Dr. Rahul Balmiki

Eczema is not a disease per se, but is a name given collectively to a group of medical conditions, which can cause the skin to become inflamed and irritated. Atopic dermatitis is one of the most common types of eczema.

Causes

While the exact cause of eczema is not known, the most commonly attributed reason is an increasingly sensitive immune system. The overactive immune system produces antibodies, which cause these skin reactions. It is also noted that people with allergies including hay fever and asthma are more likely to develop eczema.

Other conditions which can lead to eczema include allergic dermatitis, irritant dermatitis, stasis dermatitis, scabies, fungal infections, xerotic dermatitis, lichen planus and scalp infections.

There is also a genetic predisposition, and children whose parents have had eczema are likely to develop eczema.

Symptoms

In most people, eczema is present in the form of small blisters, which are filled with fluid and can ooze. Gradually, there could be dryness, crusting, scaling and thickening of the skin with plaque formation. The most common symptom would be itching. The different types of eczema as noted above would have diagnostic features. For instance, when testing for irritant or contact dermatitis, there would be an irritant that is causing this. Stasis dermatitis would have circulatory issues and often affects the lower legs.

In fair-skinned people, these lesions begin as red and then turn brown. There also could be lightening of the affected skin area in people with slightly darker skin.

Diagnosis

For a trained medical eye, diagnosis of eczema is not a tough task. A complete physical examination may be done to assess the extent of eczema spread. Blood tests may be done to test for allergies. In very rare cases, a biopsy may also be required.

Treatment

The goal of treatment is to reduce itching and improve moisturization. Eczema, unless associated with an infection, is not contagious.

1. Using copious amounts of creams and lotions help in improving hydration and moisturization, as they are allowed to soak into the skin.

2. Topical steroids may be required if allergy is suspected. In most cases, hydrocortisone and corticosteroid creams are very effective.

3. Associated infections like scalp infections and fungal infections should also be treated with suitable products.

4. Immunomodulator creams like Elidel are useful by suppressing the immune system and preventing flare up of the allergic reactions.

5. Cold compresses may be used to relieve itching.

Prevention

Since there is a strong genetic component related to eczema, prevention is helpful.

1. Constantly keep the skin moist and hydrated by using moisturizers, especially during winters.

2. Avoid clothes and metals which can cause allergy- like wool, nickel, harsh soaps, detergents, etc.

3. Avoid or be careful about food items which are known to cause allergies.

Exposure to the sun for a long period of time can result in several skin problems. They occur on the basis of heat, humidity and the rays of the sun. Here are the most common skin problems caused due to sun exposure:

1. Sunburn: Sunburns occur as a result of overexposure of the skin to the harmful ultraviolet rays of the sun. Melanin in the skin protects it from the sun’s rays, but in case of overexposure, melanin fails to work and sunburn is caused. The symptoms of sunburn include the skin turning red, burning in the affected areas, skin tightness and a sensation of itching. Severe symptoms are blisters, chills, fever and fatigue.
2. Age spots: Age spots are caused due to overexposure to the sun. They are brown marks, which appear on the surface of the skin, especially in the arms, hands and other body parts. Age spots get more prevalent with ageing. Symptoms of this condition include brown and gray pigmentation on the skin surface. The pigmentation occurs in a circular shape and is flat on the skin.
3. Photosensitivity: This condition is also known as sun allergy. People with photosensitivity are likely to get burned from sun exposure very easily, and symptoms of sunburn are observed. Symptoms include red and pink skin rashes accompanied by itching and burning. The area gets scaly and blistered.
4. Moles: Moles occur commonly due to sun exposure. They may appear on any part of the body. Moles may vary from being harmless to cancerous. Common symptoms include raised skin and the skin tone changing into reddish brown or black. Moles are round in shape, and some moles are painful.
5. Solar elastosis: This condition is commonly known wrinkles and occurs when the elastic tissues of the skin get deteriorated due to sun exposure. The skin turns limp on account of no strength of the tissues and collagen. Wrinkles appear, and the skin seems loose and sagging. Deep lines are formed on the skin.
6. Skin cancer: Skin cancer accounts for being the most severe and fatal result of prolonged exposure to the sun without any kind of protection. There are many forms of skin cancer. The most primary skin cancers include Melanoma, basal cell carcinoma and squamous cell carcinoma.
7. Polymorphous light eruption: This condition, known as PMLE in short, affects women between the age group of twenty to forty. It also occurs in light sensitive people who spend more time under the sun. Symptoms include a red or pink, bumpy rash and raised areas on the skin surface. Itchiness and dry patches are indicated.

A large number of skin problems occur due to long hours of sun exposure. Some of these are chronic problems, which require proper treatment.

When skin is infected by a fungus, the resultant infection is called tinea corporis (ringworm). It is most common in athletes and children. The infection may appear on the scalp, beards, groin, in between the toes and other places.

Causes:

Tinea corporis can be caused by:
1. Skin contact
2. It is contagious, so if you use towels, bed linens and clothes of an infected person, you will get infected too.
3. Touching a pet infected by tinea corporis.

Signs and Symptoms
1. The rash starts as a scant area of red, bumpy pimples and spots. Then the rash forms a ring, with raised, red borders and a clear middle. The border might look scaly.
2. The rash may show up on face, legs, arms or other body areas which are exposed.
3. The area feels itchy. It might also be flaky and dry. You might even experience hair loss in the infected area.

Diagnosis
The skin in the area will be gently scraped off and the sample will be collected. Then, the sample will be viewed under a microscope. That will help discerning, which type of fungus is causing the infection.

Treatment

The following treatment regime must be followed:

1. The skin must be kept dry and clean.
2. Fungal creams are best. Creams that contain miconazole, ketoconazole, clotrimazole or oxiconazole are excellent for fungal infections.
3. Only apply the cream on clean skin. You can use it twice in a day. Bandaging the infected area is not recommended.
4. To prevent the infection from spreading, wash your towels in warm water and use clean towels every time you bathe. Also, clean the bathroom and wear freshly washed clothes.
5. If pets are infected, treat them as well.

The infection usually goes away under 4 weeks. The infection may branch out to the nails, groin, scalp and feet. Self-care is effective, but if symptoms persist, then do consult a specialist. Ringworms have certain complications, such as scratching the skin too much causes skin infections and other skin disorders, which may need further treatment.

Periods, on their own, can be very uncomfortable but sometimes it can also trigger a rash making it all the more uncomfortable. This is a common problem faced by women who use commercial pads or sanitary napkins during this period. This is because they contain plastics, scents and chemicals that can irritate the sensitive skin in your genital area.

Here are a few tips to help you deal with these rashes:

1. Change Your Pads Regularly: Whether your flow is light or heavy, the same pad should not be worn for more than 4 to 6 hours. Change your pads even if your pad does not look full once this time has passed. Along with menstrual blood, sanitary napkins also soak up sweat and bacteria. The groin area is naturally moist and warmer than the rest of your body making it the ideal condition for bacteria to grow. Changing your pad regularly keeps these bacteria from multiplying.

2. Consider Alternatives: One of the main reasons pads cause rashes is because they rub against the skin and this friction irritates the skin. Hence, consider alternatives like tampons and menstrual cups that do not rub against the skin. You could also try cloth pads made using natural unbleached cotton.

3. Wear Right Underwear: Avoid synthetic underwear and use the only cotton while you are on your periods. This allows the skin to breathe and keeps moisture from building up inside the underwear. Also, ensure that your underwear fits well and can hold your pad in place.

4. Clean Well: Do not use wipes or tissue to clean your genital area but instead wash gently with water a few times a day. Once washed, dry the skin thoroughly before putting your underwear on. Do not use any type of soap, body wash or scents in the area. Also, avoid bubble baths and saunas.

5. See a Doctor: In some cases, a rash can also be a symptom of herpes or a vaginal yeast infection. If you alternate between pads and tampons, a rash could also be a sign of toxic shock syndrome. Hence, if the rash persists for a few days, consult a doctor. Your doctor can prescribe a topical cream to be used to relieve the itchiness and inflammation depending on the rash. You could also use an anti-chafing cream on your bikini line. Diaper rash cream is an over the counter cream that usually works well in such cases.

Botox is a wrinkle treatment, but is used for treating a range of medical conditions. It has been in use for well over 18 years and is considered to be safe when performed under the guidance of a medical practitioner. Apart from aesthetics, a range of other facial, migraine and dermatological problems can be addressed by Botox.

Myth #1

Botox limits facial expression: The primary objective of a Botox treatment is to enhance the look of a person and not the contrary. When administered by a skilled physician, you can still smile and animate like before. Botox in no way affects the sensory nerve. The muscle beneath the point of injection gets relaxed and remains active. The apprehension of limited facial activity is baseless.

Myth #2

Botox travel through your body: This again is a myth. Botox diffuses not more than 1cm into the skin. Due to its localized nature, it does not affect any other parts of the body other than the intended area.

Myth #3

Botox has toxic content: Botox, like any other drug, is safe when taken under supervision. Like other drugs, it too gets scanned by the drug regulatory authorities. It is neither dangerous nor contains any toxic substance.

Myth #4

Dermal fillers involve intense pain: Dermal fillers are not as painful as advocated by many people out there. It does have its fair share of discomfort but a medical practitioner always uses a topical anesthetic and other anxiety related medications during the treatment.

Myth #5

Downtime for Botox is fairly long: Botox is known as the afternoon injection for its convenience and easy procedure. Botox procedure has no downtime at all. Doctors often suggest against lying down for a good 2-3 hours after the injection. Dermal fillers might result in minor swelling but there are medicines to counter that too.

Myth #6

Botox is permanent in nature: Botox effects lasts for 4-6months. For people who take Botox shots regularly, it tends to last longer. 

Myth #7

Dermal fillers and Botox are the same: While people these days use them interchangeably, they are not the same. For instance, Botox lessens the effect of wrinkles by relaxing the facial muscle whereas dermal fillers add volume to the tissue and restores the muscle.

Myth #8

Botox is applied only when Facial lines are visible: This is not necessarily true. If the family of an individual has a history of facial lines, it makes sense to start Botox for facial line prevention. This delays the actual facial line appearance and requires fewer Botox shots going forward.