It is a popular belief that a good suntan is a sign of good health. In fact, a suntan is visible evidence of having received enough sunlight to damage the skin.  Our views and knowledge of the sun and a suntan have changed considerably over the years.

One hundred years ago the Europeans considered a pale complexion to be a social and fashion asset.  Large hats were worn and sunshades were carried to protect their skin from the sun.  The rich and fashionable avoided the sunlight.

A Suntan became desirable

It was in the 1930’s that attitudes began to change.  People started to enjoy outdoor activities such as walking, camping and cycling.  A suntan gradually became more acceptable and even desirable.

In the 1940’s, after World War II had ended, cheap holidays enabled people around the world to enjoy the pleasures of travel.  A most popular holiday destination was the beach.  And so the outdoor lifestyle was established, along with it, the suntan.  To have a good suntan was considered to have a healthy glow.

It was however, around this time that Australians were being informed of the potential dangers of the sun.  There was a high rate of skin cancer being reported amongst white-skinned people.  Public health campaigns were introduced to warn people of the dangers and to educate them about the use of sunscreen and the early detection of skin cancers.

The sun damages our skin

But still people persisted in sunbaking and not protecting their skin.  Repeated exposure to sunlight causes premature aging of the skin known as ‘photoageing’.  Here the skin becomes dry, wrinkly and saggy, with red and brown blotches.

There are more than 200,000 new cases of skin cancer reported each year in Australia alone.  About 8,000 of these are malignant melanomas which are responsible for about 1,600 deaths each year.  Doctors estimate that 90% are potentially preventable by taking care in the sun.

The sun has benefits too

The positive effects of sunlight are also considerable.  The warmth and light offered by the sun after a long, dark winter will hugely lift the spirits.  The aim is therefore to enjoy the psychological benefits of the sun without suffering from its hidden harmful effects.

What Happens When We Sun Bake?

When we sun bake the UV rays from the sun penetrate the skin.  This causes damage to the skins cell molecules, in particular the DNA in the cell nuclei.  By damaging the cells DNA, the function of the cell is impaired, and thus complications can begin to occur.

The body will largely repair the immediate DNA damage, but some can be inaccurately repaired.  Problems arise when the inaccurately repaired DNA is passed on to new cells when the cell divides. An accumulation of these cells may gradually lead to skin photoageing or eventually skin cancer.

Sunburn is where the damage begins

After we have experienced too much sun we feel the effects.  These common symptoms include pain, warmth, redness and swelling.  The sun causes the body to release chemicals, which are partly responsible for these symptoms.  Over exposure to the sun will cause the blood vessels to swell, which also contributes to the characteristic symptoms of sunburn.

Tanning is your skins response to UV light.  It is a protective reaction to prevent further injury to your skin from the sun.

Care In The Sun

The sun has so many benefits that we should not be avoiding it.  We should simply be taking care when exposed to it and being aware of its potentially damaging effects.

Below are some simple tips for all of us to follow to help reduce the risks and increase the pleasures of the sun.

•    Avoid the midday sun.  During summer time or in sunny climates it is between the hours of 11 am and 2 pm that the sunrays are at their harshest.

•    When exposed to the sun, cover as much of the skin as possible.  Long sleeves and a hat will significantly reduce the chances of sunburn.

•    Wear a sunscreen that offers a high SPF protection (15 or more) and has broad-spectrum protection.

•    Remember to reapply the sunscreen regularly whilst exposed to the sun.  You will need to reapply hourly and immediately after swimming or excessive perspiring.

•    It is worth applying a sunscreen routinely as part of your daily moisturising program.  Especially to the face, which is exposed to the sun even when we are not sunbaking.

Effects of the sun on Eczema

We all need to take care but for those with inflammatory skin conditions, like eczema, need to be extra careful.  Eczema may be helped temporarily by sunlight, however the sun tends to aggravate the condition as it will increase the skin itch and worsen the overall skin condition.  The sun will take the natural moisture from the skin and cause perspiration, which irritates the skin, all leading to a flare up of the condition.

People suffering from eczema can still enjoy the outdoors, however they need to take extra care when venturing out in the sun.

It is common knowledge that vitamin D helps many people with psoriasis. Why is it then that vitamin D tablets and creams alone will not control the condition?

The answer is simple. There is only so much vitamin D the body can take in before it reaches its limit and can take no more.

The way around this is to encourage the body to produce its own vitamin D. UVB and sunlight will cause your skin to manufacture its own natural vitamin D which is by far more effective than the synthetic vitamin D products.

The positive effects of UVB when treating psoriasis have been known for over 25 years. This makes it a safer form of treatment than many of the new medications simply because its side effects are known, whereas the side effects of new drugs are often not fully known for 10 – 15 years.

The only risk is over exposure to UVB (and natural sunlight) is the skin becoming burnt. If used in moderation and in accordance with an approved treatment program UVB is a very safe and highly effective form of treatment.

The World Health Organisation recommend the use of UVB in the treatment of psoriasis because it is so safe and effective.

There is a lot of fear about the use of cortisone when treating eczema.  Cortisone is a very effective form of treatment for mild to moderate eczema.  It is however important to follow a few rules when using it.

• Never use cortisone without a doctors advice when you are pregnant or under 10 years old
• Never use cortisone more than twice a day for seven days
• Never use cortisone on broken skin
• Never use cortisone unless you fully understand the directions for use instructions.  If in doubt consult your doctor or pharmacist
• Never apply cortisone thickly.  A thin layer is all that is necessary

Rosacea is a chronic blood vessel disorder affecting the blood vessels of the face.  The result is a facial rash that appears as red pimple like bumps accompanied by excessive flushing.

Although commonly called Acne Rosacea the condition is not related to adult acne.  There are no blackheads, whiteheads or cysts.  Instead the pimple like bumps may be hard and swollen.

The rash, which is often inflamed and hot, is the result of the blood vessels just below the surface of the skin becoming dilated and enlarged.  The skin becomes blotchy and flushed.

The condition is rare in children.  More commonly affecting the 30 – 40 year old age group.  Both men and women can develop rosacea, however it is marginally more common in women.

Whilst 13 million Americans have rosacea the exact cause of the condition is unknown.  It appears that it can affect anyone but is more common in people with blond hair and blue eyes.

People with a tendency to blush are more prone to develop rosacea.  However at this stage it is not known whether blushing is a predisposing factor or an early symptom.

Whilst research continues into finding a cause for rosacea, the triggers that tend to cause a flare up are well documented.  In general anything that causes the blood vessels to dilate will result in a flare up.  These may vary from a variety of foods and drugs to some climatic and emotional changes.

Treatment aims to relieve symptoms

As there is no cure at this stage for rosacea treatment is designed to alleviate the symptoms of the condition and repairing the blemishes of the skin.  Adopting some self help life style changes can do this.

• Avoid foods that trigger your rosacea.  It may take some doing to determine the triggers.  Keeping a food diary may help
• Do not allow your skin to over heat.  Avoid overly hot showers and baths
• Avoid overcrowded rooms, as they become hot and muggy
• Avoid sunburn and use a water-based sun block
• Wear a wide brimmed hat when in the sun
• Check with your doctor before starting a new medication, as some drugs will cause blood vessel dilatation.  Even over the counter drugs should be checked out thoroughly
• Try to avoid stressful situations
• Use water based face creams, as they are generally softer on the skin than oil based creams
• Do not treat the condition with over the counter steroid or acne creams.  These may aggravate the condition
• Seek medical advice as topical and/or oral antibiotics may be required to help reduce the swelling and inflammation
• Laser treatment may be required to remove lesions.

Having trouble relieving that itch?

One of the main problems for people with eczema is that persistent, drive-you-mad itch. It seems to go on and on and no matter how much cream you use it just won’t go away.

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How do you know what your rash is?

The answer is simple – you have to ask your doctor.  Only a doctor can give you a definite diagnosis.  However there are some typical characteristics that may help to give you a clue.

Eczema and Psoriasis are two rashes commonly confused

Eczema and Psoriasis are the most common rashes I get asked about and whilst they have many similarities they are distinctly different conditions.

Both eczema and psoriasis are chronic inflammatory skin conditions, ones that persist for a long period of time and they tend to run in families.  As with any chronic condition it is important to look at your lifestyle and understand how various aspects of it may affect your skin.  Unfortunately there is no known cure for psoriasis and eczema, but they can be managed.

Eczema, the itch that won’t go away

Eczema is most common in children but can affect any age group, both male and female. The most distinguishing feature of eczema is the unbearable itch.  Typically eczema skin is very dry and the lesion is red and scaly.  It usually appears on the face, neck and arm and leg folds but can appear on the whole body.

Eczema tends to run in families with the likelihood of a child developing eczema increasing significantly if one or both of the parents has ever suffered from eczema, asthma or hayfever.  Eczema is allergy based and it is these allergies that will trigger an eczema flare up.

The silvery scales of psoriasis

Psoriasis on the other hand is the result of an over production of skin cells.  The predisposition to develop psoriasis is passed on along the family line however it is environmental triggers that will result in an outbreak of the condition.

The psoriatic lesion is usually a discrete, bright red patch covered with silvery scales.  The lesions may be itchy but unlike eczema this is not a distinguishing feature.  Psoriasis usually affects the scalp, knees, trunk and elbows.

It is rare for a child to develop psoriasis.  The condition usually first appears in the late teen or early adult years.  Both males and females can be affected equally.

Whilst it is the itch in eczema and the silvery scales in psoriasis that are the distinguishing characteristics the only way to know for sure is to visit your doctor and have a proper medical diagnosis.

Eczema or Dermatitis

There is a good deal of confusion over the difference between eczema and dermatitis.  They both broadly mean skin inflammation.  Many doctors use the two terms interchangeably.

If you have atopic eczema, it is the same as having atopic dermatitis.  If you have irritant contact eczema it is the same as having irritant contact dermatitis. The condition is the same, therefore the treatment is the same.  It is just a matter of varying terminology being used by different medical practitioners.

Is it fungal?

Eczema and psoriasis are inflammatory skin conditions.  They are not fungal infections. Ringworm is a fungal condition characterised by itchy, red, scaly, inflamed circles that spread outwards leaving pale skin in the centre.  The appearance is not unlike the healing lesion of nummular (discoid) eczema.

Although similar in appearance the two conditions are not at all related.  It is important to establish if you have an inflammatory skin condition or a fungal condition before you start treatment as the treatment is quite different and eczema treatments may feed fungal infections making them worse.

Not fungal or inflammatory

Rosacea is a chronic condition affecting the blood vessels of the face.  The superficial facial blood vessels become enlarged and dilated resulting in the hot, inflamed rash that is common to this condition.  Rosacea is triggered by any condition that will cause the blood vessels to dilate.

It is important to remember that rosacea is not related to eczema or acne and the treatments normally used for these conditions may worsen rather than improve the symptoms.  Treatment is aimed at treating symptoms and avoiding trigger situations.

What to do

In order to prevent worsening of a skin condition it is important that any treatment options are selected for the condition that you have.  An accurate diagnosis of any rash can only be made by a medical practitioner.  If you are unsure of what your rash is consult your doctor before starting treatment.

There seems to be little to be said for smoking on a positive note.  It causes lung problems, circulatory problems and now it would appear that it may cause auto immune problems as well.

Studies indicate that smoking contributes to the onset and severity of psoriasis.  However despite considerable evidence linking the two the evidence at this stage is not conclusive.

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We all hate germs and many of us spend a lot of time removing any trace of them from our homes, believing that the less germs around us the less chance our children have of becoming sick.  We may however be doing more harm than good, leaving our children more prone to illness than they would be in a less sterile environment.

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I’ve said it a million times: “Cotton is best”. This is especially so for underwear.

Young girls with sensitive skin getting their first bra should look for an all cotton bra – no lace, no lycra, no cotton blends. Also avoid a bra with seams across the cup. This is not as easy as it sounds especially when looking for a pretty bra or a sporty bra.

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When you have a skin condition such as eczema or psoriasis it is very beneficial to read as much as you can so that your knowledge of your condition is as broad as possible.  The problem is that many people write in terms that many of us do not understand.

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