WINTER Call for Skin

Now that the rainy season is setting in, we get to see patients with various winter related skin diseases. The common among them is Eczema, which is nothing but a red, dry, itchy skin. Another common skin issue during this climate is Psoriasis, which is similar to eczema but with more scaling, dryness and with itching sometimes.

Basic skin care during winter for patients who already suffer from the above mentioned disease would be to start applying some medicated moisturisers, especially with ingredients such as ceramides, hyaluronic acid, shea butter , wheat germ oil and  vitamin E, to mention few. It is vital to use moisturisers at least 3 to 4 times daily to give a sustained hydration to the dry skin. There are few oral moisturisers which have recently come up, about which you can discuss with your skin physician before consuming them.

Avoiding agents which can cause dryness might be of help to reduce the dryness, such as hand wash, detergents and soaps. Rather switch over to moisturising soaps, which can prevent overt drying of skin.

In spite of the moisturisers if the itching, dryness or the redness continues , then it is best to visit your skin physician to get some short term strong creams such as steroids or oral medicines. Please do not get over-the-counter medications for the same as long-term use or injudicious use of them can worsen the existing skin problem.



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Understanding Acne/Pimples as a multi-factorial skin disease.

Acne/pimples which once used to be a skin disease of adolescent, have now become a lifestyle problem. We often see patients in their late 20s and 30s presenting with acne/pimples on face, chest and back. Invariably, the common questions, we as skin physician face are- Why are the pimples still continuing at my 30s? Doesn’t it stop after teens? When will I get a clear skin?

We often see patients with acne in age group as young as 10 years and sometimes as old as 50 years.  It is imperative to understand that Acne is more than justhormone changes. It is a multi-factorial disease and it is difficult to find one particular cause for it. The reasons for acne could be different for different people.

Treating acne does not end with giving antibiotics or antibacterial gels; rather it requires a complete assessment of one’s lifestyle. This will include assessing one’s hormone status, assessing dietary impact, assessing impact of occupation, assessing mental status and other environmental factors such as climate.

Still no research has proved to “CURE” acne. However, understanding your skin by assessing the above factors would help curb acne to a great extent

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Pores on the face can get blocked with sebum (oil secretion) and dead skin which causes clogging and results in a blackhead or a whitehead.


Anything which blocks your skin pores could result in blackheads or whiteheads. Especially if you have excessive oily skin, it could block the skin pores with dead skin resulting in a blackhead. It is not dirt as most people believe. It is simply oxidized oil. Sometimes the clogged pores appear as white bumps under the skin, which does not seem to go away easily, called as white heads or comedones. Using creamy or oily products could as well, cause blocking of pores.


- If the clogged pores appears more as whiteheads (present under the skin), do not try to extract it manually as it may result in scarring. Rather, consult with your dermatologist for prescription of retinoid tablets which would help in opening up of the blocked pore and clearing the comedones.

- Sometimes manual extraction preferably by your dermatologist, would be of help. Certain products which contain keratolytic agents such as salicylic acid will help clear the pores from within and keep clogging under control.

- Do a steam inhalation or sauna to open up the pores. Wipe the face with a soft wash  cloth or sponge. Following this, wash your face with salicylic based foaming gel to cleanse the pores. Finish, with applying ice pack to reduce the size of pores and prevent further clogging. Do this routine weekly once.


Pores cannot be removed completely from the skin, as they are natural opening on the skin. However, products containing retinol could reduce the size of the skin pores and make them less visible. Antioxidants such as vitamin C serum help prevent oxidation of sebum & prevent blocking of pores.



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Dandruff Treatment

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Patient’s  with under-eye circle often, question-why they get dark circles in spite of good sleep?  

This blog is all about under-eye circles and recent developments in its management. When the skin is thin surrounding the eye, it shows up the blood vessels underneath and cause dark circles. The common reasons for skin thinning around eyes are:  hereditary, aging, sun-damage and deep orbital socket. While the above are the basic causes for under-eye circle, there are few factors which can aggravate the appearance of dark circles such as : smoking, alcoholism, sleeplessness, starvation, thyroid and adrenal problems, bleeding disorders.

Now there are various creams available in the market to manage under-eye circles. Scientific studies have shown that creams which contains 2% phytonadione, Retinol Palmitate and Vitamin C and Vitamin E can improve the appearance of dark –circles. Opt for temporary measures such as concealers from time to time,  to mask the under-eye circles.

Other important steps to prevent under-eye circles include:

  1. Apply sunscreens in the morning. As sun can damage the collagen under skin and worsen the dark circles.
  2. Stop smoking.
  3. Massage an aqua-based moisturisers at night, to keep skin hydrated. Do not use thick paraffin based moisturises as it can be heavy on skin.
  4.  Use Vitamin A based creams, especially one containing retinol palmitate. This smoothens fine wrinkles and helps prevent dark circles.
  5. To calm puffy eyes, place cold spoons, slices of cucumbers, chilled tea bags. Sliced potatoes provides a bleaching effect.
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DANDRUFF is one of the most common hair problem

how to avoid dandruff


DANDRUFF is one of the most common hair problem faced by men and women alike.
the white flakes can be annoying and embrassing and they only show themselves at the ost
inappropriate of times
what more . they also cause ACNE

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Understanding Cosmetic Melanosis

Most people have an unspoken feeling that gravitates towards having a fairer complexion. The journey in search of the products, which claims to offer fairer tone, is widely expanding. It is expanded in such a pace, that people are often swept away by the marketing gimmicks.  Various pharmaceutical companies and cosmetic corporations endorse skin-lightening products through print media , internet and television. Thus, customers often compromise on the logical understanding of the products: how exactly it works? what could be the possible results or side effects (if any)?  are the results long lasting?

An increasing impetus to have a fairer skin tone, often results in a paradoxical effect- Cosmetic Melanosis. This is a condition, where the skin gets more darkened than before due to injudicious use of bleaching creams and over-the-counter (OTC) skin glow products. This article elucidates about Cosmetic Melanosis and the ways to prevent the same.

Hydroquinone (Hq) is the most common depigmenting agent available in the market. It gives a drastic colour change over a short period. However, the FDA and other standard setting agencies have reported that, long term use of Hq can result in blue-black darkening and thickening of skin, a condition called Ochronosis.  A study was conducted, amongst darker skin individuals from two South African hospitals. Among 69% of patients who used skin-lightening agents, 42% of females and 15% of males were recognised with Ochronosis.  Hq also makes skin sensitive to sunlight. Hence, it is mandatory to use good sun-safety measures when using Hq containing products. Nevertheless, most patients who buy OTC products are not aware of the importance of sun protection. Thus, they notice skin darkening in spite of using this agent continuously.

In fact, Hq is banned in certain parts of the world due to its long-term side effects. In India, 2% Hq is available over the counter and 4% available from doctor’s prescription. However, it is not advisable to use Hq more than 3 months due to its side effects. Though, the National toxicology programme, which provides scientific study data to FDA in U.S is still assessing the long-term dermal toxicity effects of Hq, there are few animal studies, indicating that oral Hq has carcinogenicity and immunotoxic properties.

In addition to Hq, the other common ingredients in skin glow products are steroids and tretinoin ( Vitamin A derivative).  Tretinoin helps in penetration of Hq, whilst steroid helps in reducing the irritation caused by tretnoin and Hq. This combination is studied worldwide and is proven effective in skin lightening. However, if used over a wide-time frame, steroids can result in side effects such as acne, hirsutism and telengectesia (fine blood vessels under skin) and skin atrophy. Similarly, imprudent use of tretinoin, can result in retinoid dermatitis, where there is intense irritation, dryness and redness of the skin. Using Hq and tretnoin continuously in areas with thin skin such as nasolabial folds and around eyes, can result in hyperchromia (skin darkening). Thus, it is worth an effort to have these products prescribed by a skin specialist who would advice rightly on how to apply these products and for how long to apply.

Another common way of masking skin pigmentation is through use of bleaching agents. In many areas, unregulated products are sold without listing their contents.  These agents often contain steroids, Hq and mercury oxide. In most bleaching products, Hq may be included with different names such as Quinol, Benzene-1, 4-Diol, Tequinol and many more. Thus, the customers are not aware of the exact product contents. Mercury can cause skin and nail darkening gradually. In a study conducted in 620 females from Saudi Arabia, most females were forced to use the bleaching agents, as stopping them caused more darkening of the skin. Thus, they were compelled to carry on the practice of using bleaching agents.

It is always worth an effort to understand the reasons behind pigmentation, before commencing any treatment with the skin glow products. The reasons can vary from simple sun damage to inflammatory skin disorders. Doctor’s palette of skin brightening treatment options are widely increasing ranging from topical agents to physical treatment options such as chemical peeling and lasers. A formal assessment with the skin specialist will help with:

-Understanding of the pigmentary problem in depth

-Understanding different treatment options

-Choosing the option according to your concern and skin type

-Understanding how the treatment works

-Precautions while switching treatment options

- Understanding the side effects and how to get it treated, if any


Thus, the treatment through a skin specialist will be individualised according to patient’s skin characteristic and cosmetic concerns unlike OTC products, to prevent adverse effects such as Cosmetic Melanosis.

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Care for your “Back Skin”- 28/01/13

Speaking about good skin care, skin on your back often goes unnoticed. Here are few steps to get a soft, supple and smooth skin on your back.

  1. Never let sweat to dry on your back: Excessive perspiration can clog the pores on the back on drying.  During summer, always remember to wash your skin after a strenuous activity, to remove the excess sweat.
  2. Avoid harsh scrubbing and exfoliation on the back: Use a moisturising body wash to wash your back skin. Scrubbing weekly twice is sufficient for the back skin. Use a mild sugar or oatmeal scrub for the back skin.
  3. Seek a dermatologist’s opinion for back acne: Back acne can be very difficult to manage sometimes. A benzoyl peroxide wash or a salicylic acid foam gel helps to relieve back acne. If the acne is severe, with multiple pustules and nodules, Vitamin A derivatives are helpful.
  4. Do not take shower in very hot water: Hot water generally opens up the pores. Whilst, it helps in removing the dirt on the skin, open pores can be a source for acne spots. If you go for a sauna or a hot water bath, always apply ice-cubes on your back skin to diminish the pore sizes and prevent breakouts.
  5. Adequate sun protection: When your back skin is exposed with low-back tops or blouses, the skin can get tanned. Sun-exposure can also lead to problems like polymorphic light eruptions, lupus, actinic lichen planus. These skin disorders can be prevented with adequate sunscreens and using an umbrella. Do not forget to wear a waterproof sunscreen, before swimming. Always re-apply sunscreens every 1-2 hours for adequate sun-protection, as most sunscreens do not stay on the skin for more than 1 hour.

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Monsoon Care for Skin, Hair and Nails

Monsoon is here with sunny spells, humidity and dry air at one minute and heavy winds and gush of downpours in the next. Monsoon is the most speculated season of the year. So is your skin!

Escaping from the sweltering summer, we are now in clammy monsoon, which can take a toll on your skin, hair and nail. Here are the details on what you can expect for your skin this season and how you could stay protected in monsoon clutter.

Hair Care: The humidity and the morning heat spells can make your scalp oily and hair frizzy. For many, this could be the season for hair-fall owing to sweaty, itchy and flaky scalp. This could weaken your hair and make it easily breakable. Regular use of a mild anti-dandruff shampoo is required to prevent the itching and flakiness. Remember to give your hair a wash, if you get drenched, as the rainwater carries the air pollutants.

If you are planning for a new hairdo, then monsoon is definitely not the right season. Perms, straightening and curls will not settle well on your hair strands due to humidity. Go in for a short hairstyle, which is easy to maintain and style out. Avoid hair gels and serums, as it can feel sticky with the sweaty scalp.

Skin Care: Sweaty and damp skin, especially over body folds, invites fungal infection. Keeping skin dry, bathing in lukewarm water with anti-fungal soap, helps to control fungal invasion. Seek a dermatologist, if the itch and the fungal rash are recurrent.  Whilst for some, the skin is clammy; some have a dry skin resulting in itchy and eczematous rash. Adequate moisturising at night is recommended to prevent eczema.

This is the season, when your facial skin can be rickety. It can appear dry and dehydrated at one point of time, oily and greasy in another. Daily cleansing with a soap-free cleanser is necessary for the face. Follow it up with a toner, which can maintain the pH levels and give a tighter and a firmer skin. Oil-free or a non-comedogenic moisturiser at night prevents drying of skin. Oily skin is prone for acne spots and comedones. Thus, antibiotic creams at night can help combat the spots.

Nail care: Damp and clammy feet under shoes is a source for fungal infection of toe webs and toenails. Try to keep your feet as dry as possible. Take off your shoes at work for few minutes, if your feet are wet. A wash with warm water and a salt or sugar foot scrub, helps prevent fungal infection.

Monsoon Make-up: Rain and humidity can ruin your make-up. Look at your best with these make-up tips for monsoon.

  1. Avoid foundation for skin, as it can washout with the rainwater or the humidity can make it smudged. Keep your make-up simple in monsoon. Opt for a facial compact powder on a layer of matt finish sunscreen.
  2. Switch over to waterproof eyeliner, to avoid a black eye with “kohl” pencils.
  3. Choose a powder based eye shadow to enhance your eye make-up. Shades of brown   and beige in the morning and smoky in the evening, is the style for this month.
  4. Use a long-lasting colour stay lipstick. Go in for matt-tint shades, rather than creamy and glossy ones.
  5. A creamy-blush on cheeks will complete the make-up. Keep it as subtle as possible and do not forget to blend it outwards on your cheekbones.

Natural skin remedies for monsoon: Pamper your skin with these natural skin care remedies for this season.

  1. Rose water is a natural toner for your skin.
  2. De-grease your oily skin with a mixture of rosewater and lemon.
  3. Try out honey and olive oil mix, which offers a natural conditioning to your hair.
  4. De-tan your skin with a thin coat of egg white mask for few minutes. This can remove tan and blemishes.
  5. A mixture of cucumber and potato juice serves as a natural soothing and a bleaching agent.
  6. Prevent dry chapped lips with almond paste or honey.
  7. Treat your feet at weekends with pedicure, with lime and crystal salt in lukewarm water.

Monsoon is a season of rejoice and rejuvenation for earth, free from the blazing heat. Follow the above skin care routine and enjoy this refreshing season.


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MYHTS UNVEILED: Understanding Aesthetic Procedures

Be it factual or fictitious, we all would have had a fair share of advice, when it comes to undergoing any cosmetic procedure. Though aging is a natural process and cannot be prevented, we can delay and defy aging with certain products. However, with emergence of innovative cosmetic techniques, we are bombarded with a wide array of accurate and not so accurate information about the same. Nevertheless, in few the truth may lie somewhere in between. Thus, consumers are baffled about these specialised techniques. This article aims to separate the facts from fiction and hopefully inspire you to understand the reality behind cosmetic practice.

Myth 1: You have to be old to experience cosmetic procedures.

Many have scars, facial lines and blemishes at 20s .So does that mean; they have to put up with it until 40?

Beauty is subjective. If you feel certain changes can enhance your beauty, approach a professional to get an advice on the best-suited procedure to bring that change in you. Remember, there can be no one who does not admire exquisiteness.

Myth 2: Botox is a toxic substance, which deforms facial expression.

Having a youthful look does not mean you have an expressionless face.

Botox is a purified protein derived from bacteria- Clostridium botulinum. Botulinum infection affects the central nervous system and causes paralysis. This property of the bacteria is now put to use, to relax (NOT PARALYSE) the muscles which causes the facial lines. The amount required to relax the muscles is very low and is inept to spread to anywhere else in the body. The human lethal dose of Botox is 3000 Units. Less than 100 units of Botox are required during cosmetic procedure, thus providing a wide safety margin. As we age, our muscles of facial expression leave fine creases and wrinkles. Thus relaxing these muscles for a while with Botox, will remove those lines, smoothen out the facial skin and gives a youthful look. However, this does not mean, we cannot do our normal expressions. It is only the muscles targeted, which is relaxed. The other muscles perform normally. Hence, you can still smile, frown and animate with Botox. It is advised to get this procedure done by a qualified professional , to avoid over-dosage, which can result in expressionless appearance.

Myth 3: Botox and Derma filler are the same.

Botox and fillers do not have anything in common, except that both are used for skin rejuvenation.

Botox as explained before is used to relax the muscle, whereas filler is used to replace the lost substance under the skin. As we age, the volume under the skin is lost, thus resulting in sagging and sunken appearance. Filler is the best way to replace the lost volume to revert the fullness and the youthful appearance. There are different types of fillers in the market. Beginners can have a temporary filler (lasts up to 6-9months) initially, to experience the results and if satisfied, can go for a permanent filler.

Myth 4: When Botox and Fillers disappear, you look even worse.

Probably, you will enjoy your appearance with Botox and Fillers and forget how you looked before!

As discussed before, Botox and certain fillers are temporary. Once the effect of these injections wears off, you will look the same as before you had the injections. There is no reason to feel that these procedures can make you look older once it wears off.

Myth 5: Acne scars are permanent and cannot be erased.

Old scars can be much harder to remove. Earlier, you get the treatment for acne and the scars, better the results.

There are various treatment options for acne and acne scars. It is important to understand that, acne scar management requires treatment at regular intervals, to appreciate the results. If you understand how to manage intermittent breakouts, you can even avert scarring.

Myth 6: Most cosmetic procedures are painful.

True to certain extent.

Non-surgical cosmetic procedures cause minimal discomfort. Most procedures are done after application of topical anaesthesia, which makes it easily tolerable.

Myth 7: Chemical peeling is only to treat acne scars.

Let us put it this way: acne scar is one of the treatment indications for chemical peeling.

Chemical peel is a good option for general skin rejuvenation: to erase signs of sun-damage, fine lines, blemishes and age spots. There are three types of peeling agents: Superficial, Moderate and Deep. While superficial and moderate peels are used to treat fine lines and pigmentations, deep peels are useful in management of acne scars and complete skin resurfacing. Always begin with a low concentration peel, to check how your skin responds before going for a deeper peel, as our skin type is more prone for post-inflammatory pigmentation.

Myth 8: Chemical peel is a one-time treatment.

Not very fair! Skin damage and aging is a daily process.

While certain deep-peels can improve skin after a single session, most superficial to moderate peels have to be used at regular intervals for long-lasting results. In between the peels, it is mandatory to have a good sun-protection and good skin care routine for beneficial results. Never, forget to follow the post-peel advice given by your doctor, to prevent scarring and post-inflammatory pigmentation.

This article has dispelled few of the commonest myths about cosmetic techniques. However, there are still few more myths regarding the efficiency of these procedures. If you aim to get any procedure done, seek advice from a professional who is trained to do these procedures. Before taking up the procedure get all your queries clarified, which should include: a) Pre-procedure analysis of your skin, b) Choosing the best-suited procedure, c) Details of the procedure, including the side effects and d) Post-procedure advice.

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