I walk by a very tall building. Way at the top is a name — Neora. Usually, the names on office buildings are those of the largest tenants. I look up Neora, and it is a skin care, wellness, hair care and weight management company. I have known people that have strict skin care regimens; some of them had great-looking skin and some didn’t. My skin care is more haphazard. Before the pandemic I made some attempt at skin care if I was going some place where there were going to be other human beings. I put on facial and eye moisturizers underneath my make-up. At the end of the day, I removed the make-up and moisturizers with a pre-moistened towelette wipe labeled “make-up remover.” I have also been to aestheticians a couple of times. One worked in a dermatologist office and the other one was at a beauty school. Both of them tried to get rid of the bumps in my complexion. The first one squeezed my pimples. I told her she was doing the thing my mother told me never to do. She said as long as you make a hole with a needle first, it is OK. The second one tried to control my milia, small white bumps that appear under the skin. She was successful, but wherever she removed some, a red blotch would appear that eventually healed making the skin look better. In the last couple of years I have had to use hypoallergenic eye makeup because the non-hypoallergenic kind made my eyes water. Since the pandemic started and I have made fewer and fewer connections with people in person, my skin care has deteriorated. I think we could all probably use some good skin care. Let’s find out more about it.
According to Wikipedia, skin care is the range of practices that support skin integrity, enhance its appearance and relieve skin conditions. They can include nutrition, avoidance of excessive sun exposure and appropriate use of emollients. Practices that enhance appearance include the use of cosmetics, Botox, exfoliation, fillers, laser resurfacing, microdermabrasion, peels, retinol therapy and ultrasonic skin treatment. Skin care is a routine daily procedure in many settings, such as skin that is either too dry or too moist, and prevention of dermatitis or inflammation of the skin and prevention of skin injuries.
Skin care is a part of the treatment of wound healing, radiation therapy and some medications.
Natural skin care uses topical creams and lotions made of ingredients available in nature. Much of the recent literature reviews plant-derived ingredients — which may include herbs, roots, flowers and essential oils — but natural substances in skin care products include animal-derived products such as beeswax and minerals. These substances may be combined with various carrier agents — preservatives, surfactants, humectants and emulsifiers.
There are no legal definitions in the U.S. for advertising terms "natural" or "organic" when applied to personal care products. Consumers often express a preference for skin products with organic and natural ingredients. The personal skin care market based on natural products has shown strong growth. Clinical and laboratory studies have identified activities in many natural ingredients that have potential beneficial activities for personal skin care, but there is a shortage of convincing evidence for natural product efficacy in medical problems.
Some natural products and therapies may be harmful — either to the skin or systemically. People prone to allergies should pay careful attention to what they use on their skin. Dermatologists may feel that there is enough scientific evidence to assist in the selection or avoidance of particular natural ingredients.
Background Skin care is at the interface of cosmetics and dermatology, a traditional medical discipline; there is some overlap with each of these topics. The Federal Food, Drug, and Cosmetic Act defines cosmetics as products intended to cleanse or beautify e.g., shampoos and lipstick. A separate category exists for medications, which are intended to diagnose, cure, mitigate, treat or prevent disease, or to affect the structure or function of the body — for instance, sunscreens and acne creams — although some products, such as moisturizing sunscreens and anti-dandruff shampoos, are regulated within both categories. Skin care differs from dermatology, as traditionally practiced, by its additional but less medical scope and by its inclusion of non-physician professionals, such as aestheticians and wound care nursing staff. Skin care includes modifications of individual behavior and of environmental and working conditions. Nevertheless, dermatology has co-opted some aspects of skin care, particularly in the U.S., and to a significantly lesser extent elsewhere, such as the U.K.
Many countries require that the ingredient composition of skin care products is listed on the product, using the International Nomenclature of Cosmetic Ingredients or INCI conventions. Ingredients are listed in the order of their percentage within the product; natural ingredients are listed in Latin and synthetic ingredients are listed by technical name. The U.S. government has documented more than 10,500 ingredients in cosmetic products, but only a small percentage of those chemicals have been tested for safety. Of those that have been tested, some have been identified as carcinogens (causes cancer), teratogens (causes birth defects) and reproductive toxicants (damages the ability to reproduce).
The FDA surveyed 1,687 consumers ages 14 and older in 1994 about their use of cosmetics. Nearly half of these consumers felt that a product claiming to be "natural" should contain all natural ingredients. However, although the United States Department of Agriculture or USDA has designated within its certain requirements within its specific area of regulation for organic products, the U.S. Food and Drug Administration or FDA does not recognize a definition for natural products. Accordingly, there are no legal definitions in the U.S. for the advertising terms "natural" or "organic" in personal care products. The FDA prohibits certain ingredients in cosmetics.
Some organic products which are designated organic may be intensely modified, sometimes considerably more so than conventional products.
Neonatal skin care Guidelines for neonatal skin care have been developed. Nevertheless, the pediatric and dermatological communities have not reached consensus on best cleansing practices, as good quality scientific evidence is scarce. Immersion in water seems superior to washing alone, and use of synthetic detergents or mild liquid baby cleansers seems comparable or superior to water alone.
Sunscreen Sun protection is an important aspect of skin care. Though the sun is beneficial in order for the human body to get its daily dose of vitamin D, unprotected excessive sunlight can cause extreme damage to the skin. Ultraviolet radiation in the sun's rays can cause sunburn in varying degrees, early ageing and increased risk of skin cancer. UV exposure can cause patches of uneven skin tone and dry out the skin. It can even reduce skin's elasticity and encourage sagging and wrinkle formation. Sunscreen can protect the skin from sun damage; sunscreen should be applied at least 20 minutes before exposure and should be re-applied every four hours. Sunscreen should be applied to all areas of the skin that will be exposed to sunlight and at least a tablespoon or 25 ml should be applied to each limb, the face, chest and back, to ensure thorough coverage. Many tinted moisturizers, foundations and primers now contain some form of sun protection factor or SPF. Sunscreens may come in the form of creams, gels or lotions; their SPF number indicates their effectiveness in protecting the skin from the sun's radiation. There are sunscreens available to suit every skin type; in particular, those with oily skin should choose non-comedogenic sunscreens; those with dry skins should choose sunscreens with moisturizers to help keep skin hydrated, and those with sensitive skin should choose unscented, hypoallergenic sunscreen and spot-test in an inconspicuous place — such as the inside of the elbow or behind the ear — to ensure that it does not irritate the skin.
Elderly Skin aging is associated with increased vulnerability. Skin problems including pruritus, itch or automatic tickle — a sensation that causes the desire or reflex to scratch — are common in the elderly but are often inadequately addressed. A literature review of studies that assessed maintenance of skin integrity in the elderly found most to be low levels of evidence, but the review concluded that skin-cleansing with synthetic detergents or amphoteric surfactants induced less skin dryness than using soap and water. Moisturizers with humectants helped with skin dryness, and skin barrier occlusive reduced skin injuries.
There is limited evidence that moisturizing soap bar and combinations of water soak, oil soak and lotion are effective in maintaining the skin integrity of elderly people when compared to standard care.
Acne According to the American Academy of Dermatology, between 40 and 50 million Americans suffer from acne each year. While many associate acne with adolescence, acne can occur at any age, with its causes including heredity, hormones, menstruation, food and emotional stress. Those with inflammatory acne should exfoliate with caution as the procedure may make conditions worse and consult a dermatologist before treatment. Some anti-acne creams contain drying agents such as benzoyl peroxide in concentrations of 2.5–10%.
Radiation Radiation induces skin reactions in the treated area, particularly in the axilla or armpit, head and neck, perineum and skin fold regions. Formulations with moisturizing, anti-inflammatory, anti-microbial and wound-healing properties are often used, but no preferred approach or individual product has been identified as best practice. Soft silicone dressings that act as barriers to friction may be helpful. In breast cancer, calendula cream may reduce the severity of radiation effects on the dark spot corrector. Deodorant use after completing radiation treatment has been controversial, but is now recommended for practice.
Epidermal growth factor receptor or EGFR Epidermal growth factor receptor or EGFR inhibitors are medications used in cancer treatment. These medications commonly cause skin and nail problems, including rashes, dry skin and paronychia. Preventive intensive moisturizing with emollient ointments several times, avoidance of water-based creams and water soaks — although in certain circumstances white vinegar or potassium permanganate soaks may help — protecting the skin from excessive exposure to sunshine and soap substitutes which are less dehydrating for the skin than normal soaps, as well as shampoos that reduce the risk of scalp folliculitis, are recommended. Treatment measures with topical antibiotic medication can be helpful.
Related products Cosmeceuticals are topically applied, combination products that bring together cosmetics and "biologically active ingredients." Products which are similar in perceived benefits but ingested orally are known as nutricosmetics. According to the United States Food and Drug Administration, the Food, Drug, and Cosmetic Act "does not recognize any such category as "cosmeceuticals." A product can be a drug, a cosmetic or a combination of both, but the term "cosmeceutical" has no meaning under the law." Drugs are subject to an intensive review and approval process by FDA. Cosmetics and these related products — although regulated — are not approved by FDA prior to sale.
Procedures Skin care procedures include use of Botox; exfoliation; fillers; laser medicine in cosmetic resurfacing, hair removal, vitiligo — a long-term skin condition characterized by patches of the skin losing their pigment, port-wine stain and tattoo removal; photodynamic therapy; microdermabrasion; peels; and retinol therapy.
Consumer preference for skin care products with natural ingredients Consumers often express a preference for skin care products with organic and natural ingredients. The skin care market based on natural products has shown strong growth. Clinical and laboratory studies have identified activities in many natural ingredients that have potential beneficial activities for the skin. Dermatologists may feel that there is enough scientific evidence to assist in the selection of particular natural ingredients. Consumers expect products to perform as advertised. The industry has voluntarily discontinued precursor substances that release small quantities of formaldehyde, which is a carcinogen, as well as reducing levels of the potentially carcinogenic impurity 1,4-dioxane. In addition, polycyclic musk fragrance ingredients — which have raised concerns as persistent and bio-accumulative endocrine disruptors — are being discontinued.
Alternative medicine There are significant reservations about complementary and alternative medicine or CAM including a "shortage of evidence supporting the efficacy and safety of CAM" for skin problems. However, patients express a desire to utilize natural ingredients as treatment. A literature search found a growing prevalence of CAM use for skin conditions. A number of textbooks address CAM perspectives of skin care. The purpose of this section is to review botanical compounds in skin care; a broader review the history and theory behind other CAM modalities such as psychocutaneous therapies, acupuncture and homeopathy can be found in recent reviews.
In Western medicine according to Baumann, "Botanical compounds for which dermatologic and cosmetic applications have emerged include olive oil, chamomile, colloidal oatmeal, oat kernel extract, feverfew, acai berry, coffee berry, curcumin, green tea, pomegranate, licorice, paper mulberry, arbutin and soy. "Many of these botanical sources offer biologically active components that require further in vitro and in vivo investigation."
A review of 35 plant families found that a "variety of phytomolecules, derived in particular from polyphenols, triterpenes and sterols classes, demonstrated a promising activity."
Colloidal oatmeal may be beneficial in psoriasis. Aloe vera may help in atopic dermatitis. In both these conditions, the benefit may arise from anti-inflammatory properties. For combating acne and rosacea, green tea, niacinamide and feverfew are considered efficacious. For hyperpigmentation — darkening of an area of skin or nails caused by increased melanin — and antioxidative capabilities, licorice, green tea, arbutin, soy, acai berry, turmeric and pomegranate are among those plants and compounds found to be most beneficial. Additional research is needed to determine to confirm and elucidate the benefits of these ingredients in the prevention and management of skin disease.
An assessment of clinical trials on green tea preparations and their uses in dermatology found some evidence for potential benefits.
Ayurvedic skin care is derived from medicinal practices that began over 5,000 years ago in India. Ayurvedic medicine and healing practices are based on Indian philosophical, psychological, conventional and medicinal understandings. Most of the ayurvedic skin care products contain the following herbs: aloe vera, almond, avocado, carrot, castor, clay, cocoa, coconut oil, cornmeal, cucumber, cutch tree, emu oil, ginkgo biloba, ginseng, grape seed oil, ground almond and walnut shell, horse chestnut, witch hazel and honey.
Ayurvedic approaches have been used in molluscum contagiosum or water warts, lymphatic filariasis — a human disease causes by parasitic worms, vitiligo and lichen planus, a chronic inflammatory and immune-mediated disease that affects the skin, nails, hair and mucous membranes.
Phyllanthus emblica or Indian gooseberry has been used in ayurvedic medicine. Standardized extracts of Phyllanthus emblica have a long-lasting and broad-spectrum antioxidant activity. This may be suitable for use in anti-aging cream, sunscreen and general purpose skin care products.
In traditional Chinese medicine, natural skin care ingredients include jojoba, safflower oil, rose hip seed oil, shea butter, beeswax, witch hazel, aloe vera, tea tree oil, coconut oil and chamomile.
· Egg oil can be used as an excipient/carrier in a variety of cosmetic preparations such as creams, ointments, sunscreen products or lotions. In Indian, Japanese, Unani — Perso- Arabic traditional medicine as practiced in Muslim culture in South Asia and modern day Central Asia — and Chinese traditional medicine, egg oil was traditionally used as a treatment for hair care.
· Jojoba is used for skin care because it is a natural moisturizer for the skin. Jojoba is actually a liquid wax that becomes solid below room temperature but is known as an oil.
· Shea butter is derived from the kernel of the shea tree. Shea butter is known for its cosmetic properties as a moisturizer and emollient.
Research
Dermatological research suggests that the bioactive ingredients used in cosmeceuticals have benefits beyond the traditional moisturizer. However, despite reports of benefits from some cosmeceutical products, there are no formal requirements to prove that these products live up to their claims.
Biocompatible and environmentally friendly natural compounds have the potential to provide materials with photoresistant and thermoresistant properties.
Dehydroabietic acid or DAA — a naturally occurring diterpene resin acid — has lifespan extension effects in Caenorhabditis elegans, prevents lipofuscin accumulation and prevents collagen secretion in human dermal fibroblasts. These anti-aging effects are primarily mediated by SIRT1 activation. DAA may activate SIRT1 enzymatic activity, which may have a preventive effect against the aging process.
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