Dangers of black henna

If you see a shop or stall offering to paint black tattoos onto your skin, don’t be tempted to get one. It could leave you scarred for life and put you at risk of a life-threatening allergic reaction.

Often called "black henna" or "neutral henna" tattoos, these patterns painted onto your skin are readily available abroad. They may also be available in the UK, at festivals and fairs, and to buy online.

But the black paste used in these temporary tattoos may contain high levels of a chemical dye so powerful and toxic that it is illegal to use it on the skin in this way.

Risks of 'black henna'

The risks of black henna lie in the paste’s ingredients – specifically, a chemical called paraphenylenediamine (PPD).

Although PPD can lawfully be used in hair dyes in the EU, this use is strictly controlled.

Dr Chris Flower, director general of the Cosmetic, Toiletry and Perfumery Association, explains: "PPD is safely and legally used in permanent hair dyes where clear instructions are given, and where the maximum level is controlled by law. But black henna often contains PPD at high levels, to give a dark colour quickly.

"When applied to the skin in the form of a black henna temporary tattoo, PPD can cause chemical burns and lead to allergic reactions."

How to tell if it is real henna

Real henna, which is generally safe to use, is an orange colour, with a red or brown tint to it.

Dr Flower says that everyone should be suspicious of black "tattoos".

"Real henna is never black, but is orange-brown," he explains. "Any very dark temporary tattoo should be treated with caution."

Lisa Bickerstaffe at the British Skin Foundation agrees. "Check the colour if a product is described as 'henna'," she says. "Henna is an orange-red colour, so if you are offered a temporary tattoo with 'black henna', it isn't actually true henna. If in doubt, stay away."

Both Flower and Bickerstaffe advise reading the list of ingredients. Avoid the product if it lists PPD or paraphenylenediamine. But even this is no guarantee of safety, as the ingredient list might not be accurate or comprehensive.

If there is no list of ingredients, do not use the product.

Chemical burns from PPD

Not everyone has a reaction to black henna, but it can be painful if you do.

"The signs range from discomfort, such as burning or tingling, to painful stinging, swelling, redness and blistering of the skin," says Dr Flower. "This can become very severe and lead to permanent scarring of the skin in the outline of the tattoo."

If you get a reaction like this, contact a doctor immediately and tell them what has happened.

"Mention if this is the first time you have had such a tattoo, or if you have had one before, and whether you have ever had any reaction to hair dye in the past," says Dr Flower.

"You will probably be treated for chemical burns and possibly allergic reactions."

If the reaction persists or gets worse, go back to the doctor, as the painted area can also become infected.

And it's not just black henna tattoos you might be allergic to. Bickerstaffe warns: "The reaction can lead to contact dermatitis and may mean that your skin is more susceptible to reacting to other PPD products, such as hair dye, in the future."

Read about Katy's allergic reaction to her black henna tattoo.

Becoming sensitised to PPD

Apart from the pain and possible scarring in reaction to a black henna tattoo, there is a real risk of becoming sensitised to PPD.

This means that if you come into contact with PPD again in the future, even years later, you can have a very serious allergic reaction. Allergic reactions can get worse over time, and you might not even realise you have become sensitised.

This happened to a British woman, who tragically died in 2012 after suffering a bad allergic reaction to a hair dye that she had used before.

The inquest into Julie McCabe's death heard that five years earlier she had had a black henna tattoo abroad. Since then, she had used her regular hair dye several times and experienced some reactions, such as itching and rashes. Tragically, the last time she used the hair dye, she had a very serious anaphylactic reaction and died.

Such a serious reaction is rare, but it is a potential danger.

"If you have had a reaction to a black henna temporary tattoo, it is quite likely you have become allergic to PPD, and you should be extremely careful before colouring your hair," advises Dr Flower.

"Even if you have not had a reaction to such a tattoo, you will not know if you have been sensitised to PPD, so you could react the next time you encounter it – for example, in hair colourant.

"You must follow the hair dye instructions carefully, particularly regarding the Allergy Alert Test."

Bickerstaffe advises getting tested to see if you have become sensitised to PPD. "If your skin reacts to black henna, then seek advice and a patch test from your doctor or dermatologist," she says.

"The patch test will help determine whether the reaction was due to PPD and therefore whether you should avoid hair dye. It is unlikely you will be able to use permanent hair dye again after reacting to black henna."

PPD is also found in other items, including rubbers and inks, so if you have an unexpected reaction to everyday products and seek treatment, tell your doctor or pharmacist about your sensitivity to PPD.

If you know you have become sensitised to PPD, do not use any hair dye containing PPD, or similar dyes such as p-toluenediamine (PTD).

Look on the label

If you are going to dye your hair, Dr Flower explains what to look for on the label: "The name of the hair dye has to be listed in the ingredient list on the pack – look out for p-Phenylenediamine or Toluene-2,5-diamine.

"It is also a legal requirement that all such hair dyes in Europe say 'Contains phenylenediamines' or 'Contains phenylenediamines (toluenediamines)' on the label, and these must be avoided."

Allergy tests on hair dye

Every hair dye product in the UK is required to provide information about carrying out an Allergy Alert Test, to see if you will have a reaction to the dye. You should do this test before each time you use hair dye, even if you have used the dye before.

"If you react to an Allergy Alert Test, you must not go on and colour your hair, and you should contact the manufacturer," says Dr Flower. "Although it does require a dermatologist to confirm a diagnosis of allergy or sensitisation to PPD, a reaction to either a black temporary tattoo or to an Allergy Alert Test must not be ignored."

There will be a careline or helpline number on the hair dye pack for you to call. "This means the manufacturer will be aware that someone has experienced a reaction to their product," explains Dr Flower.

"They will then be able to advise further on what action to take next, which will probably involve contacting your GP."

Your GP may refer you to a skin specialist, such as a dermatologist, who can diagnose the cause, advise on how to treat it and help you to avoid future reactions.

If you have had a black temporary tattoo in the past, try not to worry. Don't have another one, and remember to follow the instructions, particularly the Allergy Alert Test, if you use hair dye.

Bear in mind that allergic reactions can get worse over time. This means that even if you or your child has had a mild reaction in the past, any future reaction could be more severe.

If you have not had such a tattoo in the past, keep it that way.

"Don’t ever have a black henna temporary tattoo," says Dr Flower. "And no matter how much your children pester you, never let them have one either."

'My black henna tattoo left a horrible lasting legacy'

Katy Borluvie had an allergic reaction to a black henna temporary tattoo she got on holiday. She found out the hard way about the illegal ingredients in her tattoo.

"I had noticed a steady stream of people visiting a tattoo stall by the pool in the Gambia," says Katy. "I just made a spur-of-the-moment decision to get a pretty pattern drawn in black henna below my collarbone. I thought it would look really nice.

"It was a decision I now regret, because I didn’t know what the consequences could be."

The tattoo artist painted on the design Katy wanted, but straight away she felt a burning sensation and knew something was wrong. Her skin blistered soon afterwards. "It was incredibly painful and sensitive, and looked terrible," says Katy.

"I didn’t realise that the black paste in black henna can contain toxic ingredients like PPD. I had never even heard that what's in black henna – stuff I let them put straight onto my skin – can be really risky."

There was PPD in Katy’s temporary tattoo and she developed an allergy to the chemical. She had a visible scar for the next six months.

Katy says: "I used to colour my hair all the time, but because I’m now allergic to PPD, I’m too scared to ever colour my hair again. I don’t want to get a reaction like that on my scalp.

"My reaction to the tattoo hasn't affected my health in other ways, but I'm really upset that a silly bit of holiday fun turned out to be anything but. My black henna tattoo was supposed to be a temporary thing, but it has left a horrible lasting legacy."

Watch Katy talk about her black henna tattoo and hear from experts in this video from the Cosmetic, Toiletry and Perfumery Association.

'I was petrified of passing psoriasis to my children'

Ros Foreman, aged 56 when interviewed, has had severe psoriasis since childhood. Here she talks about how pregnancy, sunshine and medicines have helped.

“If I could have one wish come true, it would be to have clear elbows and knees"

“I was diagnosed with psoriasis when I was nine. I’d been skipping to school and fell over and grazed my knees and elbows. The grazes didn’t heal and within a short while, my legs and arms were covered with psoriasis.

“The diagnosis wasn’t a surprise. Psoriasis runs in my family. My aunties and uncles on both sides had it – one uncle was so severely affected that he was regularly hospitalised.

“Lots of my family have asthma too, and there's a strong link between asthma and psoriasis; my brother died after a severe asthma attack when he was 13 (I was nine).

“It was hard growing up with psoriasis. I suffered at school because you’re seen as an ‘odd’ child, and it made me quite shy and inhibited.

“I was backwards and forwards to the doctors all the time and tried all the usual lotions and potions, but they only helped a little."

Dry heat and sunshine helps psoriasis

“A breakthrough came in my early 20s, when my husband had a job opportunity and we moved to southern California. Within six months of arriving, my psoriasis had virtually disappeared. The dry, sunny, warm climate – and being able to walk around in shorts and T-shirts the whole time – really helped.

“After seven years, we returned to the UK and within a few months my psoriasis was back – and with a vengeance. It’s been with me most of the time ever since.

“I’ve had courses of UV light therapy, which help temporarily, and I’m now taking an oral treatment called methotrexate, which definitely suppresses the symptoms. But I don’t know what will happen in the future. My psoriasis seems to be getting worse with age.”

Pregnancy and psoriasis

Aside from the physical challenges of living with and treating psoriasis, Ros says the condition really gets her down psychologically.

“I’m a naturally sociable person, but sometimes I shut myself in the house and sink into a deep, dark place. I often don’t feel good about myself and my confidence falls to rock bottom.

“It’s sad, but I feel that it’s restricted my life in many ways. For example, I always wanted to be an air hostess when I was younger, but I knew they’d never take me because of my skin.”

Ros recalls that she was absolutely petrified of having children in case she passed psoriasis, and other related illnesses like asthma, on to them. “It was a big, big consideration and I put off pregnancy for 10 years because I didn’t want any kids to have this horrible disease and have to go through what I have.

“Thankfully, I decided to go ahead and I now have three sons – none of whom have psoriasis at the moment, thankfully. Ironically, my psoriasis improved during pregnancy."

Moisturisers and diet

Roz, who is from Woking in Surrey, says she relies on a daily skincare regime in addition to her medicines.

“Every day I apply moisturising creams to my whole body, ideally morning, noon and night. It’s time-consuming and messy, but I have to do it. I also steer clear of acidic drinks like orange juice, because I think that makes it worse in my case.

“The weather makes a big difference. Cold winters are the worst possible climate for me. Covering up with layers of clothes and having the heating on means my skin dehydrates and I have to constantly moisturise, which is really time-consuming.

Spring and summer are so much nicer, because my skin improves with the warmth and I find it easier to look after my skin when I’m wearing summer clothes."

Read more about psoriasis.

Psoriasis: 'Don't suffer in silence'

Award-winning actor, writer and comedian Toby Hadoke has battled with severe psoriasis for most of his life. He talks about treatments and why it’s vital to tackle the psychological, as well as the physical, symptoms.

As a performer, Tony Hadoke is used to speaking out. After two decades of roller coaster skin outbreaks, he’s discovered the benefits of applying this approach to his psoriasis.

“Psoriasis is a horrible condition. People who don’t have it don’t understand how physically and emotionally disabling it can be.

“My psoriasis covers pretty well my entire body – especially my trunk, arms and legs, and scalp. During an outbreak, my skin erupts into a napalm of plaques. Even between outbreaks, I’m never completely clear of it, there’s a reddened discolouration to my skin.

“The worst place to have psoriasis is on your face. When my face has been affected, it’s made me very self-conscious. Complete strangers would make comments like ‘hope it’s not catching’. What a horrid thing to say. When you have psoriasis, you can be exposed to that kind of lack of empathy.”

The emotional aspects of psoriasis

According to the Psoriasis Association, approximately one third of sufferers also experience depression and anxiety, and feelings of humiliation; one in five report being rejected and stigmatised because of their condition, and one in 10 contemplate suicide.

“It’s in our nature not to complain, to be pessimistic and not to seek help. People with psoriasis are pre-programmed to suffer in silence.

“But it isn’t acceptable to put up with a condition as unpleasant as psoriasis, and no-one should feel guilty about feeling sorry for themselves or wanting to be treated. I’ve found it cathartic to talk about it. It makes me feel as if I’m in control of the psoriasis, rather than it being in control of me.’

Psoriasis creams and lotions

Toby, 39 at the time of this interview, was diagnosed with psoriasis in childhood. Since then, he’s tried a wide variety of treatments with mixed response.

“I was about 11 when I had my first symptoms. I’d been prescribed penicillin for a throat infection and almost straight away I developed patches of red, dry skin. The doctor thought it was a penicillin-induced rash. But my mum, a nurse, suspected psoriasis – and she was right. I was treated with coal tar baths and it cleared up.

“For years my skin was fine, until, as a student at university, I noticed a couple of small red patches on my arm. Within hours, the psoriasis came back with a vengeance and it’s stayed with me ever since. I always know when a flare-up is coming on. Throat infections are a trigger.

“For years I used loads of different treatments, including coal tar cream, dithranol, even holistic treatments. None of them made much difference. I thought that a certain level of discomfort was my lot in life.”

Psoriasis tablets and injections

The turning point for Toby came when, in May 2012, after a particularly vicious prolonged outbreak of psoriasis that also covered his face, he was referred to the Royal Free Hospital in London.

“When I took my shirt off, the doctor was aghast at the state of my skin,” he recalls. “Since then, I’ve been prescribed more powerful treatments under the care of the hospital.

"These have included UV light therapy, tablets of the immunosuppressant ciclosporin, and a tablet called acitretin, which reduces the production of skin cells. The treatments have helped to a certain extent, though the benefits have to be balanced against potential side effects.

“For instance, the acitretin worked, but one of the side effects is that the treatment can affect your mental health, and sure enough I had a bit of a breakdown while taking it, so I had to stop.”

At the moment, Toby is self-injecting once every two weeks with a "biologic" treatment. Biologics are a new type of psoriasis therapy that reduce inflammation by targeting overactive cells in the immune system. “So far so good, my face is clear and I’m cautiously optimistic,” he says.

Psoriasis support and information

Keloid scars

Some scars grow lumpy and larger than the wound they're healing – this is called keloid scarring. Anyone can get a keloid scar, but they are more common in people with dark skin, such as people from Africa and African-Caribbean and south Indian communities.

What are keloid scars?

When the skin is broken – for example, by a cut, bite, scratch, burn, acne or piercing – the body produces more of a protein called collagen.

Collagen gathers around damaged skin and builds up to help the wound seal over. The resulting scar usually fades over time, becoming smoother and less noticeable.

But some scars don't stop growing, invading healthy skin and becoming bigger than the original wound. These are known as keloid scars, which affect around 10-15% of all wounds.

Keloid scars are more common on the upper chest, shoulders, head (especially the earlobes) and neck, but they can happen anywhere.

They're normally:

• shiny
• hairless
• raised above surrounding skin
• hard and rubbery
• red or purple at first, before becoming brown or pale

They can last for years, and sometimes don't form until months or years after the initial injury.

They're usually painless, but some can cause:

• pain
• tenderness
• itchiness
• a burning feeling
• limited movement if located on a joint

Some people feel embarrassed or upset if they think the scar is disfiguring them.

Experts don't fully understand why keloid scarring happens. They are not contagious or cancerous.

Keloid scars can sometimes develop after minor skin damage, such as burns, acne scars and even chicken pox, but they can sometimes happen spontaneously with no history of skin trauma. If you've had a keloid scar before, you're more likely to get another.

Who gets keloid scars?

Keloid scars can affect anyone, but they're more common in people with dark skin and it's thought they may run in families. Younger people between the ages of 10 and 30 are more likely to develop them.

Can you prevent keloid scars?

You can't completely prevent keloid scars, but you can avoid any deliberate cuts or breaks in the skin, such as tattoos or piercings, including on the earlobes.

Treating acne will reduce the likelihood of acne scars appearing. Avoid minor skin surgery to areas more prone to keloid scarring – the upper chest, back and upper arms – if possible.

Treatments for keloid scars

There are several treatments available, but none have been shown to be more effective than others. Treatment can be difficult and isn't always successful.

Treatments that may help flatten a keloid include:

• steroid injections
• applying steroid-impregnated tape for 12 hours a day
• applying silicone gel sheeting for several months

Other options include:

• freezing early keloids with liquid nitrogen to stop them growing
• laser treatment to reduce redness – but this won't make the scar any smaller
• surgery, sometimes followed by radiotherapy, to remove the keloid – although the keloid can grow back and may be larger than before

If you're bothered by a keloid scar and want help, see your GP.

Hypertrophic scars

Hypertrophic scars are another type of raised scar that can also restrict movement.

Unlike keloid scars, they are within the size of the original wound.

Hypertrophic scars can last for several years.

Sunscreen and sun safety

Advice for adults and children on sunscreen and sun safety in the UK and abroad.

• Sun safety tips
• What factor sunscreen (SPF) should I use?
• What are the SPF and star rating?
• How to apply sunscreen (video)
• Swimming and sunscreen
• Children and sun protection
• Protect your eyes
• Clothing and sunglasses
• Sunburn
• Who should take extra care?
• Mole protection
• Sunbed advice

Sunburn increases your risk of skin cancer. Sunburn doesn't just happen on holiday – you can burn in the UK, even when it's cloudy.

There's no safe or healthy way to get a tan. A tan doesn't protect your skin from the sun's harmful effects.

Aim to strike a balance between protecting yourself from the sun and getting enough vitamin D from sunlight.

Sun safety tips

Spend time in the shade when the sun is strongest. In the UK, this is between 11am and 3pm from March to October.

Make sure you:

• spend time in the shade between 11am and 3pm
• make sure you never burn
• cover up with suitable clothing and sunglasses
• take extra care with children
• use at least factor 15 sunscreen

What factor sunscreen (SPF) should I use?

Don't rely on sunscreen alone to protect yourself from the sun. Wear suitable clothing and spend time in the shade when the sun's at its hottest.

When buying sunscreen, the label should have:

• a sun protection factor (SPF) of at least 15 to protect against UVB
• at least four-star UVA protection

UVA protection can also be indicated by the letters "UVA" in a circle, which indicates that it meets the EU standard.

Make sure the sunscreen is not past its expiry date. Most sunscreens have a shelf life of two to three years.

Don't spend any longer in the sun than you would without sunscreen.

What are the SPF and star rating?

The sun protection factor, or SPF, is a measure of the amount of ultraviolet B radiation (UVB) protection.

SPFs are rated on a scale of 2-50+ based on the level of protection they offer, with 50+ offering the strongest form of UVB protection.

The star rating measures the amount of ultraviolet A radiation (UVA) protection. You should see a star rating of up to five stars on UK sunscreens. The higher the star rating, the better.

The letters "UVA" inside a circle is a European marking. This means the UVA protection is at least one third of the SPF value and meets EU recommendations.

Sunscreens that offer both UVA and UVB protection are sometimes called broad spectrum.

How to apply sunscreen

Most people don't apply enough sunscreen. As a guide, adults should aim to apply around:

• two teaspoons of sunscreen if you're just covering your head, arms and neck
• two tablespoons if you're covering your entire body while wearing a swimming costume

If sunscreen is applied too thinly, the amount of protection it gives is reduced. If you're worried you might not be applying enough SPF15, you could use a stronger SPF30 sunscreen.

If you plan to be out in the sun long enough to risk burning, sunscreen needs to be applied twice:

• 30 minutes before going out
• just before going out

Sunscreen should be applied to all exposed skin, including the face, neck and ears – and head if you have thinning or no hair – but a wide-brimmed hat is better.

Sunscreen needs to be reapplied liberally and frequently, and according to the manufacturer's instructions.

This includes applying it straight after you've been in water – even if it's "water resistant" – and after towel drying, sweating, or when it may have rubbed off.

Watch a video about staying safe in the sun

Check moles for change

Keep an eye on any moles or freckles you have. If they change at all (for example, if they get bigger or bleed), see your GP as this can be an early sign of cancer.

The earlier skin cancer is caught, the easier it is to treat, so see your GP as soon as possible.

Swimming and sunscreen

Water washes sunscreen off, and the cooling effect of the water can make you think you're not getting burned. Water also reflects ultraviolet (UV) rays, increasing your exposure.

Water-resistant sunscreen is needed if sweating or contact with water is likely.

Sunscreen should be reapplied straight after you've been in water – even if it's "water resistant" – and after towel drying, sweating, or when it may have rubbed off.

Children and sun protection

Take extra care to protect babies and children. Their skin is much more sensitive than adult skin, and damage caused by repeated exposure to sunlight could lead to skin cancer developing in later life.

Children aged under six months should be kept out of direct strong sunlight.

From March to October in the UK, children should:

• cover up with suitable clothing
• spend time in the shade – particularly from 11am to 3pm
• wear at least SPF15 sunscreen

Apply sunscreen to areas not protected by clothing, such as the face, ears, feet, and backs of hands. Get more sun safety advice for children.

To ensure they get enough vitamin D, all children under five are advised to take vitamin D supplements.

Protect your eyes in the sun

A day at the beach without proper eye protection can cause a temporary but painful burn to the surface of the eye, similar to sunburn.

Reflected sunlight from snow, sand, concrete and water, and artificial light from sunbeds, is particularly dangerous.

Avoid looking directly at the sun, as this can cause permanent eye damage.

Clothing and sunglasses

Wear clothes and sunglasses that provide sun protection, such as:

• a wide-brimmed hat that shades the face, neck and ears
• a long-sleeved top
• trousers or long skirts in close-weave fabrics that don't allow sunlight through
• sunglasses with wraparound lenses or wide arms with the CE Mark and European Standard EN 1836:2005

How to deal with sunburn

Sponge sore skin with cool water, then apply soothing aftersun or calamine lotion.

Painkillers, such as paracetamol or ibuprofen, will ease the pain by helping to reduce inflammation caused by sunburn.

Seek medical help if you feel unwell or the skin swells badly or blisters. Stay out of the sun until all signs of redness have gone.

Read more about treating sunburn.

Get tips on preventing and treating heat exhaustion in hot weather.

Who should take extra care in the sun?

You should take extra care in the sun if you:

• have pale, white or light brown skin
• have freckles or red or fair hair
• tend to burn rather than tan
• have many moles
• have skin problems relating to a medical condition
• are only exposed to intense sun occasionally – for example, while on holiday
• are in a hot country where the sun is particularly intense
• have a family history of skin cancer

People who spend a lot of time in the sun, whether it's for work or play, are at increased risk of skin cancer if they don't take the right precautions.

People with naturally brown or black skin are less likely to get skin cancer, as darker skin has some protection against UV rays. But skin cancer can still occur.

The Cancer Research UK website has a tool where you can find out your skin type to see when you might be at risk of burning.

Protect your moles

If you have lots of moles or freckles, your risk of getting skin cancer is higher than average, so take extra care.

Avoid getting caught out by sunburn. Use shade, clothing and a sunscreen with an SPF of at least 15 to protect yourself.

Keep an eye out for changes to your skin. Changes to check for include:

• a new mole, growth or lump
• any moles, freckles or patches of skin that change in size, shape or colour

Report these to your doctor as soon as possible. Skin cancer is much easier to treat if it's found early.

Use the mole self-assessment tool to see whether you could have a cancerous mole.

Using sunbeds

The British Association of Dermatologists advises that people shouldn't use sunbeds or sunlamps.

Sunbeds and lamps can be more dangerous than natural sunlight because they use a concentrated source of UV radiation.

Health risks linked to sunbeds and other UV tanning equipment include:

• skin cancer
• premature skin ageing
• sunburnt skin
• eye irritation

It's illegal for people under the age of 18 to use sunbeds, including in tanning salons, beauty salons, leisure centres, gyms, and hotels.

Find out more by reading Are sunbeds safe?

Look after your skin

Your skin works hard to keep you healthy, and you can return the favour by taking care of it. Here are some tips to help you keep your skin looking and feeling good.

Watch a video about how to apply sunscreen

Sun care

Sunlight contains ultraviolet (UV) rays, which are the main cause of skin ageing and can cause skin cancer.

Sunburn can significantly increase the risk of skin cancer, so it's important to protect skin against sun damage at any age, but take special care with babies, children and young people.

To help protect yourself:

• spend time in the shade between 11am and 3pm
• cover up with clothes, a hat and sunglasses
• use sunscreen with a sun protection factor (SPF) of at least 15

You need to spend some time in sunlight so your body can make vitamin D, which is essential for healthy bones.

To find out more about balancing the need for getting vitamin D and protecting your skin from sun damage, see how to get vitamin D from sunlight.

Find out more about sunscreen and sun safety.

Smoking

Smoking is linked to early ageing of the skin. It's thought smoking reduces the skin's natural elasticity by causing the breakdown of collagen and reducing collagen production. Collagen is a protein that supports skin strength.

It also reduces blood flow to your skin, so your skin gets fewer nutrients and less oxygen.

Get help to stop smoking.

Alcohol

When you drink alcohol, your body and skin can become dehydrated, leaving the skin looking older and tired. Drinking water can help your skin stay hydrated, preventing it drying out.

When you have alcohol, try to drink within the recommended limits, and have a non-alcoholic drink, such as soda water or fruit juice, between alcoholic drinks.

Washing your skin

Try to use mild soaps or bath oils – too much washing or using harsh soaps can wash away the natural oils that keep our skin healthy.

If you have dry skin, don't use harsh alcohol-based products as these can irritate skin and dry it out.

Moisturising can help prevent dry skin. If you have oily skin, avoid oil-based products and choose water-based ones instead.

Facts from the British Association of Dermatologists
The average adult has 21 sq ft (2 sq m) of skin.

On average, each square half-inch of skin contains:

• 10 hairs
• 5 sebaceous (oil) glands
• 100 sweat glands
• 3.2ft (1m) of tiny blood vessels

Common skin conditions

A short guide to some of the most common skin conditions.

Watch a video about psoriasis

Atopic eczema
Cold sores
Hives (urticaria)
Impetigo
Itching
Psoriasis
Ringworm
Scabies
Vitiligo
Warts and verrucas

Atopic eczema

Atopic eczema, also known as atopic dermatitis, is the most common form of eczema and makes your skin itchy, red, dry and cracked.

It's a long-term condition in most people, although it can improve over time, especially in children, who often grow out of it.

It can affect any part of the body, but most commonly affects:

• the backs or fronts of the knees
• outside or inside the elbows
• around the neck, hands, cheeks or scalp

Treatment, which includes using moisturisers and topical steroids, can help relieve symptoms.

Find out more about atopic eczema, including treatment advice.

Cold sores

Cold sores are small blisters that develop on the lips or around the mouth, caused by the herpes simplex virus.

They often start with a tingling, itching or burning sensation around your mouth. Small fluid-filled sores then appear, usually on the edges of your lower lip.

Cold sores usually clear up without treatment within 7 to 10 days, but antiviral creams are available from pharmacies over the counter. These can help ease your symptoms and speed up the healing time.

Find out more about cold sores and how to treat them.

Hives (urticaria)

Urticaria – also known as hives, weals, welts or nettle rash – is a raised, itchy rash. It may appear on one part of the body or be spread across large areas.

In many cases, you don't need any treatment because the rash gets better within a few days.

If the itchiness is uncomfortable, antihistamines can help and are available over the counter at pharmacies.

See your GP if your symptoms don't go away within 48 hours.

Find out more about hives, including treatment advice.

Impetigo

Impetigo is a very contagious skin infection that causes sores and blisters. There are two types:

• non-bullous impetigo – typically affects the nose and mouth
• bullous impetigo – typically affects the trunk

It's more common in children, but can affect anyone.

The infection is likely to clear up by itself within three weeks, but it's a good idea to see your GP for a diagnosis as the symptoms are similar to other, more serious conditions.

Your GP can also prescribe antibiotic cream or tablets to get rid of it quickly.

Find out more about impetigo, and how to treat and manage the infection.

Itching

Itching can affect any area of the body. Mild, short-lived itching is common, but it can sometimes be severe and frustrating to live with.

There are things you can do that may help, including:

• patting or tapping the itchy area, rather than scratching
• cooling the area with a cold compress, such as a damp flannel
• bathing or showering in cool or lukewarm water
• using unperfumed personal hygiene products
• avoiding clothes that irritate your skin, such as wool or man-made fabrics
• using a moisturiser if your skin is dry or flaky

Antihistamine and steroid cream may help relieve itching caused by certain skin conditions.

Find out more about itching, including treatment advice.

Psoriasis

Psoriasis typically causes flaky red patches of skin covered in silver scales. The patches usually appear on the elbows, knees and the lower back, and can be itchy or sore.

For some people, psoriasis is just a minor irritation, but for others it can have a major impact on their quality of life.

People with psoriasis usually have periods when they have no or mild symptoms, followed by periods when symptoms are more severe.

Most people are treated by their GP, but you may be referred to a skin specialist called a dermatologist if your psoriasis is severe.

Although there is no cure for psoriasis, treatments can improve your symptoms. They include:

• creams and ointments
• treatment with light (phototherapy)
• medication taken by mouth or injection

Find out more about psoriasis and how to treat it.

Ringworm

Ringworm is not a worm, but a contagious fungal infection that typically appears on the arms and legs, although it can appear almost anywhere on the body. It causes a red or silvery scaly rash in the shape of a ring.

Anyone can get ringworm, but it's more common in children.

You can treat ringworm with antifungal creams, powders or tablets, which are available over the counter from a pharmacy.

You may need to see your GP if you aren't sure it's ringworm, or if the infection doesn't clear up after using a pharmacy treatment for two weeks.

Find out more about ringworm and other fungal infections, including treatment advice.

Scabies

Scabies is a contagious skin condition caused by tiny mites that burrow into the skin. The main symptoms are intense itching that gets worse at night, and a rash of tiny red spots.

See your GP if you think you have scabies. It's not usually serious, but treatment – normally a cream or lotion – is needed to kill the scabies mites.

Find out more about scabies and how to treat it.

Vitiligo

Vitiligo causes pale white patches on the skin that vary in size and can occur anywhere.

They are more noticeable on areas that are exposed to sunlight, such as the face and hands, and on dark or tanned skin. Vitiligo on the scalp can make your hair go white.

Vitiligo is a long-term condition. It's not contagious. You should see your GP to if you suspect vitiligo.

Treatment aims to improve your skin's appearance, and includes:

• disguising the patches with coloured creams
• steroid creams
• treatment with light (phototherapy)

Find out more about vitiligo, including treatment advice.

Warts and verrucas

Warts are small lumps that can appear anywhere, but usually affect the hands and feet. A wart on the foot is called a verruca.

Most warts are harmless and clear up without treatment, but you might decide to treat your wart if it's painful, or if it's causing discomfort or embarrassment.

Treatments include:

• salicylic acid
• freezing the wart (cryotherapy)
• duct tape
• chemical treatments

Find out more about warts and verrucas, including treatment advice.

Find out more about the symptoms of skin tags and how they're treated