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Acne Vulgaris
Acne Vulgaris is a common disease of the skin affecting all ages near puberty. Acne is a disease of the Pilosebaceous unit, affects 80% of young people between 12 and 18 years of age. Acne may be trivial, with only a few comedones or papules or may occur as the highly inflammatory and diffusely scarring one.

Acne most commonly appears on the face but can also occur on the back, chest, shoulders, and neck.

How to Manage Acne?

Acne can be managed with the proper medication or a combination of medications. There are several prescription treatments, both topical and oral, that are highly effective in treating the different types of acne. If you have tried OTC treatments (the ones you buy from drug stores) with limited success, it may be time to see a dermatologist.

If you are using creams, gels or lotions, it is important to cover the entire affected area (don’t just spot-treat), as the medication may help prevent new pimples from forming. It is also important to follow the instructions for applying these treatments, since using too much of the products will not help your skin get better faster, rather may lead to irritation.

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Dryness Of Skin

The outermost layer of the skin is called stratum corneum. The Stratum corneum is 1mm thick, after absorbing water it becomes 3mm thick. Stratum corneum holds 5 to 6 times water. Water loss from the skin is from the dermis to blood to the epidermis by osmotic pressure.

Stratum corneum is covered with the lipid layer, which prevents water loss and maintains moisture. The water loss from Stratum corneum is called Transepidermal evaporation. Stratum corneum takes 7 to 10 minutes to absorb water from an outside water source. In the case of infants the sebaceous glands are underdeveloped and in geriatrics sebaceous atrophy causes the dryness. To replenish the lipid layer with moisturizing cream.

Factors for skin dryness

  • The oil glands do not supply enough lubrication to the skin. As a result, the skin becomes dehydrated.
  • Dry skin could be due to a genetic condition.
  • Poor diet. Nutritional deficiencies, especially deficiencies of vitamin A and the B vitamins, can also contribute to dry skin.
  • Environmental factors such as exposure to sun, wind, cold, chemicals, or cosmetics, or excessive bathing with harsh soaps.
  • Conditions such as dermatitis, eczema, psoriasis, or seborrhea.
  • Dry skin can be a sign of an underactive thyroid
  • Serious skin complications can arise for people with diabetes
  • Certain drugs, including diuretics, antispasmodics, and antihistamines, can contribute to dry skin

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Skin constantly sheds dead cells every 28 days. This shedding is normal and most of the time it is unnoticed. When the shedding of skin from the scalp becomes obvious or is accompanied by itchiness then it is called dandruff.

A fungus Pityrosporum Ovale. Over abundance of this organism is instrumental in the development of scalp, scaling and irritation.

  • Cold weather and dry indoor heating.
  • Excessive use of hair colouring products or electric hair curlers.
  • Tight fitting hats or scarves.
  • Excessive use of hair sprays and gels.
  • Stress, anxiety and tension.
  • Infrequent shampooing of hair or inadequate rinsing.

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Sharply demarcated, brown macules, usually in a symmetrical distribution on the cheeks and foreheads and sometimes the upper lip and neck, often associated with pregnancy or other altered hormonal state attributes to Melasma.

Melanocytes supply skin pigment Melanin which impart colour to the skin.

Melanosome present in the cells is in the form of small balloon-like sacs which when clubbed together makes the person look fair. But as they step out in the sunlight these sacs spread as a result colour changes into darker. If sun exposure is more, the melanosomes start to produce more melanin.

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Male pattern baldness

Androgenic alopecia is a genetic condition that can affect both men and women. It is characterized by a receding hairline and gradual disappearance of hair from the crown and frontal scalp. Hair is lost in a well-defined pattern, beginning above both temples. Over time, the hairline recedes to form a characteristic “M” shape. Hair also thins at the crown of the head, often progressing to partial or complete baldness.

The pattern of hair loss in women differs from male-pattern baldness. In women, the hair becomes thinner all over the head, and the hairline does not recede. Androgenic alopecia in women rarely leads to total baldness.

A variety of genetic and environmental factors play a role in causing androgenic alopecia. Although researchers are studying risk factors that may contribute to this condition, most of these factors remain unknown. Researchers have determined that this form of hair loss is related to hormones called androgens, particularly an androgen called dihydrotestosterone (DHT).

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Scabies is an infestation by the itch mite, Sarcoptes scabies. They reproduce on the surface of your skin and then burrow into it and lay eggs. This causes an itchy, red rash to form on the skin which tends to worsen at night. The mites which cause scabies are not visible with the naked eye but can be seen with a magnifying glass or microscope.

How do you get scabies?

Scabies usually is spread by direct, prolonged, skin-to-skin contact with a person who has scabies. Contact generally must be prolonged; a quick handshake or hug usually will not spread scabies. Scabies is spread easily to sexual partners and household members. Scabies is spread easily to sexual partners and household members. Scabies in adults frequently is sexually acquired. Scabies sometimes is spread indirectly by sharing articles such as clothing, towels, or bedding used by an infected person; however, such indirect spread can occur much more easily when the infested person has crusted scabies.

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Atopic Dermatitis
An itchy inflammation of the skin, Atopic dermatitis usually develops in early childhood and is more common in people who have a family history of the condition. The main symptom is a rash that typically appears on the arms and behind the knees, but can also appear anywhere. Treatment includes avoiding soap and other irritants. Certain creams or ointments may also provide relief from the itching.

Topical steroids are commonly used to treat moderate to severe disease, but chronic use of these agents at higher concentrations can cause skin atrophy and pigmentation changes. Chronic use of higher potency steroids can also have systemic effects on the hypothalamic/pituitary axis and inhibit growth. These adverse events may limit corticosteroid use in young children and adults in all areas, especially the face and intertriginous zones.

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Sun is necessary for life, about 15 minutes of exposure a day helps the body make Vitamin D, which is important for healthy bones and teeth. However, too much sun exposure may lead to adverse health effects, from wrinkles to skin cancer. UV strength is greatest from 10.00 am to 4.00 pm during sunny summer days. Snow, water, and sand increase sun exposure by reflecting incoming UV rays. Up to 80% of UV rays pass through clouds, meaning that sunburn is possible on cloudy days as well.

Two types of UV radiation, UV-A and UV-B, have a myriad of harmful effects on the skin, contributing to skin colour change and premature ageing. UV-A rays are not absorbed by the ozone layer and penetrate deep into the skin contributing to premature ageing. UV-B rays are partially absorbed by the ozone layer and mostly affect the surface of the skin, and are the primary cause of sunburn. Because of the thinning of the ozone layer, the effect of UV-B radiation poses an increased risk. UV radiations also weaken the immune system and are known carcinogen. It is estimated that a very high percentage of non-melanoma skin cancer (NMSC) and melanoma skin cancer are associated with exposure to UV radiation.

In response to serious health hazards raised by overexposure to UV radiations, it is essential to protect from UV radiations.

How do sunscreens work?

Sunscreens are products (chemical / physical agents) applied to the skin to protect against the harmful effects of the sun’s ultraviolet (UV) rays. Sunscreen’s active ingredients work by absorbing, reflecting, or scattering some or all of the sun’s rays.

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Vitiligo or leucoderma is a chronic skin disease that causes loss of pigment cells (melanocytes), resulting in irregular pale patches of skin. Vitiligo occurs when pigment-producing cells die or stop functioning. Loss of skin colour can affect any part of the body, including the mouth, hair, and eyes. It may be more noticeable in people with darker skin. The patches of skin affected become white and usually have sharp margins. The hair from the skin may also become white.

Treatment may improve the appearance of the skin but doesn’t cure the disease.

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Periorbital Hyperpigmentation

The eyes are often described as “the windows to our soul “and can provide all sorts of information about our general health and wellbeing. The delicate skin around the eye is very thin and prone to puffiness and sagging and hence requires special care beyond what a topical wrinkle cream can offer. Dark circles under the eyes can have causes that aren’t due to underlying disease. Examples include a family history of dark circles, exhaustion, lack of sleep, allergies, eye rubbing, or excessive sun exposure.

Periorbital hyperpigmentation (POH) or dark circle is a significant cosmetic problem. The occurrence can be an outcome of any of the intrinsic & extrinsic factors, genetics, excessive vascularity, thin skin, vitamin k deficiency, facial anatomy, chronic sinusitis, intraorbital swelling, sun exposure, allergies, fatigue, eye strain, medication-induced (hormonal therapy), excessive use of caffeinated drinks, alcohol, lack of sleep, poor nutrition, etc. The outcome is compromised aesthetics, low self-esteem, and undue psychological effects.

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