10 Tips to Keep Psoriasis under Control

Psoriasis is a chronic, recurring, non-contagious skin disorder that is characterized by raised, thickened reddish patches on the skin covered with silvery-white scales that may vary in severity and affect any part of the body, including the nails, scalp and the genital region. There are about 125 million psoriasis sufferers world wide. This makes up 3% of the world’s total population! It is estimated that six to seven million Americans have psoriasis, and each year 150,000 to 260,000 new cases are diagnosed.
The incidence of psoriasis is much lower in dark-skinned West Africans and African-Americans than in light-skinned persons of European origin. Incidence is also low in the Eskimos and the Japanese, and is extremely rare in Native Americans. Genetic, geographic and environmental factors may play a major role in this striking disparity between the races.
Most psoriasis patients undergo intense emotional turmoil while they fight to control their disease which tends to have periods of flare ups and remissions the year around. Though no cure has yet been discovered, observing certain principles in life style and skin care management will provide patients a scope for optimum control of the disease. Following are a few tips that would be useful for the psoriasis sufferers:

1. Maintain desirable health habits.
Psoriasis flare ups are common when you are weak or tired. Taking a balanced diet while reducing red meats and alcohol will go a long way in helping the skin to maintain a calm milieu interior. Patients should also drink plenty of water and get at least 7-8 hours of uninterrupted sleep every day. Do moderate exercises at least 3-4 times every week.

Remember that good nutrition, rest and exercise tune up your body and mind and keep up the equilibrium which is essential to reduce the psoriasis flare ups. These healthy habits will also reduce the chances of contracting infection, another important factor in psoriasis aggravations.

I always remind my patients that medications have only about 30% role in the management of psoriasis. Rest of the 70% involves lifestyle adjustments.

2. Quit Smoking.
Many studies have pointed out that pustular psoriasis of the palms and soles, a variant of psoriasis, is aggravated by smoking. Patients who quit smoking found their lesions clearing up faster. Research also suggests that severity of psoriasis may be linked to smoking. Hence it is highly imperative that you totally give up smoking if you want to get rid of those itchy, scaly, red patches.

3. Avoid alcohol.
Alcohol is a trigger for psoriasis. There is no doubt about it. Though some dermatologists allow moderate consumption of alcohol in psoriasis, it is my personal observation that even a small quantity of alcohol (like a glass of wine or beer) does cause flare ups in patients. Hence the verdict is - No Alcohol in any forms!

4. Learn to manage your stress.
Stress has long been linked to the induction and exacerbation of all types of psoriasis. As mentioned above, psoriasis can be considered a life style disease (much like hypertension or increased blood pressure), a combination of genetic predisposition and psycho- neuro-immuno-hormonal triggers playing a significant role in the causation, initial triggering and maintenance of the disease.
Psoriatics should try to learn and master any one of the stress management techniques like progressive relaxation, biofeedback, yoga etc. Counselling sessions and psoriasis support group participations will be beneficial for those who find it difficult to relax by themselves. According to the National Psoriasis Foundation, stress reduction works best when combined with appropriate medical treatment.

5. Avoid aggravating medications.
Certain medications taken for other diseases can aggravate or even precipitate psoriasis. Medications that can trigger psoriasis are:
• Anti-malarial drugs like chloroquine
• Beta-blockers (medication used to treat high blood pressure) and heart medication.
• Corticosteroids. Steroids are double edged swords. They can control severe psoriasis quickly, but sudden withdrawal can cause severe flare ups. Personally I avoid prescribing steroids to my patients unless it is absolutely necessary, that is, psoriasis is severely compromising their quality of life. Only after exhausting other treatment modalities do I take up this group of medications and most patients would do well to steer clear of steroids as a first line of treatment for psoriasis. Even topical steroids should be used very carefully and under medical supervision in psoriasis.
• Non-steroidal anti-inflammatory drugs like indomethacin worsen psoriasis in most patients.
• Lithium , the antipsychotic drug is a known aggravator of psoriasis.
If you have a family history of psoriasis or you are suffering from the disease, inform your physician if you are taking any of the above drugs. Your doctor may be able to substitute alternate medication.
6. Avoid Scratching, rubbing and picking at the lesions.
Any injury to the skin in both involved and uninvolved areas can produce new psoriasis lesions by irritating the basal layer of the skin and switching on the spurting action of the epidermal cells. Research shows that about 50% of people with psoriasis experience the ‘Koebner phenomenon’ — developing a psoriatic lesion at the site of a skin injury. Hence patients should carefully avoid any direct injury to the skin. Scrubbing to remove the scales is a mistake, as this can worsen the disease.
7. Treat any infectious foci at the earliest.
Studies show that some infections can trigger psoriasis. Streptococcal throat infections often precedes an outbreak of guttate psoriasis(small drop like lesions), especially in children. Inverse or flexural psoriasis is frequently aggravated by a candidal infection in the folds. Severe generalized psoriasis recalcitrant to treatment is seen in immunodeficient conditions like HIV infection. Treating the infection lessens or clears the psoriasis in most cases. Also look for signs of any infectious foci in your mouth(dental caries), throat(tonsillitis), sinusitis, gall bladder(cholecystitis), urinary bladder(cystitis) etc. Finding and treating these infections could give much better control over your psoriasis status.

8. Treat the disease before it worsens.
Most effective way to stop the itching and appearance of new lesions in psoriasis is to treat the psoriasis properly as soon as the lesions appear. Consult your dermatologist at the earliest sign of a break out.

9. Take good care of your skin.
Keeping the skin moist and supple is of paramount importance in psoriasis. Any dryness will increase the scaling, flaking and itching which will further aggravate the condition.
• Soak in a luke-warm oatmeal bath. This relieves itching and hydrates the skin layers.
• Pat your skin dry; do not rub or scrub. See tip number 6 above. Developing a habit of gently patting your skin dry is advisable.
• Apply emollients and moisturizers. Emollients soften the skin. Moisturizers lock in the skin’s own moisture to prevent dryness and cracking. One of the best ways to lock in moisture is to apply moisturizer after bathing. Regular use of moisturizers can help prevent the itch and pain of dry skin and reduce scaling and inflammation. A urea containing lotion is preferred during the day and a cream or ointment(if you don’t mind a little messiness) at night to maintain the hydration of the epidermal layers.
• Use sunscreen. Patients using retinoids should apply sunscreen 15 to 20 minutes before going outdoors and wear protective clothing. Sun exposure can cause sunburn, which can in turn trigger psoriasis. But complete avoidance of sun can cause more harm than good. A moderate supply of UV rays is indeed good for clearing up of the psoriatic lesions!

• Wear cotton clothing .Synthetics will irritate and heat up the skin and worsen psoriasis and are best avoided. If you have to wear them, wear thick cotton undergarments beneath.
• Look out for winter worsening: Cold, dry weather worsens psoriasis. Emollient creams and ointments should be used copiously during winter months. Before application of the moisturizer, remember to moist the skin with luke warm water.
The use of humidifiers, both at home and work, can add moisture to the air in winter months and help in avoiding exacerbations. Remember that air-conditioning can dry out the skin and aggravate psoriasis just like winter! Keeping the AC to minimum required coolness and regular application of moisturizing creams can overcome this problem.
10. Learn to live with Psoriasis
While there is no permanent cure, psoriasis can be successfully managed so that one experiences more good days than bad. Numerous treatment options are available, and recent advances are revolutionizing the management and care of psoriasis. No single treatment will be effective for all patients. Hence a dermatologist will consider a patient’s overall health, age, lifestyle, and the severity of the psoriasis and then decide on a treatment option that will achieve maximum effectiveness.
Psoriasis patients will do well to keep a positive mental attitude towards life and its happenings. Remember, any negative signal from the mind is an instant trigger for psoriasis!
Psoriasis, though quite a common disease, has not received the attention it deserves from the health authorities in most countries. As a result, the much needed awareness campaigns and funding of research projects have been lagging behind for decades. It was in this context that in 2004 the first World Psoriasis day was launched. Conceived by patients for patients, World Psoriasis Day is a truly global event that sets out to give an international voice to the 125 million psoriasis sufferers.
World Psoriasis Day aims to raise the profile of this condition which needs to be
taken more seriously by national and international health authorities.
Visit
http://www.worldpsoriasisday.com/
to learn more about the World Psoriasis Day on October 29th. There, you can also sign a petition calling on the World Health Organization to recognize psoriasis as a serious disease worth more attention and researches.
skin-care-tips-from-dermatologist.com

Bald Is Beautiful!

At the outset let me point out that this bit is not written to discourage those who have embarked on the enterprising trichological quests in pursuit of the hairy mirage. This is a fact : by no stretch of imagination can one consider Male Pattern Baldness a disease, though it does cause some dis-ease in the feeble minded! At the most it can be branded a cosmetologically distressing ‘problem'.

An article in praise of the chrome dome by Prof. Raja Babu of Hyderabad, one of the doyens of dermatology in India, set me browsing the net and literature to get to the root of the scant hair scenario. And this search did prove to be quite fascinating.

Here was one web site by a group of merry ladies, a fan club of THE BALD:

Quote: What was it we liked about bald men? The sense of strength, confidence, intelligence, a well-seasoned maturity combined with a well-reasoned sense of self confidence. The way they simply radiate passion and masculinity. Did you know that there is a concept that some men are so brilliant and fiery that their overwhelming passion burns out the roots of their hair? Sigh. ......

Meanwhile, all of us knew at least one sterling young man who was fretting over his hairline, and here we were trying to tell them DON'T DO IT! Agh! Toupees! Implants! Rogaine! Yuck! You might think it covers it up, but a woman always knows. Just be yourself, and be proud! Anybody who razzes you about it is either excessively immature, or just doesn't have any idea what they are talking about. Baldness is sexy. Mrrrrowww! Unquote.

There is no historical record of how long baldness has been blessing men. A reasonable guess is that our cave dwelling ancestors were never bald, but were endowed with bearish overgrowth all over to protect them from the rough exteriors. Richard Harrison and William Montagna predicted long ago in their book ‘Man' that men of future generations shall be even balder, ultimately a time will come when each and every single hair root will vanish into the oblivion of evolution. To put in a nut shell, the bald men are far ahead in the evolution tree than their contemporary hairy cousins.Wow! Something to be proud of, isn't it?

Aristotle(BC 384-322 BC) associated baldness with "libidinous males"and Hippocrates (460-377 BC) observed that ‘eunuchs do not take Gout nor become bald'. A 1983 study revealed that bald men have high concentrations of testosterone in their saliva compared to their hairy counterparts. Lots of other studies also point towards a greater aggression, a greater virility or a greater reproductive ability in the Bald Machos!

Economically also the bald stands to gain. No hair cut expense, no oil, no combs. And heavy savings on grooming time and money!

Still a lot of deluded bald heads world over spend millions every year in vain search of the hairy mirage. Since time immemorial the obsession to regrow the lost vanity had bordered on pathological obsessions for the magical cure. Look

at this ancient Egyptian remedy for the baldness: Spread a mixture(on the bald head) of the fat of a lion, a hippo, a deer, a crocodile, a goose and a serpent. Hunting must have been a part of the medical curriculum in those days! Another ‘simpler' remedy simply consists of equal parts of writing ink and cerebrospinal fluid.

Minoxidil and Fenestride compete with hundreds of alternate herbal cousins which promise miraculous cures for the distressed and the deluded. Many people who fall victims to the high profile, and most of the time unethical, advertisement gimmicks get temporary and scanty relief after years of scrubbing and rubbing.. By the time they realize the futility of the exercise they are poorer by thousands of dollars. Herman Melville in Moby-Dick (1851) puts it rather bluntly: "In truth,(if) a mature man who uses hair-oil, (then) that man has probably got a quoggy spot in him somewhere. As a general rule, he can't amount to much in his totality!". What can you say to that?

Back to the sowing days, transplanting hair roots was a fashion for a brief period, which lost its charms in the aftermath of huge chunks of gaping holes in the purse coupled with equally unbearable and prolonged pains that the courageous had to endure.

Concealment was taught to the humanity by none other than Julius Caesar the First who used to comb forward in a brave attempt to conceal his bald pate. We definitely know he was unsuccessful in his attempts as his apical activities have been carefully noted by his historians and passed on for the posterity as a' piece de coupe'! With the eminently stylish wreath becoming an object de fashion , ancient Romans were also the forerunners of the multibillion dollar wig business; though the emperors kept the laurel wreath for themselves for many centuries. and denied their citizens the ‘pleasure' of concealment.

William Shakespeare, himself a respectable bald, was quick to recognize that baldness and wit go together. The Bard noted in " The Comedy Of Errors": "...and what he (God, that is) scanted men in hair he hath given them in wit..".

We have many contemporary "greats" who adorn the Hall of Fame with natural and aided chrome pates: Yul Brunner, Persis Kambatta, Sinead O'Connor and not to forget Andre Agassi and Michael Jordan, the list is long and reads like a Who is Who in the world of the famous.. Explore the ‘heady' properties of the powerful leaders of the Nations , and , have no doubt, the Bald will shine far ahead than the hairy ones.

Forget the story of Samson and Delilah. What kind of wimp loses all his strength at the mere snip of his hair? Real men do their talking with chrome domes. Want proof? Just look at the world of professional wrestling, where the hottest and brightest superstars have smooth skin and don't wear rugs to cover it up!

Ambrose Bierce in his The Devil's Dictionary (1911), defines RESPECTABILITY as ‘The offspring of a liaison between a bald head and a bank account'. No doubt about it, yes, the bald scalp symbolizes Wealth and Wisdom. Cool!

"Skin is in," claims John Capps, president and founder of the Bald Headed Men of America, with more than 20,000 gleaming members. "The few, the proud, the bald," he says. The membership of BHMA is open to all "Bald-headed men who agree with the philosophy ‘Bald is beautiful'.. BHMA is dedicated to the belief that bald-headed men (whether chrome-dome, balding pate, or bald spot) have extra individual character. It strives to cultivate a sense of pride in all bald-headed men and to eliminate the loss of self-esteem associated with loss of hair and promotes National Rub a Bald Head Week. During the week and the annual conference held in the second weekend of September, the Founder gives speeches and makes television appearances proclaiming ‘the fun of being bald.' The organization also maintains speakers' bureau and charitable programs; compiles statistics and operates a Hall of Fame."

The Bald Pride slogans promoted by BHMA:

Bald is Beautiful

Bald is Bold

The Few! The Proud! The Bald!

Hairless Hunks!

The address of the BHMA is equally revealing: 102, Bald Drive, Morehead City, North Carolina,28557!

At last year's annual convention of the Bald Headed Men of America in Morehead City, N.C., women were the judges in deciding the best "overall appearance" of a bald head. "First they caress and feel the shape of a head," says Capps, "then they look at it from a distance to see the twinkle in the eye, and the twinkle in the smile. All this blends together and becomes as pretty as a full moon."

Last year's winner was a gregarious Leo Lane, an Australian Priest who celebrated his smooth victory by offering a blessing for every bald head at the convention.

Bald as the bare mountain tops are bald, with a baldness full of grandeur(Matthew Arnold ,1888), my Bald Brothers out there, what have we lost but our hair? The Creator could create only this many perfect heads, the rest he had to camouflage with hair! This is the age of the Vanishing Hair.... Be Proud! Be Happy! And go out there and SHINE!

Acanthosis Nigricans: A Skin Marker Of Cancer

What is Acanthosis Nigricans?

Acanthosis nigricans is the cry of the skin for attention! It is a skin disorder characterized by thickening, pigmentation and a fine or rough velvety appearance, particularly over body folds like neck, axilla and groin. The importance of acanthosis.It can be caused by a variety of causes, from obesity to cancer.

People with acanthosis nigricans are known for their resistance to insulin in diabetes.

According to the causes, acanthosis nigricans is divided into two major types:

A. BENIGN ACANTHOSIS NIGRICANS

1. Hereditary benign acanthosis nigricans: This runs in families, but does not usually show any evidence of endocrinological disturbances or internal malignancy.

2. Endocrinal acanthosis nigricans: It is associated with many endocrine problems like acromegaly, addison's disease, Cushing's diseases, insulin resistant diabetes mellitus, hypothyroidism, ovarian hyperthecosis, hepatic cirrhosis,Wilson's disease etc

3. Pseudo acanthosis nigricans: This is a reversible type and usually starts in puberty. It commonly affects dark skinned people and is associated with obesity

4. Drug induced acanthosis nigricans: Nicotinic acid is notorius in causing acanthosis nigricans. Other drugs like stilbostreol, corticosteroids, oral contraceptive pills etc can also cause acanthosis nigricans like lesions.

B. MALIGNANT ACANTHOSIS NIGRICANS(Associated with cancerous growths within).

Internal malignancies (cancers), especially the adenocarcinomas affecting the stomach, lungs etc can cause acanthosis nigricans. Sometimes lymphoma may be the culprit.

Hence it is essential to find out the cause of acanthosis nigricans. Here are a few pointers that may help in differentiating benign from malignant variety of acanthosis nigricans:
How to Differentiate Between the Innocent Benign and the Dangerous Malignant Varieties?

Features	Benign	Malignant
Onset	Birth, childhood or puberty	Adulthood, old age
Distribution
Extent of involvement	Less	Widespread
Distal extremities	Spared	Affected
Mucous membrane involved	Rare	Common-up to 50%
Hair, nail, palms & soles	Rare	Common
Pigmentation	Less, limited to thickened areas	More, extend beyond thickened areas
Skin Thickening	Mild to moderate	Marked
Skin Irritation	Less or nil	More

When to Consult Dermatologist

Consult Dermatologist when the characteristics of acanthosis nigricans are as in the malignant column above.

Salient Points indicating presence of associated internal cancer are:

• Late onset

• Rapid progression

• Severe affection

• Extensive distribution

• Mucous membrane involvement

• More symptoms like irritation and sudden appearance of skin tags

Tips On Dealing With Acanthosis Nigricans

Do's:

1. Differentiate between benign and malignant with the help of a dermatologist

2. Reduction of weight

3. Strict diabetic control

4. Regular aerobic exercises

5. Full investigations including tumor markers, hormonal assay, ultra sound scan, MRI etc

6. Regular medical check up, semi annual

7. Report any sudden changes in morphology

Don'ts

1. Scrub too much, as frequent rubbing will only increase skin thickening and pigmentation

2. Use strong abrasives: tend to irritate the skin more.

Treatment Guidelines of Acanthosis Nigricans

1. Correction of underlying cause

• Removal of tumor

• Correction of endocrine disorder

• Reduction of weight

• Removal of causative drug

2. Dietary supplementation with fish oil containing omega 3 fatty acids have been reported to be

beneficial

3. Cyproheptadine has been found useful in some cases

4. Management of Skin Lesions:

• Topical Retin A

• Salicylic acid application alone or in combination with steroids, alternating with emollient applications to minimize irritation.

• In severe unresponsive cases, systemic retinoids may be given a trial.

An Interesting Case

Curth HO (Archives of Dermatology, Vol 102, 1970) reports a remarkable case of acanthosis nigricans persisting for years even after excising a leiomyoma of stomach,squamous cell carcinoma of bladder and nephrectomy of one kidney for transitional cell carcinoma in a 84 year old man. Then one lesion of adenocarcinoma was found in his colon and removed. Surprise! His long standing acanthosis nigricans disappeared within a few days without any treatment! Moral: To achieve cure you must excise the responsible hormone secreting tumor, not just any tumor!

Disclaimer

Information provided in this article is strictly for educational purposes and is not meant to substitute for the advice provided by your own dermatologist or other medical professionals. You should not use the information contained herein for diagnosing or treating a health problem or disease, or prescribing any medication. Many skin diseases have similar morphology and may resemble one another, though their treatment protocol varies. Hence, self diagnosis and treatment are not advised. In case of doubt always be on the safer side and consult your dermatologist or physician.

More Skin Care Tips Here:
www.Skin-Care-Tips-From-Dermatologist.com

Does food aggravate acne?

The role of food ingestion in the causation of acne is a controversial one. Most dermatology text books swear that there is no role and most dermatologists toe the line. But personally I would say that food habits definitely do affect the pathophysiology of acne and acneiform eruptions. I would cite the following reasons on which I base this observation:

Many of my patients who have been on remission without clinical acne after treatment) and on a "no chocolate, no ice cream, no cola, no fried fast food' regimen have come back experiencing severe outbreaks after they restart their junk food habits! More than two decades of such solid observations cannot be discounted or discarded! Chocolates and fatty food are best avoided if you are a person with acne prone skin!

Iodides have been proven to cause acne, and hence it follows that iodide containing drugs, and foods will cause the same!

Just look at the list of iodide containing food items with the amount of iodide in each, then you will understand why I stand solidly by the food aggravation theory of acne:

Food/Beverage Iodides (ppm*)

Seafood

Clams 20
Crab 33
Kelp 1,020
Lobster 9
Oysters 8
Shrimp 17
Sole 24
Squid 39

Meat and Poultry

Beef liver 325
Chicken 67
Hamburger 44
Turkey 132

Vegetables

Asparagus 169
Broccoli 90
Brussels sprouts 23
Corn 45
Green beans 7
Onions (white) 82
Potato 9

Dairy Products

Butter 26
Cheddar cheese 27
Cottage cheese 5
Homogenized Milk 11
Sour cream 7
Yogurt 3

Drinking water 8

Miscellaneous

Coca-Cola 3
Iodized Salt 54
Potato chips 40
Seasoned 40
Sugar 2
Tortilla chips 80
Wheat germ 46
White bread 8

* ppm: parts per million

Now, with a list like that, who would dare say food is not an aggravating factor for acne?!
Now, here is an additional proof from my household itself, my second daughter, Anju, had been recurrent acne eruptions which were kept in control by my medications. Despite my advice, on the sly, she had been consuming her favorite Ferrorocher chocolates. Children, they never listen to their parents, even when they are dermatologists!). She went back to India for three months' vacation last May. Ferrorocher was not available there, and she did not like any other chocolates. She never had a single acne on her face during the last 10 weeks of her stay back home! As soon as she came back, she started on her favorite chocolate again, and again the tell tale small bumps re-appeared! My wife vouches that the chocolate was her only change in dietary intake here. Though this is only a circumstantial evidence, added along with what my other young patients have also experienced, yes, I would definitely say certain food does affect acne!

Read the Full Article Here

Stress and Skin

Stress can affect the health of skin!


Stress and prolonged, uncontrolled tension, anger, anxiety all are the nemesis of good health in general and healthy skin in particular. If you are stressed out, it will reflect on your skin first! Continuous perspiration will make the skin itchy and irritable; many stress induced diseases like psoriasis, pruritus, urticaria manifests themselves to damage the structure and integrity of the skin. Hence it is imperative that you set up a regular stress management program for yourself and your family without much delay.

How does stress affect the skin?


Skin and brain originates from the neuro-ectoderm during the embryonal development. Skin, as the fifth sense organ is supplied by millions of nerve endings that are connected to the autonomous nervous system and the brain. Hence, any changes occuring in the nervous system and the brain (mind) can affect the skin adversely.
Hence, learning to relax is very important to sustain the freshness and suppleness of your skin.
Here is a Stress Management Programme which will provide you with practical steps to manage your stress:
10 Days to Stress Free Life

New Skin Care Tips From Dermatologist Web Site launched!

Last week had been a hectic one!
2 new sites launched.
One about the Skin Care:
www.skin-care-tips-from-dermatologist.com
The second about Internet Marketing:
www.InternetMarketingResourceCentre.com

Request to all:
Please visit and let me know your opinion!
Thanks!
Dr.Hanish Babu

Basic Skin Care Tips

Basic Skin Care Tips for Healthy, Clear and Beautiful Skin

Skin is our body’s first contact with the environment. Hence, our surroundings have profound effect on the skin and its appendages hair and nails. The texture, colour and smoothness of the skin reflect a person’s health and beauty. People notice a person first (mostly the lasting impression!) from the appearance of the skin and contour of the face. Hence maintaining a healthy, clear and beautiful skin is not only important from aesthetic reasons, but also from point of view of maintaining high self esteem, positive mental attitude and self confidence.
Maintaining a healthy skin does not depend upon regular usage of costly OTC cosmetic preparations, as many advertisements would have you believe!

NO!

There is no need for strict, obsessive-compulsive skin care routines either. In fact, you may harm the skin due to over-enthusiastic cleansing and grooming!
Attaining a flawless healthy skin is a natural outcome of healthy living style!
Let us examine the factors that contribute to the health of the skin, hair and nails. These will provide us with a strong base while we consider the Skin Care in general later on.

A. Internal Skin Care

1. Balanced Nutrition: A balanced diet of cereals, pulses, vegetables, meat, chicken, eggs and fish laced with plenty of fresh salad and fruits will ensure healthy glowing skin. Most dermatology text books shy away from blaming food habits and fads viz a viz skin health and diseases. But from my experience of treating skin disease for the last 25 years, I can definitely say that food does affect the skin in more ways than we would care to admit! For example, it is well known that regular intake of oily, fried or spicy foods invariably results in flare up of pimples on acne prone skin. Some of these problem foods that may cause pimples or breakouts include chocolates ,cakes, fried food, fast foods and fizzy drinks.

2. Adequate Hydration: Drinking adequate amount of water and fresh fruit juices will ensure the suppleness and elasticity of the skin. For normal, indoor persons, daily intake of 8-10 glasses of water or fruit juices will suffice. For those who go out, the intake should be double or triple depending upon the sun exposure and humidity.

3. Regular Exercise: Regular exercise - walking, running, bicycling, engaging in sports - will have a great impact on one’s skin complexion. Increased blood flow will bring in that extra warmth and glow to otherwise dull skin complexion.
Exercise will not only help you maintain optimum skin tone and texture, but it will also make you full of energy and freshness and a general feeling of well being. Exercise is also a great stress reliever.

4. Stress Management: Stress and prolonged, uncontrolled tension, anger, anxiety all are the nemesis of good health in general and healthy skin in particular. If you are stressed out, it will reflect on your skin first! Continuous perspiration will make the skin itchy and irritable; many stress induced diseases like psoriasis, pruritus, urticaria manifests themselves to damage the structure and integrity of the skin. Hence it is imperative that you set up a regular stress management program for yourself and your family without much delay.

5. Adequate Sleep: 7-8 hours of restful sleep is essential for good healthy skin.

6. Avoidance of Alcohol and Drugs: Alcohol in excess may harm the skin by interfering with nutrient absorption from the gut as well as by interfering with normal sleep and rest.

B. External Skin Care

1. Regular Cleansing: There are 4 stages in the daily cleansing routine: Cleansing, scrub with an exfoliating agent, using a toner and finally, application of moisturizer…this daily routine should make and maintain the healthy complexion of your skin. Select a gentle skin cleansing solution that works for your specific type of skin - dry, oily, normal. Using your selected product, cleanse face in a circular motion and rinse with lukewarm water, as hot water can cause drying up...
Follow the cleansing stage with an exfoliant. A granular product is often especially effective in smoothing rough areas and releasing dead skin cells, allowing the face to be better moisturized. But do not scrub too vigorously!
After the exfoliation process is over, use a toner or an astringent to tighten the skin and remove any makeup or cleanser residue. A nice alternative to a toner or astringent would be doing putting up a facial masque, which tackles clogged pores while firming the skin and leaving it soft and silky.
Finally, pat skin dry with a soft towel while keeping a little moisture. Apply a moisturizer to help protect skin from dryness. Those who have oily skin do not have to moisturize as often as those who have dry, normal or combination skin.

2. Use of moisturizers: Moisturizers can be either water based or oil based. People with oily skin should use water based moisturizers and vice versa. These should be applied immediately after washing the skin to retain the moisture on the surface. In winter, the application of moisturizers should be done at least twice daily without fail.

3. Use of Sun Screens: By using a moderate strength sunscreen, you will be protecting your skin from sun damage, skin cancer, aging and premature wrinkles. Too much sun can blister one’s lips, leaving them red, sore and charred. Sunburned skin will eventually peel most times, leaving skin areas blotchy and sensitive. The best approach to preventing sunburn and other sun-caused skin problems is to monitor how much time one spends in the sun and to avoid sun exposure by using sunscreen with SPF 15 or greater.

4. Treatment of Blemishes: Any skin blemishes should be treated immediately by a dermatology consultation to avoid bigger, deeper scars later on!

5. Treatment of Hormonal and other Systemic Diseases that may affect the health of the skin: If the skin is persistently rough, dry and unhealthy despite normal care, the possibility of hormonal imbalance, especially those of thyroid hormones should be investigated.

Structure and Function Of Skin

The skin is our body’s largest organ, with a range of functions that range from excretion of sweat to control of body temperature. In addition to the protective function, of course. (The importance of skin can be envisaged just by thinking about the effects of burns in the body, where the protective function of the skin is compromised.)

A view through the microscope reveals the layered structure of the skin, and the many smaller elements within these layers that help the skin to perform its functions

The skin is made up of three distinct layers.
The top layer is called the epidermis. Below is the dermis, which contains the blood vessels, nerves, collagen etc. Dermis comes from the Greek word for skin, derma.

Dermatologist means a doctor who specialises in the study of Skin and the disorders affecting the skin and the appendages of skin, namely hair and nail. The lower layer below the dermis is the subcutaneous fatty layer.

The epidermis
The outer most layer of the skin is the epidermis, which contains several layers as follows, from inside out, the basal cell layer, the spinous layer, the granular cell layer, and the stratum corneum.

The outer surface of the skin is the epidermis, which itself contains several layers — the basal cell layer, the spinous layer, the granular cell layer, and the stratum corneum.

The deepest layer of the epidermis is the basal cell layer. Here cells are continually dividing to produce plump new skin cells (millions daily). These cells move towards the skin surface, pushed upward by the dividing cells below them.

Blood vessels in the dermis — which is below the basal cell layer — supply nutrients to support this active growth of new skin cells. As the basal cells move upwards and away from their blood supply, their cell content and shape change, as follows.

Cells above the basal cell layer become more irregular in shape and form the spinous layer. Above this, cells move into the granular layer. Being distant from the blood supply in the dermis, the cells begin to die and accumulate a substance called keratin. Keratin is a protein that is also found in hair and nails.

The stratum corneum (‘horny layer’) is the top layer of the epidermis — it is the layer of the skin that we see from the outside. Cells here are flat and scale-like (‘squamous’) in shape. These cells are dead, contain a lot of keratin and are arranged in overlapping layers that impart a tough and waterproof character to the skin’s surface.

Dead skin cells are continually shed from the skin’s surface. This is balanced by the dividing cells in the basal cell layer to produce a state of constant renewal. Also in the basal cell layer are cells that produce melanin. Melanin is a pigment that is absorbed into the dividing skin cells to help protect them against damage from sunlight (ultraviolet light). The amount of melanin in our skin is determined by our genes and by how much exposure to sunlight we have. The more melanin pigment present, the darker the colour of our skin.

The dermis
Below the epidermis is the layer called the dermis. The top layer of the dermis — the one directly below the epidermis — has many ridges called papillae. On the fingertips, the skin’s surface follows this pattern of ridges to create our individual fingerprints. So the ridges are not on the outermost layer of skin, as it might appear.

The dermis contains a variable amount of fat, and also collagen and elastin fibres which provide strength and flexibility to the skin. In an older person the elastin fibres fragment and much of the skin’s elastic quality is lost. This, along with the loss of subcutaneous fat, results in wrinkles.

When the skin is exposed to sunlight, modified cholesterol in the dermis produces vitamin D, which helps the body to absorb calcium for healthy bones. Here are some of the other structures within the dermis that enhance the skin’s function.

Blood vessels supply nutrients to the dividing cells in the basal layer and remove any waste products. They also help maintain body temperature by dilating and carrying more blood when the body needs to lose heat from its surface; they narrow and carry less blood when the body needs to limit the amount of heat lost at its surface.

Specialised nerves in the dermis detect heat, cold, pain, pressure and touch and relay this information to the brain. In this way the body senses changes in the environment that may potentially harm the body.

Hair follicles are embedded in the dermis and occur all over the body, except on the soles, palms and lips. Each hair follicle has a layer of cells at its base that continually divides, pushing overlying cells upwards inside the follicle. These cells become keratinised and die, like the cells in the epidermis, but here form the hair shaft that is visible above the skin. The colour of the hair is determined by the amount and type of melanin in the outer layer of the hair shaft.

A sebaceous (‘oil’) gland opens into each hair follicle and produces sebum, a lubricant for the hair and skin that helps repel water, damaging chemicals and microorganisms (‘germs’).

Attached to each hair follicle are small erector pili muscle fibres. These muscle fibres contract in cold weather and sometimes in fright — this pulls the hair up which pulls on the skin with the result being ‘goosebumps’.

Sweat glands occur on all skin areas — each person has more than 2 million. When the body needs to lose heat these glands produce sweat (a mix of water, salts and some waste material such as urea). Sweat moves to the skin’s surface via the sweat duct, and evaporation of this water from the skin has a cooling effect on the body.

The skin varies in thickness, and the number of hair follicles, sebaceous glands and sweat glands in different areas of the body. The thickest skin is on the soles of the feet and the palms of the hands. A large number of hair follicles are on the top of the head.

Subcutaneous fat
The innermost layer of the skin is the layer of subcutaneous fat, and its thickness varies in different regions of the body. The fat stored in this layer represents an energy source for the body and helps to insulate the body against changes in the outside temperature.

Functions of the skin
Our skin is more or less waterproof. It is self healing and self replacing. Skin is capable of becoming thicker if exposed to wear and tear e.g. skin on the soles of our feet. Our skin becomes darker in colour to protect against excessive sunlight. Even after burning our skin in the sun, the burnt skin peels off and is replaced by a new layer of skin. Skin is vitally important in the production of vitamin D. The skin plays a vital role in the regulation of our body temperature, as;

• It is a protective covering.
• It excretes waste products.
• It regulates temperature.
• It contains ergosterol which, under the influence of ultra-violet light, forms vitamin D.
• It is an important sensory organ.
• It is important for the maintenance of body shape.
• It protects against the entry of harmful organisms.
• Immediately underneath the skin lies the superficial fascia. Underneath the superficial fascia lies the deep fascia. These tissues are closely related to the skin and play an important role in the mobility of the skin over the underlying structures.

Welcome!

A Warm Welcome To My New Blog, SKIN CARE TIPS FROM DERMATOLOGIST!
I had been designing my own web sites since 1997, the most important ones being
www.hanishbabu.com and
www.lesstress.net

Through my gateway web page, I had been answering queries related to SKIN CARE and SKIN DISEASES for the last decade. I have received queries from all over the world.
This is my first attempt at Blogging, and, of course, I had to start with my favourite subject, Dermatology. I intend to develop this into a full fledged Expert Skin Care Tips Blog (From the Dermatologist, of-course!).
Later, I will come out with a Blog on another topic close to my heart, Stress Management.In fact, I have already brought out an e-Book on the subject. You can also join my e-Zine, which will provide you with valuable Stress Management Tips on a regular base.(Click on the image to visit and subscribe)

Regards and Best Wishes,
Dr.Hanish Babu