Five experts, five tips: How to take care of your skin

Dr Blaithin Moriarty

(Consultant dermatologist at St Vincent's University Hospital, Dublin) 
Changing weather and the passage of time leads to skin dryness. Simple measures such as taking tepid showers/baths with a bland moisturiser rather than a highly fragranced shower-detergent will reduce skin dryness. Many people need to use a moisturiser daily on their full body. Although initially onerous, this can quickly become a habit. Choose a bland product with few fragrances and preservatives to avoid allergy and ensure it comes in adequate quantities of at least 500g. There is no definition of "natural" skin care and many products, particularly those which are pleasantly fragranced, contain multiple allergenic ingredients which can lead to problems with rashes and allergies.

Mask wearing during the Covid-19 pandemic has increased facial “acne-mechanica” or “maskne”. To a certain degree this is unavoidable but gentle facial cleansing, avoidance of occlusive facial products [ie, those which trap moisture beneath the skin] and frequent mask changes will reduce the severity.

Think about the impact of the skin products you use on our environment. Many products are produced and transported at high environmental cost, packaged in small environmentally damaging containers and contain ingredients such as nano-particles which degrade slowly. Excellent skin care can be sustainable!

Dr Fiona Browne

(Consultant dermatologist, Children's Hospital Ireland at Crumlin and Temple Street) 
My top tip to parents of young children would be: "Don't spare the two Ss – sunscreen and steroids." Skin cancer is the number one cancer in Ireland and much of it can be avoided by taking simple precautions such as seeking shade, avoiding the midday sun and making sunscreen a daily habit. This is particularly important for children as childhood sunburns have been directly related to the development of melanoma in later life. There are a vast range of different sunscreens on the market and expensive brands are no better than the more affordable options. Choose an SPF50+ and reapply frequently.

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The second important S is steroid. Many parents are terrified of using steroid creams on their child's skin. One in five children will suffer from eczema. The majority will grow out of this by the time they start school and most can be managed by avoiding irritants and using frequent moisturiser. Many however, will need steroid creams to relieve the inflammation and ease the discomfort. These steroids creams, when used as directed, are safe and very effective. Your doctor will explain exactly how to use them and in what quantities. More helpful information about eczema and how to manage it can be found on the Irish Skin Foundation website, where an eczema booklet can be downloaded and access to a dermatology nurse helpline is freely available.

Dr Anne Marie Tobin

(Consultant dermatologist at Tallaght Hospital, Dublin) 
Eczema affects one in 10 adults and is caused when our skin which acts as a barrier is not functioning correctly and becomes dry and inflamed, resulting in itchy red skin. The key tips for managing eczema is to restore the skin barrier by applying emollients (moisturisers) and avoiding irritants such as harsh soaps which further damage the skin. The inflammation can then be treated with steroid ointments or if patients have severe eczema other medications such as methotrexate or dupilumab will suppress the inflammation.

Psoriasis, which affects 77,000 Irish people, results in thick scaly red patches (plaques) on the scalp, elbows and knees and other parts of the body. Applying a moisturiser is useful as it removes the scale from the plaques and is soothing. Psoriasis – if mild – can be controlled with mild steroid creams or Vitamin D-like ointments. If the psoriasis is more extensive, phototherapy (provided in 11 dermatology centres across Ireland) is helpful. There are also excellent oral or biologic medications available for psoriasis which have really transformed the lives of so many people. Psoriasis can also affect joints so it is important not to ignore any joint pain/stiffness which is typically worse in the morning or after periods of rest.

Dr Dmitri Wall

(Consultant dermatologist at Hair Restoration Blackrock and assistant professor in the Charles Institute, UCD School of Medicine) 
Hair plays a key role in identity and culture and its loss can be profoundly upsetting. The Covid-19 pandemic has been associated with a number of hair disorders, from trichotillomania, where patients consciously or sub-consciously pluck hair, to an increased incidence of the autoimmune condition alopecia areata, that typically causes patchy hair loss, but can be more extensive and affect areas beyond the scalp. With "Covid hair" (a form of telogen effluvium) which occurs about two months after contracting Covid-19, a large volume of hair shedding is experienced. Fortunately, recovery usually occurs within a few months.

The emotional distress of hair loss can drive patients to search for a magic bullet. Dietary and lifestyle interventions are commonly tried, but have, regrettably, shown limited capacity to promote hair growth. Rapid weight loss or crash diets can even trigger hair loss. Supplements are not always harmless; biotin, for example, in excessive doses, has been shown to invalidate some lab tests, including one used to diagnose heart attacks.

Sadly, delayed intervention in some, uncommon, hair disorders can lead to irreparable loss. The key is is to identify the correct type of hair loss. People with hair problems can be referred by their GPs to a dermatologist or a trichologist who have full membership of the Institute of Trichologists in London.

Kevin O’Hagan

(Cancer Prevention Manager, Irish Cancer Society) 
Getting sun burnt increases your risk of melanoma, which is the most serious form of skin cancer. While being burnt is very damaging, long-term exposure without burning can also significantly increase the risk of skin cancer. We always encourage the public to mind their skin in the sun by seeking shade, wearing covering clothes, a hat and sunglasses as well as putting sunscreen on exposed skin, and knowing when the sun is strongest. And, never use a sun bed as even one use can double your risk of skin cancer.

The survival rate for skin cancer such as melanoma is almost 100 per cent in its early stages but reduces significantly as it develops. Check your skin regularly – and your children’s skin – for anything that is new, changing or unusual.

If you notice a lump or a dis-coloured patch of skin, have it checked out with your GP.

Also show your GP any new growth or a sore that does not heal in a few weeks, a spot or sore that itches, hurts, crusts, scabs or bleeds, constant skin ulcers with no other explanation for their cause and new or changing moles.