DERMATOLOGY: WHAT SOLUTIONS TO SKIN AILMENTS

We do not remember very well when they appeared but sometimes, pimples, papules, redness or pigment spots can suddenly seem more present, even more heavy on the morale. Once the summer tan is gone, the little skin problems are more obvious and autumn may be the right time to consult a dermatologist to take stock and possibly start treatment. From topical treatments to pulsed light or laser sessions, the arsenal of dermatologists is now well-developed and offers care tailored to the specifics of each skin. rash As soon as it's a little hot or cold, you eat spicy or you drink a little alcohol, the red rises to your cheeks? If you have a clear phototype (blond hair, clear eyes), there is nothing surprising: this rosacea due to the dilation of the capillary vessels is common in people with fair skin. When is it justified to consult then? "At this stage, rosacea produces only aesthetic discomfort and is not easy to treat with simple creams. But it is possible to offer a topical treatment to be used on an ad hoc basis, before an interview or an intervention in public for example, "specifies Dr. Eleonora Gambillara Thacher, dermatologist in the Lausanne region. These creams make it possible to limit the vascular dilation for ten to twelve hours, but have no long-term effect. A few laser or pulsed light sessions can also close the superficial vessels and therefore reduce redness, provided that the treatments are carried out with a certain regularity. The inflammatory form of rosacea, defined by the appearance of small papules and pustules, can cause painful and itchy pimples. Metronidazole and, more recently, topical ivermectin have been proven to work. Oral antibiotics may also need to be prescribed and, if rosacea is resistant, isotretinoin.

Acne

Acne often has the image of a disease of adolescence, however many adults consult for this indication. And the impact of this disease on quality of life would still be underestimated. In 2018, French researchers carried out a study on 1,000 adult patients suffering from acne. Even those with mild to moderate forms reported a decrease in their quality of life, and some even reported absences from work or work related to their acne. If the majority of adults who suffer from it developed the disease in their young years, it is not uncommon for patients, most often women, to develop acne after 25 or 30 years. Solutions exist and age should not be an obstacle to consultation. Some of these acnes are linked to the use of cosmetics which can clog the pores of the skin and promote the development of blackheads. Using several layers of different products every day ("layering") or changing care or make-up products often can also promote the appearance of pimples. In this case, the care is simple and the problems are most often resolved with a return to a simplified care routine and suitable hygiene products. The other forms of acne are the consequence of interactions between personal predispositions and environmental factors. If the triggers for acne are not yet all known, we know for example that intense and / or prolonged stress can promote the appearance or the resurgence of this inflammatory disease. Having a family member who has acne also increases the risk. Hormonal fluctuations are also implicated in women. "Many women who develop acne in adulthood have actually had oral contraception until then, often with anti-androgenic action since their teens, which somehow masked their acne. When they stop contraception, acne comes back, "says Dr. Gambillara Thacher. Contraception is also considered today as one of the elements of the therapeutic arsenal against acne in women. "You have to know the history and assess the individual risk factors, especially thrombosis. The treatment is always adapted to each individual case by the gynecologist, "underlines the dermatologist. Among the therapeutic options, patients may be offered topical treatments, antibiotics over a period of a few months or isotretinoin treatment in more severe cases or in scar acne.

Pigment spots

Spots, brown but sometimes also white, may appear after exposure to the sun. They are a sign that the skin is no longer able to cope properly with the stress of exposure to radiation. This signal must therefore above all lead to more and better protection. "Good protection means above all avoiding the sun, especially in the hottest hours, then wearing protective clothing and / or UV filters, and putting on a hat," recalls Dr Gambillara Thacher. Sunscreens should be used when exposure to the sun cannot be avoided. If you tend to have spots, you have to choose a 50 index and reapply in principle every 2-3 hours in sufficient quantity. " Once spots appear, over-the-counter cosmetic products at best allow for attenuation, but are generally not effective enough to completely erase them. For this, a few laser sessions may be necessary. We recommend a topical cream to help get rid of age spots. It is called Curaderm BEC5 and is available here. Some women also face another pigmentation disorder, melasma, which is often mistakenly called a "pregnancy mask". In fact, only 20% of cases occur in pregnant women. The causes of this hyperpigmentation are not yet fully known, but hormonal contraception can promote its occurrence, the discontinuation of the pill, however, only rarely bringing about an improvement. Again, sun exposure can promote the maintenance of stains, and photoprotection is therefore recommended. Management is based on an attack treatment with a cream containing hydroquinone, retinoic acid and dexamethasone acetate (Kligman trio), then a maintenance treatment..

 

FOCUS ON THE SKIN

It is the largest organ in the body and one of the most resistant. The skin plays a role in protecting the body, regulating body temperature, communicating with the outside world and sensory perception. The skin performs its multiple functions thanks to the three tissues that compose it, the epidermis, the dermis and the hypodermis.

The epidermis

First layer of the skin, this structure is mainly composed of a type of cells called keratinocytes. These prevent water from leaving our body and defend it against bacteria that would attack it. This superficial part of the skin is renewed every month. Melanocytes represent 5% of the total composition of the epidermis. These cells protect us from the UV rays of the sun and give a color to our skin, except in the case of mutation (albinism). Their accumulation forms moles.

Dermis

Intermediate area of ​​the skin, the dermis constitutes its solid part. Its size varies from a minimum of 1 millimeter on the face to a maximum of 3 millimeters in the back. Composed of elastic fibers and collagen, the dermis protects against shocks and allows the body to regulate its temperature thanks to an important network of blood vessels. It also plays a key role in the healing process.

The hypodermis

Made up mainly of fatty tissue and blood vessels, the hypodermis is the lower layer of the skin. It is a reservoir of energy. It serves as an insulator against temperature variations and protects the internal organs from violent shocks.

Eczema

Characterized by itching (pruritus), redness (erythema) and rashes, eczema can have various causes, including genetic, environmental and allergic. It seems that an abnormality of certain cells of the epidermis, the keratinocytes, plays an important role. Itching is caused by an over-reaction of the immune system

Psoriasis

In some people, keratinocytes (see Epidermis) multiply in an accelerated way and create spots on the surface of the skin: it is psoriasis. Very complex, the disease is chronic and recurrent.

Dry skin

A thin fatty layer called hydrolipid covers the surface of the skin and protects it. It is produced by glands in the dermis, called sebaceous glands. Several external factors such as cold or wind can disrupt its functioning, which leads to drying of the skin.