Skin Care

The skin is the largest organ of our body and has a protective and regulating function. This function can be disturbed by both external and internal influences such as weather, hormonal fluctuations, stress, nutrition, bacteria and skin conditions. Every skin is different and in order to keep the skin healthy or make it healthy again, good skin care is important. Disturbed skin such as acne and eczema needs extra attention.

Acne is a skin condition that is not contagious and in which the sebaceous gland follicle becomes inflamed. The condition mainly manifests itself on the face, the so-called T-zone (forehead, nose, chin), back, neck, throat and shoulders and occurs mainly in puberty in young people and young adults between the ages of 12 and 24. In later life, acne is more common in women than in men.

Eczema is a chronic non-contagious skin condition caused by an inflammatory skin reaction. This causes red flaky spots, bumps, swelling, fissures or crusts. Sometimes the results are also wet. Eczema is often accompanied by severe itching.

Skin care cleans the skin and then takes care of the skin with lotion, oil, cream or ointment. For a healthy skin there are numerous products to maintain and care for the skin. In the case of acne and eczema, these products are not always adequate or may exacerbate the condition. Many substances, chemicals, are added to the skin care products to which the skin can react violently in case of acne and eczema.

The causes of acne are:

• Excess sebum production by the hormone androgen
• Hormones, most problems of acne begin in puberty when the body produces hormones
• Hereditary factors
• Certain medications
• The contraceptive pill
• Stress
• Menstruation and pregnancy
• Friction with clothing or the strap of a helmet
• Strong climate change
• Some cosmetics
• Too much washing

The main cause of eczema is predisposition. In addition, the following factors play a role:

• Climate factors
• Stress and tension
• Skin bacteria
• Chemical products such as soap, creams and body lotions
• Detergents
• Sweating
• Certain types of textiles, like wool and nylon.

The most common forms of acne are:

• Acne vulgaris: this is the most common form. Comedones (blackheads), papules and pustules occur simultaneously and to varying degrees.
• Acne comedonics: this is a form of mild acne in which not the inflammation, but the comedones are in the foreground.
• Acne conglobata: this form of acne is accompanied by very severe inflammations with giant and double comedones, nodules and cysts, usually followed by scarring. This acne occurs mainly in young men and can continue in their adult lives.
• Acne excoriée: with this form the acne gets worse because every pimple or blackhead is scratched or squeezed out, resulting in scarring on the face or back.

The most common eczema forms are:

• Constitutional or atopic eczema: this is the most common form. This eczema has a hereditary component. It can occur anywhere on the body.
• Seborrheic eczema: this eczema is more common in men than in women. And is common on the face, nose, head, eyebrows, eyelashes, beard area, or around the ears.
• Contact eczema: this eczema can be divided into allergic contact eczema and irritant contact eczema.

With allergic contact eczema, a certain product can cause an allergy immediately or over time. Irritative contact eczema is caused by repeated contact with (often) water and soap or another wet product.

• Nummular eczema: this is a chronic eczema with coin shaped spots mainly on the legs.
• Dyshidrotic eczema (macrovesicular eczema): this eczema is common on the hands and feet. Women between the ages of 20 and 30 are particularly affected.
• Tylotic eczema: this is a persistent form of hand eczema.

Acne is usually found in the face, the so-called t-zone (forehead, around the nose and chin), but also on the back, chest, shoulders, neck and throat. Acne can manifest itself as follows:

• Blackheads or comedones: open black comedones or closed whit comedones with a white dot
• Pimples or spots (an elevation of the skin)
• Pimples, spots or pustules (a cavity in the skin with pus)
• Subcutaneous inflammation, nodules (after healing they often leave scars) and cysts

These phenomena occur in varying combinations and in varying degrees of severity. When acne is no longer actively present, side effects such as acne scars and stains may be visible.The manifestations of eczema depend on the shape of the eczema (see the most common forms of eczema) and therefore also on the place where it occurs. The following symptoms may occur:

• (Extreme) itching
• Redness, swelling, blisters, lumps, crusts, flaking, fissures
• Dry skin
• Worsened by stress
• May be aggravated by cold and drought

You yourself can take a number of measures against acne and eczema to reduce or contain the conditions. The following measures apply to both acne and eczema:

• Clean your skin with lukewarm water
• Do not use soap or other aggressive cleaning agents in case of eczema; in case of acne you could use a pH neutral soap
• Dry your face
• Do not rub or exfoliate your skin
• Use neutral detergents
• Only use mineral foundation or water-based make-up
• Wear airy cotton clothing, avoid wool and rough fibres, avoid synthetic clothing
• Do not smoke as it has a detrimental effect on your skin
• Live healthily with a varied diet of fruit and vegetables
• Be moderate with alcohol, drink water or tea instead
• Rest, sleep and move sufficiently

The following measure applies specifically to acne:

• Do not squeeze out your blackhead, pimples and spots yourself, it can only exacerbate the condition and can also cause scars.

The following measures apply specifically to eczema:

• Do not scratch
• Keep your nails short
• Keep an itchy diary if necessary
• Seek distraction when you are itchy
• Do not bath or shower for too long
• Make sure that the skin remains oily and supple

There is no standard treatment for acne. When the inflammatory symptoms are in the foreground, the treatment is different from that for blackheads. The first choice for acne is depth cleaning. The black and white comedones are removed using a thin, small needle with the aim of reducing inflammation and preventing scarring. With a light form of eczema it is important to keep the skin supple, this can be done with a greasy cream or ointment without medication in it.

For acne

Mild acne involves the use of medication directly on the skin that loosens the top layer of the skin, reducing the risk of pores clogging.If this does not work, local antibiotics will be used. If that is not enough, antibiotics to take can be given as well. For women who wish to have a contraceptive pill, the contraceptive pill is recommended. This can have a positive effect on acne. If all this does not work, an even stronger medicine can be chosen and all other means will be stopped. (The pill may be taken if the patient also wants a contraceptive.) During treatment with medication a microdermasia treatment can often be started. The top layer of skin is removed with crystals.

For eczema

For eczema, a combination of non-medicinal cream or ointment and one with hydrocortisone in it will be chosen. Hydrocortisone also works against itching. If the medicines do not work sufficiently, stronger local corticosteroids are used. Always in combination with non-medicinal ointments and creams. If they also work insufficiently, then even stronger corticosteroids can be used once more. In the case of atopic or constitutional eczema, if local corticosteroids do not help, even stronger medicines (calcineurine inhibitors) may be chosen.

For acne

Acne can eventually heal. Any kind of acne can leave scars. Over time, the scars become less visible. There are also the following treatments to reduce scars:

• Chemical peeling
• Laser treatment
• A combination of sandblasting, tretinoin cream and laser has a beneficial effect on the scars

For eczema

Eczema can sometimes be accompanied by maddening itching. The cooling effect of menthol ointment can reduce itching. You can also wrap a coldpack in a cloth and put it on the spot that itches or is painful. Never place a coldpack directly on the skin, as it can adhere to the skin. You can keep an itching diary to deal with the itching better. You can do this under the guidance of a healthcare professional. You may also benefit from relaxation exercises to reduce itching.

Read under "Can I do something myself about acne and eczema?" the measures for lifestyle changes.

• Due to scratching a lot, the skin can be scratched open and this can lead to infection. Corticosteroids can make the skin thinner and leave stretch marks.
• Skin problems can (strongly) reduce the quality of life. People can feel ashamed, feel sad, feel insecure and have less self-confidence. Some people feel dejected or even depressed. Do not keep walking around with this, but consult a doctor.

With proper care, you may be able to reduce acne and eczema, see "Can I do something myself about acne and eczema?"

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