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Facial Plastic Surgery Clinics of North... Aug 2019Options for skin care are varied. New products are introduced constantly and it is important for the practitioner to have an understanding of products that impart... (Review)
Review
Options for skin care are varied. New products are introduced constantly and it is important for the practitioner to have an understanding of products that impart beneficial results for aging skin. Educating patients to use products with scientifically proven benefits leads to better outcomes. Patients should be encouraged to use daily sunscreen, a topical retinoid every night, and a topical antioxidant daily. Supplementing the routine skin care regimen with alpha hydroxy acids, growth factors, heparin sulfate, and defensins can be addressed individually. Exogenous stem cells do not have sufficient evidence to warrant recommending them currently.
Topics: Administration, Topical; Cosmeceuticals; Humans; Skin Aging; Skin Care
PubMed: 31280856
DOI: 10.1016/j.fsc.2019.04.007 -
Skin Therapy Letter May 2017A triad approach to the treatment of acne and rosacea has been recommended. This integrated management approach includes patient education, selection of therapeutic... (Review)
Review
A triad approach to the treatment of acne and rosacea has been recommended. This integrated management approach includes patient education, selection of therapeutic agents, and initiation of an appropriate skin care regime. Proper skin care in patients undergoing treatment of both acne and rosacea includes use of products formulated for sensitive skin that cleanse, moisturize and photoprotect the skin. Both acne and rosacea are associated with epidermal barrier dysfunction, which can be mitigated by suitable skin care practices. Appropriate skin care recommendations for patients with acne and rosacea will be discussed.
Topics: Acne Vulgaris; Humans; Rosacea; Skin Care
PubMed: 28492949
DOI: No ID Found -
British Journal of Community Nursing Jan 2020Good skin integrity is vital to good health because the skin acts as a barrier to microbes and toxins, as well as physical stressors such as sunlight and radiation. It...
Good skin integrity is vital to good health because the skin acts as a barrier to microbes and toxins, as well as physical stressors such as sunlight and radiation. It is well known that the skin loses integrity with the ageing process, and this makes older adults susceptible to pressure injury. Additionally, older skin takes longer to heal where there are injuries or breaks. This article looks at what skin integrity is by briefly outlining the physiology of the skin. It discusses how skin integrity can be impaired, what can be done to maintain skin integrity and skin health, and why skin integrity is important for pressure ulcer prevention. Some of the factors that can make skin care difficult are discussed, in addition to the role of community nurses in helping patients engage in skin care. The article outlines how community nurses can identify when there is skin integrity risk or damage and support patients and carers or relatives, in maintaining skin integrity.
Topics: Aged; Aging; Community Health Nursing; Geriatric Nursing; Humans; Pressure Ulcer; Risk Factors; Self Care; Skin; Skin Care; Skin Physiological Phenomena
PubMed: 31874079
DOI: 10.12968/bjcn.2020.25.1.22 -
Home Healthcare Now 2019This article focuses on the care and management of patients living with an ileostomy. Due to shortened hospital stays, patient teaching related to self-care of ostomies... (Review)
Review
This article focuses on the care and management of patients living with an ileostomy. Due to shortened hospital stays, patient teaching related to self-care of ostomies has shifted from the hospital to the home setting. It is important for home care clinicians to be knowledgeable about all aspects of ostomy care. Patients with ileostomies are particularly prone to peristomal skin problems, as well as fluid and electrolyte and nutritional imbalances. This article reviews the anatomy and physiology of the gastrointestinal tract, indications for the creation of an ileostomy, and prevention and treatment of early and late complications. Practical advice on ileostomy care and patient teaching is provided.
Topics: Home Care Services; Humans; Ileostomy; Patient Education as Topic; Self Care; Skin Care
PubMed: 31058731
DOI: 10.1097/NHH.0000000000000776 -
International Journal of Nursing Studies Mar 2020In aged nursing care receivers, the prevalence of adverse skin conditions such as xerosis cutis, intertrigo, pressure ulcers or skin tears is high. Adequate skin care...
BACKGROUND
In aged nursing care receivers, the prevalence of adverse skin conditions such as xerosis cutis, intertrigo, pressure ulcers or skin tears is high. Adequate skin care strategies are an effective method for maintaining and enhancing skin health and integrity in this population.
OBJECTIVES
The objective was to summarize the empirical evidence about the effects and effectiveness of non-drug topical skin care interventions to promote and to maintain skin integrity and skin barrier function in the aged, to identify outcome domains and outcome measurement instruments in this field.
DESIGN
An update of a previous systematic review published in 2013 was conducted.
DATA SOURCES
Databases MEDLINE and EMBASE via OvidSP and CINAHL (original search January 1990 to August 2012, update September 2012 to May 2018) and reference lists were searched. Forward searches in Web of Science were conducted.
METHODS
A review protocol was registered in Prospero (CRD42018100792). Main inclusion criteria were primary intervention studies reporting treatment effects of basic skin care strategies in aged people with a lower limit of age range of 50 years and published between 1990 and 2018. Primary empirical studies were included with experimental study designs including randomized controlled trials and quasi-experimental designs. Methodological quality of included randomized controlled trials was evaluated using the Cochrane Collaboration's Tool for assessing risk of bias. Levels of evidence were assigned to all included studies.
RESULTS
Sixty-three articles were included in the final analysis reporting effects of interventions to treat and/or to prevent skin dryness, pruritus, general skin barrier improvement, incontinence-associated dermatitis, skin tears and pressure ulcers. Skin cleansers containing syndets or amphotheric surfactants compared with standard soap and water improved skin dryness. Lipophilic leave-on products containing humectants decreased skin dryness and reduced pruritus. Products with pH 4 improved the skin barrier. Application of skin protectants and structured skin care protocols decreased the severity of incontinence-associated dermatitis. Formulations containing glycerin and petrolatum reduced the incidence of skin tears. Thirty-five outcome domains were identified with nearly 100 different outcome measurement instruments.
CONCLUSION
Included studies showed substantial heterogeneity regarding design, interventions and outcomes. Basic skin care strategies including low-irritating cleansers and lipophilic humectant-containing leave-on products are helpful for treating dry skin and improving skin barrier in the aged. Lower pH of leave-on products improves the skin barrier. The number of different outcome domains was unexpectedly high. We recommend to identify critical outcome domains in the field of skin care to make trial results more comparable in the future and to measure possible performance differences between different skin care strategies and products.
Topics: Aged; Humans; Skin; Skin Care
PubMed: 31945604
DOI: 10.1016/j.ijnurstu.2019.103509 -
Pediatric Dermatology Jan 2019Understanding the importance of the barrier function of the skin of preterm and term neonates is crucial in effective neonatal skin and diaper care. This literature... (Review)
Review
BACKGROUND
Understanding the importance of the barrier function of the skin of preterm and term neonates is crucial in effective neonatal skin and diaper care. This literature search aimed to review the development of different practices in neonatal care to maintain skin barrier function, in turn preventing diaper dermatitis.
METHODS
We performed two quantitative literature searches of English language studies: an initial literature search of studies published in the last 5 years was conducted using Cinahl, Medline, Embase, British Nursing Index, and DelphiS, followed by a second search of publications from 1990 to 2017 using the National Institute of Clinical Excellence Health Databases Advanced Search using key words, synonyms, and Boolean phrasing. Titles and abstracts were reviewed for relevance.
RESULTS
One hundred ten studies were analyzed for the purpose of this review; however, data are of variable quality. Guidance can be drawn from the existing literature relating to best practice options for diaper area cleansing methods, diaper type selection, and use of barrier creams. More research is required into the benefit or otherwise of diaper-free time.
CONCLUSIONS
Super-absorbent diapers reduce moisture at skin level and reduce diaper dermatitis. Barrier creams carry benefit both in prevention and cure but do not provide a substitute for frequent diaper changes. The literature does not demonstrate superiority of one cleansing method over another, but neither the use of wipes nor water increases diaper dermatitis prevalence. Further studies are required to explore the potential benefit of diaper-free time, taking due consideration of the practicalities, particularly for vulnerable neonates within the Intensive Care setting.
Topics: Diaper Rash; Diapers, Infant; Humans; Infant; Infant Care; Infant, Newborn; Skin; Skin Care; Skin Physiological Phenomena
PubMed: 30506880
DOI: 10.1111/pde.13714 -
Nutrients Mar 2018The skin is the body's largest organ, it participates in sensitivity and offers protection against microorganisms, chemicals and ultraviolet (UV) radiation.... (Review)
Review
The skin is the body's largest organ, it participates in sensitivity and offers protection against microorganisms, chemicals and ultraviolet (UV) radiation. Consequently, the skin may suffer alterations such as photo-ageing, immune dysfunction and inflammation which may significantly affect human health. Nutraceuticals represent a promising strategy for preventing, delaying, or minimising premature ageing of the skin and also to alleviate certain skin disorders. Among them, bioactive peptides and oligosaccharides, plant polyphenols, carotenoids, vitamins and polyunsaturated fatty acids are the most widely used ingredients. Supplementation with these products has shown evidence of having an effect on the signs of ageing and protection against UV radiation ageing in several human trials. In this review, the most relevant human studies on skin nutraceuticals are evaluated and the statistical resolution, biological relevance of their results, and, the trial protocols are discussed. In conclusion, quality and rigorousness of the trials must be improved to build credible scientific evidence for skin nutraceuticals and to establish a cause-effect relationship between the ingredients the beneficial effects for the skin.
Topics: Clinical Trials as Topic; Dietary Supplements; Female; Humans; Male; Risk Factors; Skin; Skin Aging; Skin Care; Skin Diseases; Sunlight; Treatment Outcome; Ultraviolet Rays
PubMed: 29587342
DOI: 10.3390/nu10040403 -
British Journal of Community Nursing Dec 2019Community nurses regularly treat patients with chronic wounds (those persisting over 6 weeks); with the complexity of both the patients' health needs and the wound...
Community nurses regularly treat patients with chronic wounds (those persisting over 6 weeks); with the complexity of both the patients' health needs and the wound itself, this often becomes a highly time-consuming task for the nurse. Wound assessment tools are designed to support all qualified nurses, regardless of whether the nurse possesses specialist wound care knowledge or not, in delivering safe and appropriate wound care. The wound assessment tool, using the acronym TIME, has been recently amended to now be known as TIMERS (Tissue, Infection/Inflammation, Moisture, Wound edge, Repair/Regeneration, Social). This article will examine what the newly amended wound assessment tool TIMERS represents, in addition to looking at the practical issues around its implementation in community settings.
Topics: Chronic Disease; Community Health Nursing; Holistic Nursing; Humans; Skin Care; Skin Ulcer; Wounds and Injuries
PubMed: 31804886
DOI: 10.12968/bjcn.2019.24.Sup12.S22 -
British Journal of Community Nursing Aug 2018Quality patient education of how to care for their stoma improves patient outcomes and enhances quality of care and efficacy. There is a need for home visits to assist...
Quality patient education of how to care for their stoma improves patient outcomes and enhances quality of care and efficacy. There is a need for home visits to assist ostomates with rehabilitation of their stoma formation, as they often feel stigmatised and are likely to withdraw from social activities. It has previously been highlighted that community care is often the weakest link in rehabilitation, highlighting the need for effective teamwork and collaboration between stoma nurse specialists and community nurses. This article will focus on some of the more common complications of stomas which will be seen in the community setting, how to treat these conditions and when patients should be referred to the specialist stoma care nurse.
Topics: Colostomy; Community Health Nursing; Humans; Ileostomy; Incisional Hernia; Skin Care; Surgical Stomas; Urinary Diversion
PubMed: 30063389
DOI: 10.12968/bjcn.2018.23.8.382 -
Midwifery Jan 2018to identify what skin practices are important for the protection of baby skin in healthy term babies (0-6 months) and generate evidence-based conclusions to inform... (Review)
Review
OBJECTIVES
to identify what skin practices are important for the protection of baby skin in healthy term babies (0-6 months) and generate evidence-based conclusions to inform health professionals and parents.
DESIGN
eleven databases were searched for all empirical quantitative and qualitative research published between 2000-2015 which explored baby skin care for bathing and cleansing, nappy care, hair and scalp care, management of dry skin or baby massage, for healthy term babies up to 6 months old. Papers not published in English were excluded. A total of 3062 papers were identified. Pairs of reviewers assessed all citations and extracted data independently. There were 26 included papers: 16 RCTs, 3 non-randomised experimental studies, 1 mixed-methods study and 6 qualitative studies. Primary and secondary outcome measures were analysed using meta-analysis or narrative descriptive statistics. Synthesis of qualitative data was not possible due to disparity of the evidence.
FINDINGS
from the small numbers of studies with comparable data, there was no evidence of any significant differences between tested wash products and water or tested baby wipes and water. There was some evidence to suggest that daily use of full-body emollient therapy may help to reduce the risk of atopic eczema in high risk babies with a genetic predisposition to eczema; however, the use of olive oil or sunflower oil for baby dry skin may adversely affect skin barrier function. There was no evidence about hair/scalp care or baby massage. Qualitative research indicates that parents and health professionals believe that water alone is best.
KEY CONCLUSIONS
meta-analysis was restricted due to the lack of consistency of study outcome measures. Although there is considerable RCT evidence comparing the use of specific products against water alone, or another product, for bathing, cleansing and nappy care, the power of this evidence is reduced due to inconsistency of outcome measures in terms of outcome, treatment site or time-point. The development of a core outcome measure set is advocated for trials assessing skin care practices.
IMPLICATIONS FOR PRACTICE
this review offers health professionals best evidence available on which to base their advice. Of those studies with comparative outcomes, the evidence indicates no difference between the specific products tested and water alone; offering parents a choice in their baby skin care regimen. Protocol available: http://www.crd.york.ac.uk/PROSPEROFILES/28054_PROTOCOL_20151009.pdf.
Topics: Baths; Female; Hair; Humans; Infant; Infant Care; Infant, Newborn; Outcome Assessment, Health Care; Pregnancy; Skin Care
PubMed: 29055852
DOI: 10.1016/j.midw.2017.10.001