This Ask the Expert article provides evidence-informed responses to common questions raised by people living with, or at risk for, lymphedema. Drawing on the combined clinical and research expertise of members of the Pathways Editorial Board, the article addresses practical topics related to long-term lymphedema management. Questions include effective strategies to support lymphatic flow, prevention of skin hardening and discoloration, distinguishing lymphedema from lipedema, sources of information about lymphatic surgery for lower-limb lymphedema, and the use of toe caps with night-time compression. The responses emphasize the central role of compression, exercise, movement, skin care, and individualized assessment in managing swelling and reducing complications. The article also explains the importance of medical evaluation for leg swelling, the limited but evolving evidence base for lymphatic surgery, and the need for careful consideration of arterial supply, skin integrity, and donning ability when considering toe compression. Written in an accessible question-and-answer format, the article supports patient education while reinforcing evidence-based and clinically grounded approaches to lymphedema care.

Women bear the brunt of human rights violations faced by persons with albinism, especially in sub-Saharan Africa. In addition to insufficient access to skin and eye care, increased rates of skin cancer, stigma and discrimination, and threats of mutilation and murder as they are reportedly trafficked for economic gain, they face heightened gender-based violence linked to misbeliefs about albinism. This study explored through a human rights lens the resilience of mothers affected by albinism, at the intersection of gender, colorism, and religion in Tanzania and South Africa. The critical ethnography involved participant observation, interviews, and sharing circles with 97 participants, including mothers and key informants such as albinism advocates, health and social workers, community leaders, and policy makers. In Tanzania, we conducted fieldwork in Mwanza and Dar es Salaam; in South Africa, in the provinces of Northern Cape and Gauteng. We present a comparative analysis of the two countries. The study shows that critical resilience comes about through social relationships, collective practices, and identities present in communities (local and national). We identified six promising practices that created conditions to strengthen gender equity: In Tanzania, peer support groups build capacity as human rights defenders; international non-governmental organizations (NGOs) fill gaps and advocate; and faith leaders act as advocates. In South Africa, progressive health system and policy frameworks, genetic counseling and health education equip families, and traditional healers act as advocates. The promising practices distilled from the Tanzanian and South African cases should be considered for broader uptake, importantly with local adaptations.

Cutaneous disease is a central component of psoriatic arthritis (PsA), contributing substantially to patient disease burden and influencing therapeutic choices. Beyond plaque psoriasis, specific phenotypes, including nail, scalp, palmoplantar, and inverse involvement, are relatively common in PsA and are frequently associated with greater functional limitation, impaired quality of life, and discordant responses to systemic therapy. Accurate identification of these manifestations is critical for diagnosis, risk stratification, and treatment optimization. This review provides a clinically oriented overview of the dermatologic spectrum of PsA, outlining epidemiology, pathogenic mechanisms linking the skin-joint axis, and the impact of skin disease on outcomes. We summarize evidence for topical therapies, conventional systemic agents, biologics targeting tumour necrosis factor alpha (TNFα), interleukin-17 (IL-17), and interleukin-23 (IL-23), targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs), and emerging treatments, with attention to phenotype-specific considerations and multidisciplinary management. The implications of persistent skin activity in complex-to-manage PsA are also discussed. A domain-based, integrated approach to skin and joint care is required to achieve effective control both of musculoskeletal and cutaneous symptoms. Systematic evaluation and treatment of skin involvement should be considered a core component of PsA management rather than an ancillary concern.

Skin aging, pigmentation disorders and skin barrier dysfunction are strongly associated with oxidative stress, chronic inflammation and extracellular matrix degradation. In this context, plant sprouts have gained popularity as a rich source of bioactive compounds and are becoming promising candidates for dermatological applications. The aim of this review was to summarize current scientific research on the potential of sprout extracts in skin care and to identify the biological mechanisms underlying their dermatological activity. A comprehensive literature search was conducted in Medline, Scopus, and Google Scholar databases up to February 2026. Studies assessing the effects of topical sprout extracts on skin structure, inflammation, pigmentation, and hair growth were included. A total of 31 studies met the inclusion criteria and were subjected to qualitative analysis. Available evidence indicates that sprout extracts have multifaceted effects relevant to skin health, including stimulation of collagen synthesis, inhibition of matrix metalloproteinases, improvement of epidermal hydration, melanogenesis, and suppression of inflammatory signaling pathways. These effects are largely attributed to bioactive compounds such as phenolic acids, flavonoids, isothiocyanates, and other antioxidant phytochemicals, which exhibit antioxidant, anti-inflammatory, and anti-aging properties. Preliminary clinical studies suggest that ingredients derived from sprouts may improve skin elasticity, hydration, and photoprotection. Although most of the evidence comes from in vitro and animal studies, it preliminarily supports the emerging concept of “food for skin” and highlights the potential of sprouted plant materials as multifunctional ingredients in dermatology.

This study addresses the need to detect the severity of acne in skin care and beauty, particularly in managing the diagnosis of acne severity more efficiently and objectively. Acne, a common skin problem, can significantly affect an individual's quality of life and self-confidence. Referring to the prevalence of acne, this study leverages advancements in Deep Learning and Convolutional Neural Networks (CNN) to design a classification model capable of identifying the severity of acne in facial images using the RGB color scheme. CNN is an artificial neural network architecture that can process image data efficiently and accurately. CNN can extract essential features from acne images, such as color, texture, and shape, and classify the severity of acne into four categories: level 0, level 1, level 2, and level 3. The simple application of the model not only provides an efficient solution for acne diagnosis but also has the potential to improve consistency and objectivity in healthcare services. By incorporating transfer learning and color schemes (RGB), the testing results show that the model successfully classifies the severity of acne with an accuracy of 86.89%. Thus, this research contributes to technical and technological advancements and has the potential to positively impact the overall quality of facial skin care services, marking a significant first step in improving facial skin care services.

Numerous preventive measures for occupational contact dermatitis (OCD) have been evaluated, but their effectiveness varies, suggesting that contextual factors and corresponding implementation strategies are important. This scoping review aimed to identify preventive interventions for OCD and explore their implementation strategies and outcomes. We searched five databases (January 2000-May 2024) for studies on preventive interventions, scoping intervention content and implementation strategies. In total, 111 articles describing 79 interventions were included, which involved components of education, personal protective equipment, skin care, workplace adaptations and combinations. Most studies were conducted among healthcare workers, hairdressers or in mixed occupations. Implementation strategies targeted individual workers with educational sessions, individual advice or consults, organisations with participatory working groups, role models or communication tools, and facilitated clinical dermatological care. Implementation outcomes were reported for 11 programs. All reported appropriateness and 10 reported acceptability to be positive. Adoption, feasibility, fidelity (adherence), costs, penetration (reach)and sustainability of preventive intervention implementation were assessed in a limited number of programs. Overall, limited evidence precluded firm conclusions on implementation outcomes. To strengthen prevention, systematic evaluation of implementation outcomes is needed.

Nurses' adherence, barriers, and facilitators to evidence-based pressure injury prevention practice in pediatric critical care units: A cross-sectional study.

Pressure injuries remain a significant and costly complication among long-term bedridden adult and older adult patients, leading to increased morbidity, complications, and a diminished quality of life. This review aimed to summarize interventions for the prevention and care of pressure ulcers among long-term bedridden adult and older adult patients in the community. Fourteen databases were searched from March 2013 to March 2024, yielding 16 studies for final analysis. Two interconnected core elements were identified: 1) multidimensional intervention pathways and 2) three targeted preventive measures. The pathways include face-to-face education/training, home visits, digital tools (WeChat/smartphone apps), multidisciplinary collaboration, and remote follow-up. The targeted measures-position management with pressure-relief techniques, skin integrity maintenance, and nutritional/fluid support-were associated with improvements in PU-related outcomes: combined repositioning and pressure-relief devices were associated with lower PU incidence, temperature-controlled skin care with zinc oxide was associated with reduced skin redness, high-protein diets and omega-3 supplements were associated with improved skin resilience and barrier function, and integrated protocols (Braden-stratified repositioning/app monitoring) may improve care efficiency. Limitations included heterogeneity in study designs and outcome measures, incomplete reporting of implementation details, and limited geographical representation, as most were conducted in China (14/16), with only one study each from Finland and India. The certainty of evidence ranged from very low to moderate across outcomes; therefore, the findings should be interpreted cautiously. This review highlights potentially adaptable strategies for community-based PU prevention and care. It underscores the need for standardized, long-term studies to enhance the generalizability and sustainability of intervention strategies. Prospero Registration Number: CRD42024524789.

Beta vulgaris-derived exosome-like nanovesicles mitigate photoaging by attenuating oxidative stress and promoting collagen biosynthesis.

Biotechnology has significantly impacted the cosmetics industry, particularly through the incorporation of plant stem cells, which possess regenerative properties beneficial for skincare. This review aims to evaluate the potential benefits and challenges of using plant stem cells in cosmetics, while discussing future directions for their application in skin care products. The review synthesizes existing literature on the regenerative capabilities of plant stem cells, their role in combating aging, promoting skin repair, and providing protection against ultraviolet damage. It also examines biotechnological methods such as plant cell cultures that mitigate issues associated with raw plant materials. Plant stem cells demonstrate self-renewal and differentiation capabilities, crucial for tissue regeneration and skin healing. Despite their advantages, the cosmetic industry faces hurdles including inconsistent terminology, regulatory challenges, high production costs, and the prevalence of marketing strategies lacking clinical validation. While plant stem cell technology offers promising advancements in skincare, the cosmetic industry must address regulatory and validation concerns to ensure consumer safety and product efficacy. Future research should focus on establishing standardized practices and clinical trials to substantiate the claims of stem cell-based products in cosmetics.

Skin care is increasingly recognized as a key element of appearance management that contributes to social relationships and self-evaluation, and it plays an important role in forming a healthy and positive image. With growing consumer interest in skin-care products such as functional cosmetics, inner beauty products, and home-care devices, it is necessary to systematically understand individuals’ interest in skin care and their product selection tendencies. College students, in particular, represent a major consumer group with high interest in appearance and skin care, often using skin care to enhance self-confidence and create favorable impressions. Accordingly, this study applied the DISC framework, which classifies behavioral characteristics into Dominance, Influence, Steadiness, and Conscientiousness, to examine the effects of DISC behavioral types on interest in skin care and skin-care product consumption tendencies. An online survey was conducted with college students living in Gwangju and Jeonnam, Korea, from April 8 to May 24, 2025, and a total of 348 responses were analyzed. Skin care interest differed significantly by gender, year in school, monthly allowance, monthly expenditure on skin/body care, interest in beauty information on SNS, and SNS-related purchase experience, while differences by major were not significant. Correlation analysis showed significant positive associations among DISC types, skin care interest, and consumption tendencies. Regression analyses indicated that Dominance, Steadiness, and Influence had significant positive effects on overall interest in skin care. Regarding consumption tendencies, Steadiness, Dominance, and Influence significantly predicted rational consumption; Influence predicted image-seeking tendency; Dominance, Influence, and Steadiness predicted brand-seeking tendency; and Influence and Dominance predicted trend-seeking tendency. Overall, the findings suggest that Dominance and Influence tend to perceive skin care as necessary and actively connect this perception to practice and product purchasing, whereas Steadiness and Conscientiousness show relatively stronger rational decision-making based on ingredients, evidence of effectiveness, and value for money rather than trends. These results support the significance of DISC behavioral types as psychological and behavioral factors explaining skin care behaviors and consumption tendencies among college students and provide practical implications for developing DISC-based skin care programs and tailored marketing strategies.

The skin is the largest epithelial organ and a critical barrier. However, in preterm infants, particularly very low birth weight infants (VLBWI, < 1500g), it is immature and highly susceptible to injury and infection. Despite growing awareness of neonatal skin care, evidence-based guidelines for this vulnerable population are lacking. This study aimed to provide an overview of current skin care practices in German Neonatal Intensive Care units (NICUs) and compare them with other European centers. A cross-sectional, web-based survey was distributed to German level III NICUs (n = 70) and selected European centers (n = 10) in May 2025. The questionnaire comprised 20 items covering skin risk assessment and skin care routines, bathing, skin antisepsis, and perceived challenges. Responses were analyzed descriptively. The overall response rate was 73.8% (n = 59). Responses were analyzed from 48 German NICUs and eight European centers. Among German centers, only 14.6% (n = 7) reported applying skin risk assessment tools, and 16.7% (n = 8) reported standardized skin care protocols. A dexpanthenol-containing cream was the most commonly used skin care product. Use of other products varied greatly, while 39.6% of German centers (n = 19) reported using no skin care products at all. Bathing was practiced in 77.1% of NICUs (n = 37), with frequency and use of additives varying. Octenidine 0.1% and its combinations were the main products for skin antisepsis. Major challenges perceived by neonatologists included high skin vulnerability (87.5%), issues with adhesives (72.9%), risk of infection (64.5%), and limited or unclear evidence in skin care of VLBWI (54.2%). Criteria for product selection included clinical evidence (60.4%), practical experience (60.4%), and hygiene regulations (54.2%). Comparison with reports from the other European countries revealed both notable similarities and considerable variations in practices across the international context. Skin care practices for VLBWI in German and European NICUs vary widely, with limited use of standardized protocols or risk assessment tools. High skin vulnerability, issues with adhesives and infection risk remain the main challenges. These findings underscore the urgent need for evidence-based guidelines to optimize skin care in this high-risk population.

Various factors such as infections, wounds, and comorbidities can disrupt the skin's physiological function. Moreover, skin lesions can result from radiation therapy. We aimed to create a new cosmetic formulation with pro-regenerative properties that is specifically designed for patients with sustained skin damage, such as those who have undergone radiation therapy. In the first stage, NE1 and IM2 peptides were synthesized, and hydrogels were prepared. IM2 is a derivative of the IM peptide, while NE1 contains the bioactive GHK sequence. In the next stage physicochemical analyses were conducted, including the evaluation of peptide stability and the developed composition's microbial purity and packaging compatibility. In addition, in vitro safety and activity assessments were implemented on human skin cells.In the final step, dermatological tests were conducted on the participants. The results indicate that the cosmetic composition is stable, possesses preservative properties, and is safe in both in vitro and in vivo studies. Peptide release studies show that within the first hours, approximately 75-80% of each peptide is released, ensuring a rapid onset of action. Analysis of cell migration indicate that both p407 and the designed composition stimulate migration of HaCaT keratinocytes in vitro. Dermatological tests did not show any irritant and sensitizing properties. Application analyses revealed that the designed composition effectively moisturizes and takes care of sensitive skin, alleviates redness and the effects of rough skin, eliminates the sensation of itching and the effects of skin tension, and soothes irritation. This formulation can be used for the daily care of sensitive, allergic, or irritated skin.

Breast cancer-related lymphedema is the most prevalent postoperative complication among breast cancer survivors. Although mobile health tools are increasingly used for patient education, evidence supporting their efficacy in lymphedema prevention remains limited. This study aimed to evaluate the effectiveness of a WeChat-based intervention grounded in the common-sense model (CSM) in improving preventive behaviors, modifying illness perceptions, and reducing lymphedema incidence among breast cancer survivors and to validate the targets of the intervention. This study used a quasi-experimental design. Participants (N=192) were recruited from the breast cancer department of a cancer hospital in Guangzhou, China. The control group (n=98) received routine care. The intervention group (n=94) participated in a 3-month CSM-guided WeChat mini-program ("Nantian e-Care") delivering tailored educational articles, exercise tutorials, arm circumference monitoring, and real-time nurse consultations. Outcomes, including preventive behaviors, illness perceptions, and lymphedema incidence, were assessed 1, 3, and 6 months post surgery. Generalized estimating equations were used for the analysis. The intervention group exhibited significant improvements in lifestyle adjustments (Wald χ22=6.9, P=.03) and physical exercise adherence (Wald χ22=6.9, P=.03) compared with the control group. Illness perception, including identity (Wald χ23=8.1, P=.04), timeline cyclical (Wald χ23=8.5, P=.04), personal control (Wald χ23=9.3, P=.03), illness coherence (Wald χ23=29.8, P<.001), and behavioral (Wald χ23=19.5, P<.001) and physical factors (Wald χ23=24.1, P<.001) were markedly enhanced. Mechanistically, skin care improvements were driven by intervention effects, personal control, illness coherence, and behavioral attribution. Lifestyle changes were correlated with intervention and illness coherence. Adherence to physical exercise was not statistically significantly affected by the intervention, although a trend was observed. Critically, the intervention group demonstrated a lower incidence of lymphedema at 6 months (7.50% vs 16.48%, χ21=3.9, P=.048). The CSM-guided WeChat intervention effectively promoted preventive behaviors, optimized illness perceptions, and reduced lymphedema risk. These findings underscore the value of integrating theory-driven mobile health tools into postoperative care and highlight scalable strategies for chronic disease management in resource-limited settings.

Nitric oxide-releasing responsive biomaterials for antimicrobial skin therapy.

Sustainable sourcing of bioactive ingredients is an important direction in the development of topical formulations. Fruit by-products generated during food processing such as apple pomace, represent a promising resource for skincare applications. The aim of this study was to evaluate the safety, effectiveness, and consumer perception of a three-step facial skincare regimen consisting of a cleansing gel, serum, and face cream containing upcycled apple pomace extract. Unlike most cosmetic studies focusing on single products, this research assessed a complete skincare routine to better reflect real-life usage conditions. All formulations underwent dermatological safety evaluation prior to the in vivo study. The clinical assessment was conducted on 30 healthy female volunteers aged 25–55 years. Skin hydration, pH, transepidermal water loss, sebum level, and skin gloss were measured on untreated skin, after the first use, and after four weeks. User perception was assessed using a questionnaire completed by 58 participants. Short-term changes in skin parameters were observed after application, while four weeks of use maintained them within physiological ranges. Skin gloss increased significantly by 4.2%, and no adverse reactions were reported. These results indicate that the tested skincare regimen containing apple pomace extract was well-tolerated and cosmetically acceptable under the study conditions.

Kumkumadi Taila is a classical Ayurvedic facial oil traditionally used in primary care as a routine preventive skincare product to enhance the complexion; however, clinical instrument-based data and detailed chemical profiling remain scarce. In this single-arm 15-day exploratory study, 30 healthy adults with Fitzpatrick skin types III-IV applied Kumkumadi Taila once daily to the face using a standardized massage and wash-off procedure, while biophysical skin parameters and safety were monitored at baseline, Day 7, and Day 15 with an integrated DermaLab Combo® device. Facial melanin index, erythema index, hydration, and elasticity showed statistically significant changes over time, whereas transepidermal water loss and skin thickness did not. This indicates short-term cosmetic improvement without detectable disruption of barrier integrity. Parallel UPLC-MS/MS QTOF analysis of the oil identified multiple bioactive phytochemicals, including safranal, berberine, palmatine, liquiritin, nuciferine, rubiadine, retinol, sesamin, and aliuretic acid, which are consistent with antioxidant, anti-inflammatory, and pigmentation-modulating actions reported in the literature. No adverse events were reported during the study. The results were statistically significant (p < 0.05), indicating that the data deviates from a normal distribution and is skewed. Overall, Melanin and Erythema Index decreased significantly, indicating improved pigmentation and reduced redness. Skin elasticity declined over time, while skin hydration fluctuated. TEWL and skin thickness remained stable throughout the study. In this exploratory proof-of-concept assessment, short-term application of Kumkumadi Taila was associated with changes in selected facial skin biophysical parameters over 15 days. The study supports its potential as a safe and accessible primary care intervention in the form of a routine preventive skincare product, and its findings highlight the relevance of traditional Ayurvedic topical formulations in routine skin care. The study also demonstrates a practical framework for evaluating non-invasive skin metrics and phytochemicals, serving as a proof of concept.

Background: A structural gap persists between foundational nursing education and the rapidly evolving technological landscape of clinical incontinence care in Japan. Increasing product differentiation requires healthcare professionals to exercise situational product selection, while undergraduate curricula often lag behind technological innovation. In addition, the diversification of the healthcare workforce introduces further complexity in interpreting locally optimized product logic. This report describes the development and evaluation of an academia&amp;ndash;industry collaborative recurrent education program designed to address these structural challenges. Methods: The program was co-developed by university faculty and an industry product development team. Theoretical sessions addressed skin pH dynamics, barrier protection mechanisms, and cleansing principles relevant to incontinence-associated dermatitis. Practical sessions incorporated visualization-based comparative demonstrations, in which simulated stool and urine were simultaneously applied to different absorbent products to externalize structural differences in absorption patterns and surface moisture conditions. The program was delivered in two separate in-person sessions at different venues in Niigata, Japan, in March 2025, with a total of 34 nursing and caregiving professionals participating across both sites, including one foreign care worker. Results: Among respondents (n = 25), 88% reported acquisition of new knowledge and 92% recognized practical applicability. Qualitative feedback emphasized the value of hands-on visualization and expressed intentions to disseminate updated knowledge within clinical workplaces. Conclusions: Academia&amp;ndash;industry collaborative recurrent education may function as an adaptive interface between foundational curricula and accelerating clinical innovation. Beyond individual skill acquisition, such programs have the potential to support shared clinical reasoning across diverse professionals and contribute to regional healthcare quality assurance in technologically advancing care systems.

Staphylococcus aureus is a major skin pathogen that causes a broad spectrum of infections, ranging from mild skin infections to severe invasive diseases. In this study, we evaluated antibacterial and antivirulence properties of selected FDA-approved skincare bioactives and antiseptics against multiple virulence factors. Minimum inhibitory concentration analysis of benzalkonium chloride, retinol, hydroquinone, and kojic acid showed strong antimicrobial activity at concentrations from 2 to 1024µg/mL. Epigallocatechin gallate effectively inhibits biofilm formation by 81.53% and reduces staphyloxanthin production by 68.26%. Retinol exhibited antibiofilm activity, eradicating mature biofilm mass by 79.18%. Furthermore, a combination of skincare bioactives with antibiotics, including oxacillin, ciprofloxacin, tetracycline, and rifampicin, demonstrated synergy and additive effects, enhancing antibacterial efficacy. Molecular docking analysis exhibited strong predicted binding affinities of skincare bioactives and antiseptics against key virulence factors. This study highlights the multitarget antivirulence potential of skincare bioactives and antiseptics as an alternative strategy to mitigate diverse S. aureus infections.

Background: Acute radiation-induced skin injury (aRISI) is one of the most frequent adverse effects of radiotherapy (RT) in patients with head and neck cancer (HNC) and may compromise treatment delivery and quality of life. Topical glucocorticosteroids (GCS) are commonly used in clinical practice for aRISI management; however, evidence supporting their proactive use remains inconsistent. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of proactive topical GCS therapy during RT for HNC. Methods: A systematic search of PubMed, Embase, and the Cochrane Library was conducted from database inception to July 2025 in accordance with PRISMA 2020 guidelines. Randomized controlled trials comparing topical GCS with placebo or standard skin care in adult patients undergoing curative RT or RChT for HNC were included. The primary outcomes were incidence of clinically significant aRISI (grade ≥ 2) and severe aRISI (grade ≥ 3), assessed using validated grading systems (RTOG or CTCAE). Random-effects meta-analyses were performed to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane RoB 2 tool. Results: Three randomized controlled trials comprising 459 patients were included. Proactive topical GCS did not significantly reduce the pooled incidence of grade ≥ 2 aRISI compared with placebo or standard skin care (RR 0.87, 95% CI 0.60-1.27). Similarly, no statistically significant reduction in grade ≥ 3 aRISI was observed in pooled analysis (RR 0.81, 95% CI 0.22-3.06). Qualitative synthesis of secondary outcomes reported in individual trials suggested potential benefits of topical GCS, including delayed onset or slower progression of aRISI, and, in one large double-blind study, a reduced risk of severe reactions. No increase in treatment-related adverse events was observed in any included trial. Conclusions: Proactive topical GCS do not significantly reduce the overall incidence of aRISI in pooled analysis. Individual studies showed trend towards delayed onset, slower progression, and reduced severe aRISI without compromising safety. These findings support the judicious use of topical GCS as part of proactive supportive care in HNC RT, while highlighting the need for larger, standardized trials to define optimal regimens and patient selection.