With small cuts and grazes where the bleeding soon stops of its own accord, the main aim is to dress the wound to minimise the risk of infection.

Major injuries with severe blood loss require urgent medical attention.

- Sterile dressings
- Local anaesthetic spray (only if the skin is unbroken)

If you burn or scald yourself it will help to place the injury under running cold water for at least 10 minutes. Also, remove any tight clothing or jewellery as there is a risk of swelling in the injured area.

Colouration and swelling. Sometimes painful.

- Cold compressions, such as ice packs
- Topical circulatory preparations

Start as small, cold, white patches on the skin and develop into red swellings that itch and burn.

- Counter-irritant preparations ( for unbroken chilblains)

Chilblains affect around 1 in 12 people. Figures suggest that women are around 6 times more likely to suffer than men.
Chilblains are caused when people are abnormally sensitive to the cold and the blood vessels contract so much that the skin is deprived of blood and oxygen.

- Calamine lotion
- Preparations containing a local anaesthetic and antiseptic

Good sun sense involves more than just applying some suntan lotion. For all-round sun safety, the following points are important:
- Use a broad-spectrum sun protection product that offers a high degree of protection.
- Use a water-resistant product for water sports
- Reapply sunscreens frequently, especially after swimming
- Use sunscreen even on cloudy days (UVA and UVB can penetrate clouds)
- Stay in the shade between 11.00hrs and 15.00hrs
- Wear a hat whenever possible
- Use a good moisturiser at night
- Use a sun-block on tender skin areas (lips, nose, ears etc)
- Use sun-block if suffering from a sun allergy
- Do not use sun beds
- Protect children – up to 80% of sun damage is caused in childhood
- Do not expose children under 3 years of age to direct sunlight
- Use sun-block or a very high protection sunscreen whenever young children are out in the sun (e.g. SPF 30 or 35)
- Make sure that children wear clothing in addition to the use of a sunscreen; hats and T-shirts are especially important.

- Topical zinc oxide or calamine may relieve prickly heat.

Milaria/prickly heat

- Topical anti-fungal preparations

Despite its name, ringworm is not a worm, but a fungal infection caught from animals or other infected humans. As the ring grows the centre of the ring appears to heal. This characteristic is useful in differentiating between Tinea and eczema or psoriasis.
If you suspect you have a ringworm infection on your scalp or under your nails it is advisable to see your GP. It can spread to other people so use only your own towel until it clears.

- Topical preparations

Impetigo is a highly contagious bacterial infection that occurs usually in young children.
Systemic antibiotics from the GP are often needed to treat impetigo, depending upon the size of the area involved.

- Antibacterial creams

Small reddish lumps; large pus- filled spots and cysts

- Topical creams and gels containing benzoyl peroxide

If your acne is particularly severe, or you have had it for several weeks, you may want to seek the advice of a GP or dermatologist

- Local antiseptics.

Boils develop when a hair follicle becomes infected, often with the bacteria Staphylococcus.
More widespread infections may require medical attention.

- Antiseptics

A tetanus booster may be required.

Insect bites (see also "Allergy/Hayfever")

-Antihistamine cream
-Hydrocortisone
- Antipruritics
- Local anaesthetic
- Antihistamine

People who are very sensitive to stings can have a really severe allergic reaction: an anaphylactic shock. Symptoms include blotchy rash, puffy face and eyes, difficulty breathing and rapid pulse. Medical help is urgently needed.

There are four symptom stages of cold sores:
1 Tingle – the skin tingles and itches before the sore appears.
2 Blister – the sore begins as a small, raised blotch that swells and forms blisters, either singly or in small clusters. These are often very painful.
3 Weeping – the blisters collapse and join up to form a large weeping sore. At this stage the virus can easily be passed to others.
4 Scab – the blisters begin to dry out and heal and a scab forms.

- Antiviral

Between 20% and 25% of people suffer from recurrent cold sores. While the majority develop only occasional lesions, a tenth will have more than six episodes a year.
Cold sores are caused by the 'Herpes simplex’ virus, picked up by contact with an infected person. The majority of the time the infection lies dormant in the nerves that supply the skin around the lips and nostrils. When reactivated the virus travels down the nerves to the surface of the skin and a new sore is formed.
Cold sores have different triggers that vary for each person, including physical and emotional stress, illness that lowers resistance, exposure to strong sunlight, menstruation, fatigue, dental treatment and injuries to the mouth.

Tissue damage on the buttocks, ankles, hips and heels.

Ulcerations to the skin on the leg.

- Support hosiery
- Leg ulcers are usually treated by nurses or health visitors.

Leg ulcers – like pressure sores – are a manifestation of an underlying problem with circulation. In comparison with other parts of the body the flow of blood through he body is precarious and can be affected by even small changes. The flow back to the heart has to work against gravity and relies on a series of valves in the blood vessels. If venous blood flow is impaired varicose veins and leg ulcers may result. People with diabetes are at particular risk due to their restricted arterial blood flow called ischaemia.

Soreness and irritation in deep crevices or folds in the skin. Usually a problem in obese individuals.

- Antifungals
- Antiseptics
- Dusting powders (to keep the skin dry)

Irritation occurs where two areas of the skin rub together and sweat collects and skin can become infected by Candida.

Eczema: used to describe conditions running in families (atopic eczema) - the skin is inflammed, red, itchy and scaly.
Dermatitis: used to describe skin reactions to external conditions (contact dermatitis) - inflammation of the skin.
Eczema can be used to describe both conditions.
In its mildest form eczema is simply a tendency to dry skin. In more severe cases the skin may crack, weep, swell, bleed or become infected.

- Emollient bath preparation
- Emollient soap
- Moisturising cream or ointment
- Corticosteroids (e.g. beta methasone) or antiseptic (non-antibiotic)
- Hydrocortisone.

There is often confusion about the terms ‘dermatitis’ and ‘eczema’. They are often used interchangeably by dermatologists to describe a range of inflammatory skin conditions. The terms describe a range of skin conditions of different causes where the main symptoms are red, dry, itchy, weeping and/or crusting skin.
Causes:
Atopic eczema: a chronic and fluctuating condition of the skin with no known cause although a family history is common.
In children, atopic eczema generally appears in the first year of life, often between the ages of 2 and 4 months. Studies suggest it affects about 10% of children. About half of these clear up by the time the child is 18 months old, but the condition may continue into adulthood.
Allergic contact dermatitis (eczema) – development of hypersensitivity to a particular ‘agent’ which can occur
after a couple of exposures or over many years of repeated exposure e.g. reaction to nickel in some jewellery.
Irritant dermatitis (eczema): a reaction of the skin following contact with irritant substances e.g. household cleaning materials. The reaction is localised to the area of contact with the irritant.

This is often referred to as severe dandruff: red, scaly and itchy skin often spreading from the scalp to the ears, eyebrows and eyelids.

- Shampoos, ointments and gels containing salicylic acis, dithranol and coal tar. Coal tar has anti-inflammatory and anti-scaling effects, while salicylic acid is a keratolytic that aids the shedding of scales. Dithranol slows down the rate of skin cell turnover. Some formulations contain the antifungal ketoconazole which alleviates symptoms.
Special formulations are available for infants with cradle cap. But gentle rubbing with olive oil is all that may be required

In babies seborrhoeic eczema starts at around 2 months with thick yellow scales on the scalp.

Itchy, sore skin between the toes that will eventually crack and peel. Sometimes appears white, inflamed and weepy.

- Antifungal or keratolytic preparations for shoes and socks.
- Antifungal dusting powders, creams, sprays and ointments.

Around one in seven of the adult population is affected by Athlete’s Foot at any one time.
Athlete’s Foot is caused by the Fungus Tinea Pedis, that colonises the outermost layer of the skin. The fungus produces an enzyme that eventually produces toxins.
Athlete’s Foot is not confined to sporty people! Anyone can get it, except the very young. The infection can be picked up by walking barefoot across a changing room floor or at a swimming pool. Once caught, the fungus flourishes in the warm, moist environment between the toes.

A small area of thickened, often hardened, skin with a central core. Found on the knuckles of the toes, particularly on the side of the little toe.

- Keratolytic salicylic acid to soften the hardened skin.
- Felt rings can be worn around the corn to prevent pressure from footwear.

Women are more prone to foot problems because of wearing high heals and pointed shoes that force the toes forward. 30% of women in the UK suffer from corns, compared to 14% of men.
NB: People with diabetes should not self-treat any foot problems but should see their GP or chiropodist.

Calluses are more extensive patches of toughened skin that can occur on any part of the body, especially the feet, hands and knees.

A rough, usually raised surface on the skin that is a regular shape and clearly defined borders. There may be black spots in the centre, showing where tiny blood vessels have become involved.
Warts normally grow on the hands; verrucas are warts growing inwards on the soles of the feet.
Genital warts (on the penis or vagina) can be very small and cause little or no discomfort.

- Wart removers containing keratolytic agent salicylic acid. This helps remove the affected skin and stimulates production of protective antibodies.
- Lactic acid has corrosive properties and is included in many preparations.
When applying these products care must be taken not to let them spread onto unaffected skin.

Warts and verrucas are caused by viral infections of the skin (30 different ones in total). They are not nearly as contagious as we once thought and can take the human body up to two years to develop immunity against the virus. This explains why warts may be present for some time and then resolve of their own accord.
Warts growing around the genital area and anus spread rapidly and require medical attention. It is important to have these removed as warts on the penis are linked to cancer of the cervix in their partner.

Skin lesions that appear as well-defined, raised, reddish, slightly itchy plaques of tissue which are covered in large amounts of loose, slightly silvery scales. The scalp is also commonly affected but the face is very rarely involved.
In complications of psoriasis the nails may be affected and 7% of sufferers have joint pain.

- Emollient bath
- Preparations and products containing coal tar, salicylic acid and dithranol

The majority of psoriasis treatments are only available on prescription.

Bumps on the skin like nettle rash or hives. Red and itchy skin.

- Calamine lotion
- Preparations containing hydrocortisone.
- Antihistamines

Urticaria affects 20% of the population at some time in their lives. Women may be more affected than men – especially in the case of chronic urticaria.
It follows exposure to a certain allergen – that may remain unidentified by the patient. Urticaria can be triggered by physical causes such as heat, cold, pressure and sunlight or viral infections.

- minoxidil and finesteride (private prescription at present) works for both men and women but needs to be used continuously.

One in twenty men start to lose their hair in their 20s; this rises to one in three in the 30s and to over four in five by the 70s. More than half of women over 50 suffer some form of hair loss.
There are an average of 100,000 to 150,000 hairs on the human head, with a life-cycle ranging from 2 to 6 years.
Normally around 100 hairs are shed every day and, when the numbers lost exceed this, hair fall or thinning of the hair is noticed.
The most common cause of hair loss in both men and women is hereditary loss, which accounts for 95% of all hair loss. This is linked to the hormone dihydrotestosterone.. Hair loss can also be related to other factors including drug treatment, thyroid disease and iron deficiency. It is also common in women about 3 months after giving birth.

Excessive shedding of scales from the scalp; itching.

- Shampoos containing coal tar or its derivatives, pyrithione zinc, selenium sulphide, keratolytics, antimicrobial detergents or the antifungal ketoconazole.
The shampoo formulation of ketoconazole is suitable for the treatment and prevention of both dandruff and seborrhoeic eczema.

Dandruff is rare in young children but increases in incidence throughout the second decade of life. It affects up to 75% of the population at some time in their lives.
It is caused by a naturally increased rate of cell turnover in the scalp, producing more of the ‘horny’ cells that make up the outermost layer of the skin. This may be linked to the male hormone, testosterone, but sufferers have also been found to have high levels of the yeast Pityrosporum ovale.

Itching, inflammation and sometimes secondary infection. Sometimes thin greyish burrows about 0.5cm long can be seen in the skin. A characteristic rash can form on several parts of the body in the usual sequence: between the fingers, wrists, axially, genitalia, buttocks and abdomen

- Antiparasitic such as malathion or permethrin.
- Benzyl benzoate, an irritant ( should not be used with children.)
- Antipruritic such as crotamiton
- Oral antihistamine

Scabies is caused by a mite that burrows into the skin.
Itching may persist for some time after the infection has been cleared.
ALL MEMBERS OF THE AFFECTED HOUSEHOLD SHOULD BE TREATED.

Many people are unaware of the fact they carry headlice as they have no symptoms.
However, after time the body may become sensitised to substances injected by the louse during feeding and this can lead to itching and possibly to secondary infection.
Black, gritty powder (louse faeces) on pillows and collars is also a sign of infestation.

- Insecticides (pediculocides) e.g. malathion, permethrin and phenothrin.
- Aqueous and alcoholic lotions, crème rinses and shampoos.
The instructions for use must be followed carefully for treatment to be successful. Headlice can also become resistant to insecticides.

There are three types of human lice: headlice, body lice and pubic lice (sometimes called crabs).
Headlice are the most commonly encountered. The only way to be sure you have headlice is to remove a live louse from the scalp.
Grooming the hair with a special detector comb over a white sheet of paper may reveal one.
At any one time 2.5% of school children will be infected with headlice. This can rise rapidly to 25% in an outbreak.
Headlice are wingless insects, growing up to the size of 2-3mm, which live on the scalp. Their six legs have claws, specially adapted for holding onto hair shafts, and they are difficult to dislodge.
Headlice can not jump or fly, nor do they live in bedding, furniture or clothes. They can be passed by close head-to-head contact. Headlice lay 6-8 eggs a night, gluing them to the base of the hair shafts. Once hatched the empty, whole egg-shell left behind is called a nit. Nits are a good sign that headlice are, or have been, present. As the hair grows, the nits stay glued in position. The distance of the nits from the scalp gives an indication of the length of time since the eggs were laid.
After treatment for headlice it is important to trace all contacts and determine the source of the infection. If this is not done the headlice may recur.

Red, sore rash that usually starts around a baby’s genitals and, if left untreated, the skin becomes shiny and tight, with inflamed spots and pus-filled centres.
Another type of nappy rash occurs in babies who wear fabric nappies. Here the redness covers most of the nappy area and is caused by an allergy to chemicals in the washing powder or fabric conditioner.

- Skin protectants, which act as a barrier to moisture, can be applied at each nappy change.

Nappy rash is probably the most common of all infant skin conditions. It is usually caused by the skin coming into contact with urine and faeces. Bacteria in the faeces break down the urine and release ammonia, which irritates the skin.
Nappy rash can also be caused by a baby’s skin not being dried properly after bathing. This type of rash usually starts in the skin creases at the top of the thighs.
If the rash starts around the anus and moves over the buttocks and onto the thighs, it may be due to candida infection.
Cases of severe nappy rash require medical attention as the rash may require treatment with a topical antibiotic or antifungal preparation

Excessive sweating

- Antiperspirants that contain aluminium salts, such as aluminium chloride hexahydrate, which help to reduce or prevent excessive sweating.

If you sweat uncontrollably, even under normal temperature conditions, it’s likely you’re suffering from Hyperhidrosis. The condition can be made worse by emotional stress or hot and humid conditions.
Inappropriate sweating occurs because the body’s internal thermostat is set incorrectly so that the body ‘thinks’ that it is overheating and attempts to cool down through excessive sweating. The most commonly affected parts of the body are palms of the hands, soles of feet, underarms, the back and the face.