Ageing Skin. When we think about this skin condition, it’s typical and normal for us to think about ageing skin from an aesthetic perspective. We think about wrinkles, fine lines, flaccid skin, uneven pigmentation and overall dryness and dehydration. We perhaps look at mature aged individuals and guestimate their age based on what we are seeing. However, it is time for us to view ageing skin in a different way.
Thanks to the generally high standard of living in most parts of the world, compared to previous generations, we are fortunately living much longer with better health. For instance, in 1946 the life expectancy was 65 years old whereas today it is 80 years old. In fact, approximately 36% of our population are over 65 years old.
Despite the fact, we are living longer and for many of us it is a healthy journey, living longer does come with new challenges. Ageing is linked to a series of physiological and pathological processes as the body overall is coping with multiple ageing organs and illnesses resulting in poly-morbidities.
Among these challenges is skin ageing. Ageing skin is associated with changes in its structure and functionality such as reduction in skin cell turnover and its potential for it to regenerate. What can all this lead too? Increased vulnerability and dryness which in turn can increase the risk of skin damage and infection.
Skin is a vital organ and is one of the most important organs of the body for our health and wellbeing. It is time for skin to be seen as an organ that must be taken care of not just for aesthetic purposes but to help maintain quality of life.
SKIN: THE FIRST LINE OF DEFENCE
We know that skin plays a vital role in being the first line of defence as its main function is to provide protection and act as a barrier between the body and our external environment. It is the largest organ of the body that also has additional functions such as maintaining body temperature, provides sensory functions in relation to temperature and touches as well as acting as a storage for water and fat stores.
Our skin consists of 2 primary layers known as the epidermis and the dermis and even though I could provide endless information about these two fascinating layers, for the purpose of this article, l will keep it brief.
The epidermis is the outer layer of the skin that plays two important roles. In no specific order, it provides protection from bacteria and other microbes and it also helps keep moisture within the skin.
If our skin becomes injured and impaired, the body can become subjected to the invasion of outside agents, which will lead to irritation and sensitivity. Furthermore, moisture can escape from the epidermis, known as trans-epidermal water loss and this can further impair barrier function.
What is worth noting here is the pH of the skin, which ideally should be between the pH of 4 to 5.5. The low pH of the skin creates what is known as the acid mantle which contributes to the barrier function of the skin. When the skin becomes damaged, it can shift the pH towards alkaline, increasing the skin’s susceptibility to bacterial skin infections.
The skin’s pH can also be increased by systemic diseases such as diabetes and even simple wound dressings can increase the skin pH which could potentially lead to further breakdown of the skin.
The dermis often called the ‘true skin’, supports and nourishes the epidermis. It contains important components of the skin such as blood vessels, nerve endings, hair follicles, sweat glands and the lymphatic system. The dermis also contains collagen which helps to provide strength and structure to the skin along with elastin fibres that provide skin its elasticity allowing it to return to shape after it has been stretched.
As we age, the production of collagen and elastin is reduced, which in turn leads to wrinkling, sagging and increased risk of skin tears. So as much as skin is incredibly durable, it too like all other systems of our body, eventually succumbs to the inevitable effects of ageing.
So how does the skin change as we age? What are the contributing factors?
We will delve into this in Part 2…..
This guest blog is written by Dora Erdossy, Dermal Educator & Dermal Clinician. With over 25 years’ experience in the Skin Care Industry, Dora Erdossy has worked as a Dermal Clinician and Educator for some of the industry’s largest brands across Australia, USA and Europe. Dora’s passion for education saw her become an educator for dermalogica and The International Dermal Institute in 2001 where she taught in Australia, Vietnam, Fiji and New Zealand.
In 2005, Dora moved to the United States where for the next 3 years, she championed the role of Senior Educator at dermalogica’s Los Angeles HQ.
Does the feeling of happiness and well-being surpass financial achievements? Unfortunately, wealth is exactly what a majority of people, the younger generation especially, associate happiness with. People rarely think to explore happiness or well-being and what constructs these phenomena. If you do, you’ll be surprised at the multitude of things you’ll find out.
We discussed happiness and wellbeing in one of our podcasts with four experts and it was an eye-opening experience. So, we thought we would share their rich opinions on the constructs of happiness with you. Here are the 5 tips we gathered from the discussion.
Invest in your relationships
As humans, we’re naturally social. In fact, people have a deep need to interact and maintain strong interpersonal relationships. This, of course, means that our relationships can have strong effects on our happiness.Byron Dempsey, a Podcast host and founder of Stream Digital Marketing, shares that “happiness is a big factor of who you’re surrounded by”.
Neuropsychotherapist and Relationship expert, Joanne Wilson explains that relationships thrive when both parties learn to communicate effectively. As you seek to connect, it’s important to maintain a balance, even when connecting with others, learn to create your “you” time.
Create a Worksheet for Prompting Positive Emotions
“Without some sort of positive emotion I believe that you can’t really be truly happy,” says Anna Block, a nutritionist coach and founder of Anna Block. This reveals that happiness has close ties with our emotions. Knowing this, how can you make yourself feel positive emotions as often as possible?
Joanne explained that maintaining a mindset of gratitude and creating a worksheet for promoting positive emotions can help. This worksheet can answer questions such as “who are two people that I can call on if I’m worried about something? … What are five things that make me laugh? … What’s the five things I want to do to keep my heart rate up?
Referring to all these when you’re feeling down can help redirect your thoughts towards positive things.
Activate the State of Flow through Practice
The state of flow is the mental position of being totally immersed in an activity. Anytime a person is in the “zone” or “flow” that person is totally involved in a certain activity and is enjoying it completely. When this is the case for you, your overall levels of achievement, satisfaction and happiness increase.
Anna Block advises that, to get into a state of flow, you should “identify what we call your character and then your highest strengths and talents…usually, the things you enjoy doing that naturally come to you”
Benny Wallington, a performance coach and founder of 101 tokens, says “the thing with flow, though, is that it’s all about practice and daily practice…If you’re not getting sleep because you’re worried, maybe there’s a form of practise that you can try – getting those practices in and making them simple enough that you can do anywhere and anytime is super crucial”
Get Adequate Sleep
When your body fails to get as much rest and sleep as it needs, stress kicks in. This stress begins to tamper with your mood. Apart from affecting your mood, depriving yourself of sleep can lead to health complications which makes it even harder to achieve optimal happiness or well-being. Therefore, to sleep better, avoid exposing yourself to bright lights a few hours before your bedtime. Leave strenuous activities and exercise for earlier in the day as well as avoiding drinks that contain caffeine in the afternoon.
Happiness and overall well-being can affect you in ways you wouldn’t imagine. It can motivate you to pursue your individual goals, and help you live a more qualitative life. Invest in your happiness today by practising these 4 tips. What gives you a sense of happiness? Share your practices with us on instagram by tagging @dermhealth.co
Marnina is a Dermal Clinician, Dermatoscopist, University Supervisor, Tech Geek and founder of Dermhealth.co
Calling for industry-wide transparency about unregulated treatments and true skin health, Marnina is committed to helping people make informed choices about how they can heal their skin, be empowered on their skin health journey and helping cut through the marketing hype so they can make decisions based on an evidence based approach.
Since her early teens, Marnina has envisioned creating a hub of specialists and leading health practitioners, offering education and support to the community in a tranquil and beautiful atmosphere. In early 2018 after several years of freelancing Marnina decided it was time to breath her passion of technology and skin health into Dermhealth.co, an online platform educating about true skin health and offering support for those experiencing skin disease, trauma and injury (and there may even be future dreams of a face to face workshop space!)
When our skin is damaged or impaired due to inflammation, disease, injury or trauma it not only disrupts our skin barrier but it can also have a significant impact on our health and mental state. Marnina believes that everyone deserves to have the opportunity to specialised consult and treatment no matter what their skin concern is.
Ultimately Marnina wishes to bring patients and practitioners together to help people face the world faster.
Whether you are a patient seeking advice on a a treatment, a mother concerned with a scar on their child or a practitioner that strives to do their very best for each client, Marnina insists there is a place for you at dermhealth.co
The 6th of February is a day to commemorate Zero Tolerance to Female Genital Mutilation. When we learned that this practice is still occurring in over 45 countries including Australia we knew it was a topic that needed more awareness.
This article covers everything we have learned about Female Genital Cutting (FGC) from interviewing three advocates in two countries. We cover the different stages of cutting, the risks involved and how we can work together to educate communities on the subject and put an end to this practice.
So, what is FGC?
FGC (Female Genital Cutting) is a procedure that involves removing parts of or the entire female genitalia. In some cases, the vagina is sewn together and a small hole is left for the purpose of urination and menstruation blood. FGC usually occurs in young girls around the age of 5.
The UN has stated that FGC is still practised in 30 countries, however, the Orchid Project believes there are over 40 countries still practising FGC to this day.
What is the biggest misconception on FGC?
People don’t think that this practice happens outside of Africa, however, forms of FGC occurs in every race and religion and is currently reported in over 45 countries globally.
People often refer to FGC as FGM (Female Genital Mutilation). Organisations such as the Orchid Project and US End FGM Network prefer to use the term Female Genital Cutting as the word ‘mutilation’ is seen as judgmental and eludes to a violent and hateful act.
FGC is not widely spoken about in the media. It is a subject that is often referred to as a mysterious, taboo topic. Many people refuse to talk about it as they believe it is a form of violence towards children and therefore wants to avoid the conversation altogether.
What people don’t understand is that FGC has been around for centuries. It is traditional for participating communities to practice FGC with a belief that the practice will reduce sexual promiscuity and protect their daughters from traumatic experiences such as rape.
What are the different types of FGC?
There are several different categories of FGC. There’s the forcible removal of the clitoris, removal of the labia and removal of both clitoris and labia and the most traumatic type of FGC is the removal of all external genitalia.
When the external genitalia is removed, the wound is sewn closed and a small hole is left for the purpose of urination and menstruation. The reason this is the most traumatic type of FGC is that at some point in that female’s life she will have to be cut open again for when she’s ready to fall pregnant. Once the child is born, the female’s genitalia is sewn back up. This type of FGC leaves women open to continuous forms of violation throughout their lives, and each time a woman is cut and sewn, scar tissue is formed which can lead to keloid scarring and health implications.
Despite varying forms of FGC and resulting physical changes to the woman’s genitalia, it is important to note that all forms of FGC are traumatic. As well as causing psychological distress the procedure is often performed in rudimentary settings where the instruments are shared and not appropriately sterilized between procedures.
Who’s at risk of FGC?
Although there are various different statistics on how many females undergo FGC, Unicef says at least 3.9 million girls at risk every year with those figures increasing dramatically each year.
It is also said that there are 200 million women living with the impacts of being cut today.
What are the physiological impacts of FGC?
Most procedures are being performed at a young age. No anesthetic is used and women are cut around the age of 5.
The most devastating risk that may happen when performing this procedure is a girl may hemorrhage or get sepsis which can both be fatal. These outcomes don’t often occur immediately but can happen weeks later. Families will often be led to believe that the fatality is due to evil spirits and not linked to the mismanaged procedure.
Long term effects of FGC consist of constant infections, UTI’s, kidney infections, difficulty passing period blood and compromise reproductive health. A study showed an increase in postpartum hemorrhage as a result of being cut.
The effects of FGC has made life incredibly difficult for these women. The rights for these women to experience sexual pleasure has been taken away from them and has made them vulnerable to conditions such as trauma, anxiety, and PTSD.
Is reconstructive surgery possible?
The clinical guidelines say there is not enough evidence that surgery is beneficial or has enough effectiveness in order for it to be mandated by the UK’s health service. Once the tissue has been cut away there are huge issues about what reconstruction actually is. No matter what happens around that, how do we deal with the trauma of that original intervention?
Organisations try to work towards ending the practice of FGC rather than focus on reconstruction.
Up until recently, little to no support was given by the government to end this practice. However, last year (2019), the UK announced it would contribute 100 million pounds to help put an end to FGC
How organisations are helping to end FGC
Some organisations such as The Orchid Project and US End FGMC Network work for hand in glove with practising communities by using respectful dialogue. The local facilitators often meet with the communities and spend around 6 months to 2 years discussing the community’s future and providing resources to teach about human rights and increasing academic education in the community. The end goal being peace, security, and well-being.
When communities start understanding human rights their minds shift, especially around gender equality. Women become more confident verbally and start conversations around FGC. They ask questions such as ‘why am I doing this to my daughter?’ and ‘do men understand the pain we’re going through?’
A majority of the communities that complete work with these organisations is making the change to stop female cutting. Some communities are even putting an end to other traditions such as arranged child marriages.
How will FGC end?
Social change is multifactorial. Raising awareness about the problem and using mediums such as Instagram, Facebook, and Twitter, can help awareness surrounding FGC can accelerate much quicker than anyone could imagine. As well as starting conversations about this practice in the broader community, supporting grassroots organisations in your local area can help to improve awareness and increase lobbying to local governments.
It is also important for healthcare professionals to become educated about the different forms of FGC and the associated health implications.
Those working with the broader community, especially in migrant communities are also urged to become educated and provide a safe space for conversation with young girls and women.
Advocates believe that if enough focus and resources are put on education and inclusion rather than judgement and exclusion we may just see an end to FGC in our lifetime, how amazing would this be.
Imagine this, you’re rushing to get to work for a big meeting as you pressed the snooze a couple of extra times and you’re waiting to collect your standard latte at your local cafe. As you turn around to leave a stranger jumps back and exclaims “what happened to your face”. You walk into the meeting shakily.
Or, you are doing your weekly grocery shop when a woman comes up to you and gives you a business card with the details of an MLM skin care product that she claims is curing people “with skin just like yours”. She is the second one this week, and you’ve lost count for this year.
Or, you’re visiting your local GP for a script as you have a standard head cold. Your regular doctor isn’t in today so you are seeing someone new as a one-off appointment. Before even asking what you’re in for today he abruptly states your skin condition, exclaiming, “I’ve never come across your skin condition during my clinical practice” and proceeds to ask multiple questions and your diagnosis and treatment. You have to tactfully segway the conversation into what you were attending for in the first place.
Or, you’re visiting your dermatologist for a recent infection. It’s a registrar day at the clinic. You prepare yourself by sitting on the treatment table. A flock of students enter the room and start reeling off medical terminology, describing every detail of how your skin condition is presenting, touching you, discussing among themselves and writing notes, without even saying hello or asking if you’re comfortable. You sit half-naked, feeling uncomfortable and vulnerable, too people-pleasing to decline.
You may have read through these scenarios and thought how absurd they are. You may think these kinds of things don’t happen in real life unless you’re a character in a tv show or an animal in the zoo.
Unfortunately, a scenario similar to these has occurred to Carly Findlay, a Melbourne based speaker, writer and appearance activist who has ichthyosis.
And, they are a likely common occurrence for many of those that live with visible skin differences or disabilities.
Are people consciously THAT rude? Have people forgotten the simple courtesies of doing unto others as you would do unto yourself?
I honestly don’t know. But it sucks.
When I heard Carly talk about similar scenarios such as the ones described above in her recent memoir, “Say Hello”, and during an interview for the Heal Thy Skin Podcast, I couldn’t shake the feeling of anger and utter disdain for people that would act in such an insensitive way.
Carly so eloquently explains it in her writing and also during our discussion that people are generally curious and have a sense of wanting to help, sometimes no matter if it is welcomed or not. Sometimes people are downright rude, but much of the time, they are just uneducated and assuming.
I can almost guarantee that the scenarios listed above could have been orchestrated by you in one form or another at one point in your life. I don’t say this to upset you but I would like to ask if you can muster up the courage to reflect and see if perhaps you could have been the perpetrator in one of these stories.
This is why I believe we need to change our language when it comes to skin conditions.
In my work as a Dermal Clinician, I’ve seen a lot of skin, in all of its glory, in many facets of disease and health.
On reflection, I can think of several times that I saw something on a patient’s skin that I hadn’t seen before to which I may have been overly eager to point out to them despite them visiting me for a completely different concern. I remember being a student and peering to look at a person presenting with a skin condition as the class gathered in a circle around the treatment table while the “patient” lying there in a daze, them never having so many people look at them before, much less while they are dressed only in a gown and their undergarments.
Those that do not have visible skin differences can act in ways that are dehumanizing, othering and discriminatory.
We wouldn’t accept it if someone was to track us down in a shopping center to give us a marketing brochure of an anxiety drug while we were doing our shopping.
Nor would we accept it if our doctor decided to bring up our IVF history if we were visiting for a common cold.
So here are 5 ways we can change our language about skin conditions:
(including spoken and internal dialogue)
1. Instead of describing someone as “suffering from x skin condition” say “living with x skin condition”. If someone has a life long skin condition that they manage every day, who are we to say they are “suffering”, they could be thriving despite their daily challenges.
2. Instead of asking someone “what happened to your skin” first ask yourself is the question relevant to the situation. If you are on public transport the relevancy of what skin condition they have is much less than the chit chat about noticing that they are reading the same book as you.
3. If in a clinic scenario, instead of medicalising their skin condition and speaking about them as though they weren’t there ask them (again only if relevant to the situation) how they are feeling, ask them to describe their concerns with you, ask what they would like to get out of the treatments – remember, not everyone is seeking a cure.
4. If you are in a work or social setting and someone has a visible skin condition instead of going out of your way to speak to them to ask about their skin condition instead say, “hello” and get to know them on a basis of who they are and how they came to be at the event, seminar, job role that you’re both at.
5. If you are tempted to approach a stranger and let them know about a product or treatment that cured your aunties best friend of their seemingly incurable skin condition. Stop and ask yourself if would you enjoy someone chasing you down to tell you about a weight loss supplement that is proven to help “people just like you”?
Bonus tip: If you have been in a situation where you were curious and politely asked someone about a visible difference and they declined to answer, don’t think that they are rude. It is likely they are in a rush, exhausted, overwhelmed or just feeling a little over the questions. It is not their responsibility to educate you, after all, would you describe your medical records with a stranger?