Acne
Acne commonly known as ‘pimples’ is a chronic inflammatory disorder of the
sebaceous unit present in the skin. In mild to moderate cases, there may be
black heads (comedones), white heads (papules) or pustules. In severe cases,
there are nodules, cysts and abscess which lead to scarring if not treated on
time. Get rid of your acne and feel confident in your own skin. At Be skin clinic Dr
Bhargavi and her team will get to the crux of acne causes and treat the
condition accordingly. Apart from medicines and creams, we also believe in
adjuvant therapies like Clean ups, salicylic peel, black peel, LED light as well
as plasma therapy.
Chemical peels don’t really peel the skin, despite what the name implies. Chemical peels for acne work by removing the surface layers of the skin in order to expose the fresh and unaffected layers below. Done in a series of four to six sessions, these peels can improve mild to moderately severe cases of acne and can be given over the face or other body areas where acne is a problem. They rapidly exfoliate the skin, allowing dead skin cells to shed more effectively. By keeping dead skin cells and excess oil from clogging the hair follicle, pore blockages (comedones) and can drastically reduce breakouts of papules and pustules.
Chemical peels fall into a broad category of Alpha Hydroxy Acids (AHAs) or Beta Hydroxy Acids (BHAs). Glycolic acid is the most commonly used (AHA )and Salicylic acid is the most commonly used (BHA) in the treatment of acne. we also believe in adjuvant therapies like Clean ups, Black peels, LED light as well as platelet rich plasma therapy
Acne Scars
Dermaroller - This is a special instrument with micro needles, which is used to fill up superficial as well as deep acne scars. The procedure will even out the skin texture through collagen stimulation.
Dermastamp - This is a special instrument, which has five small micro needles in it to treat localized depressed scars.
Light Systems - IPL acts by heating the dermis and stimulating new collagen formation. It is useful for treating red post acne scars.
Chemical Peels - 70% Glycolic Acid peels can be done to treat hyper pigmented, red and shallow scars. TCA peeling can be done for hyper pigmented and deep-pitted scars. Spot TCA peeling is a very good technique for isolated ice pick scars.
Microdermabrasion - A fine stream of aluminium oxide crystals are used to exfoliate the skin’s upper layers. The intensity of exfoliation can be varied to suit an individual’s skin type from light exfoliation to deeper resurfacing. This procedure stimulates collagen production and renews skin elasticity, thereby enhancing the skin tone and resilience. This treatment is useful for treating superficial acne scars.
Fillers - These can be used to raise sunken scars to the level of surrounding skin. Hyaluronic acid is a very safe injectable material that is used to restore structure and volume to the skin. It is a good and safe option. The effects are usually temporary lasting 6- 12 months.
Autologous Fat Transfer- This is a procedure in which an individual's own body fat is removed from the abdominal area, emulsified and put in the areas of volume loss for e.g. sunken or emaciated areas of the face.
Radio Surgery - In this procedure, radio waves are used in ablative mode to ablate the unwanted layers of the skin and flatten out the edges of scars and to promote collagen remodelling thereby filling up deep irregular scars.
Steroid Injections - Intralesional Steroid Injections like Triamcinolone 10mg-40mg may be used for raised hypertrophic scars. These injections help to soften thick stubborn fibrous tissue.
Submission - This involves subcutaneous sectioning of dermal adhesions with a sharp needle, thereby lifting the scars. This technique is useful for very deep-pitted scars, ice pick scars, boxcar scars and rolled scars.
Fractional Radio Frequency – This is a collagen inducing treatment delivered in a pixelated radio frequency energy to the skin.It helps to treat acne scars, accidental scars, surgical scars, stretch marks and wrinkles.
Rosacea
Rosacea is a common skin disease that causes redness and swelling on the centro facial areas of the face. Rosacea is most common in women and people with fair skin.
Frequent redness of the face or flushing / Small, red lines under the skin, these are dilated capillaries
Red, raised eruptions / Swollen nose / Red, dry, itchy eyes
Thick skin, usually on the nose called ‘Rhinophyma’ is seen in chronic, long-standing untreated cases.
Application of sunscreen daily with an SPF of 30 is essential.
Light paraben free, perfume free moisturizers should be used to keep the skin calm. Metronidazole and Clindamycin gels are topical antibiotics that are used for mild cases. Other times, oral antibiotics can be used e.g. Tetracycline and Erythromycin group of drugs can be used for severe cases.
Topical steroid creams, very rapidly reduce redness and swelling of the face but their use is recommended only in very severe cases for a very short period of time of about a week under supervision of a Dermatologist.
Psoriasis
Psoriasis is a medical condition that occurs when skin cells grow too quickly. Faulty signals in the immune system cause new skin cells to form in days rather than weeks. The body does not shed these excess skin cells, so the cells pile up on the surface of the skin and lesions form.
As psoriasis is a life-long condition, it is important to take an active role in managing it. Learning more about psoriasis, seeing a dermatologist to discuss treatment options, and developing a healthy lifestyle can help people live life to the fullest.
Vitiligo
Vitiligo is a skin disorder in which patients develop white spots on the skin that vary in size and location. These spots occur when pigment cells called “melanocytes” are destroyed and the pigment melanin can no longer be produced. Pigment cells are present throughout the skin, hair, mouth, eyes and some parts of the nervous system and they can be damaged or destroyed in any of these areas.
Photo-chemotherapeutic treatment (PUVA Therapy): In this photo-sensitiving agents are taken either orally or topically followed by exposure to ultraviolet A (UVA) light. Commonly used Psoralens are 8-methoxypsoralens or 4,5,8 trimethylpsoralens.
Corticosteroids: These are used topically or orally depending upon the severity of the disease. They are often used as an attempt to check the spread of the disease.
Immunomodulators: Drugs like Tacrolimus, Pimecrolimus help in bringing back the colour and also help to control the spread of the disease. They can be safely applied over a long period of time. Levamisole is a non-specific immuno modulatory oral drug, which helps in controlling the spread of Vitiligo in some cases.
Narrow band UVB Phototherapy: Narrow Band UVB for the treatment of Vitiligo has recently emerged as a promising therapy. It is the safest and most effective therapy for generalized Vitiligo. with best results on the face and neck.
Targeted NB UVB Phototherapy: It is a variation of NB-UVB. In targeted phototherapy, the beam is focused only on areas affected by Vitiligo,adjacent normal skin is left untouched.
Monochromatic Excimer Laser
Surgical Treatment
Different techniques such as Surgical excision, Dermabrassion, Tattooing, Punch grafting, Split skin grafting and Transplantation of invitro cultured epidermis-bearing melanocytes, it is reserved for stable cases with few localized stubborn patches.
Eczema
Eczema is a general term encompassing various inflamed skin conditions. One of the most common forms of eczema is atopic dermatitis or atopic eczema.
In general, atopic dermatitis will come and go, often based on external factors. Although its cause is unknown, the condition appears to be an abnormal response of the body’s immune system. In people with eczema, the inflammatory response to irritating substances overacts, causing itching and scratching. Eczema is not contagious.
However, for most patients the condition may be managed well with treatment and avoidance of triggers.
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Fungal infection
Fungal infections to the skin are common in the tropical regions like India. There are different types of fungal infections but most of them favour areas of the body which are moist and sweaty like the feet, toes, groins, buttocks and nails. Some people with depressed immune response like diabetes can also have more recurrent or widespread fungal infections.
Fungal infections may be treated with creams if it is not severe. If it does not respond to creams, oral medication with anti-fungal tablets may be required. These are prescribed for 1 week to 3 months, depending on the site and severity of infection and the type of medication used. Sometimes skin or nail tests may be performed to confirm the fungal infection before starting treatment.
Urticaria
Urticaria (hives) are localized, pale, itchy, pink wheals (swellings) that can burn or sting, they are part of an allergic reaction and are very common.
Allergic reactions, chemicals in foods, or medications may cause hives; sometimes it is impossible to find the cause. When hives form around the eyes, lips, or genitals, the tissue may swell excessively. Although frightening, the swelling usually goes away in less than 24 hours. Severe cases of hives may cause difficulty in breathing or swallowing and emergency care is required.
The best treatment for urticaria is to find and eliminate the cause whenever possible. Antihistamines are prescribed to provide relief and work best if taken on a regular schedule to prevent hives from forming. There are many antihistamines available. No one antihistamine works for everyone. The dermatologist may use combination of drugs to control the urticaria. Cortisone may also bring dramatic relief, but its use must be limited to short period.
Warts
Warts are non-cancerous skin growths caused by a viral infection in the top layer of the skin. Viruses that cause warts are called Human Papilloma Virus (HPV). Warts are usually skin-colored and feel rough to touch, but they can be dark, flat and smooth.
Warts are passed from person to person, sometimes indirectly. Dermatologists are trained to use a variety of treatments, depending on the age of the patient and the type of wart.
Treatments for warts
Salicylic Acid Lotion
Cryotherapy
Radiosurgery & Electrocautery
Co2 Laser
Other treatments
Another treatment is to inject each wart with an anti-cancer drug bleomycin.
General measures
Avoid nail biting, deep cutting of nails Should be avoided.
Skintags
Skin tags are non-cancerous skin growths on the top layer of the skin. They are brown black, skin-colored and feel rough to the touch, but they can be flat and smooth. Radiosurgery& Electrosurgery is a good treatment. Co2 Laser treatment can also be used
Pigmentation
Tired of dark patches on the skin?
Doctor will examine your skin and decide a treatment for your pigmentation, ranging from medicines to procedures.
Procedures for pigmentation include an array of Peels such as Glycolic peel, TCA peel, Yellow peel, Obagi peel, Nomelan peel, Cosmelan peel and many more.
Sun burn (Tan) - A condition commonly encountered in fair skinned people due to excessive sun exposure.
Post inflammatory hyper pigmentation: It may be seen after healing has occurred in the cases like acne, eczemas, contact dermatitis etc.
Drug induced pigmentation - Pigmentation due to cosmetics especially those containing fragrance.
Macular lichen amyloidosis
Nevus or Birth mark - Usually seen at birth but may also appear at a later age. What is the treatment for hyper-pigmented disorders?
Melasma, Photomelanosis and Post inflammatory hyper pigmentation can be treated with topical creams such as hydroxy quinine, tretinoin, topical steroids, alpha hydroxy acid creams, azelic acid, arbutin, liquorice, kojic acid. If the patient does not improve with these medicines other modalities should be used, which are:
- Chemical peeling
- Intense pulse light treatment
- Laser treatment (532nm and 1064n Q switched Nd Yag laser)
Hyper pigmentation may either be due to increased melanin deposition in the epidermis or dermis. Epidermal pigment disorders respond well to treatment while dermal pigmentation may take a long time to lighten.
Melasma - Seen as brown patches on the face, it is more commonly seen in females. It occurs due to hormonal changes in the body. The pigmentation increases on sun exposure.
Peri-orbital melanosis - Also known as ‘Dark circles’ may be hereditary, due to stress or eye strain.
Freckles and Lentigenes - These are tiny black spots on the face and are genetic in origin.
Photomelanosis - This is increased pigmentation due to sun exposure. The pigmentation occurs on exposed skin commonly on the face, neck and back.
Keloid
Keloid is a type of scar which is firm, rubbery. Keloid scar is benign, non-contagious and sometimes accompanied by severe itchiness, sharp pains, and changes in texture. There are different treatment options available for Keloids,however no treatment is considered to be 100% effective.
Treatments
Silicone sheets - One clinically proven and drug free scar treatment option is silicone sheeting. Siliconesheeting is safe and effective in reducing existing scars and helping to prevent new scars in anyone aged 3 years and above.
Steroid injections - Steroid injections are best used when the scar begins to thicken or if the person is a known keloid former.
Compression - Compression bandages applied to the site over several months, sometimes for as long as 6 to 12 months, may lead to a reduction in the size of the keloid. Silicone scar sheets may be used safely under compression garments to aid in preventing new scars.
Surgery - Surgery requires great care during and after the operation. Keloids that return after being excised may be larger than the original. There is a 50% chance of recurrence after surgical removal.
Laser therapy - A relatively new approach is to combine laser therapy with steroid injections and the use of Silicone Sheeting.
Newer treatments - These include alpha-interferon, 5-fluorouracil and bleomycin.
Moles
A person may wish to get rid of moles that are irritating, or simply because they are unattractive. The most common methods of removal include numbing and shaving the mole off, or cutting out the entire lesion and stuturing.