Guide to explain the effects of excess weight on the skin, changes that can be seen in the process of weight loss and daily protection.
Önsöz — A valuable reader from the author, obesity is not only the heart, vascular and joint health, but directly affecting the skin. Most of my patients who apply to the clinic see the irritation of the neck and seat, the cracks in the abdomen and hip, or the skin cathales as a “esthetic problem” or “a short result”. Yet a part of these findings can be an early sign of metabolic problems such as underlying insulin resistance. I was a single goal when preparing this guide: transfer complex medical information, with an exaggerated and honest language, as everyone can understand. This guide is not a diagnostic tool; it is to help you inform you, ask your doctor the right questions and notice changes in your skin in time. Weight is a journey that often wants long and patience; I was careful to use a realistic language that respects that journey. My five basic principles: I would like to get the source of each information I said trust. I look at the patient, then the treatment before it was hurt.
I promise not a miracle, realistic improvement. Proper Price Information and maintenance should be accessible for everyone. Scientific Experience I talk about clinical observation and literature for years. Stay with health.
Obesity is a chronic disease characterized by excessive fat accumulation at levels that will adversely affect health in the body. The clinical practice is often used in the body mass index (BKİ); it is considered to be obesity that BKİ has 30 kg/m2 and above. But the BMI is not enough alone; the waist circumference and oil distribution should also be included in the evaluation. Why is it important? Obesity is the risk factor for type 2 diabetes, hypertension, heart disease and some types of cancer. Besides these, there are direct and indirect effects on the skin, which is the focus of this guide. Why is the Skin Important Indicator? The skin is the largest organ in the body and reflects the mechanical (version, stress), metabolic (insulate resistance) and circulatory effects of excess weight. Therefore, changes you notice on your skin can carry valuable tips on your overall health. Scientific note: In the studies conducted, obese individuals have shown the presence of at least one skin bougus such as acantosis nigrikans, skin labels, cracks or intertrigo.
The Connection Between Obesity and Skin can be explained by three main mechanisms of excess weight on the skin: mechanical (version and stress), metabolic (insulate resistance and hormonal changes) and circulatory (revenous and impaired of lymphatic flow). The mechanical effect leads to increased skin coats, reduced friction, moisture accumulation and air circulation in these areas. This environment creates a suitable ground for irritation and fungal/bacteria infections. It can also cause skin to quickly stretch cracks (striae). Metabolic Effect insulin resistance, which is often seen in obesity, can lead to darkening and thickening such as keratinocytes and fibroblast cells in the skin by triggering excessive proliferation. Circulating Effect More fat tissue can make venous and lymphatic return difficult, which can contribute to swelling, circulatory disorder and skin changes in legs. Natural result principle: These changes are formed by accumulated over the years and are gradually straightened with weight loss. Instead of waiting for a quick conversion, it is more realistic to adopt a regular and sustainable process.
Symptoms I in the skin: Akantozis Nigrikans and Intertrigo Akantozis Nigrikans Neck back, armpit, pubic and sometimes dark colored, velvety, thickened skin areas seen in joints uniforms. The most common skin in obesity is bougus and the main reason is insulin resistance. It is painless but it can be an indication of the underlying metabolic condition. Intertrigo (Female Zone Puller) is a condition that develops due to the accumulation of rash, maseration (soft-whiteing), burning and sometimes bad smell, depending on the skin cathales (göğüs six, abdomen coat, pubic, armpit) friction and moisture. These regions are also open to fungal (especially Candida) and bacterial infections. When important? If severe pain in the intertrigo region, radiating redness, fever or bad fragrant discharge occurs, a secondary infection may be improved; in this case it should be applied to a doctor without losing time.
Symptoms in the skin II: Cracks, Leather Labels and Keratozis Pilaris Cracks (Striae Distensae) The result of rapid and excessive strain of the skin, consisting of zealing of collagen and elastin fibers, red-mor is a color area lines of pale silver over time. It is often observed in snow, hip, thigh and chest. Aesthetically discomfort verse is harmless to health. Leather Labels (Acrokordon) are small, soft, sap-dependent skin protrusions developed in areas exposed to friction such as neck, seat six and crocodile. It is associated with insulin resistance and friction; it is often harmless. Keratozis Pilaris are rashes in the appearance of small, rough, “fat skin” which is seen in the arms, thighs and sometimes cheeks. It consists of keratin accumulation in the vicinity of purulent roots; it can be seen more often in obesity. Practical advice: Leather labels often do not require treatment, but if it becomes friction or irritation, a dermatologist can easily get them with simple methods.
Other Skin and Circulatory Situations Associated with obesity are some chronic skin and circulatory situations, which are more often encountered with obesity. Here we promise not the “neden-end” relationship, but more often in the same patients, making this distinction clear is important by our trust principle. Hidradenitis Supurativa Seat is a chronic skin disease, accompanied by recurrent, painful, inflamed nodules and abscesses in six, pubic and hip cathales. Obesity and friction are considered among factors involved in the exacerbation of the disease; weight loss has been shown to reduce disease severity. Lymphine and Lipödem excess fat tissue can lead to permanent swelling (lenfödem) on the legs by compelling lymphatic drainage. Lipödem is a separate condition that is not fully straightened with diet, especially in women with symmetrical fat accumulation in the legs and hips. Venous Staz and Varis can facilitate the formation of varicose veins by increasing pressure in excess weight, legs and skin color changes attached to it. The principle of harming: Some of these cases (especially hydrdenitis purulent and lipid) can not only be explained by weight and
requires special treatment on their own. Take a doctor’s review instead of interpreting yourself.
Skin in Weight Loss Process (I): Sarkma is valuable for general health to lose weight and helps most skin bougus back. However, especially in rapid and large amount of weight loss, the skin can not always adapt to the same speed. Sarkma in the skin can not be fully tolerated after rapid weight loss due to the loss of skin, collagen and elastin, which has been stretched for a long time; it can be seen to be wrapped in abdomen, arms, leg inners and chests. This varies from person to person depending on the speed and genetic predisposition of age, weight loss. After Bariatric Surgery, fast weight loss can be more pronounced in patients with the surgery; in some patients there may be a separate aesthetic surgical evaluation. GLP-1 Receptor Agonist Drugs are the most commonly reported skin bulgus in these injection drugs used in weight management, temporary redness in the injection area, itching or tenderness. There are also researches that these drugs contribute to reducing the severity of some inflammatory skin diseases, such as hidradenitis purulent, associated with obesity. Scientific note: Research on this field is still developing; although the findings are promising, the same result is guaranteed in every patient
not.
Skin (II) and PhD Application Nutritional In Weight Loss Process can sometimes lead to protein, zinc or vitamin deficiencies, resulting in skin dryness, hair loss and wound healing. A program in balance and doctor/heavy control reduces this risk. Factors Supporting Skin Elasticity are among the factors that support adequate protein intake, regular and gradual weight loss, non-sun protection and smoking, supporting skin toning capacity. However, genetic predisposition and age can limit this process. When to apply to Doctor? When you notice pain, radiating redness or bad fragrant discharge in the nausea region, repeated, painful, inflamed nodles (hydride purulent suspicion of hydradenitis) developed, after weight loss, irritation in the skin, rash or healing wound occurs when GLP-1 developed severe or common reaction in the injection site after the drug: Do not change your weight loss process or drug without consulting your doctor. Unbalanced or very fast weight loss can carry additional risk for many systems including skin.
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Dry Nausea Zones Detention Chest six, abdomen and groin areas gently clean and dry thoroughly in the day, significantly reduces the risk of intertrigo. Wet remaining areas create suitable environment for fungal and bacteria reproductive. Breathable Clothes to choose clothes that reduce cotton, sweating and friction, reduce irritation in the coffin areas. If necessary, thin to these areas, a mulbent or cotton cloth can be placed. Nazik Cleaning and Humidification prefer pH balance to skin, soft cleaners instead of hard, foaming and perfume soaps. Regular humidification in areas prone to cracks can support a quantity of skin elasticity; but it is a realistic expectation to know that existing cracks will completely eliminate. What Can Akantozis Do For Nigrikans? This finding itself is not directly treated; it can light over time with the management of underlying insulin resistance. Avoid aggressively rubbing the region. Affordable price principle: No need for expensive products for effective skin care. Regular cleaning, dry cleaning and simple humidifiers;
is much more predictive than ambitious and expensive creams.
Skin Care Advice II: Life Style and Nutrition Graduation and Balanced Weight Management Instead of rapid and overresistent diets, a sustainable, gradual weight loss with the support of physician or dietician supports both overall health and the process of harmony of skin. adequate Protein and Water intake Protein is necessary for the production of collagen with the structure of the skin. sufficient water consumption also contributes to the moisture balance of the skin. Regular physical activity as your regular Motion Physicians see appropriate can help reduce swelling and venous stasis findings on the legs by supporting circulation. Monitoring of blood sugar and insulin resistance is valuable in terms of both general health and skin findings, since the findings such as Akantozis nigrikans can indicate insulin resistance. Natural result principle: These recommendations result in regular application that lasts months, not within weeks. Being consistent and consistent, more effective than any product.
Warning Signs: When to Apply to Doctor? Most of the findings described in this guide are not urgent; but some symptoms are warning signs that should be assessed without losing time. You can use the following list as a reference guide. Instantly Appraised In the area of nausea fire, severe pain, rapidly spreading redness on a leg, painful, single-sided swelling (especially with temperature and redness) Repetitive, painful and discharged nodles In the Shortest Time Doctor Appointment Neck, new darkening and thickening in areas such as under seats (akantozis nigrikans skeptical) Non-existing or worsening wound skin sagging after weight loss can be observed after the drug GLP-1, or severe skin reaction Rutin Control, light weight loss. Do not forget about the skin swelling labels or swelling. Early assessment is the simplest and most secure way. • • • • • • • • • • • • • • •
Approach in America (I): Definition, Guides and Statistics This section is added to complete the original content of the guide and summarizes the current definition, guide and data in obesity of the leading healthcare institutions in the United States. All information is compiled from official sources specified in the source section of the page and the guide. CDC: BKİ Classification is classified as body mass index (BKİ) 25,0-29,9 kg/m2 between US Disease Control and Prevention Centers (CDC). These thresholds cover one-on-one with the definition of BKİ ≥30 kg/m2 specified on the 4 page of the guide. Obesity Frequency with CDC/NCHS Data was determined by the U.S. National Health Statistics Center (NCHS) September 2024, according to the Data Note of 508, during August 2021-August 2023, obesity was detected in 40%,3% of US adults. This rate is 39.2% in men,41.3% in women. According to age groups, the frequency of obesity was reported by 35.5% at 40-59 years at 47.4% and 60 years. Severe obesity frequency
and it shows a gradual increase since 2013-2014.
The U.S. National Diabetes, the Institute of Digestal and Kidney Diseases (NIDDK) emphasizes that obesity is associated with risk increase for many chronic diseases, mainly in the type 2 diabetes, heart disease, paralysis, some types of cancer and joint problems, which promotes the overall risk chart on the 4 page of the guide. Scientific note: These statistics are not a diagnostic tool; only shows the overall trend in the USA. The only valid assessment for your personal situation is your doctor’s examination and follow-up.
Approach in America (II): Skin Findings and Treatment Approaches American Academy of Dermatology: Akantozis Nigrikans American Academy of Dermatology Association (AAD) states that the most frequent cause of akantozis nigrikansin is obesity and often restore this finding when adults lose marked weight with obese child. The patient information pages of AAD recommends the region to be considered by the physician, which is aggressively rubbed or attempting to cry, the underlying cause (intension insulin resistance). This information covers one-on-one with the approach on the 6th and 11. pages of the guide. Hidradenitis is a systematic compilation released in Supurativa and Weight Loss Journal of the American Academy of Dermatology, where weight loss in hidradenitis purulent patients can reduce the frequency and severity of exacerbation by reducing the friction in the skin cations; it informs that the body weight can only make a difference even 10%. This finding supports hidradenitis purulent information on the 8th page of the guide. FDA: GLP-1 Drugs’ Injection Zone Reactions in prescription information approved by U.S. Food and Drug Administration (FDA), GLP-1 receptor such as semaglutid used in weight management
The most commonly reported skin for agonist medications is considered itching, redness, inflammation, hardening and irritation in the injection area. This information is consistent with the warning of GLP-1 drugs on the 9 page of the guide. American Society of Plastic Surgeons: Skin Shake After Weight Loss American Society of Plastic Surgeons (ASPS) may always be able to adapt to the new body volume of skin and tissues after a large amount of weight loss, which indicates that this situation can lead to sagging in abdominal, arms and chest areas. ASPS recommends body shaping surgery but evaluation after gaining weight stability. This information is covered with “Deride Sarkma” and “Bariatric Postoperative” sections on the 9th page of the guide. Important: The information on this page is a summary of the public data of U.S. source organizations and scientific journals, and does not hold the location of pharmaceutical labels or guides in Turkey. For up-to-date information about your drug or treatment, please consult your Turkish Drug and Medical Device Authority (TITCK).
Summary of the guide and Main Messages This guide addressed the effects of obesity on the skin, reflections and ways of protection to the skin of weight loss process. Let's remember the main headers briefly: The connection is true: excess weight; is associated with acantosis nigrikans, intertrigo, cracks, skin labels and some chronic skin diseases. Mechanisms are different: Friction, insulin resistance and circulation disorder are three main factors located on the basis of these findings. In the process of losing weight, it is necessary to be patience: the skin takes time to shake and healing processes; realistic expectations are important. Simple measures are effective: Keeping the nausea zones dry, balanced nutrition, regular movement and blood sugar tracking support your skin health. U.S. data covers: CDC/NCHS statistics, NIDDK, AAD, FDA and ASPS sources are supported by independent sources in this guide. Closing with five principles: We did not place uncertain information of trust. We suggested not to be damaged, but to consult with the doctor.
We stressed realistic, gradual improvement. We stand out the appropriate Price Simple and accessible measures. We wrote scientific experience with clinical observation and literature. We would like to remind that this guide is not a diagnosis or treatment tool, it will not replace your existing treatment. Please consult your doctor for questions. • • • • • • •
The original sections of this guide (page 3-13, 16, 18) are based on clinical experience of preparing and general medicine literature. The following sources apply to the information referenced in the “American Approach (I) and (II) sections (page 14-15) added to this edition; all links belong to the official website of the relevant institution as of the access date. 1. Centers for Disease Control and Prevention (CDC) / National Center for Health. © Copyright 1996-2016 - All Rights Reserved. NCHS Data Brief No. 508, September 2024. cdc.gov/nchs/products/databriefs/db508.htm 2. Centers for Disease Control and Prevention (CDC). Copyright © 2018 - www.s.com. All Rights Reserved. Centers for Disease Control and Prevention (CDC). About Body Mass Index cdc.gov/bmi/about/index.html 4. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute of Health. Overweight & Statistics niddk.nih.gov/health-information/health-statistics/overweight-obesity 5. American Academy of Dermatology Association. Acanthosis Nigricans: Causes. aad.org/public/diseases/a-z/acanthosis-nigricans-
6 months American Academy of Dermatology Association. Acanthosis Nigricans: Tips for Managing. aad.org/public/diseases/a-z/acanthosis- nigricans-self-care 7. Journal of the American Academy of Dermatology. Weight loss and dietary deficiencies for hidradenitis suppurativa: A conflict review. 8. U.S. Food and Drug Administration (FDA). Highlights of Prescribing Information — WEGOVY (semaglutide) section of injection zone reactions. accessdata.fda.gov American Society of Plastic Surgeons (ASPS). Body Contouring After Massive Weight Loss. plasticsurgery.org/cosmetic-procedures/body-contouring No information on this guide does not substitute for personal medical advice. Always consult your doctor for decisions about your health.
About this Guide “Obezite and Skin Health” guide was prepared to help individuals and relatives who live skin changes associated with excess weight, understand these findings and take simple, safe steps in everyday life. In this edition, the up-to-date guide in America and the data is added to the source with a new part separated. Legal notice: The information on this guide is for general information purposes, does not carry special medical advice qualities and does not hold the location of your existing treatment. Please consult your doctor to decide about your health.