Every beauty buff knows that exfoliation is a key part of any skincare routine. Whether you use a physical scrub or a hydroxy acid solution that penetrates below the surface, sloughing away dead skin cells is essential for maintaining a smooth, glowing complexion. When it comes to hair care, it’s easy to forget the importance of looking after your scalp, but experts warn the consequences of neglecting the skin on your head can be serious. “How healthy your scalp is has a direct effect on how healthy your hair grows,” says says trichologist and Viviscal ambassador Hannah Gaboardi. “Scalp issues such as dandruff and psoriasis are linked to hair breakage. Having poor scalp health can also lead to premature hair loss.” While we talk about washing our hair, lathering up with shampoo is about keeping the scalp clean too. “Our scalps collect dust, dirt, oils and dead skin cells which can all lead to a breeding ground for fungi and bacteria,” says Anabel Kingsley, trichologist and brand president at Philip Kingsley. “Malassezia yeast – the root cause of dandruff – breeds in an oily scalp environment, contrary to popular belief that it’s a dry scalp issue.” How can you tell if your scalp health is suffering? “Some of the first things I tell my clients to look out for if they are having issues with their scalp is if it becomes itchy, starts to burn, hair loss and dandruff,” Gaboardi says. Kingsley says others signs may include: “Irritation, flaking, pustules, odour, scabbing, bleeding and excessive oil.” She continues: “Perhaps it’s because we cannot see our scalp, but it’s very often neglected, and common sense tends to go out of the window when it comes to looking after it.” So what does a sensible scalp care routine look like? The good news is that it’s not complicated, and only requires two steps. The first step is cleansing, which you’re probably already doing if you shampoo your hair regularly. “A clean scalp promotes good cell turnover, leading to super healthy strands,” says Gaboardi. “When your hair and scalp aren’t covered in the build-up – whether it be dead skin cells or product, you are less likely to suffer from dandruff.” Contrary to the recent TikTok trend for ‘hair training’ – leaving your locks unwashed for as long as possible so they produce less oil – frequent shampooing is best, according to our experts. “Daily if your hair is fine, or at least every third day if you have coarse or coiled hair textures,” says Kingsley. “You wouldn’t leave three days between washing your face, and you likely wouldn’t wear the same outfit more than a few times before washing it – apply the same thinking to your hair.” The second step is exfoliation, which can be done in tandem with your shampoo. “I always recommend incorporating a scalp massage into your routine which increases hair thickness and stretches the cells of hair follicles to produce fuller strands,” says Gaboardi. “It’s also thought that direct stimulation and stretching of human dermal papilla cells may help dilate blood vessels beneath the skin encouraging hair growth.” She likes to use a massaging tool with spiky (but soft) plastic bristles once or twice a week: “Put the shampoo on first, then massage it into your scalp. This is a great way at exfoliating the scalp and removing any dead skin cells.” Alternatively, you can apply a specially formulated scalp serum or mask. “Scalp masks containing gentle chemical exfoliants are great for general scalp health, but especially for those who suffer from dandruff and seborrhoeic dermatitis as they help to remove dead skin cells,” says Kingsley. Don’t be too heavy-handed, she warns: “You should not scrub a scalp mask into your skin – gently but firmly massage it in. “Most masks are formulated to be left on for up to an hour, but read the directions on the packaging as this will vary.” There’s one other benefit to giving your scalp a bit of TLC, Gaboardi adds: “Your hair products are able to penetrate your scalp better and easier, leading to more effective results.” Skincare for hair: 8 effective products to cleanse and exfoliate your scalp 1. The Body Shop Ginger Shampoo Bar, £10 2. Ffør Purify: Scalp Cleanse, £22 3. Philip Kingsley Flaky/Itchy Scalp Anti-Dandruff Mask, £20 4. Boots Ingredients Exfoliating Scalp Serum With Salicylic Acid, £2.55 5. Arkive The Root-ine Scalp Scrub, £6, Boots 6. Ful Detox Scalp Treatment, £30 7. Ful Scalp Massager Shampoo Brush, £9.50 8. Body Proud Sami the Duck Scalp & Body Brush, £8.95 Read More Why do some people love horror movies? TikTok influencers warn about ‘potent’ steroid cream risks among black women – dermatologist explains the risks House of the Year 2023 shortlist revealed by Royal Institute of British Architects Fatima Whitbread supporting new fostering campaign, as research finds ‘misconceptions put people off’ 5 key coat trends to complete your autumn/winter wardrobe 12 ways to weave some woodland wonder into your home

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Seven years ago, I was at my local antenatal class preparing for the birth of my firstborn. In my forties and armed with a coloured birthing ball, I looked around and gasped. All the other soon-to-be-mums were at least a decade younger than me. Some were nearly half my age. It briefly panicked me. Would I make any friends? Why did I leave it so late to have kids? Was I doing something wrong? In hindsight, though, I had no reason to worry: your forties is absolutely the best decade in which to have your first child. According to data published last week in The Daily Telegraph, the number of women becoming first-time mothers in their forties has increased in recent years: today, one in 25 UK births is to a woman aged 40-plus. That’s a lot of women just like me, despite the fact that getting pregnant over 35 gets you labelled as someone of “advanced maternal age”. That might sound harsh until you remember that older pregnancies used to be termed “geriatric” – thank God that’s been phased out. I’ve never regretted waiting until my forties, even if I had been trying for children for years by that point. My story is undeniably unique: my partner Alex took his own life while we were doing IVF, but that didn’t stop me from continuing to try to get pregnant. The maternal call was strong, so I decided to carry on with the process using Alex’s frozen sperm. Today I have two beautiful daughters with him: Lola, seven, and Liberty, five. It is an understatement to say I was ready for a baby at 40. I was grounded. Confident. Unlike when I was in my twenties or thirties, I knew exactly who I was and what made me tick. I had life experience. I no longer got FOMO. I didn’t even drink, having been through hell and back to become sober 20 years earlier. My career was fully off the ground, and therapy had helped me identify the family dysfunction I knew to ditch for the sake of my kids. I also wasn’t worried about my body bouncing back after the birth. I just desperately wanted to be a mum. Of course, there are all sorts of advantages to having children in your twenties and thirties. A huge bonus is that you’re simply more fertile. According to research, 31 is the magic age to have a baby – you’re still as fertile as in your twenties, but you also have more money. I’m sure motherhood in your fifties is great, too – although using your own eggs is highly unlikely, unless you froze them at some point before you turned 35. It means that some older mums often turn to donor eggs. Thinking back on my twenties and thirties, I don’t know how I would have managed motherhood. I don’t think I was ready to put my own needs on hold. I can’t imagine how hard it would have been to juggle work and my children, especially with the spiralling costs of childcare. I do accept that there are greater risks inherent in waiting to have kids. Both the quantity and quality of eggs dwindle. The rates of failed fertilisation, miscarriage and birth defects rise with age. There’s also the social pressure that comes with not having children early – you’re forced into endless conversations about the “ticking timebomb” of your fertility, and expected to fend off probing inquiries about your biological clock. The British Fertility Society advises women to start trying for a baby by the age of 32 at the latest, for a 90 per cent guarantee of having a child without resorting to IVF. But this advice simply wouldn’t have worked for me – I was determined to find the right person to have children with, and that didn’t happen until I was 35. When mine and Alex’s attempts to naturally conceive failed, and then Alex died, only at that point did I know I had the maturity to go it alone. I do have some regrets – I wish I’d frozen my eggs at the peak of my fertility in my mid-twenties, for instance (this process costs between £4,000 and £7,000 in the UK). But otherwise, having children in my forties was the right thing to do. Yes, I had my wobbles. I remember sobbing on the bathroom floor after yet another failed pregnancy test. I would berate myself for leaving it so late. I had to force myself to remember that many women experience fertility struggles in their twenties and thirties, too. All of those anxious feelings, though, flew out the window once I had my first child. When I left the hospital to begin parenthood alone, a new bag of nappies in hand, I didn’t have a meltdown. I was just so grateful that I’d had a baby, especially when the odds seemed so stacked against me. Sleepless nights trying to coax my child back to sleep were what I had most desired. It was all so good, in fact, that I went on to have a second child in my forties. I had a spare embryo in a freezer in St Petersburg. Now I call her Liberty. Every day since becoming a mum, I have embraced the mess and chaos, and appreciate every minute. I’m sure my younger self would cringe at the thought of me spending my evenings helping my children with their homework. But I’m proud to say that I’m living my best life. Read More Vanessa Hudgens addresses pregnancy speculation amid Cole Tucker engagement Rachel Bilson reveals she’s suffered multiple miscarriages Pregnant woman has maternity photo shoot in hospital before giving birth Hailey Bieber responds to ‘disheartening’ pregnancy rumours Like Rebecca Adlington, I also lost my baby at 20 weeks Britney Spears reveals she had an abortion while dating Justin Timberlake

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It’s no secret that women are more likely than men to be misdiagnosed by a medical professional. In fact, as many as 57 per cent of women have reported being wrongly diagnosed by a doctor. In 2016, a study found that women have a 50 per cent higher chance than men of receiving a misdiagnosis after a heart attack, while researchers found in 2014 that 33 per cent of women are more likely than men to be misdiagnosed after a stroke. When it comes to women’s health, an explicit gender bias in medicine can lead to serious and sometimes life-threatening results. That’s why Dr Erin Nance, an orthopaedic hand and wrist surgeon located in New York City, has dedicated the month of October to sharing the most commonly misdiagnosed health conditions that affect women. Her series has since gone viral on TikTok, as she discussed how symptoms of rare autoimmune disorders or infertility can present differently in women, leading to a misdiagnosis. For the first video of the series, Dr Nance revealed how postural orthostatic tachycardia syndrome - also known as POTS - affects more than one million people, but is present in mostly women aged 20 to 50. However, Dr Nance explained that POTS is so difficult to diagnose because “we can’t see it”. “This is the group of women that get written off by doctors because they look healthy. There doesn’t seem to be anything wrong with them,” she said. According to the National Institute of Neurological Disorders and Stroke, POTS is a condition in which a reduced volume of blood returns to the heart after someone stands up from a lying down position. As a result, patients with POTS may experience an increased heart rate, dizziness, or fatigue when they stand up after lying down. @littlemissdiagnosed Day 1: It’s me, POTS, I’m the the problem it’s me #littlemissdiagnosed #31for31lmd #pots ♬ original sound - Dr. Erin Nance 🇺🇸 Dr Nance explained that some other symptoms of POTS include “chronic fatigue, brain fog, total body chronic pain, GI [gastrointestinal] stomach issues, anxiety, headaches, and it can affect any part of your body”. Another difficulty about POTS is that there’s “no specific treatment” to help the condition, Dr Nance said. “We can’t do a biopsy, we can’t do any imaging, there’s no blood test for it,” she added. Instead, doctors may recommend drinking more fluid, exercising regularly, or wearing compression stockings to keep blood flow in the centre of the body. For the 14th day of her video series, Dr Nance received 1.4m views when she spoke about the commonly misdiagnosed symptoms of stroke in women. “Stroke is the third leading cause of death in women,” she began the clip. “Yet, women are over 33 per cent more likely to be misdiagnosed when having an acute stroke.” Dr Nance admitted that most women who experience a stroke are often told by doctors that they simply have anxiety or a migraine. When it comes to the “unique” symptoms of stroke that are present in women, some may experience loss of consciousness or fainting; general weakness; shortness of breath; confusion, unresponsiveness, or disorientation; sudden behavioural change; agitation; hallucination; nausea or vomiting; seizures or even just hiccups. @littlemissdiagnosed Day 14: Stroke is no joke #littlemissdiagnosed #31for31lmd #stroke ♬ original sound - Dr. Erin Nance 🇺🇸 “These unique symptoms are often the ones that are overlooked,” Dr Nance said, before detailing the individual risk factors that can put women at a greater chance of having a stroke. The first on the list of risk factors was taking birth control pills, followed by pregnancy, hormone replacement therapy, and history of suffering from migraines. “The reason why this is so important for everyone - every normal, everyday person - to know this is because the best outcomes are when women are evaluated and treated within three hours of having this symptom,” Dr Nance added. On day 16, the orthopedic surgeon explained how symptoms of a heart attack can also be wrongfully overlooked by doctors. “More women than men die of heart disease every year, yet women have a 59 per cent increased risk of being misdiagnosed with acid reflux, stress, or anxiety,” Dr Nance said. Besides chest pain, a woman may exhibit signs of a heart attack when she experiences unusual fatigue for several days; sleep disturbances; shortness of breath; lightheadedness; nausea or cold sweats; indigestion or gas-like pain; and pain in the arm, neck, jaw, or back. @littlemissdiagnosed Day 16: It’s not always Big on the Peloton #littlemissdiagnosed #31for31lmd #heartattack #womensheart ♬ original sound - Dr. Erin Nance 🇺🇸 When it comes to multiple sclerosis (MS), Dr Nance revealed on day 19 of her video series that women are 83 per cent more likely to be misdiagnosed for MS by a doctor. MS is a disease that affects the “myelin” - the protective sheath covering the brain, nerves, and the spinal cord. According to Dr Nance, some of the often-missed signs of MS include extreme fatigue, confusion, forgetfulness, and mood swings. @littlemissdiagnosed Day 19: You’re gonna be okay #littlemissdiagnosed #31for31lmd #ms #multiplesclerosis ♬ original sound - Dr. Erin Nance 🇺🇸 As for lupus - an autoimmune disease in which the immune system attacks its own tissues, causing inflammation in the body - Dr Nance shared in the 20th video of her series that women between the ages of 15 and 45 are most likely to develop the disorder. “The average time from when you first develop your symptoms to diagnosis is six years,” Dr Nance revealed. @littlemissdiagnosed Day 20: Sneaky little 👿 #littlemissdiagnosed #31for31lmd #lupus ♬ original sound - Dr. Erin Nance 🇺🇸 She claimed that 46 per cent of patients report being misdiagnosed with something other than lupus, while “54 per cent of them were told that either nothing was wrong with them or that their symptoms were psychological.” “The main problem with lupus is that the longer you go undiagnosed and untreated, then the greater risk for end organ damages,” she added. The Independent has contacted Dr Nance for comment. Read More How to optimise your 22 minutes exercise a day according to fitness experts TikTok influencers warn about ‘potent’ steroid cream risks among black women – dermatologist explains the risks Want to be a useful man? Arnold Schwarzenegger is here to tell you how How to optimise your 22 minutes exercise a day according to fitness experts TikTok influencers warn about ‘potent’ steroid cream risks among black women – dermatologist explains the risks Want to be a useful man? Arnold Schwarzenegger is here to tell you how

Jay-Z is more than just a father – he’s a style advisor too. The famed 53-year-old may not have gotten one of his daughter’s stamps of approval for his fashion sense in the past, but he has it now. In conversation with Gayle King on CBS Mornings, Jay-Z opened up about how Blue Ivy, 11, has warmed up to the idea of him being the “cool” dad. “She used to be frontin’ on me a little bit,” Jay-Z admitted. “But [now] I catch her. I catch her in the corner, you know? Now she asks me, you know, if this is cool, if her sneakers [are cool].” King, 68, inquired further about whether Blue Ivy actually goes to her father for advice on what to wear. “Yeah, yeah, yeah,” the “Empire State of Mind” vocalist proclaimed. But while Blue Ivy’s perception of Jay-Z may be on the mend, he explained how she used to be a bit overly embarrassed of him and he’d then have to explain that he really was hip. “There was a time where she was like, ‘Daaaaad’,’” he quipped. To this, he’d normally answer: “I’m cool. I don’t know what you sayin‘. I’m cool! You got cool parents! At your house, your parents [are] cool.” Like mother like daughter, Blue Ivy’s interest in style isn’t surprising considering both her mom and dad’s position in the fashion world. In the past few months, the “Lemonade” creator donned bold designer each night of her Renaissance tour, from custom Versace to Alexander McQueen. David Koma reflected on what it was like to dress the sought-after music legend for her world tour when speaking to Harper’s Bazaar. “For us, the designers, it is not just an amazing exposure but a wonderful cultural moment to be a part of,” the creative said. “A global tour like this is an incredible, culture-defining event.” “Having seen some of the videos from this tour – you just know it’s a once-in-a-lifetime magical performance that every attendee will remember forever,” he continued. “Considering the creativity that goes into putting on a show like that, it makes sense to work with designers for special couture and custom looks.” Beyoncé’s 57-concert run was special for a myriad of reasons, but being able to share the stage with her eldest daughter was the icing on the cake. Blue Ivy danced alongside her mom to songs like “My Power” and “Black Parade” for multiple concerts along the way. After the young prodigy’s first appearance in Paris, Beyoncé took to her Instagram to express how meaningful the experience was to have her daughter perform with her. “My beautiful first born. I’m so proud and thankful to be your mama. You bring us so much joy, my sweet angel,” she wrote next to a slide deck of images from the show. Blue Ivy is one of three children Jay-Z and Beyonce share. The two welcomed twins Rumi and Sir in June of 2017. The “Single Ladies” singer and “Part II” artist tied the knot 15 years ago in front of an intimate group of close friends and family. Read More What is lunch with Jay-Z worth? Less than $500k, he thinks ‘Ozempic is exposing holes in the body positivity movement’ Dolly Parton shares expert response to critics who tell her to ‘tone down’ her look ‘Ozempic is exposing holes in the body positivity movement’ Dolly Parton shares expert response to critics who tell her to ‘tone down’ her look Why Black models are boycotting Melbourne Fashion Week

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According to skin influencers on TikTok, topical steroid creams are being ‘illegally sold’ in some black Afro hair and beauty supply stores, affecting black women in particular. Angela Mavalla, a pharmacist and skincare educator, has been sharing TikTok videos garnering thousands of views, encouraging black women to stop purchasing topical steroid creams from these shops – as they are meant to be prescription-only treatments used with appropriate guidance from a doctor. When used incorrectly, the creams can make potentially make skin symptoms worse and harder to manage. “Though these creams tend to address issues like acne and eczema very quickly, because of their potent nature, the skin becomes addicted to it and will flare up badly once you stop using them,” said Mavalla. “A lot my clients – [who are black women] – that I consult privately, were coming to me with issues relating to topical steroid use, such as having terrible flare-ups because they had stopped using the cream, and needed help with tapering off them. “I began making content based on these creams, mainly to warn people of them, and found that these TikTok’s would go viral in a short space of time, with lots of people relating to it, and giving their own testimonials of how the creams damaged their skin,” Mavalla added. “I have seen instances of accidental skin bleaching, worsened eczema and hyperpigmentation, topical steroidal withdrawal and addiction, and worst of all, a crippling low self-esteem and self image. It’s awful. “The first point of call when it comes to steroidal creams should always be a pharmacy. Pharmacists are always willing to help, advise and where necessary, signpost to the most appropriate medical profession, such as a dermatologist.” Dr Unnati Desai, the national GP lead, as well as safeguarding lead for GP services and dermatology lead at Nuffield Health, acknowledged that it can take sometimes take time to correctly diagnose these conditions, and might require a biopsy. It might also take a longer period of time to get symptoms under control, as skin conditions may require trying multiple different treatment regimes to find the one that suits each individual person, as well as getting to grips with individual triggers. What are topical steroid creams and what should they be used for? Doctors prescribe topical steroid creams to treat a wide range of skin complaints – but it’s important to have proper assessments first. “They are topical medications (synthetic corticosteroids) that have an anti-inflammatory action on the skin, by suppressing the skin immune system and constricting the blood vessels of the skin where applied,” Desai told the PA news agency. “They are used for dermatological conditions that result in inflamed, itchy or irritated skin – e.g. eczema, psoriasis, lichen simplex, lichen planus, lichen sclerosus and other autoimmune dermatoses.” Why do people experience topical steroid withdrawal after using steroid creams? When used incorrectly, topical steroids may have potentially significant side-effects. And as Desai warned: “Stopping any steroid treatment suddenly can often result in a flare-up of the condition, which may be worse than the original presentation.” There are some obvious signs and symptoms to look out for to figure out if you are experiencing topical steroid withdrawal, such as red, burning skin and a lumpy, papulopustular rash. “When using a steroid cream to get a dermatitis flare-up under control, especially when a more potent steroid cream has been used for a prolonged period of time, it is necessary to slowly come off the steroid cream and wean your skin off treatment by either reducing the potency of the cream, or the frequency [of application],” said Desai. “This gives the skin time to adjust to coming off the steroid cream slowly, but also clarifies whether the skin condition is coming under control with treatment. “Sometimes, severe dermatoses require long-term use of a medication to be controlled, in which case your doctor will consider alternative treatment modalities.” What damage can it do to your skin?Desai added: “Long-term use of potent steroid creams is not recommended, as there may be some systemic absorption, which can result in suppression of your body’s natural cortisol hormone at the worst. “In most cases, it is the long-term impact on the skin itself that is the concern, as regular or long-term use of steroid creams can impact the skin integrity and thickness, resulting in thinning of the skin, stretch marks, increased hair at the site of use, enlarged skin blood vessels and bruising. “Using a steroid cream when there is an underlying infection present on the skin will make the infection worse, or using steroid creams on the face can result in other chronic skin conditions, such as perioral dermatitis or other acneiform eruptions. “Occasionally, an allergy can develop to components within the cream that can make the dermatitis worse.” How can people remain safe? Desai stressed the importance of only using topical steroid treatments under the appropriate supervision of a qualified clinician. “In addition, as most chronic inflammatory skin conditions tend to result in drier skin, self-care at home with soap substitutes and emollients is important,” she said. “This includes gently cleansing the skin one to two times daily maximum (over-washing will negatively impact the skin barrier function, as will long hot bubble baths), and using unscented emollients (medical grade skin creams designed to gently hydrate the skin), which will better protect the skin and may, depending on the skin condition, make a flare-up less frequent or less severe. “If a steroid cream is needed, a doctor will recommend the amount of cream to be used according to the size of the area affected. We use the ‘Finger Tip Unit’ (FTU) – one FTU is the amount of topical steroid that is squeezed out from a standard tube along an adult’s fingertip – as a method of advising each patient how much cream they need to use with each application.” Read More House of the Year 2023 shortlist revealed by Royal Institute of British Architects Fatima Whitbread supporting new fostering campaign, as research finds ‘misconceptions put people off’ 5 key coat trends to complete your autumn/winter wardrobe 12 ways to weave some woodland wonder into your home Hibernation mode: 5 small self-care adjustments to make before the clocks change 13 possible cancer symptoms you should get checked out

Pfizer and German partner BioNTech said on Thursday that their vaccine to prevent flu and COVID-19 generated a