Skin Conditions

Take care of your skin

DISCLAIMER: Images within this

presentation are graphic, and may
be disturbing to some viewers.

Disclaimer: This has been developed for educational purposes only. It is not a substitute for professional medical advice. Should you
have questions or concerns about any topic described here, please consult your medical professional.

© 2017 AEA International Holdings Pte. Ltd. All rights reserved.

Unauthorized copy or distribution is prohibited.
 Questionnaires
Before we begin, please fill out the following
sections
Section A:
A little bit about you
Section B:
Before the session

This is not a test. It lets us know how

effective the session was.

Your responses will be anonymous

2
 Skin is your largest organ

Epidermis - Top upper

layer of the skin
• Thinner in some parts of
the body, thicker in
Epidermis others
• Makes new skin cells
• Makes melanin, gives
Dermis skin its colour
• Has special cells; part of
your immune system
Subcutaneous
fat

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 Skin is your largest organ
Dermis – Thicker inner layer
• Blood vessels
• Nerve endings
• Hair follicles
• Glands that make sweat and Epidermis
sebum (oil)
Subcutaneous fat – Bottom layer
Dermis
of the skin
• Attaches dermis to muscles and
bones Subcutaneous
• Blood vessels and nerve cells go fat
to the rest of your body from
here
• Controls body temperature
• Stores fat
• Protects from bumps and falls

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 Functions of skin
Barrier

• Keeps germs out

• Keeps organs, body fluids in
• Helps cushion inner organs from
environmental threats

Sensation

• Temperature, pain – to prevent injury

• Touch / pressure

Regulates body temperature

Reduces harmful effects of UV

radiation

Makes vitamin D
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 Keeping skin healthy
• Eat a balanced diet focused on
fruits and vegetables, whole grain,
low-fat dairy and lean proteins
• Drink enough fluids
• Make physical activity and sleep A healthy
health priorities lifestyle is good
• Quit smoking for every part of
your body –
• Wash regularly with warm water
including skin!
• Moisturise, especially after bathing
• Protect skin from the sun’s
ultraviolet rays (no tanning beds!)
• Perform routine skin self-checks
• Manage stress, keep a healthy
state of mind

6
 Common skin
conditions
(non-infectious issues)
These include:
• Urticaria
• Heat rash
• Contact dermatitis
• Burns

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 Urticaria
Red, raised welts that are itchy.
Also called “hives”
They can appear – and disappear –
suddenly.
Often caused by an allergic reaction to:
• Food and Insect bites
• Viral infections (including colds)
• Cold and heat exposure
• Some medicines
Occasionally associated with
Treatment involves AVOIDING the trigger. If SEVERE allergies – swelling of
they are very troublesome, steroid creams the face, mouth, throat,
and / or oral antihistamine tablets can breathing difficulty. This is a
relieve the itch. Sometimes stronger medical emergency.
treatment with steroid tablets may be
required.

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 Heat rash
(prickly heat or miliaria)
• Occurs in hot and humid conditions.
• Sweat ducts – pores – get clogged
and trap sweat under the skin.
• Rash of tiny bumps surrounded by
red skin that itches, stings, or burns.
• Very common in children, but adults
can get it too.
• It usually resolves on its own but
severe cases may need medical
attention.
• Prevention: cool showers, wearing
cottons, avoiding heat / humidity.

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 Contact dermatitis

Itchy rash after contact with a substance or item.

Occurs only where the substance has touched
the skin.
Irritants: almost everyone develops a rash if
they touch irritants OR
Allergy: only people who are sensitive to the
substance will develop a rash
• Some plants, like poison ivy, oak and sumac
• Chemicals irritants / fragrances present in
skin lotions or soaps, hair dye, cosmetics
• Environmental chemicals such as pesticides
• Adhesives, latex, rubber, nickel (in jewellery,
buttons, zippers, watches etc)

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 Contact dermatitis
continued
Contact dermatitis rash is not
contagious.
Can occur immediately, or days after
contact.
Prevention: Avoid contact with the
substance.
Treatment: Steroid creams or
antihistamine tablets are generally
used to manage symptoms.

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 Burns and Scalds
Burns is caused by dry heat:
• Fires
• Electricity
• Radiation
• Chemicals
• Exposure to sun
First degree burns (minor burns) cause pain and redness, but only involve the
outer skin layer (epidermis).
Second degree burns reach to the dermis and involve blisters and swelling.
Third degree burns reach all layers and are a medical emergency.
Scalds are caused by something wet
• Hot water/liquid
• Steam

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 Treating minor burns
• Run cool (but not cold) water over the burn. Do
not use ice
• Wash off any chemicals by holding the burned
skin under cool running water for 10-15 minutes
• If clothing is stuck to the burn don’t try and
remove it
• Remove clothing and jewellery from around the
burn
• Do not apply butter or other salves/ointments
• Keep the wound clean and dry
• Do not break open any blisters
• If the burn is painful, take a mild painkiller like
paracetamol or ibuprofen.
• Monitor for signs of infection

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 Seek medical
attention
Seek medical attention if the
burn:
• is more than superficial
• the pain is severe
• a large area of skin is burnt (more
than the size of your hand)
• is on the face
• involves the mouth / airway,
hands, feet, groin or spans a joint
• or was caused by fire, chemicals
or electricity.
Remember - you may need a
tetanus booster vaccination.

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 Common skin
infections
These include:
• Normal skin “flora”
• Wound infections
• Boils and carbuncles
• Tinea (ringworm)
• Warts
• Impetigo
• Cellulitis
• MRSA

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 Skin microflora
• Also called skin microbiota or skin
microbiome

• Microorganisms live on the surface

of the skin

• They include bacteria such as

Staphylococcus, micrococcus,
corynebacterium

• Ordinarily these organisms do not

cause any harm

• However when they enter the skin

through a cut or a wound they can
cause infection (“secondary
infection”)

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 Wound infections
Any break in the skin – including surgical
wounds, bites, cuts, scrapes and burns –
should be monitored for signs of infection:
• Streaks of red coming from the injured
area
• Warm to the touch
• Exudes yellow – green pus
• Smells odd
• Pain / swelling is increasing
People who have diabetes
rather than decreasing
or are
• Fever immunocompromised
are at higher risk for
Have a medical evaluation if you develop
infections.
these or any other symptoms that concern
you.

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 Boils and carbuncles
• Bacterial skin infection - usually caused by organisms that live on
the skin every day such as Staphylococcus aureus (“staph”).
• A boil (furuncle) starts as a small, red lump that hurts.
• It gets bigger, fills with pus, and comes to a head
which then usually opens up and drains.
• Can occur on any area of skin, more common on the
face, neck, armpits, thighs and buttocks.
• It is likely to occur at the site of an infected hair follicle.
• Do not pick it open – this can spread the infection!
• See a doctor if it lasts more than two weeks, you have
a fever, or if you’re worried.
• A group of boils clustered together is a carbuncle. These are more
serious and more likely to scar; consult a doctor. They may need to
be cut open (“incised”) and drained. Occasionally antibiotic
treatment is required.

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 Boils and carbuncles
Boils Carbuncles
A boil (furuncle) starts as a small, red A group of boils clustered together
lump that hurts. is a carbuncle.

It gets bigger, fills with pus, and comes to It will leak pus from a number of
a head which then usually opens up and points.
drains.

Can occur on any area of skin, more Most often occur on the back,
common on the face, neck, armpits, thighs, or the back of the neck.
thighs and buttocks.

More common Less common

Do not leave a scar. They burst on their Leaves a scar. Needs to be cut
own and the pus will drain. open and drained.

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 Tinea (ringworm)
• Fungal infection, no worms are involved.
• Itchy, stingy scaly red patches – often with clear
centres (“rings”), blisters, yellow or white
discoloration of the nails, bald spots on the
scalp
• Common on body parts that are warm and
moist:
beard, scalp, groin (“jock itch”), feet (“athlete's
foot”)
• Easily spread from person to person, pet to
person, contact with a contaminated object
(shower floor, towels, pool water)
• Treated with anti-fungal medication (creams)
and by keeping the area dry
• Difficult infections (including hair and nails) may
need anti-fungal tablets for several weeks

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 Warts
• Small skin growths caused by group of
viruses called human papilloma virus
(HPV)

• Contagious and can spread to other parts

of the affected person’s body

• Usually painless, can itch in some cases

• More common in children

• Most commonly affected are face, hands,

knees and feet

• Usually disappear by themselves

• Can be treated if they persist, are painful,

or are causing the person to feel
uncomfortable

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 Impetigo
• Highly contagious caused by Staphlococcos or
streptococcus bacteria

• Also called “school sores”, common in children

• Rash with red weeping blisters full of “honey

coloured” fluid

• They burst and form crusts over

• Can spread to others, or to other areas on your

own body, if you touch the rash then touch
unaffected skin

• Treated with antibiotics – sometimes in cream

form, or orally (syrups and tablets)

• Cannot go to work / school until treatment

started. Sores must be covered with a
waterproof dressing / bandage

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 Cellulitis
• Serious bacterial infection of the skin
and the soft tissues underneath

• Skin is red, swollen, hot and painful

• Can cause whole-body symptoms:

fever, muscle aches, fatigue

• Increase risk for smokers, diabetics

and people with poor circulation

• Sometimes on ‘normal’ skin, but often

happens on/near broken skin: sores,
wounds, insect or animal bites

• Affected area starts small and spreads

URGENT treatment required with oral

or intravenous antibiotics

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 MRSA
(methicillin resistant
staph aureus)
• Some staph bacteria are resistant to
commonly-used antibiotics

• Referred to as “MRSA” (methicillin or

multi-resistant staphylococcus aureus).

• MRSA is also increasingly used to refer

to a multi-drug resistant group

• Can still be treated with strong

antibiotics

• Can be hospital acquired or community

acquired

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 How skin infections
spread
The bacteria, viruses and fungi can be
picked up directly from another person’s
skin, or from objects contaminated with
the bacteria.
• Sharing personal hygiene items:
towels, razors, clothing
• Using shared equipment that is at high
risk for carrying bacteria, such as
athletic equipment (helmets, weight
benches, cardio machines)
• Living in crowded/shared
accommodation: military base, student
hall, prison, nursing home
• Poor hygiene practices
• Contact sports: rugby, American
football, wrestling

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 Preventing skin infections
Simple hygiene measures are the best ways to
prevent transmission.
• Wash hands often, and thoroughly.
• Keep skin, including on the feet, clean and
dry.
• Do not share personal items: combs, towels,
clothing, headgear, razors.
• Thoroughly clean mild skin injuries when they
happen.
• Keep any wounds / broken skin dry and clean
and covered with a waterproof dressing.
• Let skin heal on its own: do not pick scabs,
pop blisters or pimples, lance boils, shave or
cut off warts, etc. These can make problems
worse and lead to infection.

26
 Preventing skin
infections
• Avoid touching someone’s
skin if they have sores or a
rash
• Clean potentially
contaminated surfaces
regularly.
• Place a barrier between your
bare skin and potentially-
contaminated surfaces (e.g.
placing a clean towel on
athletic equipment).
• Shower after exercising in a
public facility or performing
other activities with higher
MRSA risk.

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 First aid for minor skin wounds
• Wear gloves
• Get a clean cloth or dressing and apply pressure to
the area until it stops bleeding
• Wash the wound – with water and then antiseptic
• Keep the wound clean and dry until it heals
• Monitor for signs of infection

Broken skin? Think “tetanus shot”

It’s a serious, sometimes deadly disease.
Tetanus bacteria live in the environment (soil).
They enter the body through broken skin, usually
deep puncture wounds, but also through burns.
A tetanus booster vaccination is needed after any
tetanus-prone injury, unless you’ve had a booster
in the last five years.

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 Skin cancers
• One of the most common
causes of cancer worldwide

• 1 in every 3 cancers
diagnosed is a skin cancer

• Overexposure to UV rays is a
major cause

• Many are preventable

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 Skin cancer risk factors
Who is at risk? EVERYONE but
especially:
• People who have had lots of UV
exposure, including use of tanning beds
• Those who are prone to sunburn
• People with light / fair skin colour, blond
hair, light coloured eyes and freckles
• Those with a family member who
had skin cancer
• People who have had skin cancer
in the past
• People taking certain medications
• People with certain moles
• Risk for melanoma is higher in people
with more moles, especially if more than
100 moles on the body

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 Types of skin cancer
Melanoma Non-Melanoma

Non-Melanoma skin
cancers (NMSC) are
BCC and SCC aren’t more common than
as aggressive as melanomas
melanoma.
Basal Cell Squamous Cell
Carcinoma (BCC) Carcinoma (SCC)
Malignant melanoma

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 Basal Cell Carcinoma (BCC)
• Most common type of skin cancer.

• Occurs in sun-exposed skin especially

head (face, tip of nose, lips, ears,
arms, upper back).

• No symptoms and grows slowly.

• Starts as a small round lump, pale

pink or red, with a pearly edge.

• It ulcerates (“rodent ulcer”) and if not

treated can grow very large and
destroy the skin and bone underneath.

• Easily treated when small – by

burning, freezing or cutting off.

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 Squamous Cell Carcinoma (SCC)
• Usually pink lumps. Grow locally, but also
can metastasize (travel to other areas of
the body)

• May have hard or scaly skin on the surface.

• Often, but not always, tender.

• Can bleed easily and develop into an ulcer.

• Most often found on sun exposed areas -

the face, neck, lips, ears, hands, shoulders,
arms and legs.

• Rare in people under the age of 60 unless

you have a condition that weakens your
immune system.

• More aggressive than BCCs

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 Pre skin cancers
Actinic keratosis (AK), also known as a solar
keratosis

• A scaly or crusty growth.

• Most often appear on the bald scalp, face,

ears, lips, backs of the hands and forearms,
shoulders, neck or any other areas of the
body frequently exposed to the sun.

• Occasionally they itch or become inflamed.

• AKs indicates that you have sustained sun

damage and can develop into skin cancer
(SCC).

• They should be treated early – by freezing,

scraping, excision, laser or creams.

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 Malignant Melanoma
• The most aggressive type of skin
cancer, causes ¾ of all deaths from
skin cancer.

• Caused by exposure to UV light and

sunbeds and sudden intense
exposure which leads to sunburn

• The incidence of melanoma

continues to rise

• Often occurs in young adults

• Common areas include the back in

men and legs in women

• If identified early can be cured and

prevented

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 Signs and symptoms
of skin cancers
Skin changes that include:

• Non healing ulcer or bump

• Discolouration of skin

• Moles that change shape, size or

colour or start bleeding, itchy or sore

• A mole that suddenly appears or

change in an existing one

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 Malignant Melanoma
• The first signs can appear in one or
more atypical moles.

• That's why it's so important to get to

know your skin very well and to
recognise any changes in the moles
on your body.

• Look for the ABCDE signs of

melanoma.

• If you see one or more, make an

appointment with a physician
immediately.

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 ABCDE’s of malignant melanoma
- what to look for
A – Asymmetry If you draw a line through the mole, the
two halves will not match.

B – Border The borders of an early melanoma tend to

be uneven. The edges may be scalloped or notched.

C – Colour A number of different shades of brown, tan

or black could appear. A melanoma may also
become red, blue or some other colour.

D – Diameter Melanomas are usually >5mm, but they

may sometimes be smaller when first detected.

E – Evolving Any change - in size, shape, colour,

thickness, or any new symptom such as bleeding,
itching or crusting - points to danger.

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Demonstration
Making a mole map

You should be familiar with the

freckles, age spots and moles on
your body for early signs of skin
cancer

You can do a skin check yourself,

or ask a trusted friend to help.
 Treatment of skin
cancers
Treatment depends on the type of skin
cancer.

Different modes of treatment are used to

destroy cancer cells include:

• Cryotherapy (freezing)

• Chemotherapy (medication)

• Radiotherapy (high energy rays)

• Surgery (removal of cells)

ASK YOUR DOCTOR FOR A SKIN

CHECK. Skin cancer can be cured and
treatment is more likely to be successful if
discovered early.

40
 Prevention of skin
cancers
• Skin cancer is largely preventable

• Avoid tanning beds!

• Be sun smart. Avoid sun exposure

• Especially at the hottest part of the day

– Use clothing to cover your skin –
including a hat, long sleeves, long pants
– Use sunscreen (at least SPF15+ or
30+). Reapply every 2 hours, and after
swimming
– Wear sunglasses to protect your eyes

• *Australian Guidelines advise sunscreen at

least SPF 30)

41
 Questionnaires
After the session, please fill out the following
sections
Section C:
After the session
Section D:
Your satisfaction

This is not a test. It lets us know how

effective the session was.

Your responses will be anonymous.

Please return the questionnaires to
the front of the room.

42
Any questions
I will be available for the next 30 minutes if you
have any questions you would like to ask.
Thank you.
Disclaimer: This presentation has been developed for educational
purposes only. It is not a substitute for professional medical advice.
Should you have questions or concerns about any topic described
here, please consult your medical professional.

© 2017 AEA International Holdings Pte. Ltd. All rights reserved.

Unauthorized copy or distribution is prohibited.