skin

Skin

 The skin is the largest organ of the human body. It is soft, to allow movement, but still tough enough to resist breaking or tearing. It varies in texture and thickness from one part of the body to the next. For instance, the skin on the lips and eyelids is very thin and delicate, while skin on the soles of the feet is thicker and harder. The skin is a good indicator of general health. If someone is sick, it often shows in their skin.
A range of functions
Skin is one of our most versatile organs. Some of the different functions of skin include:
    A waterproof wrapping for the entire body
    The first line of defence against bacteria and other organisms
    A cooling system via sweat
    A sense organ that gives us information about pain, pleasure, temperature and pressure.
The epidermis
The skin you can see is called the epidermis. This protects the more delicate inner layers. The epidermis is made up of several ‘sheets’ of cells. The bottom sheet is where new epidermal cells are made. As old, dead skin cells are sloughed off the surface, new ones are pushed up to replace them. The epidermis also contains melanin, the pigment that gives skin its colour.
The dermis
Underneath the epidermis is the dermis. This is made up of elastic fibres (elastin) for suppleness and protein fibres (collagen) for strength. The dermis contains sweat glands, sebaceous glands, hair follicles, blood vessels and nerves.
Glands and blood vessels
The dermis is well supplied with blood vessels. In hot weather or after exercise, these blood vessels expand, bringing body heat to the skin surface. Perspiration floods out of sweat glands and evaporates from the skin, taking the heat along with it. If the temperature is cold, these blood vessels in the dermis contract, which helps to cut down on heat loss. Sebaceous glands in the dermis secrete sebum to lubricate the skin.
Hair and nails
Our lack of a complete cover of body hair makes human skin very different from the skin of any other animal. Hair is made up of a protein called keratin. The amount of hair on the body varies from place to place. Hairless sites include the lips, palms and soles of the feet. The hairiest sites include the scalp, pubis and underarms in both sexes, and the face and throat in men. Nails are made from skin cells but the only live parts are the nail bed and the nail matrix just behind the cuticle. The nail itself is made of dead cells.
Nerves
Both the dermis and epidermis have nerve endings. These transmit information on temperature, sensation (pleasure or pain) and pressure. Some areas have more of these nerves than others, like the fingertips for example.

Common problems

 Some common skin problems include:
    Acne - caused by hormones
    Dermatitis - inflammation of the skin, with many different triggers
    Fungal infections - like tinea (athlete’s foot)
    Skin cancer - from long term exposure to the sun’s UV rays
    Sunburn - a radiation burn from the sun’s UV rays
    Warts - caused by a virus.

Healthy ageing - the skin

 Skin is the first body part to show age. While age-related changes are inevitable, they are not universally embraced. A desire for younger looking skin can be satisfied with healthy lifestyle choices and good skin care.
There is a range of medical and surgical anti-ageing treatments available – however, these are not without risk. Before embarking on any surgical treatment you should consult with a dermatologist or plastic surgeon. Make sure you have realistic expectations of the potential benefits and understand all the potential risks, complications and side effects of the treatment.
Skin layers explained
The uppermost layer of the skin is called the epidermis. This layer contains pigment-producing cells (melanocytes) that give skin its colour. The epidermis renews itself constantly. New epidermal cells are born in the basal cell layer of the epidermis. These mature as they gradually rise to the surface where they ultimately die and are sloughed off.
Beneath the epidermis is the dermis, which contains blood and lymph vessels, nerves, sweat glands and oil glands. Hair follicles are extensions of the epidermis into the dermis. The dermis is made up of networks of elastic fibres (elastin) for suppleness and dense fibres (collagen) for strength. Finally, a layer of fatty tissue lies below the skin and gives it structure.
Signs of ageing
Some of the signs of ageing skin can include:
    Thinning – the basal cell layer of the epidermis slows its rate of cell production and thins the epidermis. The dermis may become thinner. Together, these changes mean skin is more likely to crepe and wrinkle.
    Sagging – older skin produces less elastin and collagen, which means it is more likely to sag and droop. Older skin is particularly vulnerable to the effects of gravity, for example, jowls along the jaw and bags under the eyes are simply skin that has yielded to gravity.
    Wrinkles – reduced elastin and collagen, and the thinning of skin, mean those ‘high traffic’ areas of the face (like the eyes and mouth) are especially prone to lines and wrinkles.
    Age spots – the remaining pigment cells (melanocytes) tend to increase in certain areas and cluster together, forming what’s known as age or liver spots. Areas that have been exposed to the sun, such as the backs of the hands, are particularly prone to age spots.
    Dryness – older skin has fewer sweat glands and oil glands. This can make the skin more prone to dryness-related conditions, such as roughness and itching.
    Broken blood vessels – blood vessels in older, thinner skin are more likely to break and bruise. They may also become permanently widened. This is commonly known as broken vessels.
Age-related skin conditions
Some skin conditions are more likely to develop as we get older. These can include:
    Seborrhoeic keratosis – a type of benign skin tumour that looks like a brown wart.
    Solar keratoses – spots of skin that are inflamed, scaly and dry. Common sites include the bridge of the nose, cheeks, upper lip and backs of the hands. Skin cancer (squamous cell) can develop in them, so examination by a doctor is advised.
    Bowen’s disease – a type of slow-growing and scaly skin patch. It may be a pre-cancerous change. Sun exposure is thought to be a cause.
    Skin cancer – including basal cell carcinoma, squamous cell carcinoma and melanoma.
Reducing your risk
Ways to reduce the signs of ageing include:
    Limit sun exposure – sun exposure accelerates ageing of the skin. If you want proof, compare the skin on your hands with that on your buttocks. Wear a hat, loose fitting clothes, sunglasses and SPF15+ sunscreen when outdoors, and avoid sunbathing.
    Don’t smoke – cigarette smoking promotes skin wrinkling and is thought to accelerate the damage caused by sun exposure. The action of puckering up for each drag on a cigarette increases the likelihood of wrinkles around the mouth.
    Moisturise regularly – dry skin is more likely to show fine lines and wrinkles. Moisturise regularly if you have dry skin.
    Care for skin gently – age-related dryness will be further exacerbated by skin irritants such as perfumed soaps, heavily chlorinated swimming pools and long hot showers. Use neutral pH balanced soaps, body washes or equivalents.
Anti-ageing treatments
There is a range of anti-ageing treatments available. However, these are not without risk and you should consult with a dermatologist or plastic surgeon to make sure you understand all the potential risks, complications and side effects of the treatment.
Some of the anti-ageing treatments offered include:
    Sunscreen – daily application during the summer months is an effective way to reduce sun exposure.
    Topical lotions – creams (such as tretinoin creams) are only available on prescription. These creams have been shown to visibly reduce fine lines and uneven skin colouration when used regularly. Niacinamide is available in a number of cosmetic creams and reduces uneven skin pigmentation.
    Injections – for example, synthetic collagen or body fat harvested from other areas of the client’s body can be ‘piped’ along wrinkles via a small hypodermic needle.
    Facial peels – chemicals are applied to the face to ‘burn off’ the top layer of skin. This removes the wrinkles and age spots and encourages faster regrowth of newer, younger-looking skin.
    Botox – wrinkle-prone areas, such as around the eyes and between the eyebrows, are injected with the Botulinum toxin. The resulting paralysis prevents the muscles from wrinkling the skin.
    Vascular laser – to remove broken blood vessels from the face or other areas of the skin.
    Laser resurfacing – laser can be used to treat wrinkles, age spots, scars and skin growths.

Cosmetic surgery

 Some cosmetic surgeries that are designed to reduce the signs of ageing include the eye lift (blepharoplasty) and face lift (meloplasty). Consult with an experienced plastic surgeon and make sure you understand all the potential risks, complications and side effects of surgery.
Moisturisers – be wary of outrageous claims
Moisturiser can keep the skin moist and reduce the appearance of fine lines. Many now contain sunscreen and some also contain skin-lightening agents. However, no product has so far been shown to ‘turn back the clock’. Consult with your doctor before buying an expensive moisturiser – you may be advised not to waste your money.

Bedbugs

 Bedbugs are small, wingless insects found all over the world. They are nocturnal parasites, which means they rest during the day and are active at night. However, bedbugs are opportunistic and will bite in the day, especially if starved for some time. They feed on the blood of humans. Bedbugs prefer to hide in bedding and on mattresses where they have ready access to a source of food.
Bedbugs have highly developed mouth parts that can pierce skin. Their bite is painless. Some people do not react to the bites, but for others the bites can become itchy and swell into reddened weals.
Although bedbugs can harbour diseases in their bodies, transmission to humans is highly unlikely; they are not dangerous, unless a person is allergic to them. However, their presence can be distressing and their bites can be highly irritating.
Characteristics of the bedbug
The characteristics of a bedbug include:
    Wingless
    Half a centimetre long
    Flat, oval-shaped body
    Six legs
    Light brown in colour, changing to rust-red after a meal of blood
    Squat head
    Large antennae
    Large mouth parts (mandibles)
    Complex life-cycle involving many stages of development
    Ability to survive without feeding for months at a time
    Susceptible to extremes of temperature.
Humans are the preferred host
Bedbugs live exclusively on blood. They prefer human blood, but will feed on other mammals if necessary.
Bedbugs are attracted to body heat and the carbon dioxide in expired air, which is how they find their host. Bedbugs commonly target the shoulders and arms.
During feeding, the bedbug’s proboscis (feeding organ) swings forward and downward to pierce the skin of the victim. Saliva (containing an anticoagulant) is then injected, which is the cause of an allergic reaction in some people. Bedbugs take around five to 10 minutes to feed. As the bedbug engorges with blood, its colouring changes from light brown to rust-red.
Common hiding spots
The living areas favoured by bedbugs include:
    Mattresses, particularly along the seams
    Bedding such as sheets and blankets
    Beneath loosened edges of wallpaper
    Between the cracks of wooden floors
    In wall cracks or crevices
    Carpet
    Furniture, particularly in seams and cracks.
Causes of infestation
Bedbugs often hide in luggage, clothing, bedding and furniture. They are most often found in dwellings with a high rate of occupant turnover such as hotels, motels, hostels, shelters and apartment complexes.
Any household can be invaded by bedbugs, but a high standard of hygiene can discourage bedbugs from spreading widely throughout a home.
Recognising an infestation
The first indication of a bedbug infestation may be the presence of bites on family members. A thorough inspection of your premises, especially the common hiding spots, may also reveal:
    The bedbugs themselves – however, due to their size, they are often hard to see
    Small bloodstains from crushed bugs on sheets or mattresses
    Rusty or dark spots of bug excrement on mattresses, bedding or walls
    An offensive, sweet, musty odour from their scent glands, which may be detected when infestations are severe.
Symptoms of a bedbug bite
The bite of a bedbug has certain features, including:
    Large weals that reduce to a red mark then gradually fade over a few days
    Itchiness
    Reddening of the skin
    Localised swelling
    Formation of blisters
    Small loss of skin tissue in some cases.
Treatment of bedbug bites
Bedbugs are not known to transmit any blood-borne diseases. However, the bites can be itchy and distressing.
Suggestions to treat bedbug bites include:
    Resist the urge to scratch.
    Use calamine lotion or anaesthetic creams to treat the itching.
    Wash the bites with antiseptic soap to reduce the risk of infection.
    Apply an icepack frequently to help relieve swelling.
    Take pain-killing medication if symptoms are severe.
See your doctor if the bite develops an infection.
Avoiding an infestation
In general, bedbugs enter your home in luggage or on secondhand items such as bedding and furniture. Taking care with these items, in addition to high standards of hygiene and housekeeping, should help to minimise the chance of an infestation in your home.
Controlling a bedbug infestation
High standards of hygiene and housekeeping alone are unlikely to control an infestation. However, keeping a house clean will reveal the presence of bedbugs at an early stage, making control easier and reducing the chance of widespread infestation.
Some general suggestions to eliminate bedbugs include:
    Thoroughly wash, vacuum or clean all surfaces and bedding.
    Wash bedding and affected clothing where possible, using hot water. Dry in a clothes drier on a hot setting.
    Vacuum mattresses, seal in dark plastic and leave outside in the hot sun for as long as possible.
    Steam clean carpets.
    Spray common hiding spots with a surface insecticide registered to control bedbugs. Follow the label directions carefully. Do not treat bedding with insecticide.
Your local council can offer information and advice on dealing with a bedbug infestation.
Hiring a professional pest control operator
A qualified pest control operator can determine the extent of the infestation, then use registered insecticides to kill the bedbugs. Repeat visits may be necessary to ensure all bedbugs at various stages of the lifecycle have been eradicated.
Good hygiene practices, such as frequent house cleaning, should help to prevent any further infestations. However, vacuuming immediately after treatment should be avoided to ensure that the residual insecticide is not removed. For further information, consult your pest control operator

Dandruff and itching scalp

 Dandruff (pityriasis capitis) is the term used to describe simple scaling of the skin on the scalp. About 50 per cent of the population suffers from dandruff. Applying simple oils (for example, bath oil) to the scalp can be useful in the treatment of dandruff.
Why dandruff occurs
The top layer of the skin is constantly being shed and renewed. Although this usually goes unnoticed when it occurs on most areas of the body, it may become more visible on the scalp as the hair traps the scaling skin.
Itching scalp
Itching scalp, with or without scaling, is a very common problem. It commonly occurs in middle-aged people, for no obvious reason. The usual response is to scratch, and this will often cause scratch marks and little crusty sores throughout the scalp. Dandruff can cause itching scalp. There are also a number of less common skin conditions that can present as itching in the scalp.
Seborrhoeic dermatitis can cause itching scalp
Seborrhoeic dermatitis is the name given to a red, itchy, scaly reaction in the scalp. It can be considered a more severe form of dandruff, except the scale is more marked and the scalp is often inflamed. It can be very itchy and can affect other parts of the body, including the face, eyebrows, beard and central chest area.
Symptoms of seborrhoeic dermatitis
Symptoms of seborrhoeic dermatitis develop gradually and may include:
    Dry or greasy diffuse scaling of the scalp. This is the most usual presentation.
    Yellow-red scaling on those areas of the body that are generally affected in severe disease – along the hairline, behind the hair, on the eyebrows, on the bridge of the nose, in the creases between the nose and the lips inside the ears, over the sternum (middle of the chest), on the underarms and groin hairy areas.
Why it occurs
Seborrhoeic dermatitis affects areas with high densities of large oil glands. The inflammation is caused by the body’s reaction to a yeast on the scalp and to products that break down oil produced by the oil gland.
Cradle cap
Cradle cap is a form of seborrhoeic dermatitis that occurs in newborns. It may not be the same disease as in adults. It results in a thick, yellow-crusted scalp lesion. Other symptoms can include:
    Splits in the skin and behind the ears
    Red facial pustules
    Stubborn nappy rash.
Older children can develop thick, stubborn plaques on the scalp, measuring one to two centimetres across.
Factors that can make seborrhoeic dermatitis worse
The incidence and severity of seborrhoeic dermatitis seems to be affected by:
    Other illnesses – for example, patients with neurologic disease (especially Parkinson’s disease, stroke and paralysis) or HIV may have severe seborrhoeic dermatitis
    Emotional or physical stress
    Genetic factors
    Seasonal – seborrhoeic dermatitis is usually worse in winter.
Psoriasis can cause itching scalp
Psoriasis is a relatively common skin condition that affects about three per cent of the population. It is often confined to the scalp, elbows and knees. While seborrhoeic dermatitis tends to involve almost all the scalp, psoriasis often occurs in small, localised patches of redness with quite prominent thick scaling. Because psoriasis may only occur on the scalp, it can be mistaken for a severe case of dandruff or seborrhoeic dermatitis. Psoriasis has a genetic link – there is often a family history of the condition. It may be triggered by some form of stress.
Medicated shampoos can help dandruff and itching scalp
Regular washing of the scalp with medicated soaps may be all that is required to relieve itching scalp. The most common anti-dandruff shampoos contain one or more of the following ingredients:
    Tar – shampoos containing tar have been used for years, usually for more severe scalp conditions. In the past, the scent of the tar-based shampoos made them less acceptable. However, newer preparations are well tolerated and simple to use
    Selenium sulphide
    Zinc pyrithione or zinc omadine
    Piroctone olamine – this is the most recent addition to the medicated shampoos. It is known as a 'second generation' anti-dandruff agent. It is less toxic than zinc pyrithione and is therefore safer for family use
    Antifungal agents.
How often to use medicated shampoos
How often you need to use medicated shampoos will depend on how severe your dandruff is and what treatment you are using. Always read the directions on the shampoo pack before using it. Some products are mild enough to be used every day, while others should only be used once a week. Over time, you will work out how often to use the shampoo to keep your dandruff under control.
Typically, those with a scaly scalp should be shampooing everyday. Infrequent shampooing may result in scale build-up and thus make symptoms worse. A medicated shampoo should be used about twice a week, leaving the lather in the scalp for several minutes to allow the active ingredient to work. On the other days, a mild, non-medicated shampoo can be used to prevent scale accumulation. A conditioner should always be used to prevent excessive drying from frequent washing

Wrinkles

 Wrinkles and sagging are age-related skin changes. Lifestyle has a major effect on the skin’s tendency to wrinkle. Sun exposure and smoking are the most common causes of premature skin wrinkling. If you limit sun exposure and avoid smoking, you can reduce the amount of wrinkles you develop.
Why skin wrinkles
Wrinkles and sagging are age-related skin changes. Elastin and collagen fibres give the skin suppleness and strength. The numbers of these fibres in the skin are reduced as we age, causing wrinkles. Our skin has a layer of fat just below the surface (subcutaneous layer), which gives form and structure. This layer of fat thins out as we age, causing the skin to sag.
Wrinkles and sun exposure
Sun exposure is the most common cause of skin damage and wrinkling. Exposure to the ultraviolet (UV) radiation in sunlight causes changes to the skin. UV rays prompt the formation of free radicals, among other things, which contribute to wrinkling and skin cancer. People with fair skin tend to experience more age-related skin changes, such as wrinkling, than people with dark skin. The best way to prevent wrinkling caused by sun exposure is to:
    Wear protective clothing
    Avoid the sun around the middle of the day
    Use sunscreen for the parts of skin that can’t be protected by clothing.
Smoking and wrinkles
As well as all the other health risks associated with smoking, smokers will have more wrinkles. These changes may not show up till you are in your 30s or 40s but they will happen. Research has shown that people who have never smoked have less wrinkles than smokers

Acne

 Acne is a medical skin problem that usually begins in the early teenage years and can last until the 30s and even 40s. It consists of mild to severe outbreaks of pimples and cysts – mainly on the face, back, arms and chest.
Cysts are lumps under the skin that have pus and other tissue in them, but do not come to a head like pimples do. They can cause scarring, blotchy, uneven skin colour and pitting.
Unfortunately, acne hits people at a time when they most want to look their best. Acne can make teenagers feel embarrassed and bad about themselves. There are treatments that can help if acne is causing distress. If you are concerned about skin problems or skin care, you should talk to your doctor or pharmacist for information about possible treatments.
Hormones and genetics
At the start of puberty, a lot of hormones are released into the body. One of these hormones is testosterone. Both boys and girls have testosterone and other related hormones called androgens, but boys have more of them. Androgens affect oil glands in the skin of the face, neck, back, shoulders and chest. They make the glands grow bigger and produce more oil (sebum).
Bacteria on the skin and blocked pores result in blackheads, pimples and cysts. A teenager is more likely to get acne if one of their parents had it during adolescence, but even in the same family, some people may get worse acne than others.
Girls tend to get it at a younger age than boys and it can become worse or ‘break out’ at certain times of a girl’s menstrual cycle, such as just before a period and they also tend to have ongoing acne, even into their 30s or 40s. Boys often have more outbreaks than girls, and they often seem to get more severe acne – worse pimples and more cysts.
Self-help strategies
Suggestions to manage acne include:
    Cleansing – cleansers specifically developed for acne-prone skin can help. Try washing the affected areas twice per day. Don’t overdo it. Too much cleansing can cause other skin problems, such as dryness or skin irritations. Try to keep hair clean and off the face and neck, as oil from the hair can make acne worse.
    Make-up – choose water-based, oil-free products where possible to avoid worsening acne by clogging the pores with oils or powder. Make-up should be thoroughly removed before going to bed.
    Don’t squeeze – picking and squeezing pimples can make it worse and lead to scarring.
    Stress – this can trigger an outbreak of pimples as it causes the release of hormones that can make oil glands release more oil onto the skin. This is why pimples seem to magically appear on stressful days, such as at the time of an exam or special date. While stress may be difficult to control, at least you know that the outbreak is due to stress, not a sign that the treatments do not work.
    Diet – there is now more evidence that a low-GI diet may help some people with acne. Many people think that lollies or chocolate cause pimples. Research has not shown any strong link with these foods, but if you notice that eating certain foods causes pimples for you, try avoiding them.
Treatment for acne – non prescription
Some acne treatments can be bought over the counter at chemists or supermarkets. These work by cleaning the skin and drying up excess oil. Mild irritation can occur with such treatments. If this happens, take a short break from treatment and restart after a few days. If the irritation is excessive, stop the medication and speak to your doctor about an alternative.
It is a good idea to talk to the pharmacist before you buy a product to find out which treatment might be the most useful for you. A cleanser for acne-prone skin may be all that is needed for mild acne. Don’t rely on advertisements or the advice of friends.
Treatment for acne – professional
If your acne is not improving with over-the-counter treatments or if you have more severe forms of acne, you will need to see your doctor. They can prescribe medication after assessing your acne. The may also refer you to a dermatologist. Medications can lead to huge improvements in how the skin looks and can reduce the number of new pimples.
Medical treatments are topical or oral and can include:
    Retinoids, which unblock pores of existing acne and prevent new blockages from developing
    Antibiotics to kill bacteria and reduce inflammation
    Hormonal agents, such as the contraceptive pill, to reduce the amount of androgen in the body and therefore oil secretion.
Doctors may also recommend more than one acne treatment, as different treatments work differently to fight acne. Fixed-combination products are also available, which blend together two treatments into one product.

Sweat

 Sweat is produced by glands in the deeper layer of the skin, the dermis. Sweat glands occur all over the body, but are most numerous on the forehead, the armpits, the palms and the soles of the feet. Sweat is mainly water, but it also contains some salts. Its main function is to control body temperature. As the water in the sweat evaporates, the surface of the skin cools. An additional function of sweat is to help with gripping, by slightly moistening the palms.
Normal sweating
Normal, healthy sweating is caused by:
    Hot temperatures, such as in summer
    Physical exercise
    Emotional stress
    Eating hot or spicy foods
    Fever associated with illness.
Increased sweating (hyperhidrosis)
Abnormal increased sweating is known as hyperhidrosis. Idiopathic hyperhidrosis is the most common form of excessive sweating. It is called idiopathic because no cause can be found for it. It can develop during childhood or later in life and can affect any part of the body, but the palms and soles or the armpits are the most commonly affected areas. The excessive sweating may occur even during cool weather, but it is worse during warm weather and when a person is under emotional stress.
Some known causes include:
    Obesity
    Hormonal changes associated with menopause (hot flushes)
    Illnesses associated with fever, such as infection or malaria
    An overactive thyroid gland (hyperthyroidism)
    Diabetes
    Certain medications.
In the majority of cases, no investigations are required to diagnose hyperhidrosis. Occasionally, a blood test for thyroid disease is recommended.
Treatment for excessive sweating
Treatment for excessive sweating depends on the cause. This may include:
    Reducing weight – if obese
    Medical management – to reduce the hot flushes of menopause
    Antiperspirant applications – sprays, powders and roll-ons
    Iontophoresis – the activity of sweat glands is temporarily reduced by passing a low-level electric current through the skin
    Botox injections – to paralyse sweat glands. The effect from a single injection lasts six to nine months
    Surgery – to the nerves that control sweat glands may be considered in severe cases where all other treatments have been unsuccessful.
Self-help strategies for hyperhidrosis
Some strategies for managing hyperhidrosis at home include:
    Wear loose clothing.
    Use antiperspirants that contain aluminium chloride and are designed for hyperhidrosis – follow the instructions carefully. While advertised mainly for use in the armpits, these agents can also be used on the palms, soles and forehead or wherever the hyperhidrosis occurs.
Reduced sweating (hypohydrosis)
Reduced sweating is called hypohidrosis, if there is partial loss of sweating, or anhidrosis if there is complete lack of sweating. This can occur for a number of reasons, which include:
    Some skin disorders
    Burns to skin that damage the sweat glands
    Underactive thyroid (hypothyroidism)
    Dehydration
    Prolonged excessive heat or exercise during hot weather.
Lack of sweating may create problems of temperature control and lead to steep rises in body temperature during hot weather. Occasionally, this can be life threatening.
Heat stroke and heat exhaustion
Heat stroke (or sun stroke) can occur in hot weather when not enough sweat is produced to keep the body cool. Symptoms can include:
    Muscle cramps
    Headache
    Nausea
    Vomiting.
Excessive loss of body salts and water can lead to a life-threatening complication known as heat exhaustion. Heat stroke can be managed, and heat exhaustion prevented, by seeking a cool, shaded place, drinking plenty of fluids and sponging the body with water, if necessary