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Departments
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Dermatology
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Patient Information
Chemical peel is a
cosmetic procedure for treating pimple marks, suntan, age
spots, freckles, certain types of pimples, fine wrinkles and
superficial scars. It improves the texture and complexion
and gives a fresh look to the skin. Chemical peels should
only be performed by a trained Dermatologist as it needs
considerable expertise
1. How does a chemical peel work?
Chemical peels work by removing the superficial layers of
the skin. Subsequently, a new layer of skin is formed
resulting in improvement of dark spots, black heads and
superficial scars.
2. What are the types of Chemical peels?
Glycolic acid, trichloracetic acid, mandelic acid,
salicyclic acid, jessners’ solution have been used for
chemical peeling. Glycolic acid is a naturally occurring
“fruit acid” and is the most commonly used and safe peeling
agent.
3. How is Chemical peel / Glycolic acid peel performed?
Glycolic acid peel is applied to the skin and allowed to
work for a few minutes, subsequently it is neutralized and
washed off. The concentration and duration of the peel is
progressively increased each sitting till optimum effects
are obtained.
4. What can I
expect during and after a Chemical peel?
A mild itchy or stinging sensation is experienced during the
peel. A transient redness may be experienced for a few
minutes. Occasionally, slight flaking may be seen which
turns brown and clears away by 3 days. Do not expect the
skin to really peel off. It is an office procedure and you
can return to work after the procedure. The best results can
be obtained after 3 days and it is advisable to schedule
glycolic acid peel 5 days before social events.
5. How many
treatment sessions would be needed?
About 4-5 sessions would be needed at 2 weekly intervals for
optimum results.
6. What
precautions are needed after the peel?
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Use a mild
cleanser and wash the face gently. |
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Avoid sun
exposure and use a broad spectrum sunscreen. |
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Do not prick,
scratch or rub the skin. |
7. What are the possible complications?
Glycolic acid peel is generally safe and has been widely
used. A test peel may be done in those with sensitive skin.
Hyper or hypopigmentation, reactivation of herpes are some
of the rare complications that can occur.
1. What is
Vitiligo?
Vitiligo or Leukoderma is a skin disorder where white spots
develop on the body. Vitiligo can develop at any age and
affects both genders and all races.
2. Is vitiligo
contagious?
No. Vitiligo is not contagious. Hence it cannot be spread
from one person to another by contact.
3. Why does vitiligo develop?
Vitiligo develops due to the destruction of the colour cells
(Melanocytes) of the skin. Research has suggested that these
cells are destroyed by the immune system. There are multiple
causative genes in different combinations causing vitiligo.
Certain environmental factors are also suspected as triggers
for vitiligo.
4. Is Vitiligo
hereditary?
Genetic factors do play a role in vitiligo. A family history
of vitiligo is present in 10% of cases. However, the risk of
genetic transmission is low.
5. Are all white patches vitiligo?
No. Vitiligo is just one among several skin disorders that
present as a white spot.
6. Will the vitiligo spread to involve all the skin?
The extent of
vitiligo is very variable. It could be limited to a few
small spots or be very extensive. It is not possible to
predict the spread or the extent. Oral medications would be
needed to suppress the spread in progressive vitiligo.
7. What are the treatment modalities available for
vitiligo?
There have been many advances in the treatment of vitiligo.
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Creams and
Ointments: Topical corticosteroids, tacvolimus and
calcipotriol are useful for the treatment of small patches
of vitiligo. They may be used in combination. |
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PUVA (Psoralen
- UVA therapy): It involves taking a medication called
psoralen either in the form of a tablet or as a skin
solution followed by Ultraviolet light (UVA) exposure.
Sunlight can also be used as a source of light. It needs
close supervision by the Dermatologist. The Psoralen works
by absorbing the light and stimulating the colour cells to
produce colour pigments. |
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Narrow band
Ultra Violet B (NB-UVB): The advantage of using of
Narrow band UVB light is that there is no need for using
tablet or solution before the exposure. Excimer Laser is
also a type of NB-UVB therapy. This therapy can
be done by hospital visit or by using portable, home-use
devices. |
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Vitiligo
Surgery: Vitiligo surgery involves transfer of colour
from normal area and transplanting to the white spots.
Suction blister grafting, epidermal split thickness grafting
and melanocyte transfer are the commonly performed
procedures. Melanocyte transfer involves separating the
colour cells from the epithelial cells and transfering these
colour cells alone. Surgery is the treatment of choice for
segmental - type of vitiligo. Surgery is performed in those
whose vitiligo is not spreading and who have not responded
to the other treatment methods. |
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Camouflage:
They are helpful for temporary cover up of the white spots.
Waterproof cosmetics with good colour match are now
available. Self - tanners are also available. |
Psoriasis is a
common, chronic skin disorder characterized by reddish
rashes with thick silvery scales. It has a waxing and waning
course and needs early and prolonged treatment. About 10% of
individuals with psoriasis can develop arthritis with pain
and swelling of the joints. Psoriasis commonly involves the
skin over the knees, elbows, back, scalp, palms and soles.
1. Why does Psoriasis develop?
Research has found
that psoriasis develops because of the abnormal activation
of the immune system in the skin resulting in rapid turn
over of the cells of the skin. The cells which take normally
28 days to reach the surface, reach it by 3-4 days in
psoriasis and the cells are immature. Complex genetic
factors also play a role.
2. What are the factors that can influence Psoriasis?
Smoking, alcohol,
physical and emotional stress, throat infections, cold
climate, scratching and certain medications (eg. Certain
medications given for high blood pressure) can aggravate
psoriasis.
3. Can
Psoriasis spread from one person to another?
Psoriasis cannot
spread by contact. It is a common misconception that
psoriasis can develop by contact with the scales of a person
with psoriasis. Persons with psoriasis should not be
avoided.
4. Can
Psoriasis be genetically inherited?
The chance of genetic transmission to offsprings is low. It
is estimated to be about 1 in 10, if one of the parent is
affected by psoriasis.
5. Can Psoriasis become serious or life threatening?
Sometimes,
psoriasis can involve the entire body and is called
erythrodermic psoriasis. There is also another rare type of
psoriasis called pustular psoriasis where there is pus
formation and high fever. These two forms of psoriasis can
make a
person very ill.
6. What is the
treatment for Psoriasis?
Psoriasis can be
easily controlled in most individuals. Mild Psoriasis is
treated with creams, ointments and scalp solutions which
contain corticosteroid, coal tar, Vit-D derivatives,
salicyclic acid etc.
Moderately
extensive psoriasis is best treated with light therapy, eg.
PUVA (Psoralen with Ultravoilet A), PUVASOL (Psoralen with
Sunlight), and Narrowband Ultraviolet B therapy.
Severe psoriasis would need oral medications which need
strict monitoring for side effects and has to be taken under
the supervision of the Dermatologist.
Newer treatments
include Biologic therapy which work on immune cells and the
chemicals released by them. It would take many more years
for these medications to become more affordable. These
medications are reserved for resistant cases and can cause
side effects such as increasing the risk for infections.
7. Is there a permanent cure for Psoriasis?
Psoriasis is
easily controllable. Early and appropriate treatment would
be necessary for clearing psoriasis and any recurrences
should be treated early.
Once the psoriasis is cleared, it may remain so for a
variable period of time which may be days, months or years.
In some, it keeps coming back at very short intervals. It is
not possible to make the psoriasis never comeback, hence no
permanent cure.
The public should
be warned of elements that collect huge amounts of money
upfront, promising cure.
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MIOT introduces the revolutionary, state
of the art, Light Sheer Diode Laser System for
permanent hair reduction. That's great news for
men and women who want to get rid of unwanted
hair conveniently, reliably and safely. Its time
to say good bye to waxing, shaving, plucking and
depilatory creams. Some of these methods are
messy, painful and all are temporary.
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1. Why does one
have excessive hair?
Most people have
excessive hair due to genetic factors and have no underlying
medical problems. Some have excess hair due to certain
hormonal disturbances, such individuals may have menstrual
irregularities, excess weight and acne in addition to excess
hair.
Certain
medications can also lead to excess hair growth.
2. What are the advantages of LASER Hair removal over other
hair removal methods?
Shaving, waxing,
plucking and depilatory creams are temporary hair removal
methods. They only remove the hair shaft and the hair roots
are left behind. Some of these methods are messy, some are
painful and all are temporary. Electrolysis, involves
introducing a thin electric proble into the hair follicle
and destroying it by passing an electric current. This was
the only permanent hair removal method in the past. It is
extremely time consuming as treatment is done hair by hair
and can result in scarring.
LASER hair removal
is the latest method that gives long lasting results. It is
a convenient and more effective method and even large areas
can be treated with ease.
3. How does LASER hair removal work?
The LASER device
produces a beam of highly concentrated light of specific
wave length. This light is absorbed by the pigment cells
within the hair follicle and transmitted to the hair
follicle which gets destroyed.
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Result in long
term hair reduction after multiple sessions of treatment. |
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Work well for
treating hair over any part of the body and the whole body
can be treated as well. |
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Achieve
permanent hair destruction by one single session of
treatment. |
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Work equally for
all patients. Individuals with dark hairs and fair skin
respond best to treatment. White hair doesn't respond to
LASER treatment. |
4. What can I
expect from the LASER treatment?
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With each
treatment session the hair becomes finer, lighter, fewer and
its growth reduced. |
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Multiple
sessions would be needed to achieve significant hair
reduction. |
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There may be a
small risk of pigmentation of skin after laser treatment
that will usually resolve with time and sun protection. Skin
lightening creams may be necessary at times. |
5. Is Laser
Hair removal painful?
LASER hair removal
is well tolerated. It is commonly describe as the feel of a
rubber band snap against the skin. In sensitive areas a
topical anesthetic cream is applied prior to treatment.
1.Why do pimples develop?
Pimples are a
common problem in the age group of 12-25 years. During this
age there is increased production of Androgen hormones. This
hormone stimulates the oil secretion on the face and
subsequently the oil pores become blocked. This blockage is
visible as black heads and white heads. Subsequently,
bacteria (Propionobacterium acnes) proliferates in the oil
secretions inside the blocked pores leading to reddish and
pus filled pimples.
2. What are the
factors that aggravate pimples?
Applying cosmetic
creams, sunscreens, moisturizers and oils on the face
aggravates pimples as they lead to further blockage of
pores. Hot, humid climate increases oil secretion and
blockage which worsens pimples. There are also certain
medications which can cause or aggravate pimples.
3. Are there any diet restrictions to prevent pimples?
There are no diet
restrictions. Pimples are not caused by eating fatty food,
chocolates or any kind of food.
4. Are there
any tests required for those with pimples?
Pimples occurring
beyond the age of 25 years in women especially when
associated with excessive hair growth and irregular menses
need further evaluation. Hormonal tests and ultrasound scan
to detect ovarian and adrenal problems, may be necessary.
5. Why is early
treatment of pimples important?
Pimples can lead
to ugly dark spots and scars that can badly affect the
appearance of the face. Early treatment of pimples can
prevent these dark spots and scars.
6. How are pimples treated?
The treatment of
pimples depend on the severity and type of pimples. Mild
pimples are treated with creams that unblock the pores and
those that kill the pimple causing bacteria. Moderately
severe pimples need oral tablets to kill the bacteria in
addition to creams. Oral retinoid therapy is reserved for
severe pimples with scarring. Oral retinoid therapy is
contraindicated in pregnancy and monitoring of liver
function and cholesterol levels is necessary. Dryness is a
common problem during retinoid therapy. You can get further
details regarding retinoid therapy and necessary precautions
during your consultation. Individuals with a hormonal
problem would need specific hormonal therapy in addition to
the treatment measures for pimples.
7.What are the
general precautions that need to be followed?
General
precautions include washing face with a gentle soap
regularly to remove excess oil without making the face dry.
Excessive washing and scrubbing is not necessary and can
irritate the skin and make pimples worse. "You cannot wash
pimples away". All kinds of cosmetics, moisturizers,
sunscreens should be avoided. If cosmetics have to be used,
oil-free cosmetics with a 'non-comedogenic' labeling should
be used. Cosmetics should be washed away at night or at the
earliest with a gentle soap. Squeezing, pricking of pimples
should be avoided to prevent aggravation, scarring and
darkening.
8. How are pimple marks and scars treated?
Dark spots
following pimples are best treated by chemical peels
(Glycolic acid peels). Chemical peels improve dark spots and
superficial scars in addition to enhancing the general
complexion and shine on the face. They are also useful in
clearing pimples faster and prevent blockage of pores. Scars
are treated based on the type and depth of scars.
Subscisions, punch excision, punch elevation are done for
individual depressed scars. Certain scars are best treated
by Microdermabrasion or Fractional CO2 LASER. These
treatments are individualized and you can get further
details during your consultation.
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F.
Understanding Hair Transplant Surgery
1.What causes baldness in men?
Baldness in men, also called male-pattern-baldness is
medically known as ‘Androgenetic alopecia’. ‘Andro’ stands
for male hormones or androgens and ‘genetic’ implies that it
is inherited. Baldness occurs due to the effect of the male
hormone – dihydyrotestosterone (DHT). This tendency can be
inherited from either side of parents and even their
forefathers.
In male pattern baldness, the hair starts to become thin and
eventually lost. It affects the front of the scalp, evident
as a receeding hair line and the top or crown area of the
scalp.
2. What are the treatment options for male pattern
baldness?
The treatment options for baldness include medical,
surgical treatments and camouflage measures.
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Medical treatment: Topical Minoxidil and
Oral Finesteride are effective, FDA approved
treatments for hair loss. However, they work
so long as they are used. |
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Hair restoration surgery: It offers a
permanent, living solution to lost hair.
Once the transplanted hair gets accepted, it
grows normally and they can be cut and
styled to our liking. |
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Camouflage measures: Cosmetic enhancers
include colored powders, sprays that help to
camouflage and reduce the visibility of the
bald scalp. ‘Hair weaving’ or ‘hair
bonding’, use artificial hair that are
weaved into existing hair or stuck on the
scalp. Hair pieces or wigs are also
alternatives. |
3. What is Follicular-unit Hair transplant?
Hair grows in clusters of 1-4 hairs, these clusters
comprise the ‘Follicular-unit’. When hairs are transplanted
as a Follicular-unit, it gives the most natural result.
4. What is the
principle behind the Hair transplant?
The hairs on the back and sides of the head are
resistant to the hormones causing baldness and when they are
transplanted to the bald area, they retain their resistance
to baldness. This principle is called ‘donor dominance’.
Hair transplant is based on this principle.
5. How is hair
transplant surgery performed?
Hair transplantation is done under local anaesthesia.
The procedure typically lasts from 4-8 hrs depending on the
number of grafts that are transplanted. The procedure
involves removing a strip of skin on the back and sides of
the head and closing it with sutures. The strip is then
dissected under video microscopy and the individual hair
follicles are separated. MIOT, is one of the few hospitals
to follow the advanced video microscopic dissection
technique. The hair follicles are then transplanted into the
front and top part of the scalp.
6. What is Follicular unit extraction?
It is a technique, where the individual hair follicles
are extracted one by one and transplanted to the recipient
area. It is a sutureless procedure.
7. What happens following the Transplant Surgery?
The transplanted hair would be shed along with scabs.
This is normal to occur. Although the hair is shed, the
roots remain behind. New hair grows from the roots and it
takes 3-4 months to reach the surface. The complete outcome
of the surgery will be evident by about 10 months.
8. What would be the long-term outcome of a Hair
transplant surgery?
Grafted hairs continue to grow as would normal hair in a
life time. However, it is very necessary to continue medical
therapy to halt the balding of existing hair in other areas.
A repeat transplant may be necessary in some individuals who
have progressive baldness.
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