Self-care is relevant to all aspects of our health and, without a doubt, it is also relevant to our skin. “Healthy skin is balanced skin,” says Eva Vilarrasa, a dermatologist and coordinator of the hidradenitis suppurativa unit .

To take care of the health of our skin, the doctor recommends following the same guidelines as to preserve health in general: “We are a whole and the skin is a reflection of our health.” Sleeping well, exercising, having a healthy and balanced diet, as well as hydrating it and protecting it from the sun are other basic recommendations to properly care for this important part of our body. It is also essential that we avoid excesses, such as the consumption of tobacco or alcohol.

There are a number of recommendations that can help you delay natural aging and prevent some skin problems.

  • Sleep well . Rest is a fundamental part of our general health, and of course, the health of our skin. When we sleep, our production of collagen and elastin increases, which help us maintain firm, elastic and luminous skin. A restful sleep also improves circulation, so the skin is oxygenated and this prevents the appearance of bags and dark circles. In addition, if a person sleeps well, they will enjoy a good state of mind, which will have a positive impact on our health.
  • A healthy and balanced diet can prevent premature aging of our skin. Our diet should include antioxidant foods such as fruits and vegetables, legumes, whole grains, and proteins. Foods rich in omega 3 and vitamin C are also advisable. On the contrary, ultra-processed foods, refined flours and foods high in sugar should be avoided. It is also very important to drink water, to help keep the skin hydrated.
  • Self care routine . It is important that we adapt our treatments according to our age and the needs of our skin, however: daily cleansing, hydration and sun protection are essential.
  • Exercising . Physical activity brings more blood and oxygen to the skin cells, which favors cell renewal and the elimination of toxins. It also reduces stress levels and improves rest
  • Eliminate tobacco and alcohol . Smoking contributes to skin aging as it narrows the blood vessels that are in the superficial layers of the skin. It also removes oxygen and nutrients. For its part, alcohol causes dehydration and inflammation (spider veins and redness).
  • Manage stress . Stress and anxiety sensitize the skin, making it more vulnerable and prone to developing breakouts and skin problems. Rest, exercise, a healthy diet or relaxation techniques can minimize its sequelae.

Our way of living influences our skin

In addition to physical factors, our current lifestyle compromises the health of our skin: “It is not an entity, nor an isolated organ; our way of living influences our skin”, affirms the dermat logo.

We live in a society that causes us stress , which sometimes translates into sadness and negativity that can affect our self-esteem. We stop having proper eating habits, snack between meals, cook less and abandon physical exercise, becoming sedentary. “All of this affects our general health, but it also has a significant impact on our skin health,” says Esther Margarit de Miguel, psychologist and nurse. CAP Can Bou, Castelldefels.

 Connection between mental health and physical health

The psychologist stresses that “there is a great connection between our mental health and our physical health. It could be compared to a house that is supported by these two pillars. Both are essential to keep it standing and when one of they are affected, the house can shake,” he says.

For Dr. Vilarrasa , “our skin is a mirror of our interior and stress influences and affects its well-being, as well as many other pathologies. Psoriasis or hidradenitis suppurativa are skin diseases that worsen when we have a emotional problem and we are stressed . If we suffer episodes of stress, patients with skin problems have more flare-ups, or their lesions worsen. This factor also occurs in reverse, that is, when someone has the worse skin, the psychological state suffers and their quality of life is altered. The inflammatory system affects neurally and makes the person have a worse mood. The two things go together and improve the skin pathology it improves the mood and vice versa”.

What is hidradenitis suppurativa?

Within dermatological pathologies, hidradenitis suppurativa is one of the skin diseases that most affects the quality of life of those who suffer from it. About 1% of the Spanish population suffers from this little-known disease, both by society and by health professionals.

Hidradenitis suppurativa is characterized by being inflammatory (chronic in some patients), recurrent and appears in the form of abscesses, boils -sometimes oozing- in areas that cannot be seen with the naked eye. “It usually manifests itself in folds or in the areas of the apocrine glands. But, it does not only have skin manifestations (it can affect other parts of the body) and it can be associated with other diseases such as metabolic syndrome , overweight, obesity, alteration of lipids, hypertension, joint involvement, and emotional and psychiatric involvement”, comments the dermatologist Vilarrasa.

What are your symptoms?

Identifying hidradenitis suppurativa can only be done clinically, since there is no specific analysis that detects it. This means that you have to look at the symptoms that the patient has. “They are usually lesions in certain locations -armpits, genitals, buttocks or under the breasts- in the form of boils, lumps or undules. The diagnosis of this pathology is determined when more of two episodes in a period of less than six months and on a recurring basis”, says Eva Vilarrasa.

Sometimes this pathology is confused with acne because the lesions are similar (especially in the most severe acne). Years ago, some hidradenitis suppurativas were called acne inversa, as if it were acne in the inverted areas. “They really are different pathologies, with different triggering factors, although sometimes they go hand in hand. There are many patients who present both pathologies and in a serious way. This can cause confusion”, says Dr. Vilarrasa.

More prevalent in women

According to studies, this skin pathology is more prevalent in women than in men, although the difference is not very significant. It is believed that there may be hormonal factors or habits such as hair removal, which could have an influence, but this has not been proven. Publications state that for every 60 women there are 40 men with this skin problem, although in consultation and in patients with moderate/severe hidradenitis the proportion is more balanced.

In Spain, the percentage of patients is around 1% (in the world, the affectation is between 1 and 4%). However, “we believe that there may be an underdiagnosis of the disease, since it is little known both by patients and by doctors and society,” says Dr. Vilarrasa.

Early detection

The diagnostic delay of hidradinitis suppurativa is estimated to be between seven and ten years. It may seem strange, since it is a pathology that manifests itself in the skin, and that the patient sees and suffers, but, again, the general ignorance explains why, on many occasions, it takes so long to diagnose this condition. pathology. “The patient himself often does not consult, or does not go to the right doctor and can confuse the problem with an infection,” says Dr. Vilarrasa.

For the correct approach to these patients, it is necessary to insist on early diagnosis, since with the passage of time this type of lesions are hardly reversible. “Some treatments that are carried out with pills or injections reverse the lesions, but others, if they progress, end up making tunnels in the skin and do not disappear with laser or surgery. These sequelae also entail problems psychological”, comments Eva Vilarrasa.

 Silvia Lobo also highlights the importance of having an early diagnosis: “If we reach advanced stages, we may have to stop studying or working. Primary care is the door of the National Health System and must recognize how much this patient beforehand and refer him to a specialist in a timely manner. It also requires that doctors or emergency services have training in this pathology. If this is achieved, we will improve the lives of these people”, ensures.

The role of nursing is also decisive. “We must try to empower the patient and give them all the information they need about their disease. We also have to monitor them in the event that they have to undergo cures or undergo treatment. Our role is essential for them to comply with therapeutic adherence”, emphasizes Esther Margarit de Miguel.

Sandra Velasco, Head of Immunology at Novartis , considers the collaboration of all agents in the healthcare ecosystem essential to make innovation accessible to all patients with dermatological pathologies who need it. “We need to collaborate among all of us to be able to provide solutions and improve the approach to these pathologies. United we will be able to have a really significant impact on the lives of these people.”

Social stigma

Esther, Eva and Silvia agree on the stigmatization suffered by patients with dermatological pathologies throughout their lives. In the case of hidradenitis, contrary to what happens with other skin diseases, it is not visible to the naked eye, since it rarely appears on the face or hands. This means that society does not give it the importance it has and, often, it is trivialized. However, the symptoms it causes -pain, itching, suppuration and sometimes a bad smell- can affect the patients in their social relationships. These are patients who often have episodes of irritability, sadness or even depression and who see their sexual relations and relationships affected.

As in almost all pathologies, we must not forget the role that relatives and relatives can play in the patient’s treatment. “They must maintain an active attitude; ask him how he is and what he needs. They can accompany him on visits to the doctor, ask questions and normalize his illness; talk to him, accompany him and soften this stigma that generates shame. Do not judge,” says Esther Margarit de Miguel.

One of the main objectives of the Asendhi association is trying to normalize this pathology and eradicate this stigma. For this they work to give visibility and promote awareness at a social level with initiatives such as the Barometer of Hidradenitis Suppurativa . As Silvia Lobo explains, “it is the first document in which patients with Hidradenitis Suppurativa are asked their opinion about their doctors, work… as well as the degree of dissatisfaction with the health system and its own life with the aim of trying to improve them”.

 Accept the disease and learn to live with it

The patient must accept the disease and understand that he is not guilty of suffering from it. You also have to learn to love yourself. You must obtain the necessary information to know what your disease consists of: what it is, what symptoms it presents, who to go to. And all this knowledge can be collected through doctors, specialists or nurses who accompany you. You can also go to patient associations, to feel supported and to offer you testimony from other people who have the same pathology. “They must learn to overcome their limitations and begin to value from the capacity: what I am capable of doing despite having this affectation. This will help them to live with the disease ,” says Esther Margarit de Miguel.

Silvia Lobo laments the scant psychological help that this type of patient has to face a disease that can become completely disabling. “The national health system still does not have psychological or psychiatric support to face the day-to-day of many patients with diseases that, today, have no cure. Each and every one of “The actors in this disease have to be active in learning about the disease and influencing self-care. A trained and conscious patient will live better.”

On a professional level, “it is important that doctors in both dermatology and primary care, or surgery have basic knowledge of psychiatric dermatology or psychodermatology,” says Esther Margarit. “It may be the case that, even in mild degrees on a physical level, the patient suffers a great psychological impact, so it is important that we are prepared and have tools.”

Immunodermatological diseases are many and very varied. In fact, they affect more than 250 million people worldwide. “They are chronic diseases, without a cure and have a very serious impact on quality of life, such as hidradenitis. At Novartis we are committed to the development and innovation of therapies that provide an improvement in the quality of life of these patients. We always try to be one step ahead to understand the causes and provide solutions to unmet needs so that patients with these diseases can feel better in their skin”, concludes Sandra Velasco.

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