Info for the Week
Acne (pimples, zits) is predominantly a condition seen in adolescents, heralding the onset of growth spurt. Present days it is seen extending beyond adolescence to adulthood.
During puberty, hormones and proteins come into play to give the growth spurt, most important of them being Insulin Like Growth Factor 1 (IGF 1). This protein leads to increase in the multiplication of cells lining the sebaceous gland (oil glands) and synthesis of fat (sebum) within the oil gland. These two events lead to an early stage of acne, called comedones. Bacteria named P. acnes, normally present on the skin, feeds on the fatty substance, leading to a red bump and a pustule.
All these changes are orchestrated by proteins and hormones, triggered by Growth Hormone. Present day food, rich in carbohydrate and dairy, add to the growth spurt, leading to exaggerated growth spurt, manifesting as persistent and severe acne. Diet definitely has got a role in reducing the severity of acne. Therefore, avoidance of high glycemic foods, dairy, and pro inflammatory foods helps in controlling acne and its sequelae.
Skin is the largest and the heaviest organ of the human body, with a surface area of 1.5-2 m2 and contributing to 1/7 to 1/6 of the body weight. It is the body’s largest water storage site, containing almost 1/3 of the total body fluids. It holds 1/3 of our circulating blood, more than even the brain. It constitutes the major energy reserve, with skin fats providing storing energy enough to last 40 days.
It is also a major sensory organ, helping us to know the surrounding environment, to protect ourselves from the possible irritants, to maintain our posture and balance and to initiate a flight and fight response. The sensory function of the skin is so sensitive that it can discriminate the differences in weight of as little as 0.005 gms and react to temperatures between -18oC and +44oC and send nerve impulses with a velocity of 2 metres per sec, to the spinal cord and the brain.
Therefore, skin, along with its appendages and glands, is an organ of protection, perception, perspiration, perfusion, and it reflects one’s personality, boosts one’s performance, and powers metabolism of vitamins and hormones. Thus taking care of the skin is very important, lest the individual gets penalised! Respect your skin and the skin respects you. Don’t take it for granted!
Skin provides a fascinating theater of life in which, in contrast to all other organs, one can directly watch, dissect and manipulate key principles of biology and pathology in action. Environmental insults and ways of life leave unmistakable traces on the skin. A thorough professional examination of the skin can reveal many invaluable clues about a person’s general well being, internal disease, social, cultural and eating habits, psychological disturbances and occupation. Skin therefore provides ample information for the dermatologists and physicians alike, for the eyes that know to find them.
In recent years, the pattern of dermatological diseases have shown significant changes. Many diseases that were once very common, such as skin manifestations of nutritional deficiencies, skin infections, leprosy, sexually transmitted diseases etc., have become uncommon. On the other, problems such as acne, psoriasis, vitiligo, skin manifestations of systemic diseases and other autoimmune diseases have been on the rise, and many of these problems are being increasingly linked to diet and lifestyle changes.
Also, with the improvement in living standards, there is increased ‘demand’ for improving the health and feel of the skin. Dermatologists of the day are required to be equipped with the skills and tools to help the cosmetic needs of our people.
The practice of dermatology has been revolutionized in the past 2 decades. It is now a great blend of the art of medicine and the science of the most latest technology. The latest technological advances such as lasers, nanotechnology, phototherapy, cryotherapy, collagen induction therapy, photography and many more have joined the armament of dermatologists. Present day dermatologists are also trained in cutaneous surgery to treat many skin lesions and to help problems such as scars, baldness etc.
Melasma with photo ageing is a common problem, resulting from exposure to UV rays, glycation from excess sugars in the diet, free radical damage and genetic predisposition. It is managed with ideal sun screens, dietary modifications and anti oxidants. Image shows a case of melasma, improved with the use of sun screen and life style modification and supplements.