthesis of the corneal cells, which thus also for a reduction in dry skin care. The advantage argininhaltiger ointments to harnstoffhaltingen Externa could thus stimulating dermal natural enzyme system, because increased substrate leads to an increased implementation in urea .

Skin and scar treatment : What treatment options are there?

admin — Sat, 20 Sep 2008 20:36:37 +0000

Both injuries as well as in cosmetic surgery plays an important role in wound healing. She is disturbed, are often large and ugly scars. The medicine now has many new ways of preventing scar formation or in the case of scars already incurred, such a way that an aesthetically significantly improved picture.
Scarring arise when injuries or surgical wounds by the upper skin layer, the epidermis, through into lower layers of skin. . In this case, a complete restoration of the skin no longer exists. for example by smooth cuts, forming a narrow, barely visible scar. .A variety of reasons, such as in large-scale injury or wound, healing can result in disturbances, during which most conspicuous scarring arise.

For the prevention and treatment of such aesthetic scar deformities can now depending on the initial injury, localization and form non-operational and operational procedures for obtaining the best possible outcome effectively be combined:

Compression therapy for prevention

So that those affected will not suffer under excessive scarring, it is advisable for certain injuries or starting individual circumstances from the outset, preventive measures. A compression or pressure therapy may be used if the risk of the formation of hypertrophy. scarring and large proliferations (in the jargon keloids) exists. Affected are, for example, patients undergoing extensive injuries such as burns, skin disease have. Customized shirts or elastic compression stockings exert pressure on the affected skin from bodies. . The resulting lack of oxygen prevents excessive collagen formation, which cultigens scars and may lead proliferations.

What do scar creams, cortisone preparations and silicone gel?

In many cases, however, already applying a drug or tool on the wound or fresh scar ensure that an optimal result of the wound is reached. die Vitamin A Very small and shallow scars can be used locally to apply creams and tinctures, the vitamin A or the female hormone estrogen (in women only!) That improve – provided that the funds will be applied. The application of silicone gel helps patients with a known predisposition to the training of proliferating scarring (keloids). An optimal protection against recurrence of scars, the combined use of silicone gel with operational procedures or laser surgery. Also entering from preparations into the wound can abnormalities in the proliferating prevent scar.

Cold treatment, peeling and lasers

Even if long-term scars already exist, help is possible. EA number of methods are available to the scars structure to improve. which in principle to all forms of scarring is suitable. These are the scars by cold applications, by spraying with liquid nitrogen or by a special probe in contact practices, superficially freezes the tissue and so desolate.

Can also be healed skin areas using lasers or chemical peeling smooth. For Atrophic (thin, depressed) scars are primarily of Er: YAG laser or pulsed CO2 laser used. To treat depressed acne scars offers include a medium-deep chemical peeling with trichloroacetic acid (TCA) to.Often these so-called minimally invasive procedure with a local drug therapy combined.

Cutting and milling – the operational procedures

Large and deep, depressed scars can be easily removed surgically. The field will be cut out and then stitched the wound. For small deep scars which is suitable Punching technology, with the scars of the affected area . The advantage: The wound must not be stitched, but is equipped with a lockable tape. Operative corrections are also possible with bad scars histories that lead to tensions. These should be in the best possible case to a late stage after the scar to be carried out. For several far-flung, cultigens scars herds recommends the so-called dermabrasion – until the skin in the area between the upper and leather skin.

Natural substances Injection

Finally, in recent years the use of biomaterials also for the treatment of scars proved. Substances like collagen, hyaluronic acid or own fat are here on everyone’s lips. These are the scars injected area and offer the advantage of a generally very good tolerability. To an aesthetically pleasing result to maintain the applications, however, from time to time be repeated.

Cosmetics and their effects on skin

admin — Sat, 20 Sep 2008 19:16:22 +0000

Under certain conditions, skin care ingredients of funds inflammatory processes in the skin trigger. Conversely, there are substances in cosmetics, the inflammatory processes can hamper effective. The following table summarizes these contrasting ingredients exemplary compared.Inflammatory reactions of the skin by infections, radiation, injury, mechanical and chemical stimuli triggered and expressed in general by redness, local temperature increase, swelling, burning and itching.The concentration `sCosmetic Ingredients irritations through can be triggered at high concentrations, ie when a threshold dose is exceeded. This is true for purifying the type of surfactants sodium lauryl sulfate to the skin measurements long as comparative Standardizations serves. Sodium lauryl sulfate denatured proteins and acts hämolysierend.

High doses of vitamin A (retinol) lead to reactions, as they are from vitamin A acid (retinoic acid) knows. While sodium lauryl sulfate is an example of a direct irritation offers, the reaction of vitamin A only indirectly by subsequent biochemical conversion into another substance. The strength of the irritation of many individual factors, such as skin thickness, the integrity of the barrier and the individual tolerance. For example, to ensure that children’s skin is much more permeable.

A connective tissue may be a general sensitivity for Hypertonic cause water phases. In this case, it is irrelevant what substances in the water phase. It plays physically seen only the resulting total concentration of a role. In rare cases, the tolerance limit even in hypotensive water phases achieved when released by evaporation of the drug contained in the water on the skin are concentrated.

How critical concentrations, is also in fruit acid treatments significantly. Here are the irritations even intends to create a regeneration of the skin to provoke. The threshold dose depends on the pH of the preparations from; at low pH is lower the threshold dose, with increasing pH with proportional increases fruit acid salts them.
Phototoxic operations
More or less unpredictable are the ingredients of plant extracts in people prone to allergies. Therefore, we recommend a test on the forearm when it is not safe. The culprit may proteins, biogenic amines and sharpness substances with the type of stimulus to capsaicin.

In contrast with other ingredients are predictable reactions when certain conditions occur. This is especially true for phototoxic inflammation, which in the case of natural and synthetic ingredients are observed. The allergenic Ascaridol, a terpene Endoperoxide, formed in the tea tree oil under the influence of atmospheric oxygen and ultraviolet radiation.

Figure: Ascaridol; in the middle are the two oxygen atoms of the endo-peroxide  

Another allergenic Autoxidations product of tea tree oil is 1.2.4-Trihydroxymenthan. Similarly with Bergamotteöl whose Bergapten ingredient, a derivative psoralens (5-methoxypsoralen), with appropriate concentration can cause skin inflammation. 

Psoralens (furocoumarines) are also in lemon and orange peel, so it is imprudent for the removal of shells and related contamination in susceptible individuals phototoxischer dermatitis around the mouth can occur.

Even the Hypericin of St. John’s wort shows photosensitising properties. Accompanying a rather innocuous appearance later are stubborn.Phototoxic reactions are always to be observedSt. John’s wort is often administered orally and shows the need for unusual skin reactions, even after other factors than just the funds used skin care research. As a frequently occurring natural substance is still in mascara  used to say, whose content in Abietic acid leads to contact allergy, the actual cause is not, however, the acid itself, but its reaction product with atmospheric oxygen.

Among the synthetic materials react especially polyether of ethylene glycol, also known as PEG, and their connections with long-alcohols – “ethoxylated alcohols” such as CETEARETH, Pareth (INCI) – under the influence of UV radiation with atmospheric oxygen.
  Figure: formation of Hydroperoxide from PEG’s

(R1 and R2 symbolize different PEG chains remaining)
The educated Hydroperoxide are very aggressive and one of the causes of the dreaded Mallorca acne. It is therefore advisable to maintain fresh and perfumed not immediately suspend the sun, since the proportion of UV radiation, a variety of substances changed and dismantled, including antioxidant vitamins. The same applies to the use of deodorant products, if they are essential oils or synthetic chlorinated hydrocarbons contain. Since it comparatively more sensitive skin are applied, here is special caution.

Allergic reactions to preservatives are widely known and need at this point is not particularly emphasized. This applies without exception to all in the annex to the Cosmetics Regulation listed substances.
Anti inflammatory
Now there are substances in cosmetics, which can inhibit inflammation. These should be – it was said – not the sun Suspended, because of their sensitivity easily dismantled and thus may be ineffective. They work by different mechanisms:

Antioxidants inhibit depending on the structure of the above Photooxidation by:
by UV light generated hydrocarbon radicals defuse,

Activated oxygen molecules or intercept

formed with the oxidation products.

But they are no panacea, because they themselves are consumed, and therefore a limited capacity. The disadvantage is that they themselves naturally by the combination O2/UV be attacked. Moreover, they can not in any high concentrations, since then, such as vitamin E, own radical chain reactions, and thus become counter-productive. A sound basic forms of protection of this intact NMF of the skin. Detailed information about cosmetic practice in 2006 (2), 12-14 to find. Extracts & Co with their anti-inflammatory drugs to help the sun to treat erythema. These include aloe, sunhat and D-panthenol (see Cosmetic Practice 2006 (3), 8-9).

Not all the inflammatory processes in the skin by atmospheric oxygen and sunlight triggered. Other triggers are infections, injuries, chronic mechanical stimuli as well as barrier-and disorders. Regardless of the trigger inflammation cascade follows the same pattern multiples at which the body’s own enzymes are involved. An important key enzyme is 5-Lipoxygenase, the arachidonic acid to 5-Hydroperoxyeicosatetraensäure (5-HPETE) oxidized, from the subsequent proinflammatory Leukotrienes LTA4, LTB4, LTC4, LTD4 and LTE4 arise.

Picture: Education proinflammatory Leukotrienes

(Formulas from top to bottom: arachidonic acid, 5-HPETE, leukotrienes LTA4)
 The skin with Bowellia nanoparticles in people who acne vulgaris, actinic keratosis, psoriasis and atopic tends, in practice has proved very good. The formation of the above is Leukotrienes including by omega-3-acids, such as α-linolenic acid (for example, comes in linseed oil and rosehips before) and Eicosapentaensäure (part of the fish oil) reduced.

Omega-3-acids and omega-6-acids (linoleic acid, γ-linolenic acid) are among the essential fatty acids and inhibit inflammation in terms of yet another interesting feature. They are in the skin by 15-Lipoxygenase to anti-inflammatory acids oxidized. Natural oils with a high proportion of essential fatty acids are bound, therefore, for skin care is of great value. Because of their sensitivity, they are best applied at night.

Among the anti-inflammatory extracts were representative of many other Calendula (active ingredients: terpenes), Spitzweg Erich (active ingredient: Acetosid), Mahonia (belongs to the substance: Berberine), chamomile (among other ingredients: aloe vera-α), willow bark (various phenolic Agents), Arnica (substances that are derived from Helenalin) to call. Arnica is just one example of the individual tolerance of different plant extracts. Apart from the healing effects may also opposite effects such as arnica allergy, dermatitis and eczema occur.