Dr Sunil Sanghi, 57, senior consultant, dermatology, studied medicine at the Armed Forces Medical College in Pune. A fellow of the American Association of Dermatology, he enjoys playing lawn tennis and table tennis.
BEYOND ‘JUST’ SKIN: The condition of our skin is indicative of overall health. Thus skin which is yellow, blotchy or sallow is indicative of trouble elsewhere. Many diseases like hepatitis first manifest as itching or rashes on the skin. The quest for beauty has shone an even more intense spotlight on it.
THE LOOK OF HEALTH: A healthy skin reflects a healthy body. Such skin is smooth, warm, hydrated and has an even tone. There are five primary skin types: oily, dry, normal, combination and sensitive. Each skin type has its own sets of unique characteristics and needs that can affect the look and feel of your complexion. A balance of oil and moisture leads to blemish-free and smooth skin with fine pores. While genes play a major role in skin type, care routine, sunlight, temperature, stress, hormones, smoking, alcohol and exercise also affect it.
SIGNS THAT ALL IS NOT WELL: Flakes, cracks, rashes or visible hair and nail changes.
NORMAL CHANGE: The skin becomes thinner over time. There is loss of volume, especially in the cheeks, and bags form under the eyes. The effects of aging on the face are inevitable. These changes are normal with time. A newborn has delicate skin, teenagers have acne and the elderly have wrinkles. During pregnancy or rapid weight gain or loss, stretch marks can appear, which, despite the marketing hype, will not go. The marks result from the dermis―the middle layer of the skin―being stretched beyond its capacity and a resultant tear in its fibres.
WHAT IS UNACCEPTABLE: Severe acne leading to scars, rapid wrinkling and loss of volume or early progression of baldness.
INDIAN SKIN: Is much thicker than Caucasian skin, more prone to pigmentation and less prone to melanoma, the most dangerous type of skin cancer. The pigment in the skin is a boon.
MALE SKIN: Is approximately 20 per cent thicker than female skin, with more collagen (protein) and tightness. Men get more infections, but women have more pigmentary disorders, allergic diseases and hair problems. (The scalp is also skin.)
WHERE WE LIVE: Has little impact on our skin, though external factors like low temperature and high altitude cause changes. Low temperature, for instance, makes it harder for the skin to retain moisture, and makes it dry or itchy.
DIET: Which supports overall health also promotes good skin health. Nutritious food like fruits and vegetables, whole grain and healthy fats are good for the skin. Among the biggest misconceptions about diet is the role of food allergens in skin conditions and certain food practices associated with acne (eating sour foods, for example, does not enhance acne).
COMMON INDIAN SKIN PROBLEMS: Acne (clogging of hair follicles under the skin), eczema (inflammation of skin), psoriasis (build-up of cells causing scaly, itchy skin), fungal infections and hair disorders. Increasing pollution and temperature can trigger or worsen skin problems like rashes.
NO CURE FOR SKIN PROBLEMS? This is a misconception. With rapid advances in available therapies, most chronic skin conditions like psoriasis can be treated, ensuring a good quality of life. Both cure and continuous management work in various skin diseases just like in other chronic conditions like diabetes and hypertension.
WHY SO MANY STEROIDS? Dermatologists use steroids when needed. In such cases, benefits outweigh risks. The problem is self-medication, with over-the-counter prescriptions, especially topical steroids, being misused. The current epidemic of fungal infections is caused by the use of OTC medication, which addresses some obvious problem, but aggravates the real cause. For some conditions like anaphylaxis―a life threatening inflammation―steroids can be life-saving. The only skin regime you need: Good cleaning in the morning, followed by a toner (for removal of left-over dirt), moisturiser and sunscreen. In the night, use a cleanser, toner, retinoids and a moisturiser.
UNFAIR FAIRNESS: Allergic reactions are very common with the long-term use of pigmentation creams available over the counter. These lead to untreatable pigmentation and red, sensitive skin which persists lifelong.
EXPENSIVE IS NOT BEST: It is a myth that expensive creams can keep your skin young forever. The skin cream industry is huge, with significant reach on social media. But no skin cream can protect indefinitely against aging. It is better to visit a dermatologist once to understand the correct regimen for your skin, rather than spending money on products which are industry-driven.
SKIN FADS: Such as the recent Korean glass skin trend only promote misinformation for a ‘perceived’ perfect skin. No one should cultivate false hopes as there has been no scientific analysis of ingredients in products which promise the unbelievable.
NATURAL IS NOT ALWAYS SO: Products marketed as ‘natural’ are popular among consumers, but being natural does not mean they are effective or safe. Though comparatively expensive, they offer no additional benefit over cheaper medicated products. Aloe vera, for example, has been used for centuries for its health, beauty and medicinal properties. Though usually safe, it may cause allergic reactions in some people. This is true of all products.
LOOK OUT: For skin products that are healthy and good for the environment. Read and understand labels. Avoid parabens, for instance, which upset the skin's environment. Look for detailed information on the ingredients used. Organic products might not have lab-made substances, but colours and fragrances can also cause allergies. A sunscreen, for instance, is useless if it does not have zinc oxide, and can in fact have harmful ingredients, such as salicylate.
GOING TOO FAR: The influence of social media in promoting the use of expensive, anti-aging products at a young age.
MYTHS: Chocolate and oily food cause acne. Anti-bacterial soaps are good for skin. Natural and organic products are a better choice. All sun exposure is bad for skin. The higher the SPF the better the sunscreen.
SOME RED FLAGS: Fever with rash, painful swelling of skin, change in existing moles, loss of sensation or fluid-filled eruptions.
DO NOT SELF-MEDICATE: Any self-medication should be stopped immediately. Let me give two examples: We are currently going through an epidemic of fungal infections caused by OTC steroids. And self-medication with antibiotics is leading to significant antibiotic resistance.
TRAPS: The quest for ever-youthful skin leading to misuse of anti-aging creams. Hair oils that cure balding. Complete cure of psoriasis, vitiligo and eczema with alternative medicine. Quick-fix botox/bleach/skin peels.
TIPS: Have a balanced diet of adequate fruits, green leafy vegetables and healthy fat in the form of nuts and flax seeds. Follow a skin care regimen with cleanser, moisturiser and sunscreen. Carefully read what ingredients go into these products and use as per skin type, weather and external environment. Avoid stress and smoking, and exercise adequately. Essential oils can have some benefits, but which ones to be used should be individually determined. Such oils in heavy concentration can lead to skin irritation and worse.