Positive Health Online

Fans of the sun-tanned skin do everything to obtain a good tan and to be attractive. When the summer finishes, the tan fades away little by little. Fortunately, nowadays there are solar studios where one can get brown even in winter months. At the beginning, exposure to the sun is very relaxing and pleasant, but after a certain time the skin stops tanning and, in pigmented sections, spots begin to be observed. How can modern dermatology help us in order for our skin to look flawless?

Medicine and Cosmetics. Do You Know Your Skin?

Skin is a complex organ that covers and shapes the body, protects the organism from various outside and inner factors and ensures stability of its inner parts. Skin surface of an adult is about 1.5-2 metres. The total mass of the skin is about three kilos and the thickness is from 0.5-4 mm. Consistency is softly elastic; density varies from region to region. Turgor depends on the body region, blood supply, secretory functions and various outside and inside influences. Skin elasticity is good and this gives the opportunity for considerable stretch and shrinkage. Owing to this, skin keeps its function even when body weight varies considerably. It is dotted with a lot of openings – skin pores – orifices of the outlet canals of sudoriferous and sebaceous glands. Secretions of these glands – sweat and sebum – mix on the surface and emit the typical smell for every individual.

The skin consists of three main layers: epidermis, dermis and hypodermis.

The outer layer, called the epidermis consists of flat epithelium of many layers, which renews by mitotic fission of the basal cells. The four layers arranged from dermis to the surface are as follows: basic (stratum basale), spiny (stratum spinosum), grainy (stratum granulosum) and corneous (stratum corneum). The cells (melanocites) in the epidermis produce the skin pigment, melanin. The latter is responsible for skin colour. Biochemically, epidermis consists of scleroprotein, albumen, lipid substances and free cholesterol.

Dermis is under the epidermis. This is the virtual skin layer and basically it contains connective tissue. The two dermal layers are: upper (stratum papillare) located under the epidermis and real dermis (stratum reticulare). They are built from connective tissue collagen filaments, plasmocites and leucocites.

The real dermis is abundantly supplied with blood and lymph vessels, nerves and nerve endings. The hair follicle and its root, sudoriferous and sebaceous glands are in the real dermis. Biochemically, the collagen filament contains about 60 per cent water, 0.5 per cent mineral salts (Fe, K, Na, Mg, Cl). They are rich in amino acids – mostly glycine, lysine, arginine, histidine and phenylalanine. There are also mucoid substances rich in aminoproteins and imidasol.

The subcutaneous layer called the hypodermis is under the dermis. It consists of connective tissue filaments that connect the dermis with adjoining organs. The space between them is filled with fatty tissue (lobuli adipos) built from fat cells. Biochemically, the hypodermis is built from 30 per cent water, 3.5 per cent fibrous substances and 65 per cent fat. They contain fatty acids – olein, stearin, palmitic acid – and they together with glycerol make a tri-ester. Because of the high fatty content, hypodermis has the function of a thermal isolator and is the most important power reserve of the organism.

Skin Physiology

Keratopoiesis is a process of formation of the normal corneous layer which consists of cells filled with albumin called keratin. The cells from all layers of the epidermis undergo complex morphological and biochemical changes. They continually renew themselves and maintain the strength and completeness of the skin.

Melanogenesis is a complex biochemical process that converts the colourless amino acid tyrosine into an insoluble colourful polymer called melanin. Melanin is the most important pigment and the skin colour of everybody depends on it. Without melanin the skin of albinos becomes transparently white. Melanin protects adjacent tissue against sharp and chronic damage by ultraviolet radiation that causes burning, ageing and malignant degeneration. Melanin also protects against the harmful effect of free radicals and regulates the biosynthesis of vitamin D in the skin. Its distribution in the human races is according to solar radiation.

A human being uses up about 2000 calories during 24 hours; 1500 of them are lost through the skin, The skin is a bad conductor of heat; physiological cooling is slow and is regulated by absorbing thermal rays from outside at the same time. This process proceeds passively. The skin fulfils its active thermoregulating function by secretion of sweat.

Some of the rays reflect off the corneous layer and thus perform the protective function of the skin. Other rays (UV) penetrate but are absorbed by the basal cells and increase the synthesis of melanin.

The elasticity of the skin is due to mechanical properties such as deformation, dynamic and static strength. The effect of filling up the skin with liquid, its physical strain, elasticity, resistance in case of mechanical impact and relaxation ability, is the so called skin turgor. It is a property of the skin's elasticity. It depends on the sex, age, hormonal state, hydration etc.

Skin Conditions

There are dry, greasy and mixed type skins. The greasy type is a result of exaggerated secretion from the sebaceous glands, more than adequate for the skin's need. Humidity and hot climates stimulate sebaceous glands. Greasy skin has distinctive qualities. For example, age spots, pigmented change and wrinkles come into view later than with other types of skin. Freckles don't appear and sunburn is less likely. On the other hand, greasy skin is more likely to have acne, widened pores and look 'glittering'.

Dry skin is a result of the loss of natural fat. The reasons for this are many: genetic factors, vitamin shortage, bad nutrition or different illnesses. This is more common among women under 35 years old. Fair-skinned people more often have dry skin. Advanced in years, the dermis usually gets thinner and drier.

Chapped and split skin means extremely dry, dehydrated skin. It is usually located in regions which are exposed to outside influence: face, arms.

Skin suffers from different diseases, mostly from acne. It is an inflammatory illness, and pimples, blackheads and cysts can appear.

Acne usually appears during puberty when the secretion of androgens (various male sex hormones) increases rapidly. This stimulates the production of keratin and sebum. The shortage of nourishing substances or excessive consumption of processed food containing saturated and hydrated fat also causes acne.

Skin is the largest organ of the body. It breathes. If the pores are occluded by dust or other substances, the microbes that have penetrated there cause flushing and inflammatory reactions. The use of synthetic chemical substances that have been the base of the cosmetic industry for many years is a reason for super-
sensitiveness/hyperaesthesia/ allergy of the skin.

In the course of time, wrinkles appear because the skin has lost its elasticity. For as long as the skin is flexible, skin flaps disappear as soon as a grimace does. Otherwise, the lines made by a smile or an angry face don't disappear when the face has a more neutral expression. Then the flaps become deeper and deeper and convert into wrinkles. The first wrinkles are in the area of the eyes, known as 'laughter wrinkles', then around the mouth and cheeks. The dermis gets thinner and drier and this is another reason for wrinkles. Other reasons that influence the speed and the extent of spread are: nutrition, muscle tone, usual expression of the face, stress, good skin care (or lack), polluted environment, smoking, long sun exposure.

Young people often complain of pigment spots on their skin after sun exposure, although the duration may vary and not be excessive. The explanation is that they are caused by holes in the ozone layer and some other factors.

But from the scientific point of view, substances that can be found in some plants, fruit, vegetables and drugs are the reasons. They accumulate in the skin and skin sensitivity to sunlight increases.

Taking such substances in food or even by touching these 'catalysers' of sunburn like onion, garlic, fig and some drugs – for example, tetracycline – the human being runs a considerable risk of damaging its dermis by covering it with unpleasant, lasting, dark spots.

Remember that the skin is sensitive and does not like the sun too much.

Bronze suntan that we flaunt after a holiday may look wonderful but it isn't useful. The myth that the suntan is health was debunked long ago. Experts warn that the skin has its memory and does not forgive even one damage caused by ultraviolet rays. In practice, dark tan is an involuntary attempt by the dermis to protect itself from the sun, and its rays penetrating into the deepest layers. If sunbathers are dosed correctly, then their immunity increases. But staying on the beach for only a few hours exhausts the protective mechanism and that is harmful.

As far as beauty is concerned, everything is relative. On the one hand, the tanned body looks really nice. But on the other, the skin gets thicker, coarse and loses some of its moisture in stopping the penetration of ultraviolet rays. As a result of this, wrinkles appear and even 'furrows'. In a few weeks after the summer holiday the wonderful bronzed tan has gone, but the wrinkles remain. It is proven that, because of excessive sun exposure, skin-ageing happens faster and pigmented spots appear.

And something more… Only a few days in the intense sun are enough to be taken ill with keratoma, which can be treated but sometimes without success. Mostly, baldheaded people who don't use a hat are the frequent victims.

Let's remember that sun protection cream does not protect the dermis from dark spots that bring about cancer. Those people who use a lot of sun protection cream may have more and darker spots than those who don't.

It is true that the body accumulates more vitamin D, but maybe more than is necessary, and often before you get to the beach.

Development of Cancer

If the skin turns red after a long stay in the sun, burning occurs which causes cells to perish 'in the prime of life'. When there is damage, the organism makes some kind of self-repair but it isn't unpunished. If burning happens again, it is possibly a defective cell that starts division and conveys genetic disinformation to other cells. The process can go on for years and inner reserves won't be enough to stop the increase of malignant cells, which are 'immortal' by an irony of fate.

Skin cancer is a widely spread oncological disease.

Even in early childhood, with a fair complexion and red hair, skin spots caused by the sun, known also as freckles, can appear. With growing up, freckles disappear in certain places. If the skin is exposed to UV-rays continuously, freckles hardly fade away and remain noticeable.

Examination shows that freckles are preceded by a pigment similar to the dark pigment of normal complexion, while in the lighter part of the skin, around the freckles, red pigmentation can be observed.

The extent of skin tan is determined by these pigments, the combination of which determines its type. With people of fair complexion, it is not possible to achieve a uniform and complete suntan.

Spots on the skin caused by exposure to sun and the so-called age spots can appear on skin which has been exposed to the sun for many years, but also after having visited a solarium frequently.

Unlike freckles, which are never bigger than a few millimetres, skin spots caused by exposure to the sun are as big as a few centimetres. Those spots often appear on the arms and the face as well as around the neckline and on the neck. As a rule, the geriatric spots are of one and the same pigmentation and are very rarely pigmented non-uniformly. If they are not of uniform pigmentation, one should consult a dermatologist because the skin cancer (the so-called melanoma) begins its development from such spots.

If pigmented changes of the skin are in relief, they are not spots but a kind of wart.

Skin cancer at an early stage is characterized by the horny layer becoming thick and hard, like a crust, that can be pigmented brown. Skin spots can turn into pigmented warts and increase in size significantly. Using a microscope, the dermatologist can distinguish an ordinary wart from a malignant tumour that has already formed a melanoma or pigmented carcinoma.

The modern dermatologist has a number of efficient methods of treatment for skin pigmentation: from improving the skin's appearance to the complete removal of spots. The methods involve local treatment with ointments, bleaching creams; treatment with fruit acids; laser therapy as well as cryogenic therapy, processing spots with liquid nitrogen.

The best protection against the appearance of spots on the skin is to avoid exposure to the sun for a long time and to use enough means of protection.

Acceleration of the microcirculation of the skin can be achieved by taking vitamin C that makes oxygen accessible.

When production of melanin is not sufficient, this may result in pigmented spots. The use of vitamin V helps to bleach them.

Some products for sun protection, which contain essence of bergamot, lemon, crane's bill and others are not recommended because they favour the appearance of diffuse pigmented spots on the dermis.

To get a tanned complexion in summer without danger for your health, you have to learn how to sun your body. It is better not to sunbathe directly on grass because the sap of some herbs can have a harmful effect on your skin.

What is the best sun protection cream for your skin?

Most people think that when they buy high factor cream (LSF) they will protect themselves from darkening while sunning. Unfortunately, this is not true. When you use a high protection factor cream your skin may darken. The special cream protects the skin from burning and retains the darkened skin.

Skin burning is an inflammatory process and the damaged cells regenerate themselves by removing the cells of the upper skin layer that have accumulated pigment which turns red.

Should You Continue to Use Protective Cream if Your Skin has Already Darkened?

It is widely believed that once your skin has darkened it is not necessary to use sun protection cream. But even darkened skin can be damaged if sunned intensively, although, the consequences only become visible later, like skin-ageing or the appearance of so-called 'age spots'.

Which Rays Are Harmful for Your Skin?

UVB and UVA rays!

UVA rays don't cause skin burning but penetrate deeply into the corneous layer and accelerate skin-ageing.

According to new research, high doses of UVA irradiation can bring about skin cancer.

UVB-rays are far more aggressive than UVA-rays and cause skin burning.

What Is Sun Allergy Like?

After sun exposure, different changes in the skin occur in most cases: for example, turning red, skin blisters or intensive heat or itch. If you have such problems, it is better to avoid the sun and to use cream with very high sun protection factor.

How to Calculate Your Sun Protection Factor?

According to dermatologists, after a short time in the sun, the first visible turning red occurs at sun exposure; they call it the erythematous dose.

The time this takes varies from 20 to 40 minutes and depends on the type of skin. If you have planned to sun for two hours and the time after your skin turns red is only 10 minutes, we get the respective sun protection factor 12:120/10=12 (according to the old rule). Skin darkening without UVB-rays burning (according to the new rule) = keep the rule 60 per cent of the time in the sun and then the skin turns red. This means doubling the sun protection factor to 24 or more accurately calculated to factor 20.

If you want to obtain an even sunburn, you have to take into consideration your dermis type.

The right choice of cosmetic products for skin protection and for prevention of pigmented spots while you sun is of great significance.

Firstly, the type of skin and its individual needs have to be specified correctly.

The main criteria used to specify the skin types are: the intensity of greasing and the ability to retain moisture.

Four main types of skin are distinguished when choosing the right cosmetic product for sun protection.

Normal skin has an even complexion: mat, without surplus glitter. The skin looks sleek, elastic and fresh. There aren't any defects on it like widened pores, blackheads, pigmented spots and so on. This skin stands soap washing very well and doesn't suffer from excessive discomfort. It is stable to different cosmetic products and unfavourable climatic conditions.

Dry skin can be thin, tender, mat, sleek. In youth, the skin looks very beautiful but as a rule it tends to early ageing. It starts peeling, loses its elasticity early and wrinkles appear especially around the eyes. If it is not looked after with appropriate skin care, these processes develop quicker. Dry skin is allergic to soap, unfavourable climatic conditions and unsuitable cosmetic care.

Greasy skin looks thick and coarse, with large pores and greasy glitter. Blackheads and inflammation often occur. The pH level is strongly alkaline. It looks like lemon peel. But this skin has some advantages: it keeps its elasticity and stands up to soap washing and unfavourable climatic conditions.

Combined type skin has features of normal and greasy skin at the same time. The skin is usually greasy in the T-zone (forehead, nose and chin) and tends to blackheads and pimples, but is normal in the rest of the face.

Freckles are not a mistake of nature, but the protective reaction of the organism to the harmful effect of ultraviolet rays. These rays are very dangerous for fair-haired and red-haired people because they have little melanin content.

The function of freckles with pigment is to accumulate the sunrays and in this way protect the dermis.

Preventing freckles and unpleasant pigmented spots is not difficult. What must be done is to wear sunglasses, wide brim hats and loose clothes in natural material.

Between midday and three o'clock it is better to be in the shade. If, however, you have decided to go out in the sun, it is absolutely necessary to use a sun protection cream with high protective factor.

Modern Methods of Treatment for Skin Scars and Fibrosis

A lot of people suffer from various skin scars, which, in many cases, besides visible changes in the skin, cause sensitivity to environmental and weather changes. These scars are often a result of operative interventions.

Scars can stiffen and knit with the connective tissue. Operation scars such as those after arthroscopy and bypass or the scars from skin injuries and cauterizations shrink after a certain time or turn into the so-called colloid scars.

Scars are treated in one and the same way as haematomas and fibroses in surgery, dermatology, gynaecology and orthopaedics. In fact, in many cases their treatment finishes with wound closing.

With treatment for wounds using the help of kinesis therapy, precautions and prophylactic actions can be taken against undesired scars. The old scars that have already appeared can be treated in such a way that their structure and condition become more flexible, movable and soft.

When treating a scar with the help of cross friction and cross stretching of 'scar block connecting tissue', scar slackening is obtained.

Scar diagonal slackening causes scar skin to loosen in all directions.

Using the treatment for haematomas, some time later a considerable absorption is observed. The treatment for haematomas/fibroses (sedimentation of proteins/ internal haemorrhages in tissues) is based on metabolism acceleration in tissues where the device has been placed.

Prescriptions Against Freckles

These prescriptions easily prepared at home will help you to get rid of your freckles.

Strawberry: Squash ripe strawberries and run over the freckles before bedtime; in the morning rinse your face with water.

Horseradish: Chop the horseradish finely and pour on a little vinegar. In two weeks' time strain the mixture. Use the prepared sap for rinsing your face.

Lemon juice: Steep tampons in fresh lemon juice and wet the freckles before bedtime. Avoid the sun and the freckles will disappear.

Parsley: Pigmented spots on the skin can be bleached by parsley juice too.

References

1. Dobrev D. The Effect of Our Sun. Healer. Sofia. 2000.
2. Petrova M. Ph.D. Our Skin and How to Protect it from the Sun. Health&Happiness, Sofia. 1999.
3. Sokolova A. 100 Illnesses and 100 Prescriptions. Globus. Sofia. 2001.