Let’s Take Care of Our Beautiful Skin

Aging Skin

As we continue to age, so does our skin. Our skin is the largest organ of our body and it is important to treat it with care. There are many factors that contribute to the aging of our skin. These include intrinsic factors, which are internal factors that are part of the natural aging process; and extrinsic factors, external factors in our environment in which we can alter. A combination of these two processes causes our skin to age, sometimes prematurely.

Intrinsic Factors: “So our skin is aging too, oh great…”

• Fine wrinkles

• Thin and transparent skin

• Loss of subcutaneous or underlying fatty tissue between your skin and muscle, leading to decreased skin turgor or elasticity which results in noticeable loss of firmness in the face, hands and neck

•Bones shrink away from the skin due to bone loss, which causes sagging skin

•Decrease in skin’s natural oils resulting in dry skin that may itch

•Inability to sweat sufficiently to cool the skin

Extrinsic Factors: “For those who worship the sun…”

Photoaging: Skin damage caused by sun exposure is called photoaging and is probably the #1 external factor to aging. Photoaging causes noticeable changes in the skin such as freckles, age spots, spider veins on the face, rough and leathery skin, fine wrinkles, loose skin, blotchy complexion, actinic keratoses (thick wart-like, rough, reddish patches of skin). All skin cancer can be traced to sun exposure. Photoaging occurs over a period of years, the skin loses its natural ability to repair itself after repeat exposure to sun damage.

Gravity: When the skin loses its elasticity, gravity causes drooping of the eyebrows and eyelids, looseness and fullness under the cheeks and jaw (jowls and “double chin”), and longer ear lobes.

Daily Facial Movement: Facial movement lines become more visible after the skin starts losing its elasticity (usually as people reach their 30s and 40s). Lines may appear horizontally on the forehead, vertically between the brows (glabella), or small curved lines around the mouth.

Sleep Position: creases result from the way the head is positioned on the pillow and may become more visible after the skin starts losing its elasticity. Sleep creases are commonly located on the side of the forehead, as well as on the middle of the cheeks. Sleeping on your back may improve these sleep creases or prevent them from becoming worse.

Smoking: Cigarette smoking causes biochemical changes in our bodies that accelerate aging. It can create facial wrinkles in people as young as their twenties, which result in deep wrinkles and leathery skin as we age.

Reference: American Academy of Dermatology. (2010). Aging Skin Net, Causes of Aging Skin. Retrieved from www.skincarephysicians.com/agingskinnet/basicfacts.html

Dry Skin

“Is your skin as dry as an elephant’s? Try these easy tips!” Dry skin and itching is common in later life due to the decreasing amount of oil glands in our skin. About 85% of older people develop “winter itch” because overheated indoor air is dry. The loss of oil glands as we age may also worsen dry skin. Anything that further dries the skin, such as the overuse of soaps or hot baths, will make the problem worse. If your skin is very dry and itchy, see a doctor because this condition can affect your sleep, cause irritability, or be a symptom of a disease. Some medications make the itchiness worse.

Reference: WebMD. (2012). Healthy Beauty, The Effects of Aging on the Skin.
Retrieved from www.webmd.com/healthy-beauty/cosmetic-procedures-aging-skin?page2

Six Tips to Soothe Your Skin

1. Say yes to warm and no to hot:
A steamy shower feels good, but that hot water is not good for your dry skin. The problem is that hot showers strip your body of its natural oil barrier, and you need that barrier to help trap moisture and keep your skin smooth and moist. So turn down the temperature and don’t linger too long. Skin care experts recommend short, warm showers or baths that last no longer than 5 to 10 minutes. Afterward, gently pat your skin dry and moisturize your body.

2. Cleanse gently:
Wash with gentle soaps that are fragrance free. Products with deodorant or antibacterial additives can be harsh on the skin. You might also consider a cleanser that contains ceramides. Ceramides are fatty molecules that make up the outer layer of your skin; they help skin hold in moisture. Try not to use many toners, peels, and other astringents made with alcohol, as they can dry your skin. When you exfoliate, remember to not scrub too hard, as it can irritate and thicken skin.

3. Shave smartly
Shaving can irritate dry skin. As you shave unwanted hair, you are also scraping off the skin’s natural oils. The best time to shave is after you shower, according to the American Academy of Dermatology. Hairs are softer and more pliable after bathing, making shaving easier. Always use a shaving cream or gel, and shave in the direction the hair is growing to protect your skin. Make sure the razor is sharp; a dull razor blade can cause additional irritation. Lastly, change your razor blades often.

4. Cover up
Sun damage is one of the main causes of dry skin, wrinkles, and roughness. You can help prevent that damage by wearing a broad-spectrum SPF 30 sunscreen year-round and dressing right. In cool weather, dress in layers to prevent overheating and perspiring excessively; both can irritate the skin. To prevent dry, chapped lips in winter, use a lip balm with SPF 15 sunscreen, and cover your lips with a scarf. In the summer, wear light, loose, long-sleeved shirts when out in the sun, and wear a wide-brimmed hat to shade your neck, ears, and eyes.

5. Follow the rules of moisturizing
The simplest moisturizing products can soothe dry skin. Petroleum jelly makes a great moisturizer, or you can use mineral oil, a favorite cream, or lotion. If you like a very rich moisturizer, look for one with shea butter, ceramides, stearic acid, or glycerin. A consistent, smart moisturizing routine helps:

• Wash with a fragrant free liquid cleanser, preferably one with ceramides to replenish the skin’s outer layer.

• Pat skin dry for less than 20 seconds.

• Apply a thick moisturizer to slightly damp skin within minutes of bathing to trap in moisture.

• Moisturize your hands every time you wash them so that evaporating water doesn’t draw even more moisture from your dry skin.

• Finally, wear a moisturizing cream with sunscreen of SPF 30 or higher to get the added benefit of sun protection.

Humidity in Winter

Cold, dry air is a common cause of dry, irritated skin. Heating your house keeps you warm, but it also removes moisture from the air, which can make dry skin even more parched. To replenish that missing moisture quickly and easily, use a humidifier.

Reference: WebMD. (2009). Healthy Beauty, 6 Quick and Easy Dry Skin Relievers. Retrieved from http://www.webmd.com/healthy-beauty/features/6-tips-relive-dry-skin-fast?page=2
www.webmd.com/healthy-beauty/features/6-tips-relive-dry-skin-fast?page=2

By: Lauren Dawes
Nursing Education Program of Saskatchewan Student
January, 2013

Adult Acne

“Don’t tell me I have to live with wrinkles and acne…”

Unfortunately, acne can begin in adulthood too, and three quarters of adult acne occurs in women. Hormone fluctuations are usually responsible, which is why women may suffer “cyclical acne” that shows up before their menstrual periods, or acne flare-ups during pregnancy or menopause.

Of course there are emotional issues that can go along with adult acne. Some say “why should I have acne and wrinkles at the same time”? This can be very troublesome for women and common for those who have had hormonal acne at other times in their life. However, there are treatments that are available for both acne and wrinkles (see other page), so consult your healthcare professional.

Reference: Canadian Dermatology Association. (2013). Skin, Hair & Nails, Acne. Retrieved from www.dermatology.ca/skin-hair-nails/skin/acne/#!/skin-hair-nails/skin/acne/adult-acne/

Treatments

Talk to your doctor about prescription treatments. Your doctor may recommend one treatment, or suggest combining a cream with an oral medication. You have several options:

• Prescription creams containing retinoids (derived from vitamin A) to help unplug follicles.

• Gel containing 5% dapsone, which is thought to help fight inflammation involved in acne.

• Combination creams that combine the cleansing agent benzoyl peroxide and antibiotics such as clindamycin. •Birth control pills, such as Yaz, which can regulate the hormonal fluctuations that initiate breakouts.

• Oral antibiotics, which act as anti-inflammatories.

Using a type of retinoid like Retin-A, (related chemically to vitamin A) on the skin will help to keep the pores clear and the skin exfoliated, and will also help with wrinkles.

Reference: WebMD. (2010). Acne Health Center, Adult Acne Is Treatable. Retrieved from: http://www.webmd.com/skin-problems-and-treatments/acne/features/adult-acne-is-treatable www.webmd.com/skin-problems-and-treatments/acne/features/adult-acne-is-treatable

Ways to Reduce Acne Scarring

Prevention is the best treatment for acne scars, which includes treating acne early and managing it to prevent new lesions from forming. There are several ways to treat scars if you do develop them:

• Tretinoin creams and gels can be used as a way to treat superficial scarring. They help with new collagen production, which assists the skin to build new, unscarred tissue.

• Chemical or alphahydroxy acid (AHA) peels or creams help to even out skin tone by smoothing out slight imperfections.

• Microdermabrasion is recommended for superficial mild acne scars. It is a short treatment that removes the uppermost layers of damaged skin. (See Skin Procedures)

• Injectable fillers include materials such as collagen and hyaluronic acid, which are injected below the skin’s surface to plump up pitted areas from rolling scars. (See Skin Procedures)

• Laser skin resurfacing improves the damaged uppermost surface layer, which helps to smooth out the appearance of deeper scars. It also encourages new collagen formation in the skin. (See cosmetic treatment section)

Reference: Canadian Dermatology Association. (2013). Acne, Acne Scarring.
Retrieved from http://www.dermatology.ca/skin-hair-nails/skin/acne/#!/skin-hair-nails/skin/acne/acne-scarring/

By: Lauren Dawes
Nursing Education Program of Saskatchewan Student
February, 2013

Skin Cancers

“Yes, you must do skin self-assessments”

Abnormal Skin Lesions: After the age of 50, our risk for skin cancers increases significantly. Therefore, it is important to perform thorough skin assessments and check for any change or new development of moles. This should be done annually at your complete physical check-ups with your healthcare provider, as well by doing self-assessments on a monthly basis. There are a couple factors that may determine if you are at higher risk of abnormal skin lesions: how much sun you have been exposed to throughout your life; your skin type. Those with fair skin are more likely to burn and are more susceptible to abnormal skin lesions.

Basal Cell Carcinoma: Basal Cell Carcinoma (BCC) is the most common form of skin cancer found in Canada. Fortunately, it is the most treatable but will continue to grow if left untreated. Basal cell skin cancers usually appear on sun exposed areas as a result of radiation from the sun. Frequent severe sunburns and intense sun exposure in childhood increase the risk of BCC in adulthood. Many people are susceptible to this form of skin cancer, however those with fair skin and blond or red hair who usually burn when out in the sun are most at risk. The risk also increases as people get older, especially those over the age of 50.

Early warning signs to look for are:

• a firm, flesh colored or slightly reddish bump, often with a pearly border. It may have small blood vessels on the surface, which gives it a red color.

• a sore or pimple-like growth that bleeds, crusts over and then reappears.

• a small, red scaling patch seen most often on the torso or limbs.

Treatment for BCC: Treatment options depend on the tumour (size, location etc.) and the patient’s own health status. Your dermatologist will discuss treatment options with you. Some treatment options are simple surgical excision (removal), curettage (scraping out tissue), electrodesiccation and cautery (electric current to destroy cancerous tissue), or laser surgery.

*Remember any sore that does not heal within four weeks should be examined by your dermatologist.

Squamous Cell Carcinoma: Squamous Cell Carcinoma (SCC) is the second most common form of skin cancer found in Canada, after basal cell. This form of skin cancer may grow quickly over a period of a few weeks and must be treated because it may continue to grow in size, damaging the surrounding skin, and may spread to other areas of the body. It appears on chronically sun-exposed areas such as the head and neck, arm, back of the hand and leg. Areas to be particularly careful to check for this cancer include the rim of the ear and the lip since the cancer can be more aggressive at these locations. Frequent sun exposure is the leading cause of this skin cancer.

Early Warning Signs and Treatment of SCC: Watch for thickened, red, scaly bumps or wart-like growths. They may also look like an open sore or crusted skin.

Treatment of squamous cell carcinoma can be discussed with your dermatologist. It consists mainly of surgical excision (removal), but other treatments can be explored.

Malignant Melanoma: Malignant melanoma is a less common but a highly dangerous form of skin cancer. When found at an early stage, melanoma has one of the highest cure rates of all cancers, at more than 90 percent. If left untreated, melanoma starts to invade deeper into the skin. When it reaches the blood stream or the lymphatic system, it can spread to other parts of the body, possibly resulting in death. Melanoma can develop within weeks or months or it can be slow growing over several years.

Melanoma can start as a new, brown or black, flat, freckle-like spot on the skin. It can also begin as a change in the shape or colour of an existing mole or coloured spot. Melanomas tend to be dark in colour, although some are a mixture of colours including red, blue and white. These tumours grow, so look for a change in the size of a spot. The key is to look for changes. Excessive sun exposure plays a leading role in the development of this type of skin cancer, especially those who have had severe, blistering sunburns.

Anyone can get melanoma, however fair skinned people who have sun-sensitive skin that often burns are more likely to get this disease. People with freckles and red or blond hair fall into this group as well as those with blue or green eyes. Those with many moles (more than 50), or moles with an unusual colour or shape, or with large moles, have an elevated risk. A close family history of melanoma is another risk factor. Anyone with one or more of these risk factors should have a spot check by a dermatologist; it could prove to be a life saving visit.

Actinic Keratoses: Although actinic keratoses are not true skin cancers, it is important to have these lesions treated as they have the potential to change into squamous cell skin cancers. Too much sun exposure over many years leads to a disruption in the normal development of skin cells, affecting the upper layer of the skin, called the epidermis. The sun’s rays damage the skin’s DNA, leading to this abnormal growth of the cells. Fair-skinned people who freckle and burn easily are at greatest risk. People over the age of 40 who have had a lot of sun also have a high risk for developing actinic keratoses. Outdoor workers face a greater risk because of their widespread sun exposure.

Warning Signs of Actinic Keratoses:

• Red, rough, scaling spots on sun-exposed areas.

• It is common to have a few at a time.

• These spots may sting or itch.

Treatments for Actinic Keratoses: There are a variety of treatments. Your dermatologist will advise you of the most suitable treatment based on the number of lesions, their location, your age and your general health. Treatments include cryosurgery (freezing of the lesion with liquid nitrogen), surgical removal, and creams.

Remember to check ABCDE:

Asymmetry: If the shape on one side is different from that of the other, not even.

Borders: Are the borders are irregular or ragged.

Color: Are there color variations of black, brown, red, blue or white throughout.

Diameter: The diameter should be no more than 1 cm.

Evolution: Changes in color, size, shape, or symptom, such as itching, tenderness, or bleeding.

Reference: Canadian Dermatology Association. (2013). Skin Cancer.
Retrieved from http://www.dermatology.ca/skin-hair-nails/skin/skin-cancer/#/

Additional Resources:

Skin Cancer Foundation
http://www.skincancer.org/

Mayo Clinic Skin Cancer:
http://www.mayoclinic.com/health/skin-cancer/DS00190 Health Canada: http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/diseases-maladies/cancer-eng.php

Canadian Cancer Society:
http://www.cancer.ca/

By: Lauren Dawes
Nursing Education Program of Saskatchewan Student
February, 2013

“Enhance the already beautiful you!”

Products

Proper skin care is probably one of the best ways you can maintain your skin. This includes washing your skin both morning and night with a cleanser, and perhaps a toner, moisturizer, and eye cream. Protection against UVA and UVB rays is an extremely important step in preventing further sun damage to your skin. Ensure that your sunscreen is broad spectrum, with an SPF of 30 or higher in order to properly protect your skin from the sun. Also having an SPF in your other skin care products such as your lip balm, moisturizer, or concealer and foundation can be beneficial.

Antioxidants: Unfortunately, as humans we are unable to produce certain essential antioxidants such as vitamins C and E. These antioxidants help to repair our skin against UV rays from the sun that damage our skin and in turn activate free radicals, which can become carcinogenic.
Some of these antioxidants such as vitamin C are consumable orally, however, recent dermatology studies suggest that our skin does not get enough through oral administration and topical forms of antioxidants are therefore necessary.

References: Burke, K. E. (2004). Photodamage of the skin: protection and reversal with topical antioxidants. Journal of Cosmetic Dermatology, 3(3), p. 149-155. doi: 10.1111/j.1473-2130.2004.00067.x
Lin, J. Y., Selim, M. A., Shea, C. R., Grichnik, J. M., Omar, M. M., Monteiro-Riviere, N. A., & Pinnell, S. R. (2003). Jour- nal of the American Academy of Dermatology. doi: 10.1067/mjd.2003.425

Vitamin A (retinol): Retinols help to improve both healthy and photoaged skin by stimulating the production of collagen to diminish fine wrinkles. Retinol also improves the skin’s overall texture by retaining water. This in turn helps our skin to recover from a less thin and fragile state, which is common as our skin ages.

Reference: Kafi, R., Kwak, H. R., Schumacher, W. E., Cho, S., Hanft, V. N., Hamilton, T. A., King, A. L., Neal, J.D., Varani, J., Fisher, G. J., Voorhees, J. J., Kang, S. (2007). Improvement of Naturally Aged Skin With Vitamin A (Retinol). Arch Dermatol, 143(5), p. 606-612. doi:10.1001/archderm.143.5.606

Vitamin C: Vitamin C is a naturally occurring antioxidant found in our body from dietary sources. The topical use of vitamin C is popular among anti-aging remedies today. Antioxidants are extremely beneficial to our skin, as they battle free radicals, which occur when our skin is exposed to ultraviolet light (mostly the sun), as well as with normal aging of the skin. Vitamin C works on photoaged skin to protect and promote the formation of new collagen, defense from new ultraviolet light exposure, improvement of hyperpigmentation (darkening of the skin), and improvement of a variety of inflammatory conditions of the skin. It is recommended to use vitamin C in conjunction with your daily application of sunscreen, as it combats the free radicals that emerge due to exposure to UV light.

Reference: Farris, P. K. (2005). Topical Vitamin C: A Useful Agent for Treating Photoaging and Other Dermatologic Conditions. Dermatologic Surgery, 31(7). doi: 10.1111/j.1524-4725.2005.31725

Cosmetic Treatments

Cosmetic treatments are also available to help repair your skin from sun damage, and eliminate or decrease facial wrinkles and sagging skin. These include:

Facial: A facial is a procedure commonly done in spas. Treatments may vary but generally have the same premise, to renew and refresh the skin. Usually a facial will start with a consultation, skin cleansing, and then a skin analysis. Throughout the treatment the esthetician will exfoliate the skin, execute extractions of clogged pores, perform a facial massage, apply a facemask, and then end the procedure with the application of toner, serums, moisturizer and sunscreen.

Reference: Brown, A. (2013). What Is A Facial? The Basic Steps of A Professional Facial. About.com. Retrieved from http://spas.about.com/od/massage/a/whatisafacial.htm
http://spas.about.com/od/massage/a/whatisafacial.htm

Chemical Peel: A chemical peel (sometimes called chemexfoliation or derma peel), like all cosmetic treatments and procedures, aim to improve the overall look and feel of the skin, diminish age spots and fine lines caused by sun damage, and improve certain types of acne and mild scars. This treatment can be done on the face, neck, or hands. This treatment uses a chemical such as glycolic acid, salicylic, or carbolic acid, which are applied to small areas on the face to create a controlled wound, from which new skin will take its place. There are variations in the type of treatment you may choose to receive, ranging from light, medium to deep chemical peels, which differ in the depth in which they infiltrate the skin. The best candidates for chemical peels are generally those with fair skin with lighter hair, as they are less likely to have an uneven skin tone after the procedure.

References: WebMD. (2012). Healthy Beauty, Chemical Peels and Your Skin.
Retrieved from http://www.webmd.com/healthy-beauty/cosmetic-procedures-chemical-peel-treatments American Society of Plastic Surgeons. (2012). Chemical Peel, Minimally Invasive Procedure.
Retrieved from www.plasticsurgery.org/Cosmetic-Procedures/Chemical-Peel.html

Intense Pulse Light Laser Treatments (IPL): Eliminates or reduces damage to your skin caused by the sun such as freckles, brown age or liver spots, and fine lines. It significantly improves the superficial and deep layers of the skin. Photorejuvenation also stimulates the production of collagen, which adds plumpness and elasticity to our skin. As the collagen is stimulated, lines and wrinkles are decreased. Usually a series of treatments are recommended.

Reference: Bella Sante MD. (2013). IPL Photorejuvenation.
Retrieved from www.bellasanteclinic.com/procedures/ipl.html

Facial Fillers: As we age, the fatty tissues in our skin start to deplete. Facial fillers help to restore the volume that is lost in our fatty tis- sues. There are a few variations in facial filler products. The most common is hyaluronic acid, however, others include polylactic acid, calcium hydroxylapatite, and polymethylmethacrylate (PMMA). Hyaluronic acid is found naturally in the skin but depletes over time. Hyaluronic acid works to moisturize and improve the skin’s tone. The gel of the facial filler is injected directly into facial wrinkles or lines, creating a volumizing effect.

References: Bella Sante MD. (2013). Facial Fillers. Retrieved from http://www.bellasanteclinic.com/procedures/fillers.html American Society of Plastic Surgeons. (2012). Brand Name Procedures and Treatments, Branded Treatment Options. Retrieved from www.plasticsurgery.org/cosmetic-procedures/brand-name-procedures-and-treatments.html

Botulinum Toxins or Neuromodulators (Botox): Botox temporarily reduces facial wrinkles by selectively inhibiting the nerve impulses from the muscles that create the lines and wrinkles either on the forehead, crows’ feet, or lower face. This relaxes the muscle, which prevents the muscle from creating wrinkles giving the skin a smooth appearance.

Reference: Bella Sante MD. (2013). Botox. Retrieved from http://www.bellasanteclinic.com/procedures/botox.html

Microdermabrasion: A microdermabrasion or “micro” treatment employs the use of a diamond tip wand to gently slough of some of the superficial layer of the skin. Microdermabrasion works to improve the overall quality of the skin by evening out skin texture, treating acne blemishes, enlarged pores, and superficially sun damaged, blotchy skin.

Reference: Bella Sante MD. (2013). Microdermabrasion. Retrieved from
www.bellasanteclinic.com/procedures/microdermabrasion.html

Radiotherapy Treatments: There are several different trade names that correlate with radiofrequency treatments such as Accent or Titan. These treatments work to tighten our loose and sagging skin by applying heat to break up adipose tissue, which in turn melts the fat cells and stimulates the collagen in our skin. This will result in gradual skin tightening over a period of six months.

Reference: Bella Sante MD. (2013). Cellulite and body contouring with Accent Radiotherapy. Retrieved from www.bellasanteclinic.com/procedures/cellulite.html

Additional Resources: American Society of Plastic Surgeons: www.oplasticsurgery.org/Cosmetic-Procedures.html Bella Sante MD:www.bellasanteclinic.com

Caution: When it comes to cosmetic treatments, the bottom line is you get what you pay for. Today there are many at-home treatment options such as at-home microdermabrasion, as well as treatments offered in a variety of settings, clinics, salons and spas with varying levels of qualifica- tions. Be careful to choose a reputable product and clinic. Often physician-owned clinics have medical grade products and machinery that other salons are not able to purchase. Medical-grade services will most likely give you the best results. Also beware of procedures performed in other countries. The cost may be cheaper and therefore, more appealing but the quality is often poorer.

Questions

Things to consider when contemplating cosmetic or aesthetic procedures

Questions about the service provider:

• Who will carry out the procedure?

• What training do they have to provide this procedure?

• How frequently do they carry it out?

Questions about the procedure

•Is the procedure right for me?

•Will it change my appearance the way I hoped?

•Am I doing this for myself or to please someone else?

•How long does the procedure take?

•Is the procedure painful and, if so, what form of anesthesia is used? •What are the risks involved?

•Are there any other options available for me to achieve the results I want?

•Do you have any ‘before and after’ photographs that I can see?

Questions about after the procedure

•What care and pain relief will I need after the procedure?

•Will I have swelling or bruising?

•At what stage will I be able to judge the results of the procedure? •How long do the results last?

• Will I need a more than one procedure?

* Always remember to ask any other questions that you may have.

Reference: The College of Physicians and Surgeons of Ontario. (2013). Get the Facts: What you should know about Cosmetic Surgery. Retrieved from
www.cpso.on.ca/ policies/positions/default.aspx?id=1726

By: Lauren Dawes
Nursing Education Program of Saskatchewan Student
February, 2013

“Long, beautiful lashes are no longer just for celebrities! Treat yourself like a star!”

Some women are also affected by hair loss of the eyebrows or eyelashes. This may be related to the reasons mentioned above but also due to adverse affects of previous cosmetic or aesthetic treatments, as well as general aging, as our lashes tend to become thinner over time. The most popular solutions for replacing hair loss in these areas, other than false lashes, is the product Latisse (bimatroprost topical solution 0.03%) and eyelash extensions.

Latisse: Is proven to grow your lashes longer, thinker and darker in just 16 weeks and the best part is that they’re your own lashes. An off label use of Latisse is to the eyebrows, which will have the same effect. Latisse requires continued use in order to keep results.

Reference: Allergan. (2012). Latisse. Retrieved from www.latisse.com/

Eyelash Extensions: Another popular option is eyelash extensions. In this case, synthetic or authentic mink hair is individually glued on to each eyelash. The only requirements are that lashes are at least 3mm in length to start out with and there is no allergy to the adhesive. Also keep in mind that extensions require monthly maintenance.

Reference: Montanera, D. (2013). What to know before you get eyelash extensions. Best Health Magazine. Retrieved from
www.besthealthmag.ca/look-great/beauty/what-to-know-before-you-get-eyelash-extensions

By: Lauren Dawes
Nursing Education Program of Saskatchewan Student
February, 2013

“You won’t just find them on sailors and motorcyclists…”

Tattoos are becoming more and more common today and you won’t just find them on sailors and motorcyclists. Tattoos are a permanent mark or design in the skin by injecting ink into the top layer of skin through a needle. However, because a tattoo affects the dermis (inner layer) of your skin, it is important to take special considerations for the health and overall well being of yourself and your skin.

Infection

Since a needle punctures the skin, there are of course risks for infection. This would include symptoms such as redness, irrita- tion, inflammation, and possibly pus from the tattoo site.

Allergic Reaction

Another risk is an allergic reaction of the skin due to the ink; this can cause an itchy rash that sometimes may not be apparent until years after receiving the tattoo.

Blood Borne Illnesses

Another risk is blood borne diseases if the tattoo needle has not been properly sterilized between clients. These would include diseases such as hepatitis B, C, as well as HIV or tetanus.

Make sure to carefully decide whether or not you want a tattoo. Tattoos are permanent and sometimes removal does not always work well. Also, it is an investment which can be costly and one must also closely consider the possibility of regretting it one day. Another consideration to include is location. Is it somewhere that is concealable if possible or is it in a location that could potentially stretch with weight gain or pregnancy. Finally, never get a tattoo while under the influence of alcohol or drugs.

Here are some safety precaution tips:

• Who does the tattoo/what are their qualifications?

• Do they follow provincial requirements and licensing standards?

• Does the tattoo artist wear gloves?

• Does the tattoo artist use the proper equipment? This means all new equipment and ink from unopened packages.

• Does the tattoo artist sterilize the non disposable equipment?

Take care of your new tattoo:

• Remove the bandage after 24 hours. Apply an antibiotic ointment to the tattooed skin while it’s healing.

• Keep the tattooed skin clean. Use plain soap and water and a gentle touch. Pat, do not rub the area dry.

• Use moisturizer. Apply a mild moisturizer to the tattooed skin several times a day.
• Avoid sun exposure. Keep the tattooed area out of the sun for at least a few weeks.

• Choose clothing carefully. Do not wear anything that might stick to the tattoo.

• Allow up to 2 weeks for healing. Do not pick at any scabs. This increases the risk of infection and can damage the design and cause scarring.

If you think your tattoo might be infected or you are concerned that your tattoo is not healing properly, contact your doctor. If you are interested in tattoo removal, ask your dermatologist about laser surgery or other options for tattoo removal.

Reference: Mayo Clinic. (2012). Tattoos: Understand risks and precautions.
Retrieved from http://www.mayoclinic.com/health/tattoos-and-piercings/MC00020

Additional Resources:
Mayo Clinic Adult Health: http://www.mayoclinic.com/health/tattoos-and-piercings/MC00020
FDA U.S. Food and Drug Administration: http://www.fda.gov/forconsumers/consumerupdates/ucm048919.htm Discovery Health: http://health.howstuffworks.com/skin-care/beauty/skin-and-lifestyle/tattoo-safety.htm

Permanent Makeup:

A relatively new trend in tattooing called micropigmentation (permanent makeup or cosmetic tattooing) is the injection of permanent pigment into the skin’s dermal layer to enhance a facial feature such as the eyebrows, or to permanently apply makeup such as eyeliner or lip liner to the face. This procedure is permanent, just like a tattoo, therefore it is important to carefully consider this option and to seek a trained professional.

References:
The American Society for Aesthetic Plastic Surgery. (2012). Micropigmentation.
Retrieved from http://www.surgery.org/consumers/procedures/skin/micropigmentation Micro-pigmentation Centre Inc. (2006). Client Procedures.
Retrieved from http://permanentmakeup.micropigmentationcentre.com/procedures.aspx
American Society of Plastic Surgeons. (2012). Permanent Makeup. Retrieved from http://www.plasticsurgery.org/Cosmetic-Procedures/Permanent-Makeup.html
All About Facial Rejuvenation. (2013). Micropigmentation: Is Permanent Makeup Right For You? Retrieved from http://www.facialplasticsurgery.net/micropigmentation.htm

Tatoo Removal “Think before you ink…”

Tattoos are meant to be permanent and therefore, removal can be difficult. There are a few options available on the market for tattoo removal. Some include creams, dermabrasion, excision, or laser.

At-Home Creams: There are many at-home remedies such as Tattoo-off or Wrecking Balm Tattoo Removal and Fade System.

Dermabrasion: This is the use of a high-speed rotary abrasion device. Basically it is rubbing off the skin cells (kind of like sand paper) as a form of tattoo removal.

Excision: This is the surgical removal of a tattoo. This method removes a tattoo entirely, however, the patient will be left with a scar. Also, this method of tattoo removal is usually only appropriate for smaller tattoos, as it may not be possible with tattoos that cover a larger surface area.

Laser: Q-switched lasers are the common method of treatment. The lasers work best on those with dark tattoo ink such as black and light pigmented skin. The laser works by releasing a powerful pulse of energy that travels in the skin and uses heat to shatter the ink on the skin. The body then naturally absorbs and excretes the ink particles. You will likely need multiple treatments to completely dissolve the tattoo.

Reference: Mayo Clinic. (2012). Tattoo Removal. Retrieved from http://www.mayoclinic.com/health/tattoo-removal/MY01066/DSECTION=what%2Dyou%2Dcan%2Dexpect Resources:
About.com Tattoos/Body Piercings: http://tattoo.about.com/od/tatremoval/a/tatremoval.htm
Discovery Health: http://health.howstuffworks.com/skin-care/beauty/skin-and-lifestyle/tattoo-removal.htm

By: Lauren Dawes
Nursing Education Program of Saskatchewan Student
January, 2013

Veins

Spider Veins

Are tiny blood vessels that are apparent on the skin’s surface, they are often found on the face or legs Their appearance is usually red, blue or purple in color; they look like a spider web or tree branch. Spider veins can be caused by the back flow of blood in the vein, as well as by hormonal changes, sun exposure, or injury.

Varicose Veins

Are swollen, twisted, enlarged veins, usually found in the lower legs and most commonly seen in women. The presumed cause of varicose veins (sometimes called varicosities), are ineffective valves. The valves in normal functioning veins are one directional, moving blood towards the heart and preventing the backflow of blood in the vessel. When these valves become ineffective, some blood starts to flow backwards, causing pooling in the vein. Varicose veins tend to affect nearly all aging adults at some point during their life due to weakening and stretching of the vessel walls. However, there is a higher incidence of varicose veins in people who stand on their feet for prolonged periods of time, such as teachers or nurses. Varicosities may also be due to conditions that exert increased pressure on the vascular system such as pregnancy or obesity.

Symptoms often associated with varicose veins are:

• Aching

• Cramping

• Burning

• Throbbing pain and discomfort

• Mild swelling and itching

• Unpleasant cosmetic appearance

At-home treatment for varicosities and spider veins include:

• Avoiding standing for prolonged periods of time

• Raising your legs when resting or sleeping

• Wearing elastic support hose/stockings

• Avoiding crossing your legs when sitting

For more severe forms of varicose veins, treatment includes:

Radiofrequency or laser ablation: A laser uses a highly concentrated beam of light to emit heat that damages the vessel. This creates scarring, causing the vein to close. The use of a laser can be superficial, which is appropriate for spider veins or tiny varicose veins that are just under the skin’s surface. Alternatively, an endovenous method may be used which involves the insertion of a small catheter into the vein, guided by ultrasound. When using this technique a local anesthetic and light sedative may be required during the treatment.

Sclerotherapy: This is the ideal treatment for smaller varicose veins. It involves injecting a sclerosant (usually a salt-based solution) directly into the vein to cause irritation and scarring to the vessel walls. Consequently, the vein collapses, resulting in the rerouting of blood through healthy veins. The scarred vessel eventually dissolves. Results will often be apparent in one month.

Surgical vein stripping or ligation: Is a surgical treatment that involves either the entire removal of the diseased vein (stripping), or tying off the healthy part of the vein from the damaged portion (ligation). This is an outpatient procedure often done with local or general aesthetic. Most vein treatments are very successful, however, new spider veins or varicosities can form due to the same lifestyle and/or genetic factors; there is no cure for weak vein valves. The best method to decrease the occurrence of varicosities is prevention, especially by wearing compression support stockings throughout the day.

References:

HealthLinkBC. (2012). Laser Treatment for Varicose Veins. Retrieved from http://www.healthlinkbc.ca/kb/content/otherdetail/tn10097.html

Womenshealth.gov. (2010). Varicose veins and spider veins fact sheet. Retrieved from http://www.womenshealth.gov/publications/our-publications/fact-sheet/varicose-spider- veins.cfm

Mayo Clinic. (2013). Varicose Veins. Retrieved from http://www.mayoclinic.com/health/varicose-veins/DS00256

Emedicinehealth. (2013). Varicose Veins. Retrieved from http://www.emedicinehealth.com/varicose_veins/article_em.htm

PubMed Health. (2012). Varicose Veins. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002099/

By: Lauren Dawes
Nursing Education Program of Saskatchewan Student
February, 2013

Hirsutism in Women or Where is All this Hair Coming From?

Are you developing hairs on your chest or chin? It may be a sign of an underlying illness.

Hirsutism is the condition that causes a woman to develop excess hair on the body, especially in places where hairs are not normally found such as the chin, chest, abdomen and back. It results in women who have higher than normal levels of androgen.

The adrenal glands of a woman can produce male hormones (androgens) but to a level lower than in a man. When a woman’s androgen level is above normal, it stimulates the growth of thick hair. Excessive hair growth can cause mental and emotional concerns in a woman, possibly arising from a feeling of loss of her femininity.

Causes of Hirsutism

Often the cause of hirsutism is unknown and many women affected are normal. Known causes can be:

• Adrenal gland issues, such as tumors of the adrenal gland or enzyme deficiency

• Ovary causes such as polycystic ovarian syndrome

• Drugs like steroids, convulsion medications, thyroxine and drugs containing heavy metals.

When is Excessive Hair Growth Abnormal?

Excess hair growth is abnormal when it is present with any of the following symptoms:

• Deepening of the voice

• Loss of sexual desire

• Irregular menstrual cycles

• Receding front hair line

• Obesity

• Excessive oily skin and acne

How can Hirsutism be Managed?

If you notice hair growth with any abnormal symptom listed above, seek your doctor’s attention immediately. On the day of your appointment, take along a list of medications you are taking. Sometimes stopping a medication which may be a potential cause can reverse the problem. Make sure you inform your doctor if you want to have a baby soon because some medications used for treatment of hirsutism can harm an unborn baby.

Treatment of Hirsutism involves:

• personal care, including waxing, plucking and shaving

• hair removal therapy using modern methods like laser treatment and electrolysis

• medications such as oral contraceptives, drugs that block male hormones and topical creams

• lifestyle modifications such as losing weight can lower androgen levels and decrease unwanted hair.

Controlling hirsutism usually requires a great deal of patience. Treatments may take about six months before you notice an improvement. This is because the life cycle of a hair follicle is approximately six months. Make sure to continue treatment consistently for a prolonged time to prevent hairs from growing back.

Resources:

Canadian Dermatology Association
www.dermatology.ca

Mayo Clinic
http://www.mayoclinic.org/diseases-conditions/hirsutism/basics/definition/con-20028919

References:

Canadian Dermatology Association, Hirsutism, Retrieved January 3, 2015 on www.dermatology.ca/skin-hair-nails/hair/hirsutism/

Journal of the College of Family Physicians of Canada, Approach to the management of Idiopathic Hirsutism, Vol. 58, February, 2012

Hirsutism: Strategies and Evidence, Retrieved January 10th on www.medscape.org/viewarticle/572621_4

Up to date, Patient information: Hirsutism, Retrieved January 10th, 2015 on www.uptodate.com/contents/hirsutism-excess-hair-growth-in-women-beyond-the-basics

What is Hirsutism (excessive Hairiness)? What Causes hirsutism?, Retrieved January 11, 2015 on www.medicalnewstoday.com/articles/182659.php

The North American Menopause Society, Menopause Practice, 5th Edition A clinician guide: Hirsutism,

Information on Hirsutism and Hair Removal treatments, Retrieved February 4th, 2015 on www.hirsutism.com.