Pimples

Pimples

Today, we’ll discuss about Pimples, also sometimes called Acne or Muhase(मुंहासे) in hindi.

Why does it occur, what are the problems it can cause and how to get rid of it?

There are oil glands, also called sebaceous glands present in the deeper layer of our skin. These glands have ducts which open up in the surface of our skin. Oil (sebum) is produced within these glands and gets secreted via their ducts.

*Sebum is essential for the skin. It keeps the skin soft, smooth & shiny.

Problem/defect in secretion of these glands can cause pimples :-

  1. Excessive oil secretion can cause pimples
  2. If the secretion is normal, but there is blockage in the ducts or pores through which the oil/sebum is secreted, it causes pimples.
  3. Bacterial infection can cause pimples – A specific bacteria called Propionibacterium Acne or simply P.acne feeds on the sebum produced by our glands and grows on it. Our body’s immune system tries to remove the P.acne bacteria and this reaction causes inflammation and painful Red bumps (acne) in the affected area.

CAUSES OF ACNE  / PIMPLES

There can be multiple factors that can cause pimples or acne, some of the most common of which are discussed below :-

  1. Genetic – It is observed that, if in a family the father or mother has a case of pimples, there is a good chance of it appearing in the children too.
  2. Hormonal Imbalances – There are significant hormonal changes during the age of 13 to 25 years. This may cause increased activity of the sebaceous glands in our body, hence increased oil secretion and cause pimples.
  3. Side effects of medicines , such as
  4. Anti convulsants ( for example Carbamazepin, Phenytoin )
  5. Anti Tubercular, used in treatment of Tuberculosis (Isoniazide)
  6. Anti depressants (Lithium, Sertraline)
  7. Side effect of steroids
  8. Excessive use of cosmetics – Cosmetics which are oily / greasy, or which have high concentration of chemicals like Lanolin, Petrolatum etc, block the pores  of our sebaceous glands, hence causes pimples.
  9. Diet – There is no definite proof or data to show that our diet directly causes pimples but it is said that eating
  10. High glycemic diet (containing high amount of sugars) &
  11. Fast foods (especially which contains lots of oil) may cause pimples.

Also, there are many aggravating factors which do not cause pimples but, if there is someone already suffering from pimples, these factors can make the condition worse :-

  1. Stress
  2. Insomnia (lack of sleep)

For example, during exams, many students suffer from lack of sleep due to exam stress and anxiety, and this can aggravate the problem of pimples.

  • Hot & humid climate – hot climate causing excessive sweating can also lead to pimples.

SITES AFFECTED

There is a misconception among most people that pimple can only occur in the face. However, that is not at all true. Pimple can occur anywhere in our body, where there are sebaceous glands. For example, it can occur in :-

  1. Face
  2. Shoulder region
  3. Chest region
  4. The back, and even in the
  5. Scalp region

TYPES OF ACNE

  1. Neonatal Acne – It appears in the infant within 2 weeks after birth. It is caused due to the influence of maternal hormones.

Usually, there is spontaneous recovery by 1-3 months of age. Or it can be cured by giving medicine too.

  • Infantile Acne – Occurs in children during 6months to 16 months of age.
  • Pre-pubertal Acne – Occurs in children during 7 to 12 years of age.
  • Acne Vulgaris – Most common type of acne. Occurs in children during 13 to 25 years of age.

*Over 70-80% of individuals are affected during this age gap.

This does not cause any physical problems in our body, but it may lead to mental / psychological problems, as people often tend to see their faces in mirrors, and this can cause mental irritation. This may lead to lack of mental focus and self confidence.

  • Adult Acne – May occur in adults after 30 years of age. Usually, it occurs due to hormonal imbalances.

WHAT TO DO

In case of appearance of pimples, the first thing that you should do is consult a dermatologist.

This helps in proper diagnosis of your condition, as there are many skin diseases which mimic the appearance of pimples or acne.

Skin rashes mimicking acne are ;-

  1. Milia
  2. Trichoepithelioma
  3. Gram negative Folliculitis
  4. Acne Rosasea
  5. Syringoma
  6. Veruca Plana
  7. Sycosis Barbae

After diagnosis, the severity or grade of acne / pimple is assessed.

The gradation of pimples is done as follows :-

  1. Grade 1 – Pimple contains only black heads and white heads
  2. Grade 2 – Papules are present along with black heads and white heads
  3. Grade3 – contains pustules and pits
  4. Grade4 – contains nodules and cysts

TREATMENT

Grade 1 & 2 pimple can be treated by :-

  1. Topical creams, such as
  2. Retinoid creams, containing Tretinoin, Adapaline.
  3. Antibiotics, containing Eryhtromycin, Clidamycin, Benzoyl Peroxide, Azithromycin, Dapsone.
  4. Azaleic acid & Glycollic acid are also used
  5. Oral Medicines
  6. Oral Antibiotics – Doxycyclin, Minocyclin, Lymecyclin, Azithromycin
  7. Oral Isotretinoin – effective, and should be taken by dermatologist’s advice only.
  8. Chemical peeling – In this process, certain chemicals such as Salicylic acid, Glycolic acid are used. They induce (a) rapid drying / clearing of pimples & (b) removes the pigmentation as well.

Also, in case of pregnant women, oral medicines are deferred, so it is an appropriate alterantive.

It is a highly effective way of treating pimples. For chemical peeling, you should consult your dermatologist. The number of sessions and the number of days required for this depends on the severity / grade of your condition.

  • LASER treatment – It is also an effective way of treatment, however it’s quite expensive as well.

*For doing chemical peeling or LASER treatment, always consult a dermatologist. Never do Laser in Saloon / Parlor, as it can cause various side effects, which can be bad for your skin.

DOs & DON’Ts

  1. Early Treatment – People often tend to ignore their pimples, thinking that it will gradually go away. And yes, it might go away. But, if you delay its treatment, and it does not goes away on its own, this may lead to pigmentation (darkening of the skin) and scarring, which might remain for the rest of the life. This can reduce the self confidence of the individual.

Thus, you must always consult a dermatologist for effective and fast recovery.

  • Use face wash twice daily, after waking up and before going to bed.
  • Remove your makeup
  • Use Light moisturizer, which are Non-comedogenic, Aqua/Gel based. This will make your skin soft.
  • Use broad spectrum Sunscreen SPF 30 – There is a misconception that sunscreen aggravates pimples in oily skin. However, that is not true. There are many Non-comedogenic & Oil free sunscreens, which can be used to keep your skin healthy and pimple free.
  • Drink plenty of water
  • Include fresh fruits in your diet
  • Do NOT pop or squeeze your pimples – This may spread the inflammation and there are high chances of pigmentation occurring in that area.
  • Avoid using Over-the-counter (OTC) products or self medication – These medicines may reduce your pimples temporarily but may contain steroids which will actually flare up the pimples and cause many side effects.

10. Avoid excessive Scrubbing – Scrubbing won’t cause peeling off of your pimples but might aggravate your problem and cause inflammation in the area.

11. Do not experiment on your face – Do not use toothpaste or other sorts of home remedies on your face for removing your pimples.

Toothpaste contains a certain antibiotic called Triclosan, which may reduce inflammation, but it does not completely cures pimples. It is also not effective for everyone.

Experimenting on your face can cause various side effects such as allergic contact dermatitis, which will just worsen your condition and take more time for treatment.

For more details, kindly watch and subscribe to my Youtube Channel.

Blog by: Dr. Uttam Kumar Lenka, Consultant Dermatologist. Kolkata.

Idiopathic guttate Hypomelanosis

Idiopathic guttate Hypomelanosis

IGH  (Idiopathic guttate Hypomelanosis). You might know about Vitiligo, it is an auto-immune disease in which people get white patches on their skin, which may spread all over their body.

However IGH is a totally different disease. It may look similar but it’s not at all related to Vitiligo.

🔹It usually occurs in patients above 50 to 60 years of age.

🔹In IGH, small white spots 2-5mm in diameter, usually occurs in hands and legs, and skin that’s more exposed to the sunlight, or in sites of skin damage.

🔹These are not painful and does not spread across the entire body. However this may cause cosmetic problems for many patients.

The main underlying cause of IGH is decreased melanin synthesis which causes loss of pigmentation and appearance of white spots.

There is still not a full proof way of curing IGH but various modes of treatment have been found to be effective on many patients, which are –

1. Cryotherapy – using liquid nitrogen spray on the affected area, which then regenerates

2. Tacrolimus ointment – which helps in repigmentation

3. Retinoid cream – which helps in tissue regeneration and reduces signs of aging by promoting collagen formation in tissues

4. Many people have tried laser treatment and chemical control with 88% phenol, which have proved effective in reducing the white spots. However it’s not hundred percent effective.

Finally, I’d like to say that IGH is just a sign of aging and not a disease as such. So nothing to be worried about. It is often seen in people whose parents also have this condition.

If you’ve got white spots or patches in your skin, I’d recommend you to visit a Dermatologist who could differentiate if you’ve got Vitiligo or IGH or any other disease with similar symptoms. Thank you.

For more details, kindly watch and subscribe to my Youtube Channel.

Blog by: Dr. Uttam Kumar Lenka, Consultant Dermatologist. Kolkata.

Lichen Simplex Chronicus

Today, we’re going to discuss about Lichen Simplex Chronicus abbreviated as LSC or sometimes also called as Circumscribed Neurodermatitis.

So let us discuss what is LSC, what causes it and how can it be treated.

In some people, areas of skin becoms thick and black due to excessive itching and may lead to ulcer. This is called LSC.

Now, why does this occur?

Well, no exact cause for this is known as of now. However, it if often found in people with high levels of stress and anxiety.

The problem with LSC is that it is known to occur in both healthy and diseased skin. Diseased skin meaning skin with Fungal infection such as

Tinea Corporis
Atopic Eczema
Seborrheic dermatitis etc.  

There are many such skin diseases in which the skin starts to itch excessively. This causes tge skin to become thick and black. The skin creases and lines become unduly prominent. This marks the beginning of LSC disease.

Where is its most common site of occurrence?

  1. Back of the neck
  2. Ankle
  3. Wrist
  4. In the private parts of both genders, such as Vulva in females and Scrotum in males, and in the anus.

The problems faced by the patient

  1. Paroxysmal or Severe itching which may cause skin ulceration, wounds or infection
  2. Appearance – Skin becomes thick and black with prominent skin creases.

This is called Lichenification of skin, hence the name Lichen Simplex Chronicus. Chronicus means long term, that is, the symptoms may last for a long duration in an individual and is also seen to relapse, even after treatment.

DIAGNOSIS

Diagnosis of LSC is done by general Clinical examination of the symptoms.

However there are other skin diseases with similar symptoms such as :-

  • Localised or Hypertrophic Psoriasis
  • Lichen Planus Hypertrophicus
  • Seborrheic dermatitis
  • Chronic contact dermatitis

In case of the diagnosis not being accurate via clinical examination, Skin Biopsy is used to diagnose LSC.

TREATMENT

  1. Use moisturizer frequently to prevent dryness of skin.
  2. Many steroid ointments can be prescribed for treatment as follows :-

(i) Topical High potent Corticosteroid – such as Clobetasol, Halobetsol etc.

(ii) Topical Medium potent Corticosteroid – such as Mometasone, can be used with application of plaster for longer duration of effect.

*Never use steroid cream for a long period without tge advice of a dermatologist, as it may cause Thinning and Atrophy of the skin.

3. Other Topical creams such as Topical Doxepin, Calcipotrial, Tacrolimus, Pimecrolimus can be used for treatment. However, they are not as effective as the topical steroid ointments.

4. Initraleaional steroid injection can be used for treatment as well, if treatment using application of cream and ointments is ineffective.

However, the injection has to be administered by a professional Dermatologist only as there can be risk of appearance of white patches on skin, Skin atrophy or Pitting of the skin.

5. Advanced therapy includes Botox Therapy, which has been found to be effective in many cases but is still not considered as a full proof method of treatment.

Whatever the treatment might be, it should be kept in mind that LSC is a chronic diseas and is often seen to relapse in many patients. Thus, along with Cream / Ointments or injections, patients are sometimes given Oral medications which include Anti – histamines (to reduce itching) or in severe cases Oral steroids are given, but in small doses.

For more details, kindly watch and subscribe to my Youtube Channel.

Blog by: Dr. Uttam Kumar Lenka, Consultant Dermatologist. Kolkata.

What is Purpura?

Purpura is recurrent bleeding of the skin and mucous membrane, which causes appearance of visible purple spots, hence the name ‘Purpura’.

Normally, in any case of bleeding due to any injury, the bleeding gradually stops. This stoppage of bleeding is called Hemostasis.

Basically there are 3 stages of Hemostasis:-

  1. Vasoconstriction, that is, narrowing of blood vessels in the area of injury
  2. Platelet plug formation – platelets, one type of cells in our bloodstream aggregate at the site of injury to form a plug for stopping the flow of blood.
  3. Sealing by clotting factors

Now, defects in hemostasis(blood clotting) can be due to :-

  1. Decreased platelet production
  2. Defective platelets (non funtional)
  3. Normal production and function of platelets but there’s excessive storage of platelets in the spleen, which causes lower concentration of it in the bloodstream.

Defect in any of the above stages of hemostasis will cause bleeding problems and various types of Purpura.

We’re going to focus mainly on two tyoes of Purpura

1. Senile purpura  and  2. Steroid induced purpura

Senile Purpura

It can be seen in patients who are above 50 to 55 years of age. For example, if we apply too much pressure while holding their hand or there’s any kind of friction or scratch, the area develops red or purple patches.

‘Senile’ means aging and ‘purpura’ refers to purple. Senile Purpura is a problem associated with aging only. It is not any kind of dangerous or fatal disease.

Mechanism of how symptoms are manifested in Senile Purpura :-

As we age, there is reduction in production of collagen and elastin in our body. This causes thinning of our skin and makes our blood vessels fragile or weak.

That’s why, even in cases of minor injuries, there is defective vasoconstriction, which causes blood to come out of the blood vessels.

Our body defense system(macrophages) then tries to clear out the blood that has come out.

The macrophages destroy the Red Blood Cells (RBC) in the bbloo, which causes release of hemosiderin pigment from the RBC, which is brown in colour.

This sometimes causes the patches to be brown in colour.

Steroid Induced Purpura

This is caused by long term use of steroid ointments and creams on the skin.

Mostly people buy steroid creams to apply it on their face for brightening their face or to reduce pimples. However, in truth what’s happening is that their skin becomes thinner and this causes tge skin to appear bright or reddish. And this leads to them getting addicted to the steroid cream. However, its prolonged use makes the blood vessels fragile.

Any kind of pressure or minor injury will then cause red patches over the skin via the similar mechanism discussed above.

Cause

Apart from defect in Hemostasis, Purpura can also be cause by excessive exposure to direct sunlight.

Those who regularly work under the sun are more susceptible to photodamage.

This causes reduced collagen production in the body.

This makes the skin fragile.

Most Common site affected

Purpura can be seen anywhere in the body, even the face. But it is mostly found to occur in the extensor aspect of the hand, that is the surface, which is usually most exposed to sunlight.

Prevention

  1. When purpura occurs due to aging, it cannot be prevented but other factors causing Purpura can be cocontroll as mentioned below.
  2. Avoid excessive sunlight by using full sleeved clothes and broad-spectrum sunscreen.
  3. Take plenty of Vitamin C. Citrus fruits like Orange, lemon, guava etc. are rich in vitamin C.
  4. Do not use steroid cream without a dermatologist’s advice.

Treatment

  1. Purpura is benign condition, that is, it is not dangerous. It is self-limiting, which means that, given 1 to 3 weeks, the reddish or purple sots dissolve automatically.
  2. It is seen that ‘Arnica cream’ works in reducing the symptoms in some causes but still, it is not fully effective.
  3. It is best to avoid any excessive pressure, friction in the affected area.
  4. Use sunscreen, moisturizer containing Vitamin C and Vitamin E, which helps to keep the skin firm.
  5. Also Vitamin C tablets and supplements can be take as vitamin c helps the body produce collagen and strengthens the skin and blood vessels.

For more details, kindly watch and subscribe to my Youtube Channel.

Blog by: Dr. Uttam Kumar Lenka, Consultant Dermatologist. Kolkata.

Dr. Uttam Kumar Lenka received the “PRIDE OF BHARAT” award!

During the Corona epidemic, he continued to treat patients in and around Calcutta, West Bengal, and the state of Odisha, fulfilling his duty as a matter of course and becoming a favorite among patients and relatives.

In addition, he has been able to successfully treat many patients who have connected via mobile and the internet to discuss their issues.

In addition, Dr. Uttam Lenka has launched a YouTube channel called Skin & Hair Clinic to raise awareness about various skin problems and their treatment, especially how to deal with skin and hair related common issues.

At this time, he was selected as one of the leading dermatologists in the city of Calcutta by the Trade and Media Institute. He was honored with the “PRIDE OF BHARAT” award in the presence of renowned Bollywood actor Sunil Sethi at a function organized by trade and media in Delhi on Saturday.

Are you facing dark armpits, neck, elbows and knees on your body ?

Are you facing dark armpits, neck, elbows, and knees on your body? Do you want to get rid of these? So let’s discuss what is it? causes, prevention, and treatment

The term is called ‘Acanthosis Nigricans ‘. It is a skin condition characterized by dark patches in body folds n creases. Especially it occurs in underarms, neck, in ladies under the breast’s, groins even on the elbows or the knee joints.. This is seen as hyperpigmentation and in some conditions, it is associated with itching.

So this manifestation of the skin can be because of obesity ( i.e diabetes) or can be seen in people who are suffering from Hormonal disorder ( it’s called PCOS Polycystic ovarian disease or Syndrome ) It’s the result of ovarian hyperfunction .. it begins with a detailed history of menstruation, infertility or miscarriage and symptoms of increased testosterone-like increased in facial hair in females, acne or thinning of hair on the scalp. Therefore Healthy Eating, regular exercise, and weight reduction is to be done to control PCOS .. Success ineffective management of women with PCOS is through a Synchronized effort between the Dermatologist, Gynecologist, Dietician, and physical trainer ..
*
Prevention & Treatment*
To reduce the appearance of acanthosis nigricans, dermatologists prescribed creams can be used to lighten the skin or to soften thick and Rough patches. Laser treatment can be done to reverse skin thickening or lighten the skin, Antibacterial soaps, tropical antibiotics creams, and oral medications can be used.

Glycolic Acid cream can be applied at night 6-10% cream twice a week and Hydroquinone based cream also can be applied twice a week.

So at last now discuss how home remedies are beneficial for your dark underarms .. Apply Apple cider vinegar, aloe vera gel, cucumber, potato, Multani mitti, turmeric, lemon juice, olive oil, castor oil, and almond oil to reduce dark underarms.