of the most important substances the skin produces, which also makes it such a resilient organ, is a compound known as sebum. This compound is produced in the sebaceous glands of the skin and it is an oily material due to the fact that it contributes the majority of lipids to the surface of the skin. These lipids are fat molecules that help to keep the skin hydrated and healthy. When the production of this compound is too much, an oily skin results and when it is too little, a dry skin is the result.
Often, people find the need to seek a healthcare expert’s opinion when there has been failure of improvement following the use of various over-the-counter medications, creams and lotions. In the main, the use of such compounds is most fuelled by the suggestion of friends and peers and not by trained professionals. People may find the need to visit a doctor for examination and advice when they develop recurring skin infections or develop excessive dryness, redness and itchiness of the skin as a whole or in part. This is also the case when people sustain tears and bleeding in patches of the skin that are excessively dry. Having persistent and numerous pimples is another reason for people to visit the doctor and it is important to understand that most of these patients are women, both young and old. Lastly, there are the infected pimples that cause so much emotional and physical discomfort, being the reason some people go to a doctor.
In summary, to have too much sebum being produced can cause skin problems just as to have too little can similarly be harmful. Too much production of this substance will cause oily skin and the development of acne, a topic we have previously discussed on this page. Underproduction of this compound can similarly lead to the development of dry skin that can become flaky or scaly and itchy. The face, scalp and chest have the largest concentration of sebaceous glands in the body. Each area of skin can have as many as 900 of these glands per square centimetre. The sebum produced in these glands then travels along the follicular ducts which connect these glands to the hair follicle where the growing hair pulls the sebum onto the surface of the skin.
The production of sebum is regulated strongly by changing hormone levels. Therefore, testosterone in males plays this crucial role and the level of production will fluctuate depending on the quantity of testosterone being produced. Generally, sebum production surges to a peak soon after birth and reduces sharply during the first week of life. During puberty, there is a surge of testosterone in the body which is responsible for the increased production and secretion of sebum. Both the circulating level of testosterone and the production rate of sebum decline with advancing age. Females who generally produce only small amounts of testosterone traditionally have a more even level of production of this substance. You can obtain an index of this rate of production by judging how quickly your hair or finger nails grow back after they were cut.
Sebum contributes about 90 per cent of the lipids that are found on the skin’s surface. These lipids help to retain moisture and keep the skin supple. They also help protect the skin from damage due to ultraviolet radiation. It also contains sapienic acid which is important in the combat of the skin against Staphylococcus aureus, the most commonly found bacteria living on the skin. By acting out this protective role, sapienic acid helps to prevent infections caused by Staph aureus and certain types of dermatitis. Many components of sebum, including its fatty acid components and another substance called squalene have anti-inflammatory properties that further help to protect the skin. Sebum also transports some fat-soluble antioxidants to the surface of the skin where it may contribute to the prevention of skin damage arising from oxidation. Antioxidants are natural compounds that protect the skin from being damaged by free radicals. Lastly, one other health benefit of this compound is that it is slightly acidic and this property helps it to protect the skin from penetration by harmful bacteria and viruses. However, in either situation of overproduction or underproduction of this substance, there are consequences for the individual. Too much production can lead to the formation of oily skin and such people will notice that their pores appear to be larger than usual but more commonly, that their skin always appears to be greasy or shiny.
Such excessive production can lead to the formation of plugs within the pores when the sticky sebum combines with dead skin cells and cause the formation of pimples and blackheads. Since such pores can also trap bacteria within them, it follows that the bacteria can cause skin inflammation and local infections. When the blocked pores rupture, bacteria, dead cells and sebum get to be spilled into surrounding tissues and cause acne and pain. This is the general reason for the use of antibiotics at this stage of treating these lesions. More often, however, people can control some of these effects by deploying an effective skin care routine which will include the deployment of products that contain salicylic acid; benzoyl peroxide; beta-hydroxy acid and glycolic acid. The most profound recommendation for people with such oily skin is basically that they avoid the use of any oil-based or alcohol-based skin cleaners because these can further irritate the skin and cause even more oil production. Very profoundly, while beauty parlours all over the country claim to understand some of these facts, the truth remains that doctors are often constrained to treat these lesions with a variety of medications which often include hormone therapy, corticosteroids, retinoids, topical and oral antibiotics, light therapy and chemical peels.
Underproduction of sebum also causes a variety of skin and health problems such that people who have an underactive sebaceous glandular function may develop dry, flaky and itchy skin. These symptoms often get worse when people deploy the use of skincare products that contain harsh chemicals. Therefore, moisturisers are the important products to look out for, and these products should have squalene, ceramides, hyaluronic acid, glycerol and alpha hydroxy acids.
People can also treat dry skin at home by performing gentle exfoliation using a gentle face scrub and employing the help of a humidifier to add some moisture to the air. These may be expensive undertakings for the majority of the people who need to do it but it is more practical to bathe with warm water in most circumstances rather than hot water. As we noted before in the last paragraph, it is important to avoid the use of any oil-based or alcohol-based skin cleaner because of the risk of further skin irritation and injury. From the foregoing, it is notable that there is a lot that the individual who suffers from the consequences of either too much sebum or too little of it can achieve at home by diligent application of simple products designed to keep the skin healthy.
Our forebears with little or no understanding of human biology formulated the use of palm-kernel oil and ori (shea butter) in the management of dry skin. Till this day, these two products remain the mainstay of basic skin care in our local communities and villages. These are natural products that have no additives and would do well to solve many of these problems if diligent use of warm water and simple toilet soap will be deployed in keeping the skin clean and free of the risk of having clogged pores and tears that often become the precursors of various types of skin infections.
Questions and answers
Dear Sir, may this mail meet you in sound health and wellness. I am thanking you for educating the Nigerian populace in your column in Sunday PUNCH. May Almighty Allah continue to strengthen you. My question is: what are the best drugs to use to treat stomach ache and what are the causes of stomach aches? Thank you.
Kadiri
Thank you very much for your prayers. Your words of support are very kind. You have asked an important question that was dealt with comprehensively on this page in April, 2020. This is a huge topic. Causes of stomach pain will range from simple things like indigestion to certain types of allergy to peptic ulcer disease and gastroenteritis and then to more serious problems like cancer. Treatment will depend on what is responsible for such pain and there is no best drug or most effective drug that can cover the entire spectrum.
Dr Sylvester, thank you very much for the work you are doing on behalf of the people. I just want to find out if it is possible for my 11-month old nephew who is visiting the country for the first time to have malaria just 13 days after arrival. He suddenly developed a cough and catarrh two days ago and fever the previous night. What can we do about this?
0813xxxxxxx
Thank you for your words of encouragement. It is possible for him to have malaria as there is no previous exposure to the disease. The obvious choice for you would be to go to a hospital and have your nephew examined by a pediatrician. There is a background of respiratory tract infection which could have been contracted during the journey but malaria is also a distinct possibility. Malaria can only be confirmed through a simple blood test and this test will show if there is any need to worry about a bacterial infection as well.
Good day doctor. I have a seven-year-old son who has complained on and off about lower abdominal pain for almost one year. About three weeks ago, we went to a general hospital near where we live and he was tested by the doctors who told us that he had urine infection and prescribed Augmentin for him. We could not afford Augmentin so we bought Fleming of the same dose because the pharmacist told us it is the same thing. He used the medicine and got better but after about six days, the pain started again and we went back to the hospital. The doctor ordered us to do a scan and said he has appendicitis and that he needs an operation. Can a small boy of seven years have appendicitis? We are very confused and have no money for this kind of operation. What do we do?
0802xxxxxxx
I sympathise with you very much. Children that young can have appendicitis and it is easy for it to become complicated due to certain characteristics that are beyond the scope of this page. Please take him back to the hospital and obtain professional directions about where to go for his required operation. It may not be as expensive as you have been led to think. Good luck.
Dear doctor, I drove my brother’s car from Ibadan to Lagos about four months ago and when I woke up the next day, my body was not the same. I have been having pains in the right leg ever since and sometimes the leg becomes so painful and jerky that I cannot stand. Now, I am afraid to drive so that I don’t have an accident. What should I do? Thank you, sir. 0703xxxxxxx
Thank you very much for this question. Unfortunately, you did not provide your age or gender. However, to develop this kind of pain so suddenly like you have described it, there is the possibility that you developed sciatica, a kind of pain caused by a compressed nerve in the lower part of the back. The intermittent pains you suffer from may be due to spasms which make an accident more likely in case you drive. Therefore, it is important that you go to a hospital and see a doctor for proper examination. Then you can have the appropriate form of treatment which will likely be made up of medications and physiotherapy. Recovery would take some time. Rarely, an operation may be required to free the trapped nerve.
Good day doctor. I am typing this question with a lot of difficulty due to severe pains I have on my shoulders. The pain is worse on my right shoulder and it is so serious that sometimes I am not able to sleep at night. Now, I cannot drive and that makes me very unhappy because I really love driving. Some of my friends have told me it is arthritis but I did an x-ray of the right shoulder and nobody saw anything. What should I do please? I have avoided using any medication until I get the correct advice. Thank you, sir.
0803xxxxxxx
Thank you very much for your question. Once again, we are hampered by the fact that we do not know how old you are and what your gender is. However, while driving is supposed to be a pleasurable experience depending, of course, on the health of your car, it is important to understand that physical disabilities can sometimes hamper that experience. Your experience is one of such impediments and it is important to go to a hospital where you can obtain a proper examination so that it will become obvious what the issue is. X-rays are good but sometimes the views required for certain ailments are special and have to be requested by a doctor. It is not enough to simply walk into a radiological centre and get an x-ray done just like that. You would have exposed yourself to radiation but failed to obtain the benefit of that exposure.
Congratulations doctor on your column reaching a crucial milestone of 10 years. I believe this column stands out among others. My question refers to your essay on the uses of aspirin sometime back, and I want to know if it is a recommended routine for everyone to use baby aspirin every day. I am 60 years old now and I am a woman just seeking to know what I should do. My younger sister who is based in the United States as a practicing nurse told me to use it on alternate days, but from what I read in your essay, only those with health problems like high cholesterol level, diabetes and high blood pressure should use it as prescribed. Please correct me if I am wrong. Thank you for your work, sir.
0803xxxxxxx
Thank you for your words of support. Of recent, the use of soluble aspirin in small doses of 75mg or 81mg per day to forestall the risk of forming blood clots has been controversial. Every good thing is deeply controversial by the way, but if you are as healthy as you have indicated above, there is no need for you to use baby aspirin after the age of 60 years whether as a daily routine or as a medication to be used on alternate days. I will add heart disease to the list of conditions you mentioned in your question but will state that one is likely to suffer from gastrointestinal bleeding when the medication is used beyond the age of 60 years. So, madam, you can do without it absolutely and free yourself from an obligation to use aspirin.
Good day to you, sir. My father fell down in his bathroom about 10 days ago and we took him to traditional bone setters when he was no longer able to walk, but they simply rubbed herbs every time around his right buttocks where he hit the floor and he was not getting better. So I took him for an x-ray on the advice of a doctor friend and we found that he has a fracture of the neck of the femur. Now, the hospital I took him to said he would need an operation to enable him to walk normally again. He is 76 years old. They then said we should take him to the Federal Medical Center, Lokoja. Is it safe for him to do this kind of operation?
0902xxxxxxx
This kind of operation is commonly performed at that advanced age because that is the age at which this kind of injury often occurs. So, you have done the right thing by allowing a doctor friend to guide you and the best thing you can do to get him to the FMC in Lokoja. There are orthopaedic surgeons there and they will assess the nature and severity of his fracture before giving you advice on the best way to treat him. Best of luck.
