Rhytides or wrinkles are visible creases or folds in the skin.
Fine wrinkles is <1 mm in width while coarse wrinkles is >1 mm in width.
The decision to treat wrinkles depends on the degree that they bother the patient, the nature and severity of the wrinkles, and the patient's willingness to accept the risks and costs of treatment.
The patient should understand that protection from the sun at any age will reduce the risk of photoaging (including wrinkles), actinic keratoses and squamous cell cancer.
Taking the oral extract product of the fern Polypodium leucotomos (PLE) on top of the standard topical hydroquinone cream and sunscreen reduces the severity of melasma to a greater extent compared with the standard treatment alone in Asian patients, a pilot study has shown.
Sexually transmitted infections (STIs) are common, with rates of many infections increasing over the last two decades.1 Community screening studies in the UK have shown a prevalence of about 10% for chlamydial infection2 and (among women screened in an urban setting) 3% for gonorrhoea.3 In women (Figure 1), these potentially serious infections are often asymptomatic, whereas the presence of symptoms such as vaginal discharge generally indicates a less pathogenic (but still potentially debilitating) infection, with an organism such as Candida. STIs are often multiple, and the finding of one infection should prompt consideration of testing for others. Many sexual health services now initially provide screening tests for asymptomatic women, but a more comprehensive assessment—comprising detailed history4 and genital examination5—is usually necessary when symptoms are present.
High use of hydrochlorothiazide (HCTZ) appears to significantly increase the risk of nonmelanoma skin cancer (NMSC), particularly squamous cell carcinoma (SCC), suggests a recent study. Use of other diuretic and antihypertensive medications does not appear to be linked to NMSC.