The Skin Specialist's Clinic

THE MONTHLY SKIN CARE TIP FROM THE SPECIALISTS
SUNSCREEN- AN AID TO PREVENTING RECURRENCE OF HERPES SIMPLEX ON THE LIPS!

Those who have had herpes eruption on the lips know how annoying it can be. From the start with tingling sensation and discomfort to the frank blisters that may appear.

Known triggers include: fever (hence fever blisters), the common cold, and exposure to Ultraviolet radiation (UVB) from the sun. Yes, the sun and herpes do not mix well.

The sunny season is here again and for those who get recurrent eruptions even in the absence of fever, flu or cough the sun is the likely trigger.

What to do about it? Use lip balm with sunscreen or simply apply a sunscreen lotion every morning and repeat at noon. Do this throughout the sunny period.
And you will have adorable lips throughout .

The Weekly Skin care tip from the specialists!
SMELLY FEET WITH HOLES ON THE SURFACE – PITTED KERATOLYSIS!.

Pitted keratolysis is a skin condition that affects the soles of the feet and less commonly the palms of the hand. It is caused by a bacterial infection of the skin and gives off an unpleasant smell.
How does it look like? Most often the thickest weight bearing area of the soles will have many small 2-5mm pits. The skin might be macerated and emit an annoying odour.
Conditions that make people more likely to develop pitted keratolysis include: sweaty feet; hot and humid weather; unventilated footwear such as rubber boots or vinyl shoes.
Here’s what to do for self-care:

Keeping the foot dry is very important.
 Wear absorbent socks and change them daily
 Wash your feet with antiseptic or antibacterial soap daily and dry thoroughly after.
 Minimise use of tight fitting unventilated foot wear. Open shoes or sandals come in handy
 Avoid sharing towels and foot wear with other people
 Apply antiperspirant daily to the feet

If attempts to minimise moisture does not improve the condition, seek help from your dermatologist. The dermatologist might give one of the following or combinations of prescription strength aluminium hexachloride, topical macrolide antibiotics or give you tablets to swallow. The pits and odour should disappear within 4 weeks.

YOUR WEEKLY SKIN CARE TIP FROM THE SPECIALISTS!
WHITE DISCOLORATION ON THE NAILS - LEUKONYCHIA!
Lots of people are probably swallowing oral anti-fungal tablets for a white spot on their fingernail presumably with a diagnosis of a fungal nail infection but are all white spots due to fungus?? The answer is NO.

The medical term for white discoloration of the nail is leukonychia. In true Leukonychia the problem is found in the nail matrix (the nail growth centre) and most of the matrix is under the skin near the cuticle. The moon of the nail which can be visible or invisible is the outermost portion of the matrix.

True leukonychia takes many forms from white spots on the nail (leukonychia punctata) to white strips on the nail (transverse leukonychia) to partial and total white discoloration of the nail.
Leukonychia punctata where little white spots show up on the nails is the most common type. In small children, nail biting is a wide known cause and a few fingers may be affected. In this situation the white spots will vanish in roughly 4-6months, which is the period of time required for the fingernails to entirely regrow.

Most cases of leukonychia is caused by insignificant injury to the nail matrix (like nail biting), however, leukonychia can be a sign of underlying medical problems. Such medical problems include: arsenic poisoning, kidney disease, low protein from liver disease, side effect of chemotherapy drugs.

Fungal infections and excessive nail dehydration from nail polish comes from the outside and cause what we call a pseudoleukonychia because the nail matrix is not involved.
It is therefore important to have a concrete diagnosis of your nail discoloration. This may prevent unnecessary use of expensive antifungal tablets or may lead to early diagnosis of an underlying medical problem.

Confused about the white discoloration on your nails? Contact us today!

YOUR WEEKLY SKIN CARE TIP FROM THE SPECIALISTS!
DARK LINES ON THE NAILS – SHOULD IT BE A CAUSE FOR CONCERN??

Dark lines that appear from the cuticle to the tip of the toe or fingernail can be a normal colour change in some dark skinned individuals. Other causes include nevi (birthmarks), trauma, medication and other internal diseases.

A big reason for concern if the possibility that the dark lines are a result of subungual melanoma. Subungual refers to skin underneath the nail. Melanoma is a type of Skin Cancer which if not detected early spreads so fast and is fatal.
Below are features of dark lines on the nail that should warrant concern for subungual melanoma.

A. Dark lines occurring in individuals between 40-60 years old. The years with peak occurrence of melanoma.
B. Brown-black band with breadth >3mm and irregular borders.
C. Change in nail band appearance over time.
D. Digit involved. The thumb is more likely to be affected by subungual melanoma than the great toe; the great toe is more likely than the index finger.
E. Extension of the brown black pigment to the skin on the nail folds.
F. Family or personal history of atypical birthmarks or melanoma.
Nails generally can tell us a lot about our general health. If you have concerns about changes in nail appearance, make an appointment to see one of our doctors today!

YOUR WEEKLY SKIN CARE TIP FROM THE SPECIALISTS!
CRACKED OR FISSURED TONGUE!
Have you ever worried because you have cracked or fissured tongue? Don’t worry, you are not alone, millions of people around the world have it. The good news is that this condition is often harmless and is usually considered as variant of normal tongue architecture. Although tongue fissures are harmless it is wise to visit the doctor or oral specialist and confirm the case before making decision by yourself.
What is fissured tongue or cracked tongue?
Fissured or cracked on tongue simply denotes a harmless condition of the tongue where there are shallow or deep cracks, grooves or fissures on the surface the tongue. Fissured tongue is also called as scrotal tongue or lingua plicata. Although tongue fissures are often diagnosed in adulthood, it can also be seen during childhood. As we grow fissured tongue seems to be more prominent and severe (with increasing age). Men are more affected than females.
Fissured Tongue Causes
The exact cause of fissured tongue is unknown. Experts suspects it may be inherited or may be associated with certain conditions. It is sometime seen in Down syndrome, Melkersson-Rosenthal syndrome and oro-facial granulomatosis. It is also associated with pustular psoriasis and geographic tongue.
Signs and symptoms of fissured tongue
Most of the cases of fissured tongue may be asymptomatic unless derbis builds up in these fissures. Fissured tongue mostly affects top surface of the tongue that sometimes extends out to the edges of the tongue. The depth and size of the fissures varies, it may just be shallow or as deep as 6 mm in diameter. When large and prominent, the fissures or grooves may connect with each other separating the tongue into different sections or lobules.

How is the diagnosis made?
Diagnosis is usually made with just direct visual examinations. Your dentist or healthcare provider may spot it initially. No other tests are required but your doctor may check for possible association if any.
Fissured Tongue Treatment
There is no specific therapy or medications for fissured tongue. As this condition is harmless, no treatment is required besides cosmetic concern. If bad breath, infection or any other symptoms are experienced due to debris collection on fissures, it is advised to brush the top surface of the tongue regularly. This will eliminate any derbis in the fissures and help prevent infection and bad breath. Make sure to hydrate yourself with plenty of water and avoid excessive spicy and hot food if it bothers you. If tongue fissuring was due to infection, your doctor will provide the medications accordingly.
If your tongue fissures are painful or if there is any bleeding and other associated signs and symptoms, visit the doctor immediately. He/she will evaluate the case and manage accordingly. Don’t try to diagnose or treat yourself just because you have seen some pictures or fissured tongue remedies on the net. Before treating it by yourself make sure you are doing it the right way so you don’t have to regret later.
In most of the cases fissured tongue or cracked tongue is nothing to worry about. Just make sure to confirm the case with the oral specialist and maintain good oral hygiene.


YOUR WEEKLY SKIN CARE TIP FROM THE SPECIALISTS!
CRACKED OR FISSURED TONGUE!
Have you ever worried because you have cracked or fissured tongue? Don’t worry, you are not alone, millions of people around the world have it. The good news is that this condition is often harmless and is usually considered as variant of normal tongue architecture. Although tongue fissures are harmless it is wise to visit the doctor or oral specialist and confirm the case before making decision by yourself.

What is fissured tongue or cracked tongue?
Fissured or cracked on tongue simply denotes a harmless condition of the tongue where there are shallow or deep cracks, grooves or fissures on the surface the tongue. Fissured tongue is also called as scrotal tongue or lingua plicata. Although tongue fissures are often diagnosed in adulthood, it can also be seen during childhood. As we grow fissured tongue seems to be more prominent and severe (with increasing age). Men are more affected than females.

Fissured Tongue Causes
The exact cause of fissured tongue is unknown. Experts suspects it may be inherited or may be associated with certain conditions. It is sometime seen in Down syndrome, Melkersson-Rosenthal syndrome and oro-facial granulomatosis. It is also associated with pustular psoriasis and geographic tongue.
Signs and symptoms of fissured tongue
Most of the cases of fissured tongue may be asymptomatic unless derbis builds up in these fissures. Fissured tongue mostly affects top surface of the tongue that sometimes extends out to the edges of the tongue. The depth and size of the fissures varies, it may just be shallow or as deep as 6 mm in diameter. When large and prominent, the fissures or grooves may connect with each other separating the tongue into different sections or lobules.

How is the diagnosis made?
Diagnosis is usually made with just direct visual examinations. Your dentist or healthcare provider may spot it initially. No other tests are required but your doctor may check for possible association if any.

Fissured Tongue Treatment
There is no specific therapy or medications for fissured tongue. As this condition is harmless, no treatment is required besides cosmetic concern. If bad breath, infection or any other symptoms are experienced due to debris collection on fissures, it is advised to brush the top surface of the tongue regularly. This will eliminate any derbis in the fissures and help prevent infection and bad breath. Make sure to hydrate yourself with plenty of water and avoid excessive spicy and hot food if it bothers you. If tongue fissuring was due to infection, your doctor will provide the medications accordingly.
If your tongue fissures are painful or if there is any bleeding and other associated signs and symptoms, visit the doctor immediately. He/she will evaluate the case and manage accordingly. Don’t try to diagnose or treat yourself just because you have seen some pictures or fissured tongue remedies on the net. Before treating it by yourself make sure you are doing it the right way so you don’t have to regret later.
In most of the cases fissured tongue or cracked tongue is nothing to worry about. Just make sure to confirm the case with the oral specialist and maintain good oral hygiene.

YOUR WEEKLY SKIN CARE TIP FROM THE SPECIALIST
ROSACEA – ANOTHER PIMPLE LIKE RASH!
This common and rather chronic skin condition is often misdiagnosed as acne (pimples). Typically it affects the convex surfaces of the nose, cheeks, chin and forehead. It is more common in the older age group 30-60 years and affects more women than men.
Symptoms begin with mild flushing in the cheeks and redness which is often difficult to see in black skin. There may be long term facial redness and an uncomfortable itchy rash.
From the uncomfortable itchy rash, sufferers can then develop bumps and pus filled swellings. Those who suffer from rosacea often complain of fullness or thickening of the skin. There is no white or black heads characteristic of pimples, although some people can have both rosacea and acne (pimples). In very severe cases the small bumps become larger (nodules), there is increase in size of sweat glands and diffuse enlargement of a region of the skin known as phyma. If the nose is affected we call that thickened nose rhinophyma.
So what causes this annoying condition? The exact cause is still elusive. Over the years many possible causes have been proposed including genetic predisposition, associated systemic infections like Helicobacter pylori a germ involved in causing peptic ulcers, infestation with the demodex mite. None of these has been proven beyond doubt but each at least has a grain of truth.
And probably what you want to hear is whether there is treatment for rosacea. Yes, treatment typically involves topical medications that help reduce inflammation and redness of the skin. Tetracycline class of antibiotics do have useful anti inflammatory properties in low doses. Surgery and lasers for thickened phymatous skin.
Early treatment of rosacea does help prevent disfiguring complications like the thickened nose in rhinophyma. Are you a rosacea sufferer? Our team of specialists are more than happy to guide your treatment and restore your beauty. Contact us today

YOUR WEEKLY SKIN CARE TIP FROM THE SPECIALISTS!
HAIR LOSS CAUSED BY EXCESSIVE PULLING OF HAIR – TRACTION ALOPECIA!
Many women often desire to get that sleek, super neat appearance around the hairline as such end up with hairstyles like cornrows, twists and braids. Not a bad thing at all as it surely looks elegant! Unfortunately for some, the excessive tension applied to hair with these styles lead to a form of hair loss known as traction alopecia (TA).

Traction Alopecia is a common form of hair loss seen along the front and sides of the scalp. It is due to chronic use of tight hairstyles such as tight ponytails, tight braids, hair weaves, and hair rollers.

The tight tension on the hair leads to loosening of the hair shaft from the follicle, after which inflammation of the hair follicles known as folliculitis ensues.
Traction alopecia initially is non-scarring and therefore reversible; however, it can later on turn into a scarring form of hair loss which is more difficult to handle.

The chances of getting TA in those with natural hair with traction in form of braids, with or without added extensions is higher than in those wearing long natural hair without added extensions.
The chance is even higher when extensions such as braids or weaves were added to chemically relaxed hair.

What can be done about it?

Discontinuation of the tension producing hairstyle is key to treatment. If this is done early, permanent hair loss may be averted.
It helps to vary one’s hairstyle to prevent continued build-up of tension to the hair follicles. If you experience any scalp pain or soreness, then it means the time has come to loosen up or change your hairstyle.
Your dermatologist will help treat any secondary bacterial or fungal infection of the follicles if there is any. And also use anti- inflammatory medications by injection or topically to allow hair regrow. The regrowth is possible only if your hair follicles have not been permanently damaged.
Severe cases of TA can be treated with hair transplantation.

YOUR WEEKLY SKIN CARE TIP FROM THE SPECIALISTS!
DERMOGRAPHISM – IS IT JUST SKIN WRITING?!

Some people’s skin is so sensitive that when it is slightly stroked or scratched it forms red lines/swellings which may or may not be itchy. Dermographism so it is called, comes from the words dermo- meaning skin and graph- meaning write. Literally dermographism is the ability to write on one’s skin.
This Unique reaction affects about 2-5% of the population, and is brought about by chemical mediators such as histamine released from mast cells in the skin after stroking.

In simple dermographism, most people are asymptomatic except for the swellings. In fact, some people have taken this condition and turned their body into art drawing flowers and writing poems.

On the other hand in a small proportion of individuals the lines and swellings are accompanied by itching; medically we call this symptomatic dermographism. Symptomatic dermographism can significantly affect one’s quality of life. Imagine not being able to wear certain cute clothes because they rub against your skin triggering itchy swellings; or being unable to cover yourself with your favourite beddings just because it would get so itchy that you cannot sleep.
The itch is often worse at night and can be aggravated by heat (e.g. from a hot bath), minor pressure such as from scratching or rubbing with towels, exercise, stress and emotion.

So what should one with symptomatic dermographism do?? Get a diagnosis from your dermatologist who will then start you on treatment aimed at relieving your symptoms. Avoiding factors that aggravate the symptoms is another very important aspect of management.

What is the outlook?? The natural history of Dermographism is unpredictable. But it usually lasts several months to years. It might come and go; in many patients the condition gradually improves and disappears in 5-10 years.

YOUR WEEKLY SKIN CARE TIP FROM THE SPECIALISTS!
POPPING PIMPLES – SHOULD ONE DO IT!

It is common for some people with pimples to always squeeze out that glowing red bump. What a great relief it is to see those contents come out. Few lucky ones get rid of the red bump without any consequences, however some develop worsening swelling with pus formation and usually these heal with uglier scars.

This is the downside of squeezing pimples. One unknowingly pushes contents into the deeper layers under the skin, introduces bacteria deeper and provokes more inflammation that may result in scarring.

Other than the ugly scars that might result, bacterial infections more so from pimples in the triangle formed between one’s eyes and the corners of the mouth can be life threatening. This is because blood vessels in this area drain to the base of the brain giving bacteria a free ride to wreak havoc in this sensitive part of one’s body. Complications include sinus infections, brain infections and formation of blood clots in veins known as cavernous sinus thrombosis that might result in death.

On a good note, a professionally done pimple/comedone extraction by a dermatologist or aesthetician minimises the risks of these complications. The procedure is usually done in a sterile (clean) setting. Your Dermatologist/aesthetician will use a sterile tool that looks like a pen to squeeze out the hard pellets or fluid from the pimple.
We advise you have a trained professional extract your pimples.