Characteristics of the ageing skin, xerosis cutis and its complications

People in the developed countries are living longer. Geriatric dermatology is playing an increasingly important role as chances of developing skin-related problems increase with their ageing. Skin ageing is induced by two main processes: intrinsic and extrinsic. Extrinsic ageing is caused by environmental factors such as sun exposure, smoking, alcohol consumption, air pollution, and poor nutrition. Intrinsic ageing reflects the genetic background and depends on time. The aged skin is characterised by the appearance of dryness, atrophy, wrinkles, pigmented lesions, patchy hypopigmentation, and elastosis. This article provides an overview of skin ageing processes and common conditions found in the elderly persons such as xerosis, pruritus, and eczema.

Collagen supplements: trend or truth for the treatment of ageing skin in menopausal women?

In recent years, collagen drinks have become a popular supplement, which has been stimulating the appetites of collagen-conscious patients, due to their perceived health and beauty benefits. These beauty supplements are frequently promoted on social media and endorsed by celebrities for their glowing skin and the wrinkle-reducing results. With collagen shots, powders, capsules, gels, gummy sweets, chocolates and coffee creamers filling shop shelves and advertised on social media channels, it may be challenging to avoid being swayed by all the hype. This article aims to help us explore the science behind the hype and if collagen supplements are safe and effective to take and why.

Fillers and dermabrasive therapies

Facial ageing involves several key processes: loss of volume; laxity of tissues; and surface skin changes of wrinkles, pigmentation, vascular lesions, and textural changes. Surgery remains the mainstay of treating laxity or sagging of tissues. Fillers are an increasingly popular and effective method of replacing lost volume, or preventing it, and there are a myriad of options for dealing with the surface skin changes. This chapter deals with the principles of the appropriate use of fillers by looking at the patient suitability, the products available, and the proficiency of the injector. Steps to avoid complications are outlined and the management of these rare complications are discussed. A brief discussion is given of the place of chemical peels, dermabrasion, topical agents, and lasers in the improvement of the appearance of ageing skin.

The Flourishing Folds

The Flourishing Folds is a solo video-art project, which re-negotiates the author’s relationship with ageing through creating intimate skin-portraits in near-touch close-up. The article reflects on these processes of re-possessing and re-purposing images of ageing skin and shares affirming experiences of embodied, sensory-perceptual video making. Tibetan Buddhist meditation practices inform the project and the article shares reflective writing on deep body meditations that dwell in locations where creasing skin offers pockets for holding spiritual humility and where folds form valleys that map sacred sites of vulnerability, self-acceptance and self-esteem. Writings by Stephen Connor, Claudia Benthien and Michel Serres illuminate the text with reflections on skin and embodied consciousness. New paradigms for dancing into maturity and the visual artwork of Helen Chadwick, Pipilotti Rist, Marna Clarke and Faith Wilding inform the project. The article writes into locales where creasing skin may increase skin-on-skin contact and offer sites of sensual, sensed soul, consciousness.

The assessment of usefulness of innovative instrumental treatments for non‑invasive reduction of a double chin

One of the most common defects in the facial area is the so‑called “double chin”. The problem affects both males and females, and its occurrence is associated with several different factors. It is commonly believed that this defect is a result of excessive adipose tissue location in the lower face. However, the problem seems to be more complex. It is also facilitated by the loss of firmness and elasticity of ageing skin, and in many persons the existence of a double chin results from their anatomical structure, and therefore is determined by genes. Besides, incorrect posture accentuates the defect. It may seem that such minor change does not affect the appearance to a large extent. Whereas, in most cases it causes that the border between the jaw line and the neck disappears what, in turn, distorts the face contour. All this makes a person with a double chin look much older than he or she in fact is. This leads to negative self‑esteem, makes people feel ashamed, and quite often is the main reason for avoiding interaction with other people. So, it is no wonder that persons with such defect seek methods offering its mitigation.Surgical methods give quick and satisfactory effects. However, they are fraught with high risk of complications, and as such they cause anxiety and ultimately discourage patients from making the decision. Luckily, significant improvements in the field of cosmetology and aesthetic surgery offer a wide range of possibilities to reduce a double chin in a manner which is completely non‑invasive, pain free, and does not require long lasting convalescence. In this case, very good results are achieved with the use of innovative technological solutions, such as HIFU and cryolipolysis. Aim. The main aim of this paper is to assess the efficiacy of cryolipolysis in the double chin reduction and the description of innovative instrumental methods allowing for a non‑invasive reduction of this defect.

Skin tears: prevention and management

Skin tears commonly occur at the extremes of age and are associated with skin changes in ageing skin. They are considered to be acute wounds caused by mechanical forces, such as blunt trauma. While the true prevalence and incidence of skin tears is unknown, the available evidence suggests that these wounds occur in all healthcare settings. Importantly, skin tears are preventable with the implementation of a risk-reduction programme, which includes twice-daily skin moisturisation. Where these injuries do occur, it is important to categorise the extent of damage as well as to choose the most appropriate dressing to avoid adding any risks for further trauma.

Smokers’ Perceptions of Cigarette Packaging With Audio Warning Messages: A Focus Group Study in Scotland

Aims The use of audio pack cues or messages is a recent trend in packaging design. There is scope to use audio technology to communicate health and cessation messages via cigarette packaging. We explored how smokers responded to cigarette packs which played audio health messages. Methods Twenty focus groups were conducted in Scotland in 2015 with smokers (n = 120) segmented by age (16–17, 18–24, 25–35, 36–50, >50), gender and social grade. Perceptions of cigarette packs which played audio warnings were explored, with four messages used: (1) a cessation message with a quitline number, (2) mortality message, (3) fertility message, and (4) message about ageing skin. Results Audio warnings were thought to increase message impact, particularly among younger smokers, as they would be hard to ignore or avoid, and repetition may lead to the messages being memorized. The warnings were considered annoying or embarrassing, and participants suggested they may discard the packs and use alternative storage. Some participants suggested that the audio warnings were off-putting and may alter their smoking behavior, with the mortality message deemed most effective and was considered relatable and felt personal. Older smokers were least likely to believe that audio warnings would affect their smoking behavior, although some thought that they may enhance cessation attempts among smokers seeking to quit, and could deter new or potential smokers, for example, young people. Conclusions Cigarette packs with audio messaging may have a role to play, now or in the future, as a novel way of communicating health and cessation information. Implications There is a lack of research exploring smokers’ perceptions of cigarette packs which play audio health messages. This focus group study provides an understanding of smokers’ immediate responses to cigarette packs which played a short health message when opened. Smokers generally viewed them as annoying or embarrassing, and some suggested the use of alternative storage. Audio warnings were thought to increase message salience, memorability, and impact, for younger smokers in particular, and some suggested that they be off-putting for themselves or others.