Best Care for Normal Skin types & The structure of normal skin

Normal Skin

Normal skin has an even tone, soft, a smooth texture, no visible pores or blemishes, and no greasy patches or flaky areas. This type of skin has a clear, fine-textured, supple and smooth surface which is neither greasy nor dry. It glows with an inner health which stems from good blood circulation and excellent health. There may be occasional pimples in women just before menstruation due to increased hormonal activity, which makes the sebaceous glands overactive. Acne is, however, not a problem for people with normal skin.It is beautiful, but it needs care if it is to last. Neglect can lead to signs of aging and wrinkling.

Best Care for Normal Skin:

This skin requires is cleaning it twice a day with a mild baby soap and water and toned with something mild, like rose water.

• At night, to keep your skin’s normal moisture- balance apply a thin film of home-made moisturizer.

• Any time your skin becomes slightly oily or slightly dry in any area correct these tendencies by following the advice given regarding these types of skin.

• Follow every cleansing with a mild freshener to keep pores tight and to remove traces of cleanser clinging to the skin. Use an astringent with a low alcohol content.

• Avoid direct heat on the face-including that from blow dryers.

• Always use a mild, oil-based moisturizer under makeup to help retain surface moisture.

• Guard against the drying, aging effects of the sun by using makeup products that contain a sunscreen.

• Once every two weeks, stimulate the circulation and smooth the surface of the skin by using a nondrying mask.

Essential Oils For Normal Skin

Chamomile
Fennel
Geranium
Lavender
Lemon
Patchouli
Rose
Sandalwood

COMBINATION (normal-dry) ANALYSIS
Pores: as for normal skin, may be invisible in dry areas
Texture: as for normal skin, may also have dry patches on cheeks, chin or forehead
Sebaceous Activity: Cheeks tend not to have much oil flow, and if this is combined with areas of dehydrated, patches on cheeks and forehead may feel a little tighter than elsewhere.
Visual Analysis: as for normal skin, prone to dry skin around eyes, outer cheek area and neck, premature ageing may occur in dry areas if moisture levels are not maintained.

Normal skin is extremely healthy, and requires no unique care. It is blemish free, smooth and soft, and responds well to mild cleansing, and light, non-greasy moisturisers. Immersing your skin in your own mixture of some of the botanical ingredients listed below, will leave it feeling hydrated, and give additional benefits of reviving any leftover lackluster, dull complexions left over from winter.

There is no better time than the present to get into the habit of facial massaging. This will tone and tighten the muscles of the face, and using your own personalised blends of natural skincare, improves your circulation, allowing your skin to look and feel nourished. Normal skins need only a little more work to keep them blemish free and well-hydrated. So drink lots of pure water, eat a variety of fresh fruit + veges, fresh air + exercise are always beneficial, and remember to always apply sunscreen, especially in the hotter months, as this is the best approach to prevent premature ageing!

There is a wide variety of essential oils to choose from when choosing a blend of oils for Normal skin remedies. If your skin is slightly oily, then you may like to incorporate some of the oils from the previous article for oily skin.

A nutritious, easy to mix combo that is gentle, yet strengthening for normal skin is a blend of geranium, lavender and jasmine, mixed into a base oil of sweet almond.
· Jasmine – a beautifully nourishing oil that balances the skin
· Lavender – the powerful “all-rounder” oil, regenerative, healing, and promotes the prevention of scarring
· Geranium – balancing properties, and aids circulation

Other choices for normal / n-d skins include:
· Mandarin – tones skin
· Juniper Berry – good for circulation
· Neroli – good for sensitive skin and broken capillaries; helps cell growth, circulation; nourishing for normal-dry (n-d) combination skin
· Roman Chamomile – is very soothing if skin is sensitive
· Sandalwood – a very soothing and strengthening oil, nourishing oil for n-d skin
· Rosemary – used as a hot compress is beneficial for reviving tired skin by helping revitalise skin tone and colour

Jojoba oil is an excellent base oil, due to it’s similar composition to sebum, regulating oil levels for normal skin, and balancing hydration.
Carrot oil is an instant multi-vitamin hit for the skin, rich in: A, B, C, D and E vitamins, which are beneficial to protecting and nourishing normal skin. Use only a small proportion, as the strong pigment may cause the skin to take on a slightly yellow tinge…
Sunflower oil, is a light, easily absorbed oil, rich in A, B, D and E vitamins, so is just right for normal and n-d combination skins.

Adding Honey underneath a mask treatment is delicious for normal skin, as it smoothes and nourishes the skin by regulating the skins moisture, and is particularly good for dry and sensitive skin.

To minimise irritation when using aromatherapy in your skincare, it is recommended that a maximum of 50 drops of essential oil is added to 100ml of carrier oil. When using oils like tea tree and lemongrass add only 1 – 2% to dilute for sensitive skins.

What is Normal Skin?

Normal skin has an even tone with a soft, smooth texture. Although on the majority of what is considered normal skin there are no visible pores or blemishes and no greasy patches or flaky areas, it is ‘normal’ to have blotches and pimples and minor variations. The surface is clear, fine-textured, supple, and smooth to the touch. Normal skin glows from good blood circulation and excellent overall health. The skin is an amazing organ and it must be treated with care.

Each person’s skin is unique and is a natural combination of three factors:

1. Water content, which is responsible for the skin’s suppleness and comfort.

2. Lipid content, which is responsible for nutrition and softness.

3. Level of sensitivity, which is responsible for the skin’s resistance to and tolerance of environmental factors.

Normal skin has an adequate amount of water and lipids and a moderate sensitivity level. There is no such thing as “perfect” skin in teenagers or adults. When babies are born their skin is new and perfect, but we should have no expectation that this should be the case as we age

Keeping Skin Healthy

There are several important yet simple steps that help to keep normal skin healthy:

1. Cleansing with a mild baby soap and warm (not hot) water and toning with a mild lotion. Hot water and long baths or showers remove oils from your skin. Avoid soaps containing perfumes or dyes. These can trigger allergic responses and irritate the skin. When drying your skin, avoid rubbing and pat it dry instead so that some moisture remains. While it is still damp, moisturize your skin with an oil or cream. The stronger your soap, the more likely it is to strip oil from your skin.
2. Protection from the sun is key because ultraviolet light, invisible but intense rays from the sun, damages your skin, causing deep wrinkles, dry rough skin, liver spots, and more serious disorders such as noncancerous and cancerous skin tumours.
3. No smoking! Smoking accelerates aging and increases wrinkles. Just ten years of smoking can produce noticeable changes in the skin of young adults. Smoking narrows the tiny blood vessels in the outer layers of the skin, reducing blood flow and depleting the skin of oxygen and important nutrients like Vitamin A.
4. Moisturize regularly to keep your skin supple and hydrated. The moisturizer that is right for you will be the result of trial and error. Factors such as skin type, age, and whether you are prone to specific conditions such as acne need to be considered when choosing the right moisturizer for your skin.
5. Shave with care because shaving can cause skin irritations, especially if your skin is thin, dry, or particularly sensitive. For a healthier shave:

• Shave after a warm bath or shower or press a warm wet wash cloth to your skin to soften the hair before you begin.
• Never shave dry skin. Always apply shaving cream, lotion, or gel to protect and lubricate your skin before shaving.
• Use a clean, sharp razor.
• Shave in the direction of your hair’s growth, not against it.
• Rinse your skin afterwards with warm water.
• Avoid lotions that contain either ethyl or isopropyl alcohol. These products may seem cooling, but they do not soothe irritated skin because the alcohol evaporates rapidly.

The Case for Clean Skin: Skin that is not kept clean is prone to a number of problems. Pathogenic organisms thrive on the dead cells that continuously slough off the epidermis and mix with sweat, oil, and dust to build up on your skin’s surface. If this layer is not washed away, it is decomposed by bacterial flora, producing a foul smell. Other functions of the skin are impaired when it is excessively dirty:

• It can be more easily damaged
• The release of antibacterial compounds is reduced
• There is a greater risk of developing infections

The skin is inhabited by microorganisms that include yeasts (fungi) and bacteria. These microorganisms cannot be removed by any amount of washing. Typically, there are approximately 50 million individual bacteria per square inch of human skin. On oily surfaces such as the face, this number may rise to over 500 million. It’s important to recognize that these microorganisms keep each other in check and are a natural part of healthy skin. Antibiotics can disturb this natural balance by killing microbes and allowing an overgrowth of yeast.

• Oily skin. When sebaceous glands are overactive, producing too much of a naturally healthy skin lubricant called sebum, the result can be oily skin. Oily skin tends to be heavy and thick in nature, characterized by shininess, blemishes, and pimples. Although the skin’s oils should be kept at a minimum, moderately oily skin is not necessarily bad since it is less prone to wrinkling and other signs of aging. The downside of oily-skin is that the skin can be particularly susceptible to clogged pores or blackheads and the accumulation of dead skin cells on the surface. Oily skin can also have a sallow and rough texture with large, noticeable pores everywhere except around the eyes and neck. The trick to treating oily skin is to reduce the excess sebum without removing too much of the skin’s lipid layer. Over-zealous degreasing can trigger increased sebum secretion, making the situation worse. The best approach to cleaning oily skin is to use a solution of a mild synthetic detergent that contains no oils, waxes, or other lipid agents. Such products safely remove the oily residue and debris from the skin’s surface and should be used on a regular basis for them to work effectively. A light moisturizer can be used to counteract any tendency in the cleanser to dry the skin.
• Diet. Your skin tends to reflect what you eat. What you put into your body is just as important to skin health as what you put onto your skin. Try to eat a balanced diet rich in vitamins and antioxidants. Emphasize fresh fruits and vegetables, healthy fats, and lean proteins, and drink plenty of pure water every day.
• Monitoring Your Skin. Ask a loved one to check your skin from head to toe at least once a year. You should do this more often if you have moles and freckles and spots. Always ask you doctor to check any skin changes that concern you.

The structure of normal skin

From top to bottom, skin consists of 3 layers:

1. Epidermis
2. Dermis
3. Subcutis

A. Epidermis

The epidermis is the uppermost or epithelial layer of the skin. It acts as a physical barrier, preventing loss of water from the body, and preventing entry of substances and organisms into the body. Its thickness varies according to body site.

The epidermis consists of stratified squamous epithelium. That means it consists of layers of flattened cells.

• Skin, hair and nails are keratinised, meaning they have a dead and hardened impermeable surface made of a protein called keratin.
• Mucous membranes are non-keratinised and moist.

The epidermis has three main types of cell:

• keratinocytes (skin cells)
• melanocytes(pigment-producing cells)
• langerhens cells (immune cells).

Special stains are often required to tell the difference between melanocytes and Langerhans cells. The merkel cellis a fourth, less visible, epidermal cell.

The epidermis forms an undulating appearance, with intermittent regular protrusions of the epidermis layer (rete pegs) into the upper layers of the underlying dermis. In some areas of the body such as the palms and soles, the rete pegs are less pronounced. The pillars of dermis next to the rete pegs form the rete ridges. The small area of epidermis between rete pegs is called the suprapapillary plate.

Keratinocytes

The keratinocytes become more mature or differentiated and accumulate keratin as they move outwards. They eventually fall or rub off. They form four distinct layers, described in the table below from the most superficial to the deepest.

Layer	Cell type
Stratum corneum (horny layer)	Called corneocytes or squames. Dead, dried-out hard cells without nuclei.
Stratum granulosum (granular layer)	Cells contain basophilic granules. Waxy material is secreted into the intercellular spaces.
Stratum spinulosum (spinous, spiny or prickle cell layer)	Intercellular bridges called desmosomes link the cells together. The cells become increasingly flattened as they move upward.
Stratum basale (basal layer)	Columnar (tall) regenerative cells. As the basal cell divides, a daughter cell migrates upwards to replenish the layer above.

Immediately below the epidermis is the basement membrane, a specialised structure that lies between the epidermis and dermis. It includes various protein structures linking the basal layer of keratinocytes to the basement membrane (hemidesmosomes) and the basement membrane to the underlying dermis (anchoring fibrils). The basement membrane has an important role in making sure the epidermis sticks tightly to the underlying dermis.

The epidermis gives rise to a number of specialised appendages also called adexal structures or adnexae. Hair and nails are both examples, i.e. they are specialised structures formed by direct extension of the epidermis. The hair follicles are associated with sebaceous (oil) glands and arrector pili smooth muscle. This muscle is responsible for goose bumps appearing on the skin in response to cold.

The epidermis also gives rise to eccrine (sweat) glands, a tangle of tubules deep within the dermis that secrete a watery salt solution into a duct that ends on the skin surface. Larger apocrine sweat glands are found in the armpits and groin.

Different areas of the body have different proportions of the adnexal and hair follicle structures present. For example:

• Dense hair on the scalp and none on the palms
• Intense sweating from armpits, palms and soles compared with elsewhere.

Melanocytes

Melanocytes are found in the basal layer of the epidermis. These cells produce pigment called melanin, which is responsible for different skin colour. Melanin is packaged into small parcels (or melanosomes), which are then transferred to keratinocytes.

Langerhans cells

Langerhans cells are immune cells found in the epidermis, and are responsible for helping the body learn and later recognise new ‘allergens’ (material foreign to the body).

Langerhans cells break the allergen into smaller pieces then migrate from the epidermis into the dermis. They find their way to lymphatics and blood vessels before eventually reaching the lymph nodes. Here they present the allergen to immune cells called lymphocytes. Once the allergen is successfully ‘presented’, the lymphocytes initiate a sequence of events to (1) initiate an immune reaction to destroy the material, and (2) stimulate proliferation of more lymphocytes that recognise and remember the allergen in the future.

Merkel cells

Merkel cells are cells found in the basal layer of the epidermis. Their exact role and function is not well understood. Special immunohistochemical stains are needed to visualise Merkel cells.

B. Dermis

The dermis is the fibrous connective tissue or supportive layer of the skin. The major fibres are:

• Collagen fibres: this type of fibre predominates in the dermis. Collagen fibres have enormous tensile strength and provide the skin with strength and toughness. Collagen bundles are small in the upper or papillary dermis, and form thicker bundles in the deeper or reticular dermis.
• Elastin: this type of fibre provides the properties of elasticity and pliability to the skin.

The collagen and elastin fibres are bound together by ground substance, a mucopolysaccharide gel in which the nutrients and wastes can diffuse to and from other tissue components. The dermis also contains nerves, blood vessels, epidermal adnexal structures (as described above), and cells.

The normal cells in the dermis include:

• Mast cells. These contain granules packed with histamine and other chemicals, released when the cell is disturbed.
• Vascular smooth muscle cells. These allow blood vessels to contract and dilate, required to control body temperature.
• Specialised muscle cells. For example, myoepithelial cells are found around sweat glands and contract to expel sweat.
• Fibroblasts. These are cells that produce and deposit collagen and other elements of the dermis as required for growth or to repair wounds. A resting fibroblast has very little cytoplasm compared with an active cell and appears to have a ‘naked’ nucleus.
• Immune cells. There are many types of immune cell. The role of tissue macrophages (histiocytes) is to remove and digest foreign or degraded material (this is known as phagocytosis). There are also small numbers of lymphocytes in the normal dermis.

Transient inflammatory cells or leukocytes are white cells that leave the blood vessels to heal wounds, destroy infections or cause disease. They include:

• Neutrophils (polymorphs). These have segmented nuclei. They are the first white blood cells to enter tissue during acute inflammation.
• T and B Lymphocytes. These are small inflammatory cells with many subtypes. They arrive later but persist for longer in inflammatory skin conditions. They are important in the regulation of immune response. Plasma cells are specialised lymphocytes that produce antibody.
• Eosinophils. These have bilobed nuclei and pink cytoplasm on H&E stain.
• Monocytes. These form macrophages.

The skin cells communicate by releasing large numbers of biologically active cytokines and chemotactic factors that regulate their function and movement. These are too small to see on light microscopy.

C. Subcutis

The subcutis is the fat layer immediately below the dermis and epidermis. It is also called subcutaneous tissue, hypodermis or panniculus.

The subcutis mainly consists of fat cells (adipocytes), nerves and blood vessels. Fat cells are organised into lobules, which are separated by structures called septae. The septae contain nerves, larger blood vessels, fibrous tissue and fibroblasts. Fibrous septae may form dimples in the skin (so-called cellulite).

Combination skin or Normal skin

Combination skin is a common skin type with the frustration of having to deal with both dry and oily skin. Because the nose, chin, center of the forehead, and the cheeks all have more oil glands than any other part of the face, it is not surprising that those areas tend to be oilier and may break out more frequently than other areas. At the same time, the areas that lack oil glands can become dry and flaky. Problems occur when you attempt to treat combination skin as one unified skin type. Many ingredients that are appropriate for the T-zone (the area along the center of the forehead and down the nose where most of the active oil glands on the face are located) won’t help the drier parts of cheeks, eyes, or jaw areas and vice versa. More often than not, separate products are required to deal with the different skin types on your face because different skin types, even on the same face, must be treated differently to truly feel and look better. Once you accept this fact and adjust your routine, combination skin can be brought into balance, at least to the extent that using the right products allows! In fact, “balance” is a key word to keep in mind when dealing with combination skin. The goal is to provide your oily and drier areas with appropriate products that address the needs specific to these skin types.

The fundamental rule for all skin types of treating skin gently apply here, too, perhaps even more so. If anything, using overly-abrasive or irritating skin-care products on oilier areas will only worsen combination skin’s dual nature by making dry areas drier and creating a rough, reddened appearance over oily areas. Plus treating skin harshly does not correct or improve oiliness in any way. Because combination skin should be viewed and treated as separate skin types, I have divided the Skin Care Solutions below into three step-by-step sections. The first section lists general guidelines for combination skin, the second pertains to treating oily areas, and the third offers a protocol for treating your normal-to-dry (and, in some cases, very dry) areas. Special notes are included for dealing with combination skin that also experiences blemishes or blackheads in either oily or normal-to-dry areas.

General Guidelines for Combination Skin

• Wash your face with a gentle, water-soluble cleanser that does not leave skin feeling tight or dry. Most combination skin types do well with gel-based or mildly foaming cleansers.
• Avoid bar soaps or bar cleansers of any kind, regardless of claims of gentleness or no residue. The ingredients that keep a bar cleanser or soap in its bar form can clog pores, and the cleansing ingredients are always far more drying than a gentle cleanser contains.
• If you opt to use a toner, the same toner can be used all over the face if it does not contain ingredients that make oily areas feel slick or greasy. Water- and glycerin-based toners are ideal, but be sure they also contain plenty of antioxidants, water-binding agents, and, if applicable, cell-communicating ingredients.
• Sunscreen must be used every day, year-round. Make sure it contains one of these UVA-protecting ingredients: titanium dioxide, zinc oxide, or avobenzone. A foundation and pressed powder with sunscreen is perfect for this skin type to avoid applying moisturizers with sunscreen all over the face.
• Exfoliate and renew skin with regular use of a beta hydroxy acid (BHA/salicylic acid) product. BHA not only exfoliates the surface of skin it also exfoliates inside the pore to improve its shape and function.
• Treat dry areas (including the eye area) with a moisturizer loaded with antioxidants, water-binding agents, and ingredients that mimic the structure and function of healthy skin. Regular use of these state-of-the-art ingredients can eliminate dry skin. Make sure the product you buy is packaged in an airtight, opaque container (absolutely no jars) to keep the antioxidants stable.
• If sun damage or wrinkles are cause for concern (and they probably are, it is the rare person who has adequately avoided and protected their skin from the sun), consider adding a tretinoin product (Retin-A, Renova, Avita, etc.) to your nightly routine. Tretinoin is a cell-communicating ingredient that can generate normalized cells. These prescription-only products are available in different bases so you may choose the texture (gel, cream, lotion) best for your skin.

Treating the Oily Areas of Combination Skin

• Apply a well-formulated (meaning irritant-free and pH-correct) BHA liquid or gel at least once per day. This will not only help prevent oil blockages in the pores, but will also minimize blackheads and control blemishes. Salicylic acid is oil-soluble, which allows it to exfoliate inside the pore lining to keep dead skin cells and sebum (oil) from causing problems. It is also acceptable to apply the BHA product over your normal to dry areas. However, you may need a more potent BHA product (one containing 2% salicylic acid, for oily areas. You may have to experiment to see if a product containing 1% salicylic acid is more suitable for normal to dry areas.
• Use an oil-absorbing facial mask as needed but only apply it over oily areas. Apply after cleansing, leave on for 10-15 minutes, and then rinse thoroughly.
• If you are prone to blemishes, apply a topical antibacterial product containing benzoyl peroxide. Research in the medical journal Lancet (December 2004, pages 2188–2195) found benzoyl peroxide to be the most effective treatment, in comparison to oral antibiotics (such as tetracycline), topical antibiotics (such as erythromycin), or combination treatments. Oral tetracycline suffered in the comparison because of the common problem of eventual bacterial resistance to antibiotics. Begin with a 2.5% strength and increase the percentage if blemishes are unresponsive. If you are allergic to or your skin cannot tolerate benzoyl peroxide, then you may want to consider topical prescription options such as clindamycin, erythromycin, tetracycline, or Differin (adapalene) Gel. Tea tree oil is also an option, but has limited research supporting its effectiveness, and it is difficult to find the recommended concentration.
• For sunscreen, the easiest route is to use a matte finish foundation and pressed power with broad-spectrum sun protection, rated at least SPF 15. You would only apply moisturizer or serum to dry areas prior to applying foundation. If you do not use foundation, choose a regular sunscreen with a matte finish.
• Supply oily areas with the antioxidants and cell-communicating ingredients it needs in either serum or toner form. In this manner, your skin will benefit without making oily areas worse or causing clogged pores. Make sure the serum is alcohol-free and either silicone- or water-based.
• If oily areas become too shiny during the day, use oil-blotting papers to absorb the excess shine then touch up with a lightweight, sheer pressed powder, applied with a brush.
• For extremely oily areas, apply a thin layer of plain Milk of Magnesia prior to foundation with sunscreen. The magnesium hydroxide is more absorbent than clays or talc, and also has antibacterial properties for skin. A similar option that is more cosmetically elegant is smashbox’s Anti-Shine in Smashing Neutral (colorless).
• If sun- or hormone-induced discolorations are present, choose a gel-based skin lightening product containing 2% hydroquinone and apply at least once per day to affected areas.

Treating Normal-to-Dry & Very Dry Areas of Combination Skin

• As described above for treating oily areas, a BHA product is an option, even if blemishes and/or blackheads are not present. The difference is that for drier areas, you may prefer a BHA in a lotion or cream base. Begin with a 1% concentration and step up if needed (this may be necessary during summer months). If blemishes are present over dry areas, a BHA product is a must. Begin with 1% salicylic acid and step up to 2% concentration if needed.
• If blemishes and blackheads are not a concern, a well-formulated AHA product may be used all over the face or just over drier areas. For all-over use, choose an AHA gel containing at least 8% glycolic acid. For use over dry areas, you may prefer an AHA product in a lotion or cream base. Both AHA and BHA products are excellent for improving the appearance and feel of sun-damaged skin and encouraging skin cell turnover.
• A soothing, moisture-infusing toner may be used after cleansing to reinforce skin’s lipid barrier and boost hydration prior to applying a serum or moisturizer. Apply the next product when skin is still damp from the toner.
• Since applying two separate sunscreens can be tricky, your best bet is to get daily facial sun protection from a foundation with sunscreen rated SPF 15 or higher. It should have a matte finish for your oily areas. Because a matte finish can exaggerate dry areas, it is essential to apply a rich serum or moisturizer prior to foundation. For obvious reasons, keep such items away from oily areas.
• Choose a moisturizer loaded with antioxidants, water-binding agents, emollients, and ingredients that mimic the structure and function of healthy skin. Make sure it is packaged in an opaque container (no jars) to keep the antioxidants stable.
• A serum-type product may be all your dry areas need to look and feel better. More severe dryness will benefit from an antioxidant-rich serum paired with an emollient moisturizer.
• Use a moisturizing facial mask as needed. Make sure it contains several emollients (such as non-volatile plant or nut oils) and leave on dry areas as long as needed, including overnight.
• If your eye area is the driest part of your face, you may need a richer cream or serum than what is needed for other normal to dry areas of your face. Apply sparingly and allow a few moments to absorb before applying makeup. At night, you may want to apply your regular moisturizer to the eye area and follow with a thin layer of olive, evening primrose, or borage oil (all are extremely emollient as well as potent antioxidants).
• If blemishes are present over dry areas, apply a 2.5% benzoyl peroxide product in a lotion base. If blemishes do not respond, switch to a product containing 5% benzoyl peroxide. If you are allergic to (or your skin cannot tolerate) benzoyl peroxide, consider topical prescription options such as clindamycin, erythromycin, tetracycline, or Differin (adapalene) Cream.
• If sun- or hormone-induced discolorations are present, choose a lotion- or cream-based skin lightening product containing 2% hydroquinone and apply at least once per day to affected areas