A vast majority of women I met in my practice insist that they have very “sensitive skin”. This could mean anything from dry and tight skin, or acne-prone skin, or red flushed and angry looking skin. The worst sufferers are the ones who have skin that stings and burns.

Unfortunately, most sufferers try a variety of brands on a trial-and-error basis, which can worsen the problem and create frustration. How does one define sensitive skin? And how can one manage and care for problematic skin?

‘Sensitive skin’ is a term used by women to describe an exaggerated or unpleasant sensitivity of the skin to commonly used cosmetics and toiletries. This sensitivity can be in the form of pricking, tingling or burning sensation while using skin care products. These symptoms may also occur when the skin is exposed to harsh sunlight or cold winds. Facial skin is always the worst affected. It seems to affect women more than men, especially while they are menstruating, which suggests some kind of hormonal influence. And most women notice that their skin only behaves this way during periods of emotional upheavals, which is why experts believe that a psychogenic factor may also be at play. As there are only symptoms without much physical evidence of a rash or skin disease, it is hard for a dermatologist to ‘define’ or ‘quantify’ skin sensitivity. But we do know that the modern trend of using multiple skin care products on the skin, on a daily basis (facewash, toner, serum, moisturizer, sunscreen, fairness cream, anti-ageing cream, under eye cream, various types of make-up products in several layers), has made skin sensitivity an increasingly common problem. Added to that, many of us are constantly popping our heads into salons and spas on a weekly basis for clean ups, facials, hair removal treatments, “de-tanning” bleaches, aroma oil massages, chemical peels and various other “services” which are constantly insulting and tormenting our skin. The irony is that cosmetic manufacturers have now come up with entire ranges of cosmetics meant for “sensitive skin”, which may or may not live up to their promise, but will definitely keep your credit card warm and toasty! Do remember: ‘sensitive skin’ is inherent, but ‘sensitized skin’ from over-use and abuse is self-acquired.

Your laugh lines tend to be the most susceptible to irritation and redness, followed by the ‘apple’ of your cheeks, and finally, the skin around your mouth. If you suffer from sensitive skin, you should try to simplify your skin care regime. It is important to rule out medical conditions like acne, rosacea and allergic contact dermatitis, with the help of a dermatologist. If you and your dermatologist are unable to identify the offending cosmetic by keen observation or method of elimination, then it is helpful to perform an allergic patch test. Most of the time, you are not intolerant to the said cosmetic per se, but to one or more specific ingredients in it, which can be identified by carrying out a simple patch test. Your doctor will give you a copy of the report, naming the chemical(s) you are allergic to, and this can be used for future reference when you try to select the right skin care brands for yourself.

If your skin stings or burns, then discard all detergent, soap or deodorant based cleansers. Avoid astringents, anti-ageing creams or anti-acne gels. Discontinue use of all make-up, including eye, hair and nail cosmetics. Stay away from the salon for a while. Your dermatologist may prescribe a mild steroid cream for a few days to reduce the inflammation.

Next, make a list of all the cosmetics that you use on your skin, hair and nails, from dawn to dusk. Wherever possible, go through the ‘list of ingredients’ on the label and spot the offending allergen based on the patch test report obtained from your dermatologist. This may not be possible if you are using low grade or herbal products which do not mention ingredients on the label. Throw out creams, cleansers and body washes that are more than 2 years old. Throw out cosmetics which are more than 6 months old. Lip balms, lipsticks and mascaras are to be replaced every 3 months.

Use only lukewarm water and a bland soap-free cleanser like Cetaphil cleansing lotion to wash your face, and pat dry with a face tissue, instead of using towels. If your skin still feels hot and irritated, then spritz some rose water or thermal spring water to soothe your face. Try the Vichy Thermal Spa water, for instance, for some instant relief. Use glycerin or bland petroleum jelly to keep your skin moisturized.

Skin care products must be re-introduced first, and not make-up. Your dermatologist will choose a moisturizer which is free from fragrance, parabens and lanolin. Carry your moisturizer to work and reapply as often as you need, especially if you work in an air-conditioned office for long hours. Sunscreens are a must, and your doctor may prescribe a physical sunscreen instead of a chemical sunscreen. Sebamed and La Roche Posay Anthelios are good examples of chemical sunscreens which are suitable for sensitive skin. Avoid scrubs, toners and face washes that contain beads or granules. Reintroduce cosmetics in the following order- lipstick, face powder and powder blush. Do not use ‘long last’ lipsticks, use light eye shadow colors (white or beige), and use pencil instead of liquid eye liners.

After 3-6 months of avoidance, progressively reintroduce cosmetics one by one with a two weekly interval. Consult a dermatologist to choose the right cosmetics.

There are other kinds of sensitivity as well, which can lead to medical conditions like acne and rosacea.

Acne is mainly driven by hormonal fluctuations in the body. You may either be suffering from a hormonal condition, or your genetic constitution makes your skin react this way to normal monthly hormonal fluxes. External factors like environmental stresses (heat, humidity, pollution), diet and cosmetics only have a limited role in aggravating pimples. Certain oil-based moisturizers and sunscreens can clog up your pores and create blackheads and whiteheads. So can use of coconut oil or waxes and pomades on the scalp. Salon facials, steaming and massaging of the face can also clog your pores. Blackheads and whiteheads can eventually develop into acne, and existing acne can get infected and traumatized during salon treatments. A good moisturizer and daily use of sunscreen are skin essentials, yet many women with acne-prone skin are paranoid to use any skin care as they do not wish to anger their acne. They also tend to over-wash their skin, and when they do not use a moisturizer, their oil glands go into overdrive and produce even more sebum to compensate for the dryness. This creates an evil cycle of over-washing the face with harsher cleansers which strip the skin off its natural oils. Dry and irritated skin is more prone to sunburn and the acne leaves unsightly dark marks as remnants. So how does one care for acne-prone sensitive skin?

Cleansers containing glycolic and salicylic acid will dry up acne, but they are not suitable for sensitive skin. Try cleansers like Avene cleanance gel cleanser which contain anti-inflammatory agents. Use non-comedogenic, water-based moisturizers like Neutrogena oil-free moisturizer. Consult a dermatologist for the medical management of your acne.

Rosacea is a skin ailment where the skin tends to blush (transient redness) or flush (permanent redness) on the cheeks, tip of the nose, and sometimes on the chin. Unlike acne, which affects men and women in their teens and 20s, rosacea usually affects older individuals in their 30s and 40s. This facial redness is usually seen in response to heat, eating hot or spicy foods, caffeine, alcohol, anger, and physical exertion from sex and exercise. It may even be associated with stomach acidity issues caused by certain bacteria. Medications like steroids and hormonal pills can also cause Rosacea. It gets worse around menopause. And it may be associated with profuse sweating on the face (wet blushing). Rosacea is different from the blushing associated with social anxiety disorders, which is temporary and strictly a psychological phenomena.

If left untreated, one may eventually develop acne like bumps and boils on the face. And in severe cases, the facial redness may become a permanent state, with appearance of tiny broken blood vessels on the face, and permanent swelling and enlargement of the tip of the nose. While some sufferers complain of worsening of their symptoms with use of cosmetics and toiletries, for the large part, this is a medical condition which requires medical treatment. Use of a high grade sunscreen which provides broad spectrum coverage against Ultraviolet-A and-B radiation helps, but only as a supplement to medical treatment. Those suffering from permanent flushing can mask their facial redness using green tinted concealers. Triggers like alcohol and spicy food must be avoided as far as possible, or else the Rosacea might return despite treatment.

Ever noticed how sportstars these days are looking more and more like models and movie stars? How do they manage to look so good despite the sweat, grime and injuries of their sport? Read on to learn more.

Athletes are getting increasingly skin smart. In a profession which includes long hours in the sun or water, excessive sweating and friction, they need to take better care of their skin. Since personal time is sparse owing to rigorous training schedules, his/her skin care regime must be simple, effective and easy-to-carry.

Whether you’re a marathon runner, a swimmer or a skier, sunscreen should be the topmost essential skin care product in your bathroom shelf. A high SPF water resistant sports sunscreen like the Coppertone sports spray is ideal for you on training days. Even a water resistant sunscreen will only last for 80 minutes, so do not forget to reapply. For long hours on the field on a sunny day, I would recommend a zinc oxide containing physical block. Physical sunscreens are also a good option if you have sensitive eyes which burn or water when you use chemical sunscreens. Apply liberally onto the apples of your cheeks, your nose, chin, lips, ears and nape of your neck. It leaves a white film on the skin, but it is far more protective than a chemical sunscreen. Use caps as an added precaution if you are light-skinned. Spritz some thermal spring water like the Vichy Spa water spray to soothe your hot skin. Your lips are more prone to drying and chapping, so use an SPF-containing lip balm like the Sebamed SPF 30 balm. Clinique’s after sun rescue balm with Aloe will soothe a mild sunburn after a long day on the field. Apply a conditioning serum to your hair before you hit the pool. A cap alone is not enough protection for your hair, as chlorinated pool water tends to find its way through the cap.

Physical hygiene should be of utmost importance, especially post work out. Use Triclosan-containing soaps like Cetaphil Soapex for a thorough cleansing without drying out your skin. Wash your hair on a daily basis using the Sebamed anti-dry revitalizing shampoo. Women with light blonde hair have a rough time in the pool, as copper salts in pool water can leave a greenish tinge on your hair. Look for a chelating shampoo in your local salon or pharmacy. A good conditioner will keep your hair healthy and shiny despite frequent washing. Apply moisturizing lotions soon after you towel dry. Dust your groin and your feet with an antifungal powder. If you are not able to have a shower soon after your work-out, then use a toner to clean your face, neck and chest. Use pumice stones to rub away calluses on hands and feet, followed by liberal application of a urea or salicyclic acid containing hand & foot cream. Athletes are more prone to acne, folliculits (pus filled bumps on the hair follicules) and friction burns in their nether regions. Use a benzoyl peroxide containing soap and facewash (eg, Clean&Clear Continuous Control Acne Cleanser), to keep zits away. Apply petroleum jelly to your nipples and groin folds to avoid friction burns and chafing. Use the Mitchum unscented roll-on deodorant and foot deodorant sprays to keep body odor away.
Your skin is highly vulnerable to early ageing, uneven pigmentation, premature wrinkling and a variety of benign and malignant skin cancers. Adequate sun protection and liberal and frequent use of sunscreens will take care of most of these problems. Most of the anti-pigmentation and anti-ageing creams require strict sun avoidance while usage, which may be impractical to you. Use a Vitamin C containing cream (La Roche Posay Active C cream) or an Alpha Arbutin containing sunscreen (Ban a Tan cream) which are safe and effective. Get regular mole checks done with a dermatologist trained in the use of a special magnifying lens called a Dermatoscope. Most skin cancers and pre-cancerous conditions can be effectively treated using lasers, liquid nitrogen sprays or by surgical removal. Use RayBan or Poloroid eye glasses for eye protection. It not only keeps crow’s feet away, it will also protect your eyes against cataract. Consult a dermatologist for advice on long term laser hair reduction treatments, to keep your pits, chest/back and legs attractive and presentable during sport events. For traumatic or post-surgical scars, stretch marks, keloids or soft tissue dent-like depressions, consult your dermatologist for treatments using fractional ablative lasers, pulsed dye lasers, intralesional injections and/or dermal filler or fat transplant injections. You can opt for Botox® injections to the face every 4-6 months to treat premature wrinkling. Botox® can also provide long term relief from excessive sweating in the pits, palms and soles, which can hinder your performance. Most dermatological treatments (including lasers and chemical peels) require strict sun avoidance for over a week, which may be impractical to most of you. Instead, you can undergo treatments like the HydrafacialTM or radiofrequency or ultrasound based skin tightening treatments (eg Thermage® or Ulthera), which are safer and do not require long periods of sun avoidance.

What is the right kind of fabric an athlete must use? Spandex, Lycra, Muslin and Microfiber are best suited to protect your skin while allowing you maximum flexibility with least hindrance to your performance. Never forget to wear your socks (white cotton socks are the best) and wear flip flops in common shower areas to keep your feet and nails free from fungal infections and warts. Keep toenails trimmed short and straight, so they won’t in-grow. Look for high quality insoles and foot pads for your shoes in order to avoid painful blisters and shoe bites. Do not share shoes, gloves, towels or other equipment. Do not wear make-up during work outs. A water resistant eye pencil and lip gloss is all that you need. Drink plenty of water to keep your skin, lips and ligaments well hydrated and supple. Lastly, get plenty of sleep. Adequate sleep will rejuvenate your tired muscles and your abused skin.

The New Year is a good time for new beginnings and turning over a new leaf. If you wish to give your face and your skin an overhaul, a skilled dermatologist has innumerable tricks up his sleeve to help you achieve that. From flattening a large zit in a day to looking 10 years younger in a week, read on to find out more about dermatological makeovers.

For the conservative folk who do not wish to undergo procedural treatment, dermatologists have discovered and created a wide range of medications and cosmeceutical products, which can redefine your skin. For instance, for a woman in her late 30’s, a dermatologist will prescribe an antioxidant serum in the day time followed by a broad-spectrum sunscreen. At night, you could use an anti-ageing moisturizer containing peptides or Coenzyme Q10. If you are in your 40s, this is the right time to start using a retinol containing cream every night to banish away fine lines and wrinkles. Under eye creams containing retinol, caffeine, Vitamin K or Vitamin C can reduce dark circles, puffiness and keep fine lines at bay. If you have pigmentation prone skin, then an Alphahydroxy acid containing cream or serum may be added to your regime. If you have oily and acne-prone skin, you’ll need a salicylic acid containing face wash along with clay or silica based matte finish sunscreen and gel based moisturizers.

A night cream containing a combination of retinaldehyde and glycolic acid can keep the skin oil free, exfoliate blackheads and whiteheads, clear acne and marks and prevent fresh acne. Large painful and deep-seated acne can be flattened quickly with steroid injections, although this not a cure and must not be abused. Oral antioxidants help by acting as an internal sunscreen; omega fatty acids can make your skin look young and dewy; and oral biotin and amino-acids can keep hair and nails strong and healthy. Medicated lotions like Latisse can thicken your eyelashes and Amnexidil containing hair serums can arrest hair fall and increase hair thickness. There are various face packs, scrubs, masks and home microdermabrasion kits, which contain some of these ingredients in a higher concentration, which you can use on a weekly or SOS basis for instant hydration and glow. As you can see, there is no “one fix for all”. In fact, your dermatologist will customize your skin care regime based on your skin type and specific concerns, keeping in mind your age, skin color, ethnicity and even your budgetary constraints. Conditions like acne and rosacea will require medical treatment as well. An ultra-conservative skin care regime which only relies on topical applications will have to be followed religiously for at least 6 weeks to start noticing improvement, and your makeover will be complete in about 6 months. The regime may have to be modified as you age, or based on climatic conditions. If you are looking for lasting and long-term benefits, then proper skin care is a commitment of a lifetime.

If you are looking for faster results, or want to get rid of spots and blemishes over a ‘lunchtime/hop-in hop-out’ procedure, then you can opt for chemical peels every 4-6 weeks. A peel takes about 15 minutes and uses fruit acids or salicylic acid to even out skin tone. The benefits range from skin lightening to exfoliation, and it also has anti-acne, anti-pigmentation and anti-ageing benefits. You can appreciate the results after a single peel, and see maximal benefit after 4-6 peels, after which you can get it done once in 4-6 months for maintenance. Darker skin types can only tolerate superficial chemical peels, while medium-depth peels are reserved for deep-seated pigmentation or chemical cautery of bumps or scars.

Microdermabrasion involves skin polishing using crystals or diamond tipped heads, which can exfoliate blackheads and dead skin, while making open pores and superficial acne scars look less prominent. A medicated facial involves cleansing, exfoliation, extraction and hydration using cosmeceuticals which are delivered into the skin using jet sprays, oxygen infusion or vacuum. The results are instantaneous and these treatments are ideal if your skin is too sensitive or cannot tolerate a chemical peel.
Dermatologists also use a wide range of laser and light based devices, which can achieve a complete make-over of your skin by tightening it, eliminating fine lines and wrinkles, shrinking acne scars and pits, and burning off unsightly warts and skin tags. Various countries have manufactured a mind boggling array of dermatological lasers. Radiofrequency-based devices (such as Thermage, e2 Sublime etc) are the best for skin tightening, and they work best for those in their 40s or 50s when skin sagging is mild to moderate.

The carbon dioxide laser is the most effective laser for precise cutting or vaporization of warts, moles, cysts and skin tags.

Fractional ablative lasers like the Pixel 2940 or the Lumenis UltraPulse laser is ideal for treating acne scars, trauma scars and stretch marks.

Nonablative lasers like the Fraxel is safely used for full face skin resurfacing which irons out fine lines and wrinkles.

Light based devices like the IPL are used for painless ‘photofacials’. These devices get rid of freckles and age spots, facial redness or tiny broken capillaries on the face. They are also somewhat effective in achieving skin tightening. However, in Asian skin types, IPL devices are neither very safe nor every effective.
The Q switched Nd:YAG laser is the gold standard for getting rid of freckles, age spots and certain types of birthmarks.

The blue light laser is effective in the treatment of acne and rosacea in those who cannot tolerate (or are unsuitable candidates) for antibiotics.

Facial hair in women can also give the face an aged and masculine appearance. There are several different laser technologies that are available for removal of unwanted hair. The Diode and the Alexandrite lasers have been proven to be the best hair removal lasers across multiple clinical studies. However the long pulsed Nd:YAG laser is widely respected as the safest hair removal laser for skin of color.

The Alma Accent laser and the Velasmooth laser are used for cellulite reduction. Most of the above mentioned technologies require multiple sessions over 4-12 months to achieve the desired results.

But there is more to ageing than just ageing skin. The face ages as well. The facial bones shrink, lips lose volume and the facial fat collapses making an aged face shrunken and asymmetrical. There is an overall droop, especially in the middle of our face, and the neck loses its firmness. None of these age-related changes can be addressed by any of the interventions mentioned above. Botulinum toxin injections (popularly known as Botox) can be used to get rid of crow’s feet (wrinkles at the corners of the eye), frown lines, forehead lines and neck lines in a week’s time; literally taking away years off your face. It can also be used to create a sharp and well defined jawline (the Nefertiti face lift). The effects only last for 3-6 months, so the treatments need to be repeated on a regular basis in order to maintain the benefits. Dermal fillers like Restylane and Juvederm are safe and temporary treatments which can be used to “fill out” laugh lines, lift the droopy corners of your mouth or create brow lifts. The results are instantaneous and last for 6-9 months. There is a misconception that these treatments are only meant for older men and women. Botox injections can also be used to slim a heavy jawline or treat gummy smiles in younger men and women. Fillers on the other hand can also be used to fill out thin lips or sunken under eye tear troughs as well.

There are other treatments as well, like the ‘vampire facelift’ (where plasma from your own blood is injected into your skin) or mesotherapy injections. There is insufficient scientific data supporting the validity of these treatments. So until dermatologists and researchers come up with evidence on the safety and efficacy of such treatments, you can give it a miss. And of course, my long time readers already know my views on “fairness” treatments.

So this new year, resolve to give yourself a dermatological make over. It may not mend a broken heart or get you that dream job. But do it for the pleasure and the confidence boost that it gives you. Choose only qualified and well-trained dermatologists who stay regularly updated on these treatment techniques.

Congratulations to all the pregnant ladies out there! A pregnant woman is a beautiful sight. Your body is changing, and so is your skin. But do not allow these changes to unnerve you. Read on to learn more about skin care in pregnancy, what’s safe to use, and tips to manage unpleasant skin ailments during this time.

Your body is going through a sea-tide of physical, physiological and hormonal changes. Your skin is glowing, your hair is looking thick and lustrous, and you are receiving a lot of love and attention from all of your loved ones. However, you are also concerned about the new freckles across your face, stretch marks appearing over your belly, pimples on your face and dry and itchy skin. You are getting confused with all the warnings you are receiving from friends or the media about what’s safe and unsafe to do during pregnancy. Allow a dermatologist to help you understand what’s going on with your skin right now. This article will also give you some scientific clarity on the skin care dos and don’ts during pregnancy.

The dark areas of your skin, like the skin on your upper lip, your nipples, inner thighs and your genital skin, will turn darker. This is more noticeable in dark skinned women. Pre-existing moles and freckles also become darker and more prominent. Even old scars and birthmarks may look darker. Many women notice a dark line running down from their navel to their pubis. This line is called the Linea Nigra. Most women already have a very faint white line in that area (they may not even be aware of it), and that line turns brown and prominent during pregnancy. The most distressing problem is the appearance of brown blotchy patches on your cheeks or nose during your second and third trimester. This condition is called ‘Chloasma’ or the ‘mask of pregnancy’ as it creates the appearance of a half mask across the upper half of your face. All these pigmentary changes are caused by the hormonal upheavals in your body during your pregnant state. Chloasma can create a lot of social embarrassment and many crying spells, but the good news is that it will disappear on its own. Use a sunscreen and avoid going out in the sun without protection, as this will darken your freckles and chloasma. Physical and chemical sunscreens are absolutely safe to use during pregnancy. If your chloasma is bothering you, and if concealers are not a satisfactory option for you, then consult a dermatologist before you pick up a bleaching cream from the beauty store. Creams containing Vitamin C, Azelaic acid and Glycolic Acid are safe to use during pregnancy. Avoid skin lightening creams containing Mercury or Hydroquinone as their detrimental effects on the unborn fetus is documented fact. Post-delivery, avoid going back on hormonal contraception (like birth control pills) as they can worsen your pigmentation. If the skin all over your body turns a shade darker without any reasonable explanation, then it might be wise to have your thyroid gland tested.

If you already suffer from acne, your skin might turn oily and you might notice more severe pimple breakouts during the second and third trimester of your pregnancy. Unfortunately, most anti-acne creams and tablets are forbidden for pregnant and nursing women. Retinoid containing anti-acne creams can even cause serious birth defects in the fetus. For the particularly severe cases, where there is a risk of facial scarring from the acne, it is relatively safe to use Clindamycin, Erythromycin and Azelaic acid gels after the 4th month of your pregnancy. Use a tea-tree oil face wash (avoid Salicylic acid based cleansers), keep your face clean and dry, keep your nails off your face, avoid facials and steam bath, and do not experiment with home remedies like toothpaste. Frequent washing or daily use of face scrubs is counter-productive. Get blackheads and whiteheads manually removed by a dermatologist. You can also use face-packs made from Fuller’s earth or sandalwood powder, to get rid of excess oil and loosen blackheads. Blackhead removal strips are also safe to use.

Hormonal changes along with rapid stretching of your skin can leave you with ugly stretch marks. These may be inevitable if you are carrying twins or have gained too much weight during your pregnancy. Keep your skin well hydrated by drinking plenty of water and using thick emollient creams like cocoa butter. Apply mineral oil (Baby oil) or Vitamin A or Vitamin E containing oils or creams (eg, Bio-Oil) to minimize the appearance of stretch marks. A balanced diet along with moderate exercise during pregnancy can help you gain weight in a controlled manner. Post-delivery, go for walks and do some abdominal toning exercises to help your belly muscles regain their former shape.

Itching in late pregnancy affects 18% of all pregnant women, and is generally caused by skin dryness and over-sensitivity which is common in this state. During pregnancy, your skin is also more prone to eczema, prickly heat and yeast infections, which also create itching and discomfort. It is only a myth that itching can lead to stretch marks. Enjoy a good scratch, but if itching is accompanied by red raised rashes on your belly, then this may be a sign of cholestasis (a condition where the bile outflow from the gall bladder is obstructed by the growing uterus). There can be symptoms like nausea, poor appetite, tiredness and jaundice. If your urine is dark and the whites of your eyes appear yellow, then report to your doctor immediately. He/she will run some blood tests, prescribe an aloe, calamine or camphor based moisturizer, along with mild steroid creams and oral medications. The jaundice and itching will disappear 48 hours after delivery, and rashes also subside within 6 weeks. Itching associated with the appearance of hives and fluid filled blisters is a medical emergency and must be treated urgently. Pregnancy related itching can recur in subsequent pregnancies but it is usually worse in first time moms.

Permanent hair dyes and hair removal (“depilatory”) creams are best avoided in the first three months of pregnancy. It is perfectly safe to use make up and nail polish during pregnancy. However you may have to choose your make-up wisely if you have pimple-prone skin. If you are suffering from chloasma, avoid soy containing creams or perfumed cosmetics which contain phytoestrogens and oil of bergamot as these may worsen your pigmentation.

You may have noticed that body hair is growing faster during pregnancy. While it is perfectly safe to shave, do not shave in the shower, especially during the last 3 months as you may lose balance and hurt yourself. Avoid laser hair removal as the safety of laser radiation during pregnancy has never been investigated.

If you have been using hair growth serums before your pregnancy, you may want to consider going off the medication during pregnancy and breast-feeding. Most hair growth serums contain minoxidil (Rogaine), Amnexidil, caffeine or phytoestrogens, which are all medications that are unsafe in pregnancy. Although Allopathy regards hair oils as purely placebo, many women have benefited from the placebo effect of hair oils containing castor oil, biotine, Brahmi and gooseberry extract.
Maintain good genital hygiene using lactic-acid containing feminine washes to keep yeast infections at bay. However, do not douche.

Your nails will grow faster during pregnancy but they may also be more brittle and weak, so make sure you are getting enough protein and calcium in your diet. Use a nail hardening base coat before applying nail paint.

Maintain good dental hygiene during pregnancy by brushing, flossing and cleaning your tongue twice a day. You will be more prone to bleeding gums and dental caries during pregnancy, and it is now proven that teeth and gum infections may lead to preterm deliveries. Make sure to get enough Vitamin C in your diet.

It is safe to get manicures and pedicures done during pregnancy, but avoid getting a foot massage done as the pressure on certain nerve points around the ankle can trigger uterine contractions.
Warm baths and tub soaks can be very relaxing and can ease the aches and pains of pregnancy and improve blood circulation around your feet. But avoid hot baths if you are suffering from itchy skin. And do not fall asleep with your hot water bag as these can lead to serious skin burns.
Insect repellent creams and anti-lice shampoos are best avoided in pregnancy as they contain pesticides. Use mosquito nets and lice combs; or look for herbal alternatives.

On a parting note, when in doubt, get a second opinion from your dermatologist and gynecologist. It is always better to err on the side of caution when you carry the responsibility of an unborn innocent child’s life nurturing within you.

Can our skin and hair reflect the stress that we’re feeling? Are there any skin disorders which can reveal deep-rooted psychological anxieties and adjustment disorders? Learn more about skin ailments caused by or aggravated by stress.

There are a host of skin, hair and nail conditions- some major and some minor- which are either caused by stress or made worse by stress. A patient once told me “Oh come on Doc, when you guys don’t know the cause of a disease, you blame it on stress!” But jokes apart, certain skin ailments provide a clue to your secret anxieties, resentments and self-doubts.

Take dandruff and acne (pimples) for instance. There is a common misconception that dandruff causes acne. That’s not really true. However, both conditions have several commonalities. Both are caused by hormonal fluctuations and excessive sebum (oil) production on the skin. And they are both aggravated during stressful situations. There is nothing worse than a girl wanting to look her best on her wedding day but discovering a pimple on her big day simply because she was too anxious about getting a pimple!

Eczema is closely related to anxiety too. Eczema is a broad term for an exceedingly common allergic skin disorder and it appears in several different forms. It is typically aggravated in winters and yes, by stress. In fact textbooks have even come up with a description for an “eczema personality”. Long term eczema suffers are known to be more intelligent, timid, suspicious, anxious, depressive, have a conflicted relationship with their mothers, and show higher interests in power and social influence with less interest in money and affiliation. Having observed eczema patients for several years now, I would say that this description hits the nail straight on the head.

Hives and allergic wheals are red swollen raised areas on the skin which are intensely itchy and last for a few hours. Stress is one among a dozen different triggers which can set them off.

Alopecia Areata is a condition where one notices one or more bald patches on the scalp or any hair-bearing part of the body like the beard area. These patches are smooth and do not itch or burn. Most of the time, the hair regrows spontaneously without any treatment. And almost every patient can recall a stressful episode in his/her recent past.

Cold sores (also known as fever blisters) are painful and itchy blisters which occur periodically on the lip. Although they are worsened by anxiety, they also occur following fever, menstruation, respiratory infections or sun burns. They can be treated effectively with anti-viral medications, however the virus tends to linger in the body for several years in a latent state. Painful mouth ulcers are also linked to anxiety along with Vitamin B12 deficiency. Some of us respond to stress by sweating profusely, especially from the pits, palms and soles. Excessive sweating in turn causes a multitude of other skin ailments.

Some of us respond to stress by turning into skin pickers or nail biters. Picking or squeezing your zits is counter-productive. It does not make the pimple go away, and you will be left with ugly marks and scars which are hard to treat. Compulsive picking and pinching of the skin is a psychological disorder known as Dermatillomania, which is frequently misunderstood. Trichotillomania is a psychological disorder marked by compulsive hair pulling. These disorders generally afflict those with borderline personalities, who are unable to control themselves, and feel a great sense of relief when they pick at their skin. But the marks and scars leave them feeling ashamed and self-conscious. The guilt further aggravates their skin picking tendencies. A small subset of skin pickers complain of hallucinations or delusions where they see or believe that there are insects crawling underneath their skin. This is a severe psychosis which requires psychiatric attention. Drug abuse and certain medical conditions like Porphyrias can also bring on such hallucinations. A vigilant dermatologist can identify your correct diagnosis, and can refer you to a psychiatrist and behavioral therapist for treatment.

Hang nails are little slivers of torn skin by the sides of the nails. These are generally caused by dry skin or excessive washing, but made worse by biting or pulling. Snip it with a cuticle cutter, apply hand creams generously and do not pick on them, or they’ll get painful and infected.

Certain common ailments like hair loss, psoriasis and vitiligo (leukoderma) are also aggravated by stress. The irony is that the presence of a skin ailment itself causes stress due to social embarrassment, and this turns into a vicious cycle.

I have seen a number of patients who complain of non-specific itching, usually localized to one part of the body, like the legs or back of the neck. They do not have any specific skin ailment, and their skin only shows evidence of non-stop itching- like cuts, scratches and mild thickening of the skin. On further questioning, these patients admit to stress and an uncontrollable urge to itch when they’re feeling anxious. This condition is known as neurodermatitis. The treatment includes anti-depressants and anti-histamine medications to break the itch-scratch-itch cycle.

Why does stress have this effect on us? Our body responds to stress by releasing powerful hormones into our bloodstream. These hormones are meant to help our body cope with the stress, by increasing mental and physical alertness. However, hormones like cortisol (steroids), testosterone, adrenaline, insulin and thyroxine can play havoc on our skin and hair. When stress continues for a prolonged period of time, these hormones can alter the way our immune system works. Stressful events can also trigger an autoimmune process, where the immune cells of our body start attacking our own tissue. These immune cells are important to us as they fight against foreign invasion like infections and cancers. Stress can cause these cells to ‘misfire’ and start attacking our own skin and hair. Besides, a lot of nerve endings are connected to the skin, and stress can cause these nerve endings to release chemicals called neuropeptides, which makes the skin red and itchy. Thus the mind and skin are connected on multiple levels. In fact, ‘psychodermatology’ is now a fast growing medical field which addresses the impact of an individual’s emotions on their skin.

So if you have a child or a loved one who is suffering from a stress-related skin ailment, support them. Encourage them to speak. Get your family to counsel them. Maybe your child is being teased at school. Perhaps your friend is unable to cope with the stress of a bad relationship. Consult a counsellor if you feel the need. Hypnosis and biofeedback therapy can help in certain cases which are resistant to routine dermatological medications. Several patients have also tried acupuncture and massage therapy with moderate success. Although stress is rarely the sole culprit, it is a major ‘trigger’ for several skin ailments. Therefore these therapies are not a replacement for traditional skin treatment as they only focus on stress alleviation.Trichotillomania, dermatillomania and skin related hallucinations are severe psychological conditions which can only be addressed by a psychiatrist.

Almost everybody struggles with facial pigmentation. Especially so, if you are female, over 20, and are a woman of color. There are over 20 different varieties of facial pigmentation and just as many causes. So if you thought that the sun alone is to blame, you are very wrong.

“Pigmentation” is the most common cosmetic ailment I come across in my practice. Of course, a good number of these patients are actually referring to their constitutional skin pigment (the color they were born with), which is obviously not a pigmentation “disorder”. Fortunately, I do see a swing in the trend. There are plenty of proud, dusky skinned women. And the aim of beauty is shifting from fairness to ‘flawlessness’.

There is a huge variety of facial pigmentation disorders. Freckles are the most common complaint among light skinned individuals. Melasma and little bumpy moles called DPNs (think, Morgan Freeman) are the most common complaint in brown and black skin. There are also some rare and uncommon causes of facial pigmentation. And then there are moles and birthmarks. However going into too much detail would be much too academic for a public information article.

So I will confine myself to the most common causes and types of facial hyperpigmentation. Hyperpigmentation is caused by the overproduction of pigment melanin in the skin. The pigment tends to accumulate over the years as a natural part of the ageing process. Since Asian, Hispanic, Mediterranean and African races already have greater amount of melanin in the skin, they are more likely to develop pigmentation disorders as they age. Considering that the majority of the world’s population comes under the category of ‘colored skin’, this would explain why skin lightening creams and cosmetics are a billion dollar industry!

Sunlight is the most common and well-known cause of pigmentation. Which is why, pigmentation problems are more common in people who spend a lot of time outdoors. Both ultraviolet radiation (from sunlight) and infrared radiation (from computer screens and microwave ovens) can contribute to pigmentation. Therefore, using a broad spectrum, medical grade sunscreen from an early age is a best investment you can make towards keeping your skin spot-free over the years to come. Using a sunscreen does not provide 100% protection though. It all comes down to the SPF you are using, how much you use, and how frequently you use it. Moreover, over-the-counter sunscreens do not actually provide the level of protection they claim to do. Sun avoidance is also required in order to truly protect yourself. But remember to expose your arms to early morning sunlight without using a sunscreen. This is especially important during the winters, to ensure adequate Vitamin D production in your body. There have also been concerns about hormonal imbalances and chemical toxicity from sunscreens. However, current medical consensus grades the benefits of a good sunscreen to far outweigh the risks.

Hereditary factors are another major player in facial pigmentation. If your parents suffer from dark spots and patches on the face, most likely so will you.

Using perfumed products on the skin can also lead to darkening of the skin. This has been noted with bleaching creams and paraben-containing cosmetics as well. This condition is known as Riehl’s Melanosis.

Prolonged use of skin lightening creams that contain chemicals like hydroquinone or resorcinol can leave a bluish-black discoloration on the skin, called Ochronosis.

People who have used hair dyes for several years, end up with dark patches near the hairline. This is due to a delayed sensitization reaction to the chemicals in the hair dye. This can happen even if you have been using the same, good quality, ammonia-free hair color for years.

Friction can also cause pigmentation and a lot of people don’t realize that. Most “frictional melanosis” occur over the upper mid back or arms from the use of bath brushes and rough loofahs. But athletes tend to rub their brow several times a day, and that can result in a dark forehead.

Hormonal issues can also cause pigmentation. Uneven skin tone is therefore a common problem in adolescence, pregnancy, menopause and amongst Diabetics. Having a sluggish thyroid gland can make your face look darker than your neck. Liver and kidney disease can also create hormonal imbalances in the body. This in turn can cause a full body darkening of the skin in patients suffering from long term kidney or liver ailments.

Other serious medical disorders like Addison’s disease (effects the adrenal glands) and hemochromatosis (excess iron in blood) can also cause hyperpigmentation. Pigmented spots may appear on the nose after recovery from Chikungunya fever. Fortunately, they disappear on their own when the patient recovers from the illness.

There is a category known as ‘post inflammatory pigmentation’. This is when a pimple, any skin disease, cut, scratch or burn heals to leave behind a dark stain as a reminder. This is also the main reason why dermatologists are always telling their patients to not pick at their zits and wounds. It is not the same as a scar, which is permanent and will not disappear with time.

Certain medications can cause facial pigmentation as well. Examples include amiodarone (given for irregular heartbeat), minocycline (to treat acne), antimalarial drugs, silver, arsenic and some anti-depressants. Birth control pills can cause Melasma, And certain painkillers and antibiotics can leave oval grey patches on the lip which can take several months to disappear.

As cliched as it sounds – stress, smoking, pollution and too much sugar in your diet can also wreck your skin.

While freckles can be cute and do not cause as much embarrassment, Melasma can leave a woman distraught. Unsightly brown blotches of pigmentation appear on the cheeks, and sometimes on the nose and upper lip as well. Seen mostly in women, this condition can be hereditary or triggered by the sun or hormones. Pigmentation caused by hairdyes, cosmetics and friction are generally confined to the forehead. Hormonal pigmentation, also known as atypical acanthosis nigircans, is generally seen on the cheekbones or as a dark ring around the neck. A lot of dusky South-East Asian women have under-eye dark circles which trail off from the outer corner of the eyes like a tear drop rolling down. This generally begins at puberty as very faint lines. But the pigmentation can deepen as the woman ages. These are called Pigmentary Demarcation Lines and are almost impossible to treat. The most devastating of all, would be a condition known as Lichen Planus Pigmentosus (LPP). This condition is particularly common among the people of India and the Middle-East. The problem begins in middle age. The face and neck develops a dark brown or slate gray hue. It can also begin as multiple dark spots which all seem to pool together over time, to spread across the facial skin. LPP can spread to the trunk and arms as well. The pigmentation lies in the deeper layers of the skin and is nearly impossible to treat using skin lightening creams. Dermatologists try to control and arrest the spread of the disease using oral medications. Once the disease has burnt out, the residual pigmentation is best treated using a Q switched Nd:YAG laser.

So as you have gleaned by now, facial pigmentation can be varied, complex and sinister. A skin biopsy is often necessary to nail the exact diagnosis and study the depth of pigmentation. However, most patients refuse to get the biopsy done, as it may leave a small 3 mm scar on the skin of their face. This creates additional hurdles for the dermatologist.

If allergies are suspected, then an allergy patch testing may be ordered. Avoiding the allergen (perfumes, hair dyes etc) can rectify your pigmentation problem.

Unfortunately though, most pigmentation problems cannot be permanently cured. Facial hyperpigmentation is caused by multiple factors; which is why a single line of treatment may not work, and no treatment can completely halt the process of pigment build-up. This is another challenging facet of treating disorders of pigmentation. Doctors and patients often end up frustrated with each other. Patients go from doctor to doctor looking for the promise of cure. Their emotional vulnerability makes them easy prey for quacks who “guarantee” results. Skin lightening creams, chemical peels and lasers can actually worsen the pigmentation or create other skin problems if they are performed by inexperienced or unqualified doctors. These complications include further darkening of the skin, burns, scars or permanent bleaching of the skin. Sometimes good doctors end up making horrible mistakes because they got too emotionally invested into their patients. These patients then harangue the doctors to try more and more aggressive treatments, often by manipulating the doctor’s sympathy, guilt and ego.

With most pigmentation problems, the aim of treatment is to improve the pigmentation, and to keep the problem under control. Take freckles for instance. A good sunscreen can fade away some of the light brown freckles. And minimize recurrence. Skin lightening creams can help but often leave the patient with uneven skin tone. The cheeks may look fair from long term use of bleaching cream over the freckled areas. While the forehead, upper lip, chin and neck may end up looking a few shades darker. Chemical peels give you faster and better results compared to bleaching creams. And laser treatments are the best bet towards complete removal of the freckles. Unlike a cream or a peel, the laser can be directed specifically over the freckles, while leaving the normal skin (in between the freckles) unaffected. However, freckles can and WILL reappear. Sometimes after a trip to the beach. Or as you get older. Or even after a pregnancy. So you and your dermatologist will have to continue to work together over the years, in order to maintain the results of the treatment and keep excess melanin at bay.

Some conditions like Macular Amyloidosis, Becker’s Nevus (a type of dark hairy birthmark) or LPP can never really be treated. A responsible dermatologist must be honest with their patients and know when to say ‘No’. A good patient on the other hand, will adhere to their doctor’s recommendations on how to use a treatment and only use it for as long as it has been prescribed. Certain steroid and hydroquinone-containing bleaching creams work brilliantly. However they can only be safely used for a few weeks at a time. If you use them any longer, they may end up leaving permanent side effects on your face. So as a good patient, you must really resist the urge to buy those prescription creams every time there is a wedding or a vacation coming up. Camouflage and cover-up make up must become a lifestyle choice for you. It is a simple, side-effect free ‘quick fix’ for your damaged self esteem. And never leave home without your sunscreen!

Ever wondered about the veracity of Old Wives’ Tales and household remedies? Some of these beauty related myths are so deeply entrenched into our minds, that I find it impossible to convince patients (and my own family members!) that there is simply no truth to these fables. In this issue, I have debunked some of the most popular beauty myths of our time to reveal authentic facts, because truth be told, no one understands the human skin as well as a dermatologist does.

Cosmetic creams can turn back time and reverse skin ageing

There is a lot more to ageing than wrinkles and blotchy skin. It is not just the skin, but the face which ages as well. This includes gravitational pull on facial tissues that leads to sagging, and facial fat, bones and soft tissues which begin to shrink, leading to loss of elasticity and plumpness of the face. Nutrition and hormones play a major role as well. None of these age-related changes can be addressed by some “miracle in a jar”. Cosmetic creams can only hydrate the skin, fade away some of your age spots, plump out fine lines, and even out the tone of your skin. For serious anti-ageing measures, consult a dermatologist or plastic surgeon for medical treatments.

Cleanse, Tone, Scrub, Nourish (Moisturize) and Protect (Sunscreen) – The Mantra to good skin

This one’s mostly true. But opinion is now divided over the usefulness of a toner. If you have dry and sensitive skin, toners are too harsh for you. Toners strip off excess oil and sebum from the skin, but there are cleansers available today which do this better, without irritating the skin into secreting even more oil. Scrubs are not meant to be used on a daily basis either, as our skin has the natural ability to exfoliate. In fact, daily use of scrubs, loofahs, brushes, pumice stones and other abrasives can cause frictional damage to the skin, leaving it dry, raw and pigmented.

Repeated washing, squeezing and extraction will clear up acne and Blackheads

Acne and blackheads are not caused by dirt or by touching your face with your hands. Over-washing your face will leave your pores water-logged besides irritating your skin into secreting even more oil, leading to more blackheads and whiteheads. In fact, you are wrong if you believe that you do not need moisturizer if you have oily skin. The use of a water or gel based moisturizer after washing your face will keep your oil glands calm. This is especially relevant for those on anti-acne treatments, as anti acne creams and medications can leave your skin dry and sun-sensitive. Manual extraction of blackheads is the fastest way to get them out, but the pores can and will clog up again, unless you use the right cleansers along with glycolic acid or retinol based creams to prevent recurrence. NEVER squeeze or pick on acne. It does not get rid of acne, but will leave you with marks which take a long time to fade away. Worse, it can lead to scars and pits which are permanent deformities.

Itching during pregnancy will leave you with stretch marks

There is no scientific or logical basis to this popular belief. Stretch marks, as the term suggests, are caused by the rapid stretching of skin during pregnancy, which leads to permanent damage to some of the elastic fibers of the skin. The belly itching of pregnancy is also caused by over-stretching of the skin, hence the misconception. Enjoy a good scratch, but consult a dermatologist if the scratching leads to skin rashes and hives as these could be a symptom of pregnancy related liver issues. Using a thick greasy moisturizer like cocoa butter or shea butter can soothe some of that itch, though it won’t really keep away the stretch marks.

Shaving will make your hair grow back thicker and darker

This one’s definitely a myth. Shaving only cuts hair at the surface. It does not have any effect on the hair root, and therefore has no bearing on the thickness, color or rate of hair growth. You might feel this way as shaving leaves the hair with a blunt tip which feels coarse and stubbly when all of the shaved hair grows back together. One does’nt experience the stubbly feeling with waxing, as it pulls out hair from the roots and the hair regrows at different rates. If there was any truth to this popular myth, then there would not be any bald men in the world!

Junk food causes acne

This one’s a little complicated. For years, women have believed that chocolates and fried foods cause acne break outs. And for years, dermatologists have insisted that there is no scientific evidence to back this statement. However, obesity (often a fall back of junk food) can lead to hormonal imbalances like insulin resistance and polycystic ovaries, which in turn can result in acne. It is sugary and starchy food (known as “high glycemic diets” in medical parlance), rather than fat, which leads to hormonal imbalances. Dairy products can also lead to acne break outs. In conclusion, will diet does not cause acne, it can certainly influence it. On the other hand, food rich in zinc, selenium and beta-carotene (for eg, fish, eggs, brown rice, all orange and yellow fruits and vegetables) can help fight acne.

Cosmetics which are labeled as “All Natural” or “Hypoallergenic” are absolutely safe

I’m not trying to imply that these claims are bogus. But “All Natural” cosmetics usually contain one or two essential oils and plant extracts while the rest of the composition is made up of synthetic ingredients. “Unscented” cosmetics are free from detectable odors but may actually contain fragrances which mask the original smell of its ingredients, say the odor of Rhealba Oats. “Hypoallergenic” does not have an official definition. It only means that the product has been patch tested on a few 100 volunteers in a clinical trial, and no adverse allergic reactions were noted. It is a common misconception that ‘natural’ products are hypoallergenic. People all over the world have reported allergies to essential oils, pure aloe vera, arnica and witch hazel among others.

Plucking out one gray hair will lead to two

The age at which your hair starts to gray is genetically determined. Stress and nutritional deficiencies can make it worse. In most people, early graying occurs in zones like the temple or the forelock, so one might imagine that plucking out gray hair in these areas lead to even more gray hair. Nonetheless plucking is not a wise or long term solution. Repeated plucking can also damage hair roots. You might want to consider hair coloring, or better yet, gracefully accept your grays.

Fairness and Bleaching creams are absolutely safe

Fairness and bleaching creams contain ingredients like hydroquinone, mercury, pearl extracts, kojic acid, and steroids among others, which should not be used on a long term basis without a doctor’s prescription. Complications include paradoxical pigmentation of the skin, allergic reactions, sun sensitivity, itching, acne and skin thinning. In fact, many of these ingredients have been banned in various countries. The skin lightening effects are temporary, which is why it is easy for one to get addicted to these creams, to maintain the bleached look. Every dermatologist today will advice against the use of bleaching creams, except in the treatment of medical conditions. Use a medical grade broad spectrum sunscreen instead to fade away unwanted tan. It is important to realize that one cannot hope to become fairer than their genetically determined skin tone.

1. Your pimples will go away eventually

This is not always true. Most men will outgrow their acne by their late 20s, as a man’s body does not go through many hormonal fluctuations. But a woman’s body goes through major hormonal upheavals during adolescence, later in pregnancy, and once more around the menopausal years. In fact dermatologists are increasingly seeing women who get a pimple problem for the first time in their 30s or 40s. We even see the occasional male patient who still get large painful acne in their 40s or 50s.The treatment principles remain the same, and it is worthwhile to get a hormonal evaluation done through blood tests and ultrasound scans.

2. Lip balms are addictive and regular use of lipstick will turn your lips dark

Just as your skin will feel dry if you don’t use a moisturizer regularly, your lips will get dry as well if you do not moisturize and exfoliate regularly. This myth began because a lot of individuals are allergic to the menthol, fragrance, shimmer and artificial colors added to lip balms. Such ingredients can irritate your lips leading to stinging, lip darkening and chapping. To reduce chapping, one would end up using lip balms even more frequently, creating a vicious cycle. This goes for lipstick allergies too, though the modern lipsticks we use today are mostly hypoallergenic. If you have sensitive skin or a history of allergies, then stick to bland unscented and color-free lip balms, preferably one which also has added sunscreen. These are 100% safe. Try the Sebamed, Uriage or Avene lipbalm-in-a-stick. I prefer sticks to tubes. Avoid long-lasting lipsticks as they tend to be more irritating. And apply a coat of lip balm to your lips before you apply your lipstick.

3. Toothpaste is the best remedy for pimples

This has got to be the dumbest beauty trick there ever was! Some toothpastes contain menthol or benzoyl peroxide which can reduce inflammation, but the other ingredients in toothpaste can burn and tan your skin, especially if your skin is on the duskier side. Toothpaste can only temporarily reduce the redness of a pimple, so women end up applying toothpaste frequently or else the zit is back. This is harmful and counter-productive. Toothpaste is meant to clean your teeth, which are hard and tough. Your skin is soft and sensitive and was never designed to be molested by toothpaste!

4. What worked on my friend will work for me

Not true. Your ideal skin care regime will depend on your age, level of exposure to sun/pollution and your skin type. Skin type is classified as dry, oily, combination, sensitive, resistant, pigmented, acne prone and/or mature. You need to factor in your budgetary constraints as well. Your oily-skinned friend uses a toner which works brilliantly on her, but it might irritate your sensitive skin. Your dry-skinned friend’s sunscreen makes her skin look bright all through summer, but it might give you acne. Consult a dermatologist who can analyze your skin and recommend the right products for you.

5. You can shrink your pores

Pores do not have muscles attached to them that open and close! Pores are caused by multiple factors which include oily skin, sun damage, wrong skin care products and genetics. A facial is not going to shrink pores, unless your aesthetician has used an irritant which temporary swells your skin and tightens the pores as a result. Toners, pore reduction serums, chemical peels, microdermabrasion and certain laser treatments can shrink them but most treatments are not very effective and the results are not long lasting.

6. Expensive creams work better than inexpensive ones

No, not always. It is the formulation and the ingredients which make all the difference. There are plenty of soaps, sunscreens, cleansers, moisturizers and anti-ageing creams which won’t burn a hole in your pocket but work brilliantly. Olay, Cetaphil, Dove and Neutrogena have a wide range of beautifully formulated, dermatologically tested cosmetic creams which work very well and suit most people. AND they are not frighteningly expensive. The high price of certain skin care creams is mostly on account of the brand value, the fancy packaging, import duty and expensive advertising. Some of them may indeed contain rare and exotic ingredients, but there is no reason why the mass market products would not work just as well. Go by the formulation and not the price.

7. Hair oils control hair fall and regular waxing will make your hair thinner

Hair oil can soften and condition your hair, prevent (NOT treat) split ends and moisturize your scalp. Certain hair oils may contain ingredients like henna, gooseberry, tannins and curry leaves which can prevent (NOT treat) premature hair graying. The massage has a feel-good effect and relieves stress. However the molecular weight of hair oil ingredients is too high to effectively penetrate down to the hair roots, which makes them worthless in the treatment of hair fall and balding. Any benefit you may have experienced is purely by placebo effect.

Waxing on the other hand involves plucking and tearing out of body hair from the roots. When done regularly over a period of several YEARS, some of these hair follicles may undergo sufficient permanent damage leading to thinning of the hair. So go ahead and get your legs waxed, but do it as a grooming ritual without expecting your hair to get thinner.

8. Cellulite only affects the obese

Now here’s a myth that plenty of skinny women know is untrue! Cellulite are fat deposits that get trapped between the fibrous bands that connect the skin’s soft tissues. There is a definite hormonal element because it only affects women and over 60% of all adult women suffer from cellulite in varying degrees. Cellulite makes its first appearance in the late teen years and gets worse during pregnancy or if there has been rapid weight gain or weight loss. Exercise, adequate water intake and a no-alcohol and low-sodium diet can help you get rid of unsightly cellulite. Regular massages prevent cellulite build up. Until then, skin firming creams can tighten your skin, a good tanning lotion can hide cellulite, and certain fat dissolving lasers and local injections can improve the appearance of cellulite. But cellulite can always come back unless you keep working at it.

9. Coloring your hair can turn them gray

I am not sure how this rumor got started but I’m guessing this is a story mums feed their teenaged kids to get them to stop coloring their hair! Hair coloring involves use of a permanent dye to change the color of the hair shaft. It does not penetrate deep down to the hair roots, and it is not capable of bleaching it. Gray hair is a result of a complex interplay of genetic timing, nutritional deficiencies, sun damage and/or emotional shock. Frequent hair coloring does have some adverse effects which include dry and damaged hair, an irritable scalp, eye watering and facial pigmentation. But hair graying is not one of them. So go ahead and color your hair to cover those grays.

10. Dandruff can be cured using anti-dandruff shampoo

Dandruff can be effectively controlled and eliminated using an anti-dandruff shampoo. Doctors today have a whole range of various anti-dandruff ingredients which work on all kinds of dandruff; be it mild flaking, itchy greasy yellow scales or the stubborn scaling of psoriasis. But since dandruff is controlled by your genes, genetics and environment, it is impossible to CURE dandruff for good. This may shock most of you, but it is true- medical science still does not have a cure for something as simple and widespread as dandruff! Use your anti-dandruff shampoo regularly to avoid a recurrence.

Everyday, millions of men, women and children, participate in sports and sport related activities. Some of the most frequent injuries related to such activities, affect the skin. Besides, athletes spend more time in the sun, sweat more, shower more and certain areas of the body are under friction for several hours a day. They are more exposed to ‘the elements’ (sun, rain, wind, snow, dirt) and pollutants (smog, pollution, chlorine).

Most of these ailments are simple enough, but they can affect an athlete’s performance by causing pain or irritation; and many are contagious, leaving an entire team vulnerable. Some of these skin conditions can also lead to loss of practice time and individual athlete disqualification.

This blog hopes to educate readers on skin ailments commonly affecting sporty and athletic individuals, and how to care for them in a simple, inexpensive and easy-to-follow routine.

Infections

An athlete’s skin is an ideal breeding ground for infection of all kinds! This is because of the warm sweaty nature of your skin, and your dirt-clogged pores. Any scratches or injuries on the surface of the skin, only make matters worse. Athletes involved in contact sports seem to be the worst hit. Wrestlers are prone to ‘Ringworm’ infection of the body (a fungal infection), and herpetic whitlow of the fingers (an extremely contagious viral infection). Athelete’s foot is a fungal infection of the feet and toe gaps. It festers in individuals with sweaty feet. Fungal infections are also common in the groin (Jock itch), underarm areas and toe nails. Viral warts on the feet are common among swimmers, but can occur in any athlete who walks barefoot in common shower areas or uses unclean gym mats. Warts can be extremely painful, and tend to recur despite treatment. Scrum strep is a bacterial infection which is common in rugby players and athletes who spend a lot of time in sea water (surfers and divers). This bacteria can also create kidney infections, which require hospitalization. The infected areas are red, sore and have pus which looks like honey crusts. Water-sport athletes are especially vulnerable to some very unusual bacterial infections, which may require months of treatment with antibiotics. They are even vulnerable to sea lice (Seabather’s eruption), bikini bottom and swimmers ear (both are bacterial infections). Long hours spent under the sun or at high altitudes, can trigger cold sores of the lips and mouth. Shared mouthpieces can spread the infection among several members of a team, a veritable nightmare for any athlete or coach! Scabies and lice breakouts are terribly itchy, and can disqualify an entire team. Pimples are common from the constant sweating, and boils can appear on the back and scalp from the pressure and rubbing of helmets, chin straps, golf bags and other equipment.

Unusual bumps and growths

Any athlete whose skin rubs repetitively under their ill-fitting props and equipment, is likely to develop lumps and bumps on their skin, at those specific areas. These bumps are caused by thickened skin tissue. Some of these can become painful, and if left untreated for years, they can turn into tumors. Blisters, corns and calluses usually occur on the palms, soles, elbows, knees and knuckles. Jogger’s toe is a bruise under the toe nails, from ill-fitting shoes and sudden stops in motion. Athletes and body builders are also likely to develop stretch marks on their shoulders, knees and thighs.

Sun burns and the risk of skin cancer

Outdoor athletes probably constitute the most high-risk group in terms of exposure to ultraviolet radiation. While the light skinned races are more vulnerable to skin cancers, even the dark skinned races can develop non-cancerous tumors and growths which can be hard to treat. Contrary to popular belief, winter and aquatic athletes are at higher risk for radiation induced tumors, as water and snow reflect much more sunlight. Repeated episodes of bad sunburns can increase the cancer risk of any person. Moreover, sweating increases the chances of a sunburn. A painful sunburn can keep a sportsman off practice for several days. Moles that increase in size, itch, bleed or change color must be immediately screened for cancer. Cyclists, marathon runners and swimmers are especially unfortunate, as they do not often get the time to reapply their sunscreen. Studies reveal that most athletes do not use sunscreen at all, and the ones who do, tend to forget applying sunscreen to their lips, ears and back of the neck. Certain medications can also make the skin more sensitive to sunlight, so team doctors need to keep this in mind.

Itches and Allergies

These are rare, but athletes have known to be allergic to their equipment, especially metals, rubbers, fiberglass and chemicals in cleaning materials (footwear, wetsuits, goggles, mouthpieces, sports tapes, racquet handles etc). Allergies are itchy, and the rashes look red and oozy. Outdoor sportsmen also risk insect bites and stings. Such allergies can be debilitating. Swimmers can have very dry skin, and dry skin is itchy and allergy-prone.

Sports related skin injuries

Friction (from equipment or the inherent nature of the sport) can cause chafing, scratches, blisters, corns, calluses, bruising (black heel), bald skin patches, and ingrown hair and nails in those areas of the skin that come under the highest friction and tensile forces.

The author would like to make a special mention with regard to the use and abuse of anabolic steroids. It is well known that these drugs cause liver damage, heart attacks, high blood pressure, strokes and mood swings. From a dermatological perspective, they can cause balding, acne, facial hair growth in women, male breasts, and stretch marks. Use of shared needles is strongly condemned in the era of HIV.

Skin care for athletes

Sun protection in the form of water resistant sunscreens with SPF 50 or above is an absolute essential. Certain areas like the cheeks, nose, lips and ears can be covered with a zinc-oxide and calamine based paste, which acts as a physical barrier to sunlight. Use lipbalms which have sunscreen in it. Sunscreen must be reapplied every 90 minutes.

Protective clothing, custom-made felt-lined footwear, and professionally fit sports gear can help an athlete avoid friction injuries. For prolonged exercise, consider a second set of shoes which you can switch to halfway through the session.

It is important to bathe after every game or practice session using mild and fragrance free soaps and shampoos. This is especially important for swimmers. Wear plastic footwear to common shower areas, and do not share soaps, towels, combs or protective mouthpieces. Keep your hair and toes dry. Use antifungal dusting powders on your armpits, groins, buttocks and feet. Swimmers need to use moisturizers liberally. Choose products which are labeled as ‘allergen-free’, ‘non-comedogenic’ (do not cause acne) and ‘dermatologically tested’. Use hand and foot creams which contain urea or glycolic acid; this will keep your skin soft and take care of corns and calluses. Toe nails must be cut straight (and not rounded). Cleanse your face regularly using face-wipe tissues and anti-acne cleansers.

Gym equipment needs to be wiped regularly with diluted hydrogen peroxide or alcohol. Training garments, including socks and undergarments must be washed after every session, and dried in strong sunlight.

Athletes who come in contact with sand (eg, beach volleyball), should only play in sand which is free from animal feces. It is helpful to run a quick ‘self-examination’ of your skin, especially on your hands and feet, every day, at the end of a game or training session. Do not neglect any skin rash or itches, and report to your team doctor, who can refer you to a dermatologist. This is especially important to prevent a breakout of infestation in your entire team.

Outdoor athletes need to always carry plenty of sunscreen and insect repellents. Women athletes must always wear a sports bra for support, and to avoid nipple burns. If an athlete has had a bad allergic reaction to an insect bite, a second bite could prove to be fatal. Your team doctor must warn you about this, and you can consult a dermatologist regarding immunotherapy injections.

Swimmers must always use cap and goggles to protect their hair and eyes. Use fog free padded goggles from Speedo (model 750127). If you suspect an allergic reaction to your gear, visit a dermatologist for a patch test to confirm the same, and learn about alternatives. Injuries and allergies must be tended to immediately, in order to ensure an athlete’s undivided concentration and optimum performance. Massages and physiotherapy must only be administered by trained professionals. Drink plenty of water, and consume sports drinks only when needed, and only with the approval of your trainer.

Skin care products you must avoid if you are an athlete or athletically inclined:

Any products containing animal parts (or lanolin), fragrance, Hydroquinone (skin bleaching ingredient), mineral oil, lead, mercury, parabens, and skin care products which contain human placenta tissue.

1 in 10 babies are born with birthmarks. Contrary to popular belief, birthmarks are not just brown or black, but can be red, pink, white, blue, purple, yellow or even hairy! Most birthmarks are present at birth, but some appear a few months after birth, or even at puberty. Most birthmarks stay with you for life, while some fade away or completely disappear.Which ones are best left alone? And which birthmarks need to be treated or removed?

Birthmarks are a lot more common than we think. They are not the same as moles (those little black dots on your skin), which affect each and every one of us, and which appear later in life. I’m a “birthmark baby” myself, and have come to realize that there are a lot of myths and tales associated with birthmarks. Some pink birthmarks on the nape of the neck are known as “stork bites”. Birthmarks on the nose or between the eyes mean that the baby is “kissed by an angel”. Unusual looking birthmarks like white streaks on the body or facial birthmarks are viewed as lucky omens. On the other hand, large unsightly black birthmarks covering large areas of the body are supposed to indicate that the poor baby is “marked by the devil”! Irrespective of the kind of birthmark your baby has, it is wise to get it seen by a dermatologist for proper diagnosis and prognosis. Please remember that all birthmarks are just a quirk of nature. It is not a disease or a malformation. So do not blame yourself for your child’s birthmark as there is nothing you could have done to prevent them.

Birthmarks can be pigmented (black, brown or blue), white, skin colored, or vascular (red, pink and purple birthmarks formed out of blood vessels). I shall only cover the commonly occurring birthmarks. The medical term for a birthmark is ‘Nevus’.

Black, raised moles which appear at birth or infancy are known as Congenital Melanocytic Nevus. Cindy Crawford’s upper lip mole comes to mind. They can appear as a single mole or multiple satellite moles of varying sizes. They might grow slightly larger or darker with age, and some may sprout thick hair. Unless you have a large mole (more than 2 cm in diameter) or more than 20 such moles, they are usually not a cause for concern. If you are very fair skinned, and your mole is over an exposed part of your body (head and neck, forearms etc), then you must protect your mole from the sun, by using a sunscreen. If you have a history of skin cancer in yourself or in your family, then get an annual mole check done by your dermatologist. Your doctor will measure your mole, photograph it and examine it with a special microscope called the dermatoscope, and maintain a record in your file. Any change in the size, shape or color of the mole, must be reported to the dermatologist. If your mole starts to itch, bleed, ulcerate or form lumps beneath, then visit your doctor without delay. Such moles can be removed purely for cosmetic reasons as well. It is best to get them removed by a plastic surgeon, but do know that you’ll be left with a scar. As a rule, all excised moles are sent to the lab for microscopic examination. Lasers have also been tried to lighten these moles, but theoretically speaking, these moles must never be disturbed with lasers, as the laser excites the pigment cells and can trigger a cancerous transformation.

A large dark blue to purplish birthmark appearing around the eye is known as the Nevus of Ota. Sometimes the pigment may also affect the white of the eye. These birthmarks can either appear at birth or later in life. The pigment is usually very deep seated, and skin lightening creams are worthless as a choice of treatment. Laser treatment gives good results after multiple sessions. Camouflage make-up can be used to temporarily cover up the birthmark. They are inexpensive and make a world of difference to one’s self esteem. A regular eye check up is advised, if the eye is affected.

Mongolian spots are bluish spots seen on the lower back or buttocks of newborns. They are more common in darker skinned babies. Although they are “marks that appear at birth”, they are not considered as Nevus in the medical sense. They are completely harmless and fade away on their own in a few years. These are best left alone.

Becker’s Nevus is a large, irregular, flat, brown-to-black birthmark which only appears after puberty, and is usually located on the chest or shoulders. It is more common in boys, and the mole is usually hairier than the surrounding skin. They are usually harmless, but they remain for life. Lasers have been tried to lighten the pigmentation and get rid of the excess hair, but the treatments are painful, and the results can be disappointing. They are perhaps, best left alone.

Café au lait birthmarks are small oval flat light brown spots which can appear anywhere on the body. They are harmless, do not grow in size and stay for life. They may turn a touch darker after puberty. Unless your baby has more than 6 café au lait spots which measure more than 1.5cm in diameter, they are not a cause for concern. If a café au lait macule is large and has several dotted brown-black spots on it, then it’s called a Nevus Spilus.

Nevus achromicus is a pale, off-white birthmark which can appear in any part of the body. They may appear as isolated birthmarks or streaky lines. They are completely harmless, do not grow larger in size, do not change color but stay for life. They are best left alone, as there is no treatment for this kind of birthmark. Use sunscreens, as skin tanning might make these birthmarks appear more prominent, as the birthmark itself never tans. Camouflage make-up/foundations can be used to temporary hide the area.

Intradermal Nevus are skin colored, raised bumps measuring 5-10mm, which can appear anywhere on the body. They usually appear in late childhood or early adulthood. Sarah Jessica Parker’s chin mole is a good example. Although they stay for life, they can be left alone, as these moles are considered harmless, and never turn cancerous.

A salmon patch birthmark is a pale pink-orange birthmark which is seen at birth, usually on the face or the back of the neck. They may appear darker when the baby cries, and will seem to disappear if you press a thumb on it. They are harmless and must be left alone, as most of the time this type of birthmark disappears on its own in 3-4 years.

A port wine stain appears at birth as a flat, pinkish-red stain, most likely seen on the face. They may get darker (purplish), larger or thicker with time. Mikhail Gorbachev’s forehead stain is one such birthmark. If the birthmark is over the eyelids, then an ophthalmological evaluation is advised. A port wine stain stays for life. It is usually harmless, but must always be shown to a dermatologist, as rarely they can be associated with seizures or limb deformity. These birthmarks can be left alone, but if your child asks for treatment, then laser therapy is your best bet.

There are many more different types of birthmarks, which are rarer and beyond the scope of a public information article. Birthmark removals are rarely doctor-recommended. Most patients chose to get rid of their birthmark for cosmetic reasons alone, and that’s a personal choice. If you chose to have them surgically removed, then you will be left with a scar, so you’ll have to choose one aesthetic defect over the other. Lasers are expensive and may not work for all types of birthmarks. If you are a “birthmark parent”, then being supportive is the greatest service you can do for your child. Facial birthmarks in particular, can cause a great deal of social inhibition and emotional turmoil, especially during the teen years. I have never used camouflage make up to hide the café au lait spot on my nose. And it is my personal recommendation that you do not force your child to use cover-up foundation, or undergo laser surgery, unless they themselves ask for it. Finally, any kind of birthmark must be assessed by a dermatologist at the earliest.