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Dr. Maragatham Sridharan

Dermatologist, Chennai

Dr. Maragatham Sridharan Dermatologist, Chennai
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I believe in health care that is based on a personal commitment to meet patient needs with compassion and care....more
I believe in health care that is based on a personal commitment to meet patient needs with compassion and care.
More about Dr. Maragatham Sridharan
Dr. Maragatham Sridharan is a trusted Dermatologist in Best Hospital, Chennai. He is currently practising at Kamlam's Skin Clinic in Best Hospital, Chennai. Book an appointment online with Dr. Maragatham Sridharan on Lybrate.com.

Lybrate.com has an excellent community of Dermatologists in India. You will find Dermatologists with more than 44 years of experience on Lybrate.com. You can find Dermatologists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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English
Professional Memberships
Indian Medical Association (IMA)

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#8, Unique Villa, South Sivan Koil Street, Kodambakkam. Landmark:Near Best Hospital & Krishna Mahal Kalyana Mandapam & Opp .power House Bus Stop, ChennaiChennai Get Directions
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Everytime after two days of waxing of my arms or legs (through wax or razor), red pimples pop out due to lots of itching till full growth. This makes my arms look ugly and also leave marks. Suggest some ways.

MBBS
General Physician, Mumbai
Everytime after two days of waxing of my arms or legs (through wax or razor), red pimples pop out due to lots of itch...
This can be due to allergy of the skin to the chemical in the waxing cream. Please check the chemicals to which you have allergy and be careful in using the chemicals and medicines which can cause allergy to you.
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I have stretch marks on my belly after my first delivery what should I use to remove stretch marks.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
HOMOEOPATHIC MEDICINE SILICEA PENTARKAN ( Wilmar Schwabe India) Chew 2 tab 3 times daily for 3 months Natural Treatment .1. Aloe Vera Aloe vera is considered to be the most effective homeopathic remedy for stretch marks and various other skin problems. It is known for its healing and soothing properties. Apply aloe vera directly on the stretch marks. After a few minutes, clean it with lukewarm water. Alternatively, take a one-fourth cup of aloe vera gel. Extract oil from 5 vitamin A capsules and 10 vitamin E capsules. Mix both the oils with aloe vera. Rub this mixture carefully on the affected area until it gets fully absorbed. For better results, apply this mix daily. 2. Olive Oil Olive oil is rich in antioxidants and nutrients, which are effective for skin disorders. For healing stretch marks, warm the olive oil slightly. Rub it gently on the affected area. With this, the blood circulation will improve and stretch marks will get reduced. 3. Castor Oil Castor oil is considered to be a healing treatment for skin problems, like moles, dark spots, wrinkles, pimples, and fine lines. How is it used to heal stretch marks? Well, you can apply castor oil directly on the stretch marks. Massage it in a circular motion for 15 minutes. After massaging, wrap the affected area with thin and clean cotton cloth. Now, apply some heat with the help of heating pad or hot water bottle. Continue the process for 30 minutes daily for one month to get best results.
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I am loss my hair very quickly I am use all kind of shampoo but no work I want perfect solution to stop my hair loss so give me how I atop this.

IAT, BHMS
Ayurveda, Mumbai
I am loss my hair very quickly I am use all kind of shampoo but no work I want perfect solution to stop my hair loss ...
Hello lybrate-user! hair loss happens due to various reasons and shampoos will never be able to stop your hair loss. There could be some nutritional deficiency or hereditary factor or some medical problem if it has persisted for mor than three months. I would like to advise you to have a balanced meal with enough proteins and have two cups of green tea daily. Also have walnuts, almonds and flaxseeds regularly. Start a multivitamin supplement and exercise atleast four times a week to improve blood circulation to the scalp. If your hair loss does not reduce in two months after doing this you may need further investigation. An early treatment is the key to successful results in hair loss cases as the damage to hair follicles can be prevented with the right treatment.
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In my face most pimples it's not go hear what is to use to. remove or give the name of mrdicen.

BAMS
Ayurveda, Ambala
In my face most pimples it's not go hear what is to use to. remove or give the name of mrdicen.
These are the methods to treat pimples - •Steam your face to open the pores, which in turn clear the skin. Steam your face for a couple of minutes. • Do YOGASANA daily. Especially do SINHASANA & SARVANGASANA daily. • Use oil free face wash and drink 7 -8 glass of water daily. • Do not touch your face again & again because your finger transfer bacteria to it and make it worse. If you touch it then clean your face with water. • Mix black pepper powder in some water to make paste & apply on the pimples three times a week. • Take cucumber and papaya pulp. Mix it well and add 1 tablespoon Turmeric. Make a paste and apply it on face and leave it for 15 minutes. • Take 2 teaspoon of RAKTSHODHAK syrup of BAIDYANATH company once a day after meals
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Hello I am 27 year old, I used to get pimples on my things and after that it leaves marks on my things every week one new pimple and than mark what should I do to remove this marks and there is some marks on my leg also due to in growth hair after waxing marks left. What to do.

General Physician (AM)
Alternative Medicine Specialist, Chandigarh
Requires detailed questioning so as to ascertain your personality and to treat you symptomatically. Treatment is available, safe and without side effects in biochemic system of medication. Consult me in private.
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Hi I am 25 years old male. I got pimples on my face n some black spots. I have dry skin. I do not use any beauty products. What I do.

MD - Alternative Medicine
Alternative Medicine Specialist, Mumbai
Hi I am 25 years old male. I got pimples on my face n some black spots. I have dry skin. I do not use any beauty prod...
Hello, due to wrong feeding habit like irregular hours of eating improper food, excess of fatty acid n starches food grapes, pear, plum, tomato, cucumber, carrot spinach home made juice 1/2 times neem leaf paste appled on face every night before going to bed and wash with warm water in morning apply fine paste of turmeric with rose water 3 times a day best wishes.
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I have a problem of skin spots and pimples on my skin bcoz of oil, do I recommend any face wash for me or cream to repair it. Of which company I should buy a facewash and cream?

Diploma in Aesthetic Medicine, MBBS
Cosmetic Physician, Delhi
I have a problem of skin spots and pimples on my skin bcoz of oil, do I recommend any face wash for me or cream to re...
Hi lybrate-user, changing your face wash will not do much help to improve acne and spots. If your skin is acne prone, you will tend to develop dark spots too. Both conditions can be well treated. Ointments for acne work well along with skin lightning creams. For long term benefits peels or dermaroller treatment is highly recommended. These help both conditions acne and spots. I would be happy to help you.
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Remedies for Dandruff

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Bangalore

Dandruff or Seborrhea is one of the most common scalp diseases that majority of the population suffer from. Although, it is most common among the adolescent, but it can affect people of any age group. We all know that at some point in our lives we have desperately tried almost all types of dandruff treatment and over-the-counter antidandruff shampoos, but this is one sticky problem that keeps coming back. In most cases, the problem of dandruff itself is not very serious but it is embarrassing and irritating indeed. In certain cases it can lead to other skin problems such as pimples, acne or even worse, it can lead to social problems and lowered self-esteem.

Dandruff may be the result of a dry scalp, or a skin condition called seborrheic dermatitis. It could also be caused by eczema, psoriasis, or, very commonly, an overgrowth of a yeastlike fungus called Malassezia. Drugstore remedies might include shampoos with zinc pyrithione, which targets fungus and bacteria; ketoconazole, which also fights fungus; coal tar and selenium sulfide, which slow the growth and die-off of skin cells on your scalp; and salicylic acid, which loosens flakes so they can be washed away.

Aspirin contains the same active ingredient (salicylic acid) as many medicated dandruff shampoos. Keep flaking in check by crushing two aspirins to a fine powder and adding it to the normal amount of shampoo you use each time you wash your hair. Leave the mixture on your hair for 1-2 minutes, then rinse well and wash again with plain shampoo.

Basic Reasons for Dandruff:

Imagine a situation where you get a chance to get close and personal with your office crush, but just as you are tucking in your shirt or top you see a drizzle of white flakes on your collars and shoulder- what on earth can be more embarrassing than this? We keep brushing it off without ever trying to get to the root of the problem. But have we ever thought that the cause of this persistent problem may lie in very simple things, like our lifestyle, habits, diet, hygiene and stress? But no need to worry, because we bring to you some of the basic reasons for dandruff and 10 simple home remedies to get rid of it.

Poor Brushing:

Poor brushing leads to a higher risk of dandruff. It is a natural mechanism for the scalp to shed the dead skin cells periodically. Proper brushing and combing of hair at least twice a day is very important to get rid of these flakes. In addition, brushing also improves air supply and blood circulation to scalp and hair that's crucial for healthy hair.

Not Proper Shampooing:

Not enough washing of the hair leads to accumulation of dead cells and oil on the scalp which can lead to dandruff and itchy scalp. It is recommended to wash your hair every other day with a mild herbal shampoo because the detergent and chemicals present in common shampoos causes rough and frizzy hair. If you are using a conditioner after shampooing, make sure to apply it at least an inch away from the scalp and wash it off thoroughly so that no residue is left in the hair.

Stress:

Excessive emotional or work stress, overnight work shift, back to back exams or an ugly divorce- all these and many more things can lead to dandruff and hair loss. Stress has an impact on us both physically and mentally. But try to stick to a routine, eat healthy meals at proper times and drink plenty of water to keep situations under control.

Excessive Use of Hair Products:

While everybody out there is boasting of salon treated hair thanks to the chemical loaded styling products, it is impossible to get out with bland, plain hair. So if it is a must for you, then use the hair sprays, gels, and mousse in moderation, because certain chemicals present in these products might aggravate the problem of dandruff.

Improper Diet:

To a large extent, the modern diet is also responsible for problems such as dandruff. In the present times, our staple diet consists of processed food, refined sugar, fatty and fried food that leads to inflammation, which in turn leads to flaking and dandruff. Try to limit the intake of salt, sugar, and trans-saturated fat. Substitute the processed diet with an antioxidant-rich diet that includes minerals like zinc and vitamin B and omega 3 fatty acids. Include lots of green leafy vegetables and fresh fruits to your diet and eat them raw as well as cooked.

Dry Skin:

People with dry skin commonly complain of dry dandruff more often. The problem surges during winter because of dry weather and cold wind. They suffer from a type of dandruff that is not oily and the flakes are smaller in size.

Lemon and Coconut Oil Massage:

The citric property of lemon works wonders in reducing dandruff over time. For this massage, Heat 2 tablespoon of coconut oil and mix equal amount of lemon juice to it and massage gently on your scalp. Leave it for 20 minutes and then rinse off with a mild shampoo. Repeat this 3-4 times a week for a few weeks to get effective results.

Baking Soda:

This good old baking ingredient is of great use when it comes to fighting dandruff. Take a spoonful of baking soda and rub it thoroughly into your wet hair and scalp. Leave it on for a minute and then wash it off. Continue this four times a week for a few weeks. The results may take time to appear, but this one is a sure remedy for flakes.

Curd:

Take a small amount (enough to make a mask for your hair) of white sour curd or yogurt and leave it in the open for a day or two for fermentation. Whisk the curd and apply it to your scalp and hair like a mask and leave it on for an hour. Rinse it thoroughly with a mild shampoo. The acidic quality of the curd not only helps combat dandruff but conditions it to give it a shiny, soft texture.

Fenugreek (Methi) Pack:

Fenugreek is a spice that is readily available in our kitchen. Soak a handful of fenugreek seeds in water overnight. Make a paste and apply on scalp and hair and leave on for about an hour. Rinse it off and wash hair with a mild shampoo. Repeat this 3-4 times a week for best results. The anti-fungal property of fenugreek helps reduce dandruff and soothe irritation and itching.

Heena:

Heena or mehndi is an age-old natural hair conditioner that has been used for centuries to treat hair problems. Mix henna, tea liquor and curd in a glass bowl and add lemon juice to it. Keep aside for 8-10 hours and apply it to hair and scalp in the form of a pack. Leave it for 1-2 hours, rinse it off and wash thoroughly with a mild shampoo. Repeat it once a week for best results.

Apple Cider Vinegar:

Apple Cider Vinegar is available in any major departmental store or supermarket. Vinegar is an active agent in fighting fungus. Mix one part of apple cider vinegar with an equal part of water and keep aside. Wash your hair normally and then apply the mixture to wet hair. Massage your scalp thoroughly with this mixture. Make sure it does not get into your eyes. Leave it on for 15 minutes and rinse off with water. Repeat it daily for about a week and say bye-bye to dandruff.

Tea tree Oil:

Tea tree oil is great for hair and it smells wonderful too. Apply a small amount of this oil to the flaky patches. Leave it on for 5 minutes and wash off. Repeat this 2-3 times for a week. Tea tree oil often triggers allergies in some people. In that case, go for a tea tree oil shampoo that has at least 5% tea tree oil which works as good as the oil. Shampoo frequently and while shampooing scrub the scalp lightly and leave it in of about 5 minutes before washing off.

Fuller Earth (Multani Mitti) Hair Pack:

When it comes to skin care, there is nothing better than a fuller earth face pack. But fuller earth also works miracles for hair and scalp. The cooling effect of fuller earth soothes the scalp, removes excess oil and fights irritation. For the fuller earth hair pack, make a paste of fuller earth and water and add lemon juice to it. Apply it on hair and scalp and leave on for 20 minutes and wash off with water.

Neem Juice:

Since ancient times, neem has been used as a medicine for its natural antiseptic properties. Make a thick paste by grinding neem leaves in a food processor and apply this paste to the scalp and leave for 10 minutes then wash off with water. Leaves of neem can also be boiled in water and the water can be used for washing hair. This method is equally effective in keeping dandruff at bay.

Orange Peel Pack:

Citric acid and vitamin C in oranges helps in improving skin texture and tone. But orange peel too has great benefits when it comes to hair. The acidic property of orange peel helps reduce excess oil, and conditions hair. Mix orange peel and lemon juice in a food processor to bring it to a paste. Apply it to the scalp, leave for half an hour and wash off with a shampoo. Repeat this 2-3 times a week for best results.

Although dandruff might be a nagging problem, but remember the next time you are beating your head about the flakes, the solution might be just in front of your eyes- in your kitchen or freezer.

Olive Oil

Scalp dryness can be cured with the regular use of extra-virgin olive oil, an effective natural moisturizer.

Heat some extra virgin olive oil until it is slightly warm.
Massage it into your scalp and then wrap your hair in a warm towel.
Leave it on for at least 45 minutes or overnight and then shampoo and condition your hair.
Repeat this remedy a few times a week.


Camphor And Coconut Oil:

Here's a simple Ayurvedic remedy that you can try to get rid of your dandruff problem. As you might know, coconut oil is great at nourishing your hair and scalp.

Add one teaspoon of camphor to half cup of coconut oil and store in an airtight container.
Apply it on the scalp and massage for 10 minutes each night before going to bed.
Continue this treatment for 2 weeks and once your dandruff is in control, switch to applying only on alternate evenings.
Aloe Vera:

Aloe Vera gel has antibacterial and antifungal properties and is known to lessen dandruff in addition to its myriad of benefits for our skin and hair. Aloe Vera removes dandruff, soothes and heals the scalp, acting as a clarifying agent.

Apply pure Aloe Vera gel on the scalp and massage.

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Hi, I am having hair fall since past 1 year. As of now I'm shedding lot of hair and have white flakes or dandruff kind of dust coming off. My head becomes very itchy cause if these white particles. Thank you.

MD - Homeopathy, BHMS
Homeopath, Gurgaon
Hi, I am having hair fall since past 1 year. As of now I'm shedding lot of hair and have white flakes or dandruff kin...
If you have good faith in Homeopathy you can apply: Berberis Aq Q 10% & Cochleria Q 10% in Pure water daily and Have a head wash with Amla & Reetha Water {put some whole dried Amla (Indian gooseberry) & whole dried Reetha (the soap nut) in bowl of lukewarm water in evening and use its liquid to wash head} Internally you can also take - Natrum Mur 30 & Can nothris 30 (each thrice daily) Under supervision of qualified homeopathic consultant only Also take some vitamin and mineral supplements with Homeopathic medicines.
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Hii I am a 21 years old female and I have dry skin and I had a little bit of pimples and iam always felt to b dryness and I used a OLAY cream and Fair lovely cream. And my skin colour is black and I didn't get any shiningness and colour from it what can I do?

MD- Dermatology & Venereology,Leprosy , International Fellowship in Dermatology, MBBS
Dermatologist, Gurgaon
Hii I am a 21 years old female and I have dry skin and I had a little bit of pimples and iam always felt to b dryness...
Hi. Dryness can be due to various causes. Make sure you do not wash your face excessively (2-3 times at the most). Use a mild cleanser like cetaphil for face wash and apply a moisturiser 2-3 times a day. For getting a glow on your skin it is important to eat healthy and drink plenty of water. Avoid harsh sun and use a sunscreen regularly. You can consider going for mild peels to even out the complexion.
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Sometimes my face becomes dry and starts itching and acne appears on my face. Is it due to allergy problem or due to dryness?

B.A.M.S
Ayurveda, Banaskantha
Sometimes my face becomes dry and starts itching and acne appears on my face. Is it due to allergy problem or due to ...
Try to wash face 2-3 time/day with water. Apply aloe vera pulp of face once in day. Skip harsh soap or face wash to use.
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My skin colour is black what I have to do for make it fair in very short time period.

MBBS
General Physician, Faridabad
My skin colour is black what I have to do for make it fair in very short time period.
Apple is a miracle fruit for the skin.The alpha hydroxy acids or AHA’s present in apples improves skin color and elasticity of the skin.Soak peeled apple slices in milk for 20 minutes and then blend to form a creamy paste.Place in the freezer for 10 minutes, and then mix a tsp of lemon juice, apply all over your face and neck.Rinse off after 15 minutes with cool water and massage an ice cube.The skin looks baby soft, smooth with a rosy white glow.Follow this for a week to get fair skin naturally. or All the natural ingredients (Tretinoin, Hydroquinone and Cortisone) inlcuded in Melamet have only one goal: to improve your skin tone. Tretinoin helps prevent and treat acne and wrinkles by peeling off dead skin cells. Hydroquinone is the skin lightener agent in this equation that improves the overall tone of your skin. Cortisone is an anti-allergy ingredient that reduces inflammation and/or itching.' How to Use: Use the Melamet Cream just before bedtime. Wash it off in the morning, and apply some sunscreen if you intend to go outdoors. Failure to do so will cause significant damage and even result in your skin turning black.
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Hello sir ,I m 18 years old and day by day my hair is becoming white .What should I do? I have done full body check up by medical practitioner ? Please suggest me remedy, I really need it.

BHMS, DEMS
Homeopath, Pune
Hello sir ,I m 18 years old and day by day my hair is becoming white .What should I do? I have done full body check u...
Carrot juice is healthy as well as tasty. If you want to prevent and cure white hair then drink a glass of carrot juice on a daily basis. Your hair will not turn white and you will get rid of the problem too. It also helps in keeping your hair healthy and strong. You can make fresh carrot juice at home as well. Do not apply it on your hair because this works best when you consume it. Drinking carrot juice can be very health for your overall health as well. So, drink lots of carrot juice because it will not hurt you at all! onion may burn your eyes but you can use the paste to treat white hair. All you would need to do rub it on your scalp and let it dry some. Your grey/white hair will turn black in few days. However use this remedy on a daily basis to get desired results. If you do it once in a week, you will see no progress. Make sure that you do it everyday! you would need to peel off the onion skin and grind the onions. Apply the paste on your scalp and let it be for a while. Wash it off after 30 minutes or so. You can shampoo your hair too because onion leaves an unpleasant smell. Constitutional homeopathic medicine will give best result.
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Hi how can I remove pimples on my skin under my eyes and under nose can you give answer.

B.H.M.S
Homeopath, Lucknow
Hi how can I remove pimples on my skin under my eyes and under nose can you give answer.
Don't ever try to prick them as they will leave scar n discoloration. Take plenty of water n blood purifier homoeopathic vmedicins
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Hairfall has started since 1 yr post my typhoid disease. What cure should I take to prevent it.

MBBS, cc USG
General Physician, Gurgaon
Hairfall has started since 1 yr post my typhoid disease. What cure should I take to prevent it.
You can take nutrilite supplement 'Skin Hair Nail' that can be start after personal consultation Consult me for further management
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I am suffering from too much hairfall and my hairs are dry. I want to prevent hairfall and want to grow new hairs. Please consult me.

BHMS
Homeopath, Pune
I am suffering from too much hairfall and my hairs are dry. I want to prevent hairfall and want to grow new hairs. Pl...
Dear Sir Drinking lots of water - atleast 2 litres everyday - everyday during periods helps in maintaining the water level in your body and fastens the digestive process while taking care of the hormonal changes. Soak the fenugreek seeds in water overnight and grind it in the next morning to fine paste. Apply this fenugreek seed paste to hair and leave it for 30 minutes. Rinse off the hair. Follow it for month to see best result Hair oil massage: Proper hair and scalp massage will increase blood flow to the hair follicles, condition the scalp, and enhance the strength of your hair’s roots. It will also promote relaxation and reduce feelings of stress. You can use hair oils like coconut or almond oil, olive oil, castor oil, amla oil, or others. Add a few drops of rosemary essential oil to the base oil for better result Take homeopathy biocombination kali carb 6x thrice a day for month Revert back Thanks.
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I have been losing hair from the front part of my head, I am almost turning bald and I am just 21. I do not see any hair growing back and my hair are thinning and I have severe split ends.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
I have been losing hair from the front part of my head, I am almost turning bald and I am just 21. I do not see any h...
Homoeopathic medicine R-89 Drops ( Dr Reckeweg) Drink 20 drops in 20 ml fresh water 3 time daily R-89 Drops ( Dr Reckeweg) Massage 10 drops in 1 spoon fresh water on bald spots briskly for 5 minutes daily and move Dermaroller in those bald spots.( You can get it from a cosmetic accessories shop) Acid phos. 30( Dr Reckeweg), drink 5 drops morning empty stomach, once in week. .Wiesbaden 30(SBL )drink 5 drops daily morning empty stomach. .Natrum mur 6x( Dr Reckeweg), chew 4 tabs twicedaily . HAIR SERUM ( WOLFE DIETRI) Apply on hairs 2 hour before bath twice a week JABORANDI OIL ( WHEEZAL) Apply twice weekly esp. in the hair roots ,leave overnight and wash with a good shampoo Wash hair with Arnica montana herbal shampoo (SBL) Amla juice 20 ml empty stomach in luke warm water 10 mim before Acid phos 30 1.Drink 6-8 glasss extra water daily 2.2 glass milk daily 3.Take nutritious diet 4.Avoid junk nd spicy food,fast food,cold drinks 5.Take a sound and refreshing sleep Castor oil: • helps with hair regrowth and hair loss, • makes the hair richer and darker, • prevents split ends, • treats dandruff and dry scalp, • moisturizes the hair and makes it shine, • works in an antifungal and antibacterial way and can prevent problems such as ringworm, and folliculitis. How to apply castor oil It’s best to use castor oil as a hair mask. This is particularly helpful if you’re trying to regrow hair or give it more moist and shine. 1. Castor oil has a thick consistency, so you can mix it with coconut oil, olive oil or jojoba oil in a half and half ratio. This will make the mask easier to distribute throughout your hair. 2. Use your fingers or a brush and start applying it onto your scalp with circular motions. This gentle massage increases the blood circulation, rejuvenates the hair, and stimulates hair growth. 3. Part hair into sections and apply the oil (mixture) to each section until all your hair is covered properly and evenly. 4. Wrap your hair in a warm towel (you can also use a shower cap) and leave it for two to eight hours. You can also leave it over night. This will give the oil enough time to penetrate the follicles and hydrate your scalp and hair thoroughly. 5. Wash your hair as usual using shampoo and conditioner. Make sure you rinse all the oil out of your hair. How often should you use castor oil? This depends on your objective and type of hair. If your aim is to treat hair loss, you will need to do it at least twice weekly, but even better if you can do it three or four times per week for several weeks. For split ends and increased shine, you can use the oil as a conditioner once weekly. Be careful not to use too much of it (a pea-sized amount should do) or you can end up with an over-oily scalp. For best results use unrefined castor oil, as it contains more nutrients and healing properties.
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main 27 years old hu meri skin par ring worm ho gaye h jinme bahut itching hoti h khujlane k sath hi ye aur bade ho jate h bahut serious problem hum bahut paresan hu koi permanent ilaaj bataiye.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
Homoeopathy TELLURIUM 30 ( Dr Reckeweg) drink 5 drops in 1 spoon fresh water 3 times daily SEPIA 30 ( Dr.reckeweg) Drink 5 drops in 1 spoon fresh water at night eveery week Ointment ACID CHRYSO ( SBL) Apply locally Report after 1 month
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I have fungal infection and due to that I have ringworms on my neck and chest and I am also facing high hairfall. This issue is there from last 6 months, earlier it was very less but now it has increased and also hairfall is very much high. How can I treat this. Please refer a medicine.

MBBS, DNB (Dermatology)
Dermatologist, Mumbai
I have fungal infection and due to that I have ringworms on my neck and chest and I am also facing high hairfall. Thi...
Hi! Fungal infections are common due to hot humid weather. Wear loose cotton clothes. Keep the body parts dry. Change underclothes regularly. Changing quickly out of wet, sweaty clothes can reduce the chances of fungal skin infections. Do not share clothes, towels etc. Apply clotrimazole cream twice a day on itchy areas for 6 weeks. If no satisfactory improvement, please see a nearby dermatologist for further assessment.
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Chemical Peel and the Pathology Behind It

Fellowship in Aesthetic Medicine, MD, MBBS
Aesthetic Medicine Specialist, Delhi
Chemical Peel and the Pathology Behind It

Chemical peeling is a medical procedure which includes application of a chemical agent to the skin, causing controlled destruction of the epidermis, with or without the dermis, leading to exfoliation and removal of superficial lesions, followed by regeneration of new epidermal and dermal tissues. In simple words chemical peeling or chemical rejuvenation is procedure where a chemical agent or combination of agents of defined strength are applied the skin causing a controlled destruction of layers of the skin. This is followed by regeneration and remodeling leading to improvement of texture and surface abnormalities. It is a safe, effective and affordable option for improving skin ageing and imperfections.

Skin is considered the largest organ of the body and has many different functions. The skin is divided in two main regions, the epidermis and the dermis. The dermis is attached to an underlying hypodermis also called subcutaneous connective tissue.

Epidermis: It is the most superficial layer of the skin. The first barrier of protection from the invasion of foreign substances. The epidermis is divided into four layers – stratum corneum, stratum granulosum, stratum spinosum and stratum basalis(basal layer).

Dermis: It is composed of fibroblasts which are responsible for secreting collagen, elastin and ground substance that gives support and elasticity to skin. It supplies the epidermis with nutrients and has its role in thermoregulation. The dermis is subdivided into two zones, upper papillary and lower reticular layer.

Classification of peels according to histological depth

  1. Very superficial peel – Exfoliation of the stratum cormeum, without any epidermal necrosis.
  2. Superficial peel – Destruction of the full epidermis, up to the basal layer
  3. Medium peel – Destruction of the epidermis, papillary dermis and upto the upper one third of the reticular dermis.
  4. Deep peel – Necrosis of the entire epidermis and papillary dermis with inflammation extending to the mid reticular dermis.

Classification of chemical peeling agents

Very superficial Peel:

  • Glycolic Acid 30-50% applied for 1-2 minutes
  • TCA* 10% applied as one coat
  • Jessner’s solution 1-3 coats

Superficial Peel:

  • Glycolic acid 50-70% applied for 2-10 mins (depending on the type and thickness of the skin)
  • TCA 10-30%
  • Jessner’s solution 4-10 coats
  • Very superficial and superficial Peels are the mildest form and often called, “the lunchtime peel.” These peels break down corneocyte adhesion, causing dead skin cells to shed off to reveal the fresh, healthy underlying skin. These peels address minor skin irregularities like discoloration, acne, surface scarring, fine lines, and sun spots.

Medium Peel:

  • Glycolic acid 70% applied for 3-30 mins (depending on the type and thickness of the skin)
  • TCA 35-50%
  • Glycolic Acid 70% plus TCA 35%
  • Jessner’s solution plus TCA 35%

Deep Peel:

  • Phenol 88%
  • Baker Gordon phenol formula
  • Medium and deep peels increase the collagen and glycosaminoglycans content, cause collagen remodeling and increase dermal thickness to improve the clinical appearance of the skin with reduced wrinkles, skin tightening and pigmentary dyschromia.

Reason behind chemical peeling:

  • Wound healing process is an important reason for rejuvenation. The phases of wound healing after chemical exfoliation are apparent:
  • Inflammatory phase (1-5 days) – This phase is evident after peeling as erythma and swelling on the skin
  • Proliferative phase (2-21 days) – In superficial peels, the basement membrane is intact, hence normal epidermis is restored in 2 to 3 days. In medium to deep peels, wound is below basement membrane and re-epithelialization takes time.
  • Remodeling phase (3 weeks to 2 years) – collagen remodeling is the main reason that chemical peels cause rejuvenation and reduce wrinkles.

Indications for peels:

1. Pigmentary disorders

  • Resistant melasma
  • Pigmented cosmetic dermatitis
  • Freckles
  • Lentigines
  • Post inflammatory hyperpigmentation

2. Acne

  • Comedonal acne
  • Post acne scars
  • Acne cosmetic
  • Acne excoriee

3. Cosmetic

  • Photoageing
  • Fine wrinkling
  • Skin glow and rejuvenation
  • Oily to rough skin
  • Actinic keratosis

4. Miscellaneous

  • Keratosis pilaris
  • Macular amyloidosis
  • Dilated pores
  • Seborrheic keratoses

Contraindications

  • Active bacterial, viral and fungal infection and open wounds
  • Oral isotretinoin use within the past three months
  • Pregnancy and breast feeding
  • History of keloid formation
  • History of taking oral contraceptive and photosensitive drugs
  • Unrealistic patient expectation
  • Uncooperative patient, eg. Patient is careless about sun exposure or application of medicine
  • For medium depth and deep peels, history of abnormal scarring, atrophic skin and isotretinoin use in the last six months.

How to choose a patient:

A patient should be chosen depending upon 4P’s:

P – Pathology

P – Point of depth required

P – Patients skin

P – Previous peeling agents

Newer peels:

Many peels like mandelic acid, kojic acid, lactic acid, citric acid and many more have been introduced in the market which are also available in combination. These peels are not only more skin friendly but also more patient friendly. They have buffering agents like licorice extract and willow bark extract to minimize irritation to skin and antioxidants to infuse the skin with restorative nutrients. The change in the skin often occurs at cellular level and are not apparent to the naked hence making it more popular amongst busy patients who are seeking effective treatments quickly with little or no downtime.

Benefits of chemical peels:

The skin becomes noticeably smoother and rejuvenated.

  • It reduces pigmentation, improves dull and uneven skin tone, reduces signs of photoagaeing, acne and enlarged pores.
  • Removes dead and damaged skin cells and improves skin texture
  • Helps in removal of tan
  • Skin becomes brighter and more vivid because chemical peels not only cause re-epithelialization of the epidermis but also collagen remodeling.

Pre peel and post peel precautions:

  • Patient has to be motivated enough to get multiple sittings of the peel ( 4-8, depending on the indication and type of peel) every 2-3 weekly to get the desired result.
  • Patient should not wax, bleach, scrub, shave(the same day) or get any other aesthetic procedure like microdermabrasion, ipl, derma-roller one day before the chemical peel procedure. A gap of at least 7 days before and after the peel should be maintained.
  • Patient should use a mild soap/ non soap cleanser after the peel
  • Broad spectrum sunscreen and moisturizer should be used liberally, at least 2-3 times a day and sun exposure should be avoided.
  • Patient should be strictly prohibited from scratching, picking or scrubbing the skin.

Take home message:

Chemical peeling is a simple office procedure for the treatment of acne, pigmentation, skin rejuvenation and photo ageing. These are not one time procedures but require 6-8 sessions and maintenance peels to achieve maximum improvement and prevent recurrences. The newer peels are safer and effective.

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