Assessment of skin condition
Last reviewed: 23.04.2024
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Diagnosis of diseases of the skin and its appendages, as well as various cosmetic deficiencies, is based on the study of anamnesis, careful examination of the skin and visible mucous membranes, and, if it is shown, on the results of additional clinical, instrumental and laboratory studies. The leading role in the diagnosis is played by examination of the unaffected and affected skin. Inspection should be conducted in a warm, well-lit room. For examination of the skin in dermatocosmetology, a magnifying glass is traditionally used.
When analyzing the condition of unaffected skin, attention is drawn to its color, pattern, turgor, elasticity, moisture and the severity of the sebum. As well as on the condition of the hair and nails.
Evaluation of skin color provides an opportunity to get an idea of the state of its vessels and blood supply, as well as the pigment-forming function. Normal skin has a matte shade and a peculiar color, depending mainly on the transmission through it of blood in the vessels and the pigment of melanin. When assessing the age-related changes in the skin, it should be borne in mind that photo-aging is characterized by a slightly yellowish skin tone in areas prone to chronic insolation.
The degree of moisture and greasiness of the skin reflects the functional state of the sweat and sebaceous glands, and the pattern, turgor and elasticity are the state of connective tissue and the severity of transepidermalous water loss. Based on the combined evaluation of these parameters, the type of skin is determined (normal, dry, oily, combined). To assess the severity of fat release a fat test is used. It is performed no less than 2 hours after thorough cleansing of the skin. Apply cigarette or blotting paper, with a sheet of paper consistently pressed against the skin of the forehead, nose, chin, and then - to the left and right cheeks. If the paper is left without greasy stains, the test is considered negative, and if there are oily stains, the test is positive. When testing the condition of the skin turgor, a number of samples are used (skin folding, or skin fold test, rotational compression test, etc.). To determine the elasticity, the skin is pulled into the fold and released, while fixing the speed of its return to normal.
Assessing the condition of the hair, pay attention to the type of their growth (male and female type), quantity, strength. Hair growth by the male type The woman, as well as the weak expression of hair growth according to the male type in the man, testify to the presence of endocrine disorders. In cosmetology, women often encounter hirsutism combined with acne, age-related skin changes and other conditions and diseases. You should pay attention to the increased growth of pigmented hair on the upper lip, chin, in the periareolar area, as well as on the abdomen below the navel.
The condition of nail plates is evaluated by their shape, surface condition, color, thickness, strength. Normally they are smooth, shiny and have a uniform pink coloration.
To assess the condition of the oral mucosa, you should examine it in the area of the lips, cheeks, soft and hard palate, tongue, throat.
When examining the skin, evaluation of cutaneous vegetative reflexes (dermographism, muscular-hair reflex) is used.
Dermographism is a reaction of the neuromuscular system of the skin to mechanical irritation and is white (with spasm of blood vessels), red (with vasodilation) and mixed. It is known that for certain dermatoses a certain dermographism is characteristic (for example, white dermographism - for atonic dermatitis).
Musculo-hair, or pilomotor, reflex is caused by carrying out on the skin with a spatula or local cooling it. In response to this irritation, ephemeral follicular nodules ("goosebumps") appear,
The nature of dermographism and the severity of the pilomotor reflex allow one to indirectly judge the prevalence of sympathetic or parasympathetic parts of the nervous system.
Disturbances of skin sensitivity, if necessary, are determined by samples for temperature, tactile and pain sensitivity.
In addition to assessing the condition of the skin, its appendages and mucous membranes, it is important to consistently assess the size, consistency, mobility, sensitivity of all available palpation of the subcutaneous peripheral lymph nodes.
A feature of the description of dermatocosmetological status is the characteristic of not only all of the above parameters, but also signs of age-related skin changes.