Improve Skin Care Research Articles

Survey of European Blood and Marrow Transplant (EBMT) nurses to explore the current topical skin management of chronic cutaneous graft versus host disease in the real-world clinical environment.

To understand the current practice in relation to the management of topical therapy for cutaneouschronic Graft versus Host Disease (ccGvHD) and access to extracorporeal photopheresis (ECP) within European allogeneic haematopoietic cell transplantation centres by a survey of nurses. This was a multicentre cross-national study at eligible European Blood and Marrow Transplant centres. Eligibility required more than 30% of treated patients having allogeneic haematopoietic cell transplant. Centres performing only autologous stem cell transplants were excluded from the study. 12% of respondents were unaware of whether their centre had a policy or not for monitoring chronic cutaneous graft versus host disease. Over half had the affiliation of a dermatologist for referral, but only 19% had access to a specialist nurse. Patient education was routinely provided in most of the centres (86%). Results suggested as the severity of a patient's chronic cutaneous graft versus host disease increased, there was a reduction in the amount of topical emollients and steroids employed. Following topical therapies, systemic treatments, and other modalities such as ECP were employed with less focus directed towards topical care. Topical treatment is the backbone of any treatment paradigm for chronic cutaneous graft versus host disease, however, there is no universally agreed algorithm. Improved skin care may lead to a reduction in the amount of systemic therapy required, thus increasing patients' quality of life. There is little standardisation in the topical management of chronic cutaneous graft versus host disease, despite skin being the most cited organ affected by chronic graft versus host disease, this should be addressed.

In silico Exploration on The Potency of Basil (Ocimum basilicum) as an Anti-Aging Skin Agent

New and improved skin care products and procedures have been established by technological advances and scientific investigation. By increasing the skin's moisture, firmness, and elasticity, anti-aging skin care can enhance the skin's overall condition. The objective of this study was to examine the potential of basil's chemical compounds as an in silicoanti-aging agent. Exploration of online databases, scholarly articles from national and international journals, and analysis using docking software are selected as examples of data collection methods. Matrix metalloproteinase 1 (MMP1), with PDB code 966C, is one of the targeted proteins related to skin anti-aging. Ladanein, acacetin, luteolin, 5-hydroxy-7,4'-dimethoxyflavone and genkwanin are five basil compounds that are predicted to exhibit anti-aging agents based on the presence of the binding affinity score indicator and the similarity of the appropriate attachment sites compared to the native ligand used. The scores for the binding affinity of luteolin, ladanein, acacetin, 5-hydroxy-7,4'-dimethoxyflavone, and genkwanin are -10, -9.9, -9.9, -9.8, and -9.6 kcal/mol, respectively. At the attachment positions of five basil compounds, the interactions with ASN 180, LEU 181 and ALA 182 key amino acids, which are the attachment sites for the native ligands, were also formed.

Improving Skin Care Protocol Use in the Intensive Care Unit to Reduce Hospital-Acquired Pressure Injuries

Patients in the intensive care unit have the highest rate of hospital-acquired pressure injuries (HAPIs). In the United States, treatment of HAPIs costs an estimated $9.1 to $11.6 billion annually, with each occurrence adding an average of $10 708 to a patient's total hospital cost. In addition to their financial impact, pressure injuries negatively affect patients physically, socially, and psychologically and are associated with increased morbidity and mortality. An intensive care unit had 42 HAPIs during a single fiscal year, with 45% of them related to lack of adherence to the institution's established evidence-based skin care protocol. This project was conducted to increase adherence to the protocol and thus reduce the incidence of HAPIs in the unit. This quality improvement initiative featured an evidence-based multifaceted intervention to increase adherence to the skin care protocol. A review of medical records was used to determine general skin care protocol adherence and to measure the monthly incidence of HAPIs in the unit. The number of HAPIs in the unit decreased from 33 in the preintervention period to 11 in the postintervention period, a reduction of 67%. The rate of general skin care protocol adherence improved to as high as 76% by the end of the postintervention period. Use of an evidence-based multifaceted intervention can improve adherence to a skin care protocol in the intensive care unit, resulting in a reduced incidence of HAPIs and improved patient outcomes.

Lipid Nanoparticles Containing Mixtures of Antioxidants to Improve Skin Care and Cancer Prevention

Oxidative stress, triggered by UV radiation, is one of the major causes of free radical-associated disorders, such as skin cancer. The application of natural compounds (NCs) with antioxidant effects can attenuate free radicals’ accumulation and, therefore, provide a strategy for skin care and cancer prevention. In this work, three natural compounds, naringenin, nordihydroguaiaretic acid (NDGA), and kaempferol, were encapsulated into nanostructured lipid carriers (NLCs) aiming for the development of a formulation for cutaneous application with antioxidant properties. For the experiments, different formulation parameters were evaluated to optimize the NLCs that showed a diameter around 200 nm, which is an adequate particle size for incorporation in cosmetics. Transmission electron microscopy (TEM) analysis confirmed the NLCs’ typical spherical morphology. Encapsulation efficiency (EE) and loading capacity (LC) values revealed an effective production process, with EEs over 90% and LCs near the maximum value. The developed NLCs revealed a prolonged in vitro release of the natural compounds. The NLCs were stable under storage conditions, maintaining their psychochemical characteristics for 30 days. Additionally, they did not show any physical instability in accelerated stability studies, which also suggests long-term stability. Finally, the NCs antioxidant activity was evaluated. Interestingly, the NDGA and kaempferol mixture provided an antioxidant synergic effect. The NLC formulations’ cytotoxicity was tested in vitro in immortalized human keratinocytes (HaCaT). In addition, putative antioxidant effects of the developed NLC formulations against tert-butyl hydroperoxide (t-BHP)-induced oxidative stress were studied, and the NDGA-loaded NLC was revealed to be the one with the most protective effect. Therefore, we concluded that the naringenin, NDGA, and kaempferol incorporation into NLCs constitutes a promising strategy to increase their bioavailability and delivery to the skin.

Occupational Contact Dermatitis: An Individualized Approach to the Worker with Dermatitis.

Purpose of ReviewTo provide an up-to-date, customizable approach to the worker presenting with dermatitis.Recent FindingsOccupational contact dermatitis (OCD) is often a result of combined allergic, irritant, and endogenous factors. Potential causes of OCD can be categorized in 3 main groupings: workplace materials, personal protective equipment, and skin care. Although patterns of dermatitis may provide some indication of the etiological factor(s), patch testing remains essential in the diagnosis of allergic OCD. Management of OCD may require changes in workplace practices to reduce worker exposure to the causative agents and improve skin care practices.SummaryOCD is a multifaceted condition with significant consequences for affected workers and their families, employers, and insurers. A methodical and individualized approach to the patient with OCD should ensure timely and accurate diagnosis(es).

Trends in the use of marine ingredients in anti-aging cosmetics

The evolution in the skin care industry has been driven by the recent interest shown by consumers in novel bioactive compounds from natural sources, instead of synthetic ingredients, and fostered the efforts to develop biologically active ingredients from natural organisms, resulting in the emergence of new and improved skin care products. Although plant-derived extracts are usually among the main constituents of the cosmetic formulations containing natural ingredients, with the advance of the biotechnological field observed in the marine industry, an increase in the use of marine ingredients for this purpose has been noticed over the last years. In this study, the trends in the use of marine ingredients in a panel of anti-aging formulations commercialized in the Portuguese market was analysed, by comparing the composition of the products marketed in 2011 with products launched or reformulated in 2018. While in 2011, only 6% of the 190 anti-aging cosmetics was from marine origin, a noticeable growth was observed in 2018, where these ingredients were used in 33% of the new 103 studied anti-aging products. Algae were undoubtedly the most used marine ingredient in these anti-aging formulations, probably due to their biodiversity, easy cultivation, and growth modulation, with red algae being the most used in both of the analysed periods. On the other hand, the use of marine bacteria has suffered a decrease from 2011 to 2018. This study analyses the emerging use of marine ingredients in anti-aging products to provide researchers and the cosmetic industry a perspective of the trends in marine ingredients to develop new and improved formulations to fight the inevitable skin aging.

Effects of Oil/Moisture Changes after Using Herbal Peeling Therapy on Women in their 20s and 30s with Comedonal Acne Skin

Purpose: Nowadays, modern people are stressed both externally and internally, and as their lifestyle changes, their skin becomes more sensitive. Peeling reportedly results in fundamental improvements on the skin; it compensates for skin defects and makes the skin healthy. It is also used in aesthetics or in the hospital to manage signs of skin aging, such as wrinkles. This study aimed to present useful basic data for improving skin care by comparing and verifying oil and moisture changes. Here, we applied herbal peeling therapy to evaluate its effectiveness and development potential for skin improvement. Methods: This study examined 15 women in their 20s and 30s who had comedonal acne on the face to compare the oil and moisture changes to determine the efficacy of the peeling therapy in improving skin condition. Results: After the experiment, groups A and B demonstrated statistically significant increases in oil content (p =0.0369 and p =0.0438, respectively). However, only group A showed a statistically significant increase in moisture (p =0.009 vs. p =0.1569). Conclusion: Overall, peeling improved the comedonal acne of the subjects, except for some because of inability to control the side effects due to climate change. We look forward to conducting additional research to provide the beauty service industry with filling management without side effects.

Secondary prevention of hidradenitis suppurativa.

Hidradenitis suppurativa (HS) is a multifactorial disease with many facets of uncertain importance for optimal treatment and prevention. In order to explore options for secondary prevention in HS, we randomly and retrospectively selected 40 patients with HS that were analyzed on the basis of supposed trigger factors and proposed prevention measures. 67% of our HS patients were current smokers. They had started smoking on average 8 years prior to abscess formation. 35% complained of digestive problems and had tried different sorts of diet. We identified 2 cases of gluten-sensitive enteropathy, in which HS improved after introduction of gluten-free diet. In 7 further patients, introduction of low dairy/low carbohydrate diet considerably improved HS. 77.5% had never used any skin care in the intertriginous areas. Implementing secondary prevention by reducing irritation, avoiding shaving, improving skin care, performing laser epilation or applying fusidic acid/betamethasone cream led to an improvement in 62.5% of patients. We suggest a structured approach in daily practice in order to identify individual trigger factors. The crucial point for secondary prevention is the improvement of patient education.

Endermology treatment for breast cancer related lymphedema (ELOCS): Protocol for a phase II randomized controlled trial

ObjectivesSecondary lymphedema is a serious and debilitating condition, which may cause a range of cutaneous, infectious and joint complications with major psychological and social consequences. There is no curative treatment available. Initial symptomatic treatment includes Intensive Decongestive Treatment (IDT), which involves the use of multi-layered compression bandages, along with manual lymph drainage, physical exercise and skin care. IDT leads to an average decrease in limb volume of 20–40%, when compared to the contralateral limb. A better reduction may be obtained through the use of new adjuvant techniques, of which endermology is an example. The aim of this phase II study is to validate an IDT protocol combining endermology with standard of care in breast cancer related lymphedema. Study designA standardised care protocol was proposed by the University Hospital of Toulouse’s Lymphology team for the treatment of upper limb lymphedema after breast cancer surgery using Cellu M6 (LPG) Endermologie over 30 min. Every patient benefitted from IDT over 5 consecutive days, within the multidisciplinary Lymphology unit. Patients were randomised into three arms as follows: Arm 1: IDT for 5 days with bandages + manual lymphatic drainage. Arm 2: IDT with bandages + manual lymphatic drainage + Cellu M6 for 5 days. Arm 3: bandages + Cellu M6 for 5 days. During the study, patients will be followed-up for a period of 6 months.Use of LPG’s Cellu M6 in combination with IDT may improve upper limb volume reduction compared with standard of care. By improving breast cancer related lymphedema, we expect to minimise further fluid build-up and to improve skin care, thus reducing the number of consultations and hospital admissions caused by this condition. The results of the present research protocol are expected to promote evidence supporting the use of endermology in the field of lymphology.

Effectiveness of a skin care programme for the prevention of contact dermatitis in healthcare workers (the Healthy Hands Project): A single-centre, cluster randomized controlled trial.

BackgroundHealthcare workers (HCWs) are at risk of developing hand dermatitis (HD). Guidelines recommend moisturizers to prevent HD, but in practice their effectiveness has been poorly investigated.ObjectivesTo assess whether an intervention aimed at improving skin care leads to a reduction in HD severity.MethodsIn this 1‐year randomized controlled trial, 9 wards (285 HCWs) were allocated to an intervention group (IG), and 10 wards (216 HCWs) were allocated to the control group (CG). The intervention included provision of cream dispensers with electronic monitoring of use, regularly communicated to the HCWs. The primary and secondary outcomes were change from baseline in Hand Eczema Severity Index (HECSI) score (ΔHECSI) and change in natural moisturizing factor (NMF) level (ΔNMF).ResultsAt 12 months, the rates of loss to follow‐up were 41% and 39% in the IG and the CG, respectively. The HECSI score was reduced in the IG by −6.2 points (95%CI: −7.7 to −4.7) and in the CG by −4.2 points (95%CI: −6.0 to −2.4). There was no significant difference in ΔHECSI or ΔNMF between the groups. Relative improvement in the HECSI score was significantly higher in the IG than in the CG (56% vs 44%). In a subgroup of HCWs with mild HD, the IG showed a larger HECSI score decrease than the CG (P < 0.001).ConclusionAlthough there was no significant effect on the primary outcomes, the intervention showed overall positive effects on the HECSI score.

Evaluating the effect of electronic monitoring and feedback on hand cream use in healthcare workers: Healthy Hands Project.

BackgroundHealthcare workers (HCWs) are at high risk of developing hand dermatitis (HD). Current guidelines on HD prevention recommend the use of emollients; however, in practice, adherence is poor.ObjectiveTo assess whether the provision of creams, electronic monitoring and feedback on cream consumption can improve skin care in HCWs.MethodsA cluster randomized controlled trial was conducted on 19 academic hospital wards, including 501 HCWs, for 12 months. The intervention wards (n = 9; 285 HCWs) were provided with hand cream dispensers equipped with an electronic system to monitor use, which was regularly communicated to the HCWs by the use of posters. The process outcomes were self‐reported cream consumption in both groups, and electronically measured consumption per ward in the intervention group (IG) vs the control group (CG).ResultsSelf‐reported cream use at follow‐up was significantly higher in the IG than in the CG, before (odds ratio [OR] 2.27; 95%CI: 1.29‐3.97; P = 0.004) and during (OR 3.30; 95%CI: 1.80‐6.06, P < 0.001) the shift, whereas at baseline there was no difference between the groups. In the IG, electronically measured cream use was, on average, 0.4 events per shift per HCW.ConclusionThe intervention improved hand cream use, and may therefore be considered as a practical strategy to promote skin care in HCWs. Notwithstanding this, the application frequency remained lower than recommended in the present study and current guidelines.

Venipuncture-Induced Hematomas Alter Skin Barrier Function in the Elderly Patients.

We aimed to compare the barrier function of the skin site with the color of hematoma induced by venipuncture and the area surrounding the skin site to help improve skin care for hospitalized elderly patients. There were 50 patients with a median age of 84 years who were included in the analysis. There was no significant difference between the hematoma site-induced venipuncture and the area surrounding the hematoma site in terms of transepidermal water loss and skin sebum level. The status of stratum corneum hydration and skin elasticity on the hematoma sites was significantly lower than that on nonhematoma sites. The median skin pH was significantly higher on hematoma sites than that on nonhematoma sites. The study variables did not reveal any significant correlation with the intensity of skin erythema. These findings showed that hematoma formation in the subcutaneous tissue affected the skin barrier function and that these sites need moisturizing skin care regardless of the intensity of skin erythema.

Improving skin care through data: a pitch for patient safety incident reporting.

Improving skin care through data: a pitch for patient safety incident reporting.

Self-management interventions to improve skin care for pressure ulcer prevention in people with spinal cord injuries: a systematic review protocol.

BackgroundPressure ulcers are a serious, common, lifelong, and costly secondary complication of spinal cord injury (SCI). Community-dwelling people with a SCI can prevent them with appropriate skin care (i.e. pressure relieving activities, skin checks). Adherence to skin care remains suboptimal however, and self-management interventions that focus on improving this have been designed. Little is known on their content, effectiveness, or theoretical basis. The aim of the proposed systematic review is to synthesize the literature on self-management interventions to improve skin care in people with a SCI. Specific objectives are to describe these interventions in relation to their content, effectiveness, theory base, and adherence to reporting guidelines for intervention description.MethodsThe search strategy will combine an electronic search of nine bibliographic databases (MEDLINE, Embase, PsycInfo, CENTRAL, CINAHL, Rehabdata, CIRRIE, PEDro, ERIC) and two trial registers with a manual search of relevant reference lists. Predefined eligibility criteria will be applied in a two-phase selection process involving title and abstract screening, followed by full-text screening. A data extraction spreadsheet will be applied to included papers. Intervention content will be coded using two taxonomies (behaviour change taxonomy; PRISMS self-management support taxonomy). A validated tool (Theory Coding Scheme) and the Template for Intervention Description and Replication (TIDieR) will be used to examine theoretical basis and assess adherence to reporting guidelines for intervention description. A small number of heterogeneous studies are likely to be included in this review therefore a narrative synthesis is planned.DiscussionThis systematic review will help identify the gaps and priorities to guide future research activities in this area.Systematic review registrationPROSPERO CRD42016033191Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0323-4) contains supplementary material, which is available to authorized users.

Alcohol-Based Handrub Formulated Developed Specifically for High-use Environments Can Improve Key Skin Condition Measures While Maintaining Aesthetics and Antimicrobial Efficacy

Use of electronic-compliance-monitoring (ECM) systems has shown that hand-hygiene compliance (HHC) measured by visual observation is significantly overestimated. It is expected that as use of ECM becomes prevalent, there will be significant increases in compliance. As HHC increases, the trade-offs of skin care and aesthetics become apparent to the user, resulting in lower compliance. Traditional methods of increasing emollients to improve skin care often negatively impact aesthetics and efficacy. The objective is to formulate a product that is both aesthetically preferred and provides superior skin care even under high-use (100x/day). Test products were a standard alcohol-based handrub foam (ST-ABHR), one designed for high-frequency use (HF-ABHR), and a lotion control. A forearm-controlled application test was used to evaluate hydration, barrier function (TEWL), and redness. Test products were applied 20x and 100x over 8 hours for 5 days. Healthcare workers (HCW) evaluated aesthetics and antimicrobial efficacy was assessed using ASTM E1174. It was demonstrated that high-frequency use (100x/day) of a traditional ABHR resulted in a compromised skin barrier. It was also demonstrated that after 5 days of high use, skin hydration increased by 31%, barrier function improved by 24%, and skin redness reduced by 38% for HF-ABHR compared to ST-ABHR. Subjective evaluations by HCW showed HF-ABHR had equivalent aesthetics to ST-ABHR. Finally, efficacy of both ABHRs were at parity, meeting FDA requirements. Traditional products are likely not good enough to promote high levels of HHC without resulting in damaged skin. It is possible to formulate an ABHR that delivers superior skin care under high-use conditions, while maintaining aesthetics and antimicrobial efficacy. It is critical for an ABHR to deliver in these three areas to sustain increased compliance for improved efficacy. ABHRs designed for a high-compliance environment can enable HCW to practice better hand hygiene without tacky build-up or compromising skin condition.

Using evidence-based practice to prevent hospital-acquired pressure ulcers and promote wound healing.

A hospital and a nursing education program collaborate to improve skin care.

Comparing Multicomponent Interventions to Improve Skin Care Behaviors and Prevent Recurrence in Veterans Hospitalized for Severe Pressure Ulcers

ObjectiveTo compare a multicomponent motivational interviewing (MI)/self-management (SM) intervention with a multicomponent education intervention to improve skin-protective behaviors and prevent skin worsening in veterans with spinal cord injury (SCI) hospitalized for severe pressure ulcers (PrUs). DesignSingle-blinded, prospective, randomized controlled trial. SettingSix Veterans Affairs SCI centers. ParticipantsVeterans admitted for a severe (stage III/IV) PrU were followed up to 6 months postdischarge. InterventionTelephone-based individual MI counseling plus SM skills group (SM+MI; n=71) versus an active control group of telephone-based individual educational counseling plus group education (n=72). Main Outcome MeasuresSelf-reported skin-protective behaviors, objective skin worsening. ResultsIntention-to-treat analyses found nonsignificant increases in skin behaviors in the SM+MI versus education control intervention arms at 3 and 6 months. The difference in behaviors used between SM+MI and education control intervention participants was 4.6% (95% confidence interval [CI], −11.3 to 2.7) (0–3mo) and 3.0% (95% CI, –8.7 to 3.9) (0–6mo). High rates of skin worsening were observed (n=74, 51.7%), usually within 3 months postdischarge and most frequently within the month postdischarge. Skin worsening, skin-related visits, and readmissions did not differ by study arm. Study limitations are presented. ConclusionsFor persons with chronic SCI and severe PrUs, complicated by multiple comorbidities, a primary focus on improving patient behavior is likely insufficient to address the complex problem of PrUs in SCI. More health care systems–level changes such as collaborative care may be needed to reduce PrU recurrence, especially in this era in which many people are discharged from the hospital unhealed or with little sitting tolerance.

Hand hygiene compliance and irritant dermatitis: a juxtaposition of healthcare issues

Reduction and prevention of health care-associated infections is a worldwide priority with emphasis on increasing hand hygiene compliance. Repetitive exposure to hand hygiene products and procedures is a significant factor in the development of occupational irritant hand dermatitis. Compliance has been difficult to achieve often due to skin irritation. The introduction of alcohol hand rubs has positively influenced compliance but rates remain lower than required. Genetic and environmental factors to the frequency and severity of irritant contact dermatitis have been identified. Because of the skin's role in innate immunity, maintenance of epidermal integrity is a key strategy for reducing health care-associated infections. In this review, we examine the interdependence of the two issues and the challenges of simultaneously accomplishing both goals. We emphasize research conducted among healthcare workers in their clinical settings. The factors that influence skin integrity and the challenges in meeting both goals simultaneously are explored. Cosmetic scientists have played key roles in the development of improved skin care products, and the issues present an excellent opportunity for them to provide potentially life-saving contributions to health care.

The spectrum of skin diseases in a rural setting in Cameroon (sub-Saharan Africa)

BackgroundSkin disorders are generally considered to be more prevalent in the rural areas of Cameroon. This study was carried out to verify this assumption by describing the spectrum of skin disorders in a rural setting of Cameroon.MethodsWe carried out a community-based clinical skin examination of 400 consenting subjects from 4 villages of Cameroon: Nyamanga (27%), Yebekolo (24%), Mbangassina (23%) and Bilomo (26%).ResultsThe overall prevalence of skin diseases in our sample was 62% {95% CI: 57.2%, 66.8%} (248/400). The commonest skin disorders were: fungal infections (25.4%), parasitic infestations (21.4%), atrophic skin disorders (11.7%), hypertrophic skin disorders (9.7%), disorders of skin appendages {acne} (8.9%), benign neoplasm (6.5%), bacterial skin infections (5.2%), pigmentation disorders (4.8%), and dermatitis/eczema (4.0%). Skin infections and infestations constituted 52.82% of all skin disorders. The overall prevalence of infectious and parasitic infestation was 32.75% {95%CI: 28.17%, 37.59%} (131/400) as against 29.25% {95%CI: 24.83%, 33.98%} (117/400) for non-infectious disorders.Among people with skin infections/parasitic infestations, those with fungal infections and onchocercal skin lesions were the most prevalent, accounting for 48.1% (63/131) and 35.1% (46/131); and an overall prevalence of 15.75% {95%CI: 12.3%, 19.7%} (63/400) and 11.5% {95%CI: 8.5%, 15.0%} (46/400) respectively.There was secondary bacterial infection in 12.1% {95%CI: 8.31%, 16.82%} (30/248) of subjects with skin diseases. Hypertrophic and atrophic disorders of the skin were mainly keloids (9.68%), scarification marks (6.05%) and burn scars (5.65%). Skin diseases like dermatitis and eczema (4.03%), malignant tumours and pigmentation disorders were rare in our sample.The proportion of subjects diagnosed with skin disorders after examination (62.8%) was significantly higher than the proportion of 40.8% that declared having skin diseases (p < 0.0001).ConclusionThe prevalence of skin diseases in the rural Mbam valley is alarming, dominated by easily treatable or preventable skin infections and their magnitude is highly neglected by the community, contrasting with findings in the urban setting. Similar studies are needed in other ecological/demographic settings of the country in order to construct a better understanding of the epidemiology of skin disorders. This would lead to the development of national policies to improve skin care.

Collaboration with traditional health practitioners in the provision of skin care for all in Africa

The Task force for Skin Care for All: Community Dermatology seeks to meet WHO objectives, to draw attention to the role of Traditional Health Practitioners and to develop integrated skin care. In many African countries patients will first use traditional medicine to treat skin diseases. Many traditional practices are beneficial but some are harmful. The Task Force recommends education of traditional and modern health practitioners to improve collaboration, safety and efficacy. Thereby, it aims to improve skin care and to reinforce the best practices.