By Dr Jameel Sayed

Do you know the largest organ in your body? Is it the liver or pancreas or lungs, any guesses?

You will be surprised to know that it is the skin. Yes, skin is largest organ of our body which apart from protecting internal organs from various damages, it also performs many other important functions like temperature control, water balance, immune function, Vitamin D synthesis apart from having a major role in giving you cosmetic appearance in the form, colour, tone and texture.

Hence aptly said ‘beauty is skin deep’.

We seek treatment for illness just because of pain, weakness, some handicap, or some other loss of function. With respect to skin, a patient seeks treatment not only for symptoms like itching but also for changes in appearance like redness, change in colour to white or black, or just to look good proving the cosmetic importance of skin unlike other organs in our body.

As most of the changes in our skin is not life threatening we tend to find easy way out  of treatment in the form of home remedies, easy help from grannies, a quick advise from friends, relatives or some just ignore it thinking it will just go.

Today’s article is aimed at clearing some of misconception amongst general public which are deeply embedded from generations and are hard to break. I will discuss few skin conditions which are commonly seen.

White patch

A white patch on face or anywhere else causes lot of anxiety within patients because of predetermined thoughts and stigmas attached with it. There are many misconceptions about it. Patients come with a preset thinking about the cause. A white patch is usually thought to be some deficiency usually calcium and vitamins.

Patients are so much obsessed with it that they start with sentence like “doctor my son/daughter has calcium deficiency ...” And at the end of consultation they get disappointed when told that “it’s not due to calcium deficiency”. So what exactly is the cause for a white patch on the face? It can be any of the following diseases.

 

Pityriasis Alba

This is the most common skin condition which is present as white patches on the face, particularly in children. The patches are faint with ill-defined border. It can be slightly itchy with minimal scaling. Usually present on cheeks, forehead or chin. It is just a type of eczema and commonly seen in patient with an allergic skin disease called atopic dermatitis. Treatment is simple. Moisturisers are very helpful and in some cases mild steroid creams can be used.

 

Polymorphous light eruption

This is allergy due to sunlight. It is present as white patches with well-defined borders, sometimes even as ring like skin lesions. It is present on sun exposed areas like forehead, cheeks, temple, neck and forearm. Patches are itchy on exposure to sunlight. Treatment is topical steroid cream and sun protection in the form of sunscreen lotions. Wearing a cap and well covered clothing protects skin physically.

 

Tinea Versicolor

Well-defined scaly white patches without any symptoms, but may be slightly itchy at times. It is a fungal infection.

 

Vitiligo

It’s also known as leucoderma, present as milky white patches. There can be patches also elsewhere in the body.

 

Leprosy

This presents as faint white patches. If present on face it can be confused with any of above diseases. Loss of sensation and loss of hair over the affected areas confirms the diagnosis. There can be widespread lesions on other parts of the body.

 

Chicken pox

Though chicken pox is very common, the general public has lots of misconception about causes, precautions and treatment about it. Some communities believe it to be a curse from God.

The commonest confusion is about the restrictions to be followed during course of the disease. Some people restrict patients with chicken pox with food like salt, non-veg, oily food, etc. Some have a notion that taking shower is not allowed. I have seen patients who had not taken bath for 5-7 days before coming to me which causes lot of secondary bacterial infection in the form of pus, which in turn causes permanent scaring.

Whereas chicken pox is just a viral infection spread from one person to another by close contact, coughing, sneezing and talking. Patients with chicken pox should isolate themselves and stay at home in order to prevent it from spreading to others. They can eat anything they wish. They can and should take bath as usual. Prompt treatment should be started with antiviral medicine early in the course of the disease to prevent it from spreading to others and prevent complications like extensive scarring.

 

Acne (pimples)

As much as 90 % of teenagers are affected by acne to some extent. It is due to spurt of hormones during puberty. Acne can appear even later in ages due to hormonal imbalance, stress, heat and humidity and due to certain medicines.

 

Misconceptions about acne

l Acne can appear only on face (truth is acne can appear on neck, arms, chest and back apart from face).

l Caused by dandruff falling on face.

l Excessive sexual activity or masturbation.

l Bad hygiene.

l Eating oily food, chocolates.

l But indirectly, dairy products due to presence of hormones given to cattle to increase milk production, can cause acne.

 

Following are the instructions for those with acne:

l Wash face frequently.

l Avoid pressing and squeezing acne lesions.

l Avoid applying oil or oily creams on face or areas affected by acne.

l Seek prompt and regular treatment from a dermatologist, as the control of acne takes several weeks.

l Recurrences of acne are known till skin gets over hormonal changes during teen years.

l Treat the associated cause if any.

 

Misconceptions about treatment of skin diseases

Generally, treatment of skin diseases is taken very lightly. We tend to either ignore the disease thinking it will go on its own. Or we seek treatment only if it causes itching, pain etc. By doing so we might be inviting trouble in the form of spread within patient himself or spread to others if it is a contagious skin disease. Some disease if ignored can cause permanent changes like white or black colour of skin or permanent scarring.

 

Self-medication

This is major problem regarding treatment of skin diseases. We all consider creams or ointments as just another cream. Dermatologists usually come across situation where patients use a cream or ointment given to his relative or friend for some particular skin disease which he/she was cured of.

We usually hear sentences like “doctor I used this cream which was given to my father for some particular disease.”

Here I would like to point that creams/ointments are specific medicines like tablets, capsules or injections. Do we pick up any tablet for any disease? Will you take your father’s blood pressure medicine when you have loose motion? The answer is no. Similarly we just cannot use any medicine kept at home. All creams/ointments are specific medicines given for specific diseases.

Most of the cream/ointments in dermatology are steroids. Steroids are like double-edged knives which work wonders when used wisely under doctor’s supervision. If overused they can cause long-term and permanent side effects like white patch, thinning of skin, stretch marks and spider veins.

If a steroid is used in fungal infection it may cause temporary decrease in redness and itching. But actually it must be flaring the infection as fungus thrives in presence of steroid causing widespread disease. It is for this misuse that sale of steroid creams is restricted and to be given solely by prescription of a doctor.

We usually come across some patients asking for particular steroid cream which was sold to them by a certain beauty parlour as whitening agent to look fairer. Actually whitening of skin is a side effect of steroid cream and in the long-term it can cause some serious side effects mentioned earlier.

Some patients once prescribed a certain steroid cream never come back to the doctor and keep on applying the same cream for months together again inviting side effects. Restriction of sale of steroid creams again avoids such a situation.

Finally, self-treatment like oils, salt, lemon juice have little role in dermatology with modern-day treatment in the form of advanced creams, lotion and various newer nano technology preparation.

In short, do not ignore skin problems, seek medical help promptly. Leave the treatment part for the doctor. Follow the course of treatment to have healthy glowing skin forever.

 

l (Dr Jameel Sayed is a specialist dermatologist at Aster Medical Center on C-Ring Road.)