Wednesday 3 April 2013

On Body Odour


Kapil was a handsome 25 year old aspiring to be a model. But his complaint was ” I suffer from terrible underarm odour. I shower daily and also use a deodorant , but after a few hours I am back to square one . It really is very embarrasing and limits my career prospects and social
life ”.

A complaint which is not as uncommon as one would like to assume .
In this day and age where people are so conscious of their physical fitness and looks, smelling good has also become very important. When you walk into any party, you will smell a mixture of aromas from heady perfumes to sexy colognes . But ,our natural body smell can be just as effective, as it contains a mixture of sweat and pheromones, which can be attractive to the opposite sex. So, why is that some people have an unpleasant body odour ( popularly known as
B.O ), especially in the Bombay summer ?

Bad body odour ,as everyone knows can send friends and enemies scampering away from you,
leaving you to wonder why they suddenly had to leave.

What causes body odour ?
SWEAT + BACTERIA = BODY ODOUR .

Many people think that body odour is caused by sweat. But actually, sweat by itself, is odourless.
It is the bacteria which are present on our skin which breakdown the sweat components to give
rise to the malodorous stink. The greater the amount of sweat , the greater the bacteria acting on
it. and the stronger the smell . Hence, the misconception that B.O in due to sweat . But it’s only
the sweat present in the underarms, the genital region and the feet which causes body odour
when acted upon by the bacteria.

Why do only some people have B.O ?
Everyone sweats . But everybody does not radiate a malodorous stink. People who sweat
excessively or who have an overgrowth of bacteria on the skin do .
Stress , excessive humidity, and obesity cause excessive sweat production . Women with thyroid
disorders and menopausal women, and overweight people tend to sweat profusely . They also
have a higher growth of bacteria which can lead to more body odour.

How to prevent B.O ?
Prevention centres on decreasing sweat production or decreasing the bacterial activity.
The war on body odour is best fought with the following actions :
- Good personal hygiene. Bathe twice a day with an antibacterial soap . These soaps prevent
over-activity of the bacteria.
- No underarm hair. The hair traps the sweat and bacteria and provides a good foundation for
the smell of stale sweat.
- Never wear yesterdays clothes today . The stale sweat smell will emanate from you even if
you have scrubbed your body clean. The “locker room” syndrome of smelly unwashed socks
is only too well known !
- Wear natural cotton clothes and avoid synthetic materials. Cottons and natural fibres
allow the skin to breathe and help the sweat to evaporate. Whilst synthetic materials like
polyester and lycra are occlusive, and trap the sweat, making a good breeding ground for
the skin bacteria.
- Dust an antifungal powder on your feet , especially between the toes, before wearing
cotton socks . If your feet sweat profusely , wear open sandals or remove your shoes and air
your feet intermittently.
- Use a deodorant or an antiperspirant, Deodorants actually reduce the bacteria on the skin,
and at the same time the perfume in them masks the smell of B.O , whilst anti-perspirants,
actually block the sweat pores and hence decrease your sweating. But a few words of
caution -deodorants can cause allergic reactions in your skin due to the perfumes in them ;
anti-perspirants, because of the aluminium salts which block the pores, can harm your body.
Sweating is an important excretory mechanism of your body, and blocking it, interferes

with temperature regulation and excretion of toxins from your body.
Avoid foods with spices and garlic . Unfortunately, these same seasonings which incite
your taste buds and salivary glands, are also excreted in your sweat and they act as a signal
to the whole world that you indulged in them.
Do not substitute perfumes for a bath. A soap and water bath can never be substituted by
perfume. It is a disastrous combination of stale sweat and perfume which makes others
noses curl in disgust.
Learn to relax. Since stress and anxiety are known factors for increased sweating , learn to
stay cool. Practice meditation and relaxation techniques.

So, stay cool , smell good and win friends !

Aging Skin


As we grow older, we see and feel certain changes in our skin, the body’s largest and most visible organ .It
becomes drier, more wrinkled and spots and growths appear. The skin tends to heal more slowly.

Some of these changes are natural, unavoidable and harmless. Others are itchy or painful, and some such as
skin cancers, are serious and require immediate medical attention. Many problems can be prevented whether
avoidable or not, health endangering or merely cosmetically undesirable, most unwanted aging-associated skin
problems can be addressed by therapies now available.

Wrinkles
As skin ages, it loses its elasticity. Collagen and elastin, the tissues that keep the skin supple, weaken. The skin
becomes thinner and loses fat, so that it looks less plump and smooth. While all these changes are taking place,
gravity is also at work, pulling at the skin , causing it to sag.

Can Wrinkles Be Avoided?
How wrinkled your skin becomes depends largely on how much sun you have been exposed to in your lifetime.
The sun is the major cause of unwanted changes in the skin with aging .Cigarette smoking can also contribute to
wrinkles. Wrinkles also depend on your parents the tendency to wrinkle is inherited.

The good news is some wrinkles can be prevented. To avoid wrinkles caused by the sun, beginning childhood,
always wear a sunscreen with an SPF of at least 15, a hat with a brim and other protective clothing when in the
sun. Don’t deliberately sunbathe and limit sun exposure between 10 am and 3 p.m. If you have already sun-
damaged your skin, you will still benefit from beginning sun protection as an adult. Over the counter “wrinkle”
creams and lotions may help dry skin and make if feel better, but they do little or nothing to reverse wrinkles

Treatments for Aging Skin
There are some promising treatments for aging skin. Retinoic acid, a cream that has been used successfully
in treating acne, has been shown to improve the surface texture of the skin, reduce irregular pigmentation,
and increase dermal collagen. It is currently the only treatment approved by the FDA as safe and effective for
reversing some of the effects of sun damage. Alpha hydroxy acids also show promise in reversing some of the
effects of the sun. Creases caused by facial expressions such as squinting, frowning or a dermatologist, using
what are called dermal fillers,. A naturally produced toxin can also be used to relax the small muscles and thus
eliminate fixed expression lines like frown markers.

None of these remedies can guarantee eternally youthful skin, but they can improve the overall appearance
of your skin . Severely wrinkled skin can be improved with surgery, lasers or chemical peels. Before you
undertake any home-treatments or surgery, discuss your options with your dermatologist.

Dry Skin
As we age, our skin becomes drier. This can result in flaky and itchy skin, especially in cold,dry,windy
climates .Milder cases of dry skin can be managed with a moisturizer used after bathing, while the skin is still
damp.Oils may be added to the bath water, but then the tub can become dangerously slippery.

Petrolatum, an ingredient in many lotions,creams and ointments is an excellent moisturizer.Many moisturizers
contain chemicals such as urea, alpha hydroxy acids, lactic acid, or ammoniukm lactate to reduce scaling and
help the skin hold water.Some of these chemicals can irritate the skin, however.Your dermatologist can help
you decide which is best for you.

Bathing less often and using milder soaps or a soap substitute, or soaking in a tub of warm water without soap
can help relieve dry skin.Hot water is more irritating to dry skin than simply warm water. After bathing and
drying off a moisturizer such as petrolatum or lanolin should be applied immediately to seal in moisture.

If dry skin continues to be a problem consult your dermatologist. Severe flaky, itchy and cracked skin may be a
sign of a more serious problem.

Skin Lesions
Skin growth and lesions become more common as we age. They may range from harmless seborrheic warts
liver spots or age spots to skin cancers that require immediate treatment.Most are caused by years of sun
exposure.

Among the most common are red, scaly spots called actinic keratoses . If ignored, they may become skin
cancers that eventually need to be removed surgically . In the early stages they can be removed by applying a
chemotherapy cream or freezing with liquid nitrogen.

Squamous cell carcinoma typically develops on the rim of the ear,the face, the lips or the back of hands.These
skin cancers can destroy normal tissue and occasionally spread to internal organs.

The most common form of skin cancer is basal cell carcinoma .It usually appears as a small, shiny ,flesh bump
on the head neck or chest.It more common in older fair-skinned people with blond or red hair and blue or green
eyes. Untreated,these skin cancers can bleed and crust over They grow slowly and rarely spread to other parts of
the body.When treated early squamous cell and basal cell skin cancers have a95 percent cure rate.

Malignant Melanoma is a less common but more serious form of skin cancer. This skin cancer usually appears
as a dark brown or black mole-like growth with irregular borders and variable colors.Men over the age of 50 are
at the highest risk for melanoma, but it can affect anyone of any age. Melanoma has been associated with severe
childhood sunburns.The most frequent sited for melanoma are the upper back in both men and women, the chest
and abdomen in men and the lower legs of women.

Any change in an existing mole could be a sign of melanoma and should be examined immediately by a
dermatologist. Melanoma can spread to other organs and can be fatal.

Other Growths
Several other skin growths are common in older individuals.These include:

“Age spots” or “liver spots” – These flat, brown areas are called lentigines. They have nothing to do with
the liver- they are caused by the sun and usually appear on the face,hands,back and feet.They are generally
harmless, although large flat irregular dark areas can be a form of melanoma and require evaluation and
treatment. Commercial “fade” creams will not make lentigines disappear ,but effective prescription medications
and laser therapies are available.

Seborrheic Keratoses – These brown or black raised spots or wart-like growths look like they were stuck on the
skin surface.They are not cancerous and are very common in older people.If annoying , they can be removed
easily.

Cherry Angiomas- These are harmless,small, bright red domes created by dilated blood vessels.They occur in
more than 85 percent of middle-aged and elderly people,usually on the trunk . Electrocautery or laser therapy
removes these spots.

“Broken capillaries” or Telangiectosia – These dilated facial blood vessels are usually related to sun
damage.They respond to the same treatments as angiomes.

Skin Diseases
Some skin diseases more common in older people are shingles ( herpes zoster), varicose veins, leg ulcers and
seborrheic dermatitis.

Shingles/ Herpes Zoster – Shingles is an inflammation of a nerve caused by the same virus as chicken pox.
Early symptoms are localized pain, headache or fatigue. Shingles can affect people of all ages, but is more
common (and painful) in older adults.

The virus attacks a nerve root and follows the course of that nerve.It results in lines of blisters on the
scalp,face,trunk or extremities .The disease usually only affects one side of the body.

Shingles can become serious and cause complications.A dermatologist should be contacted immediately if
shingles is suspected, especially if the condition appears near the eyes ,as treatments are most effective if started
within 3 days of onset.

Seborrheic Dermatitis – The signs of seborrheic dermatitis are redness and greasy- looking “scales” on the
skin it usually affects areas of the skin with a high concentration of oil glands, such as the scalp, sides of the
nose,eyebrow,eyelids,behind the ears, and the middle of the chest. It occasionally affects other areas such as the
navel,breasts,buttocks and skin folds under the arms.

Seborrhea dermatitis can be successfully treated and may even go away on its own, but it tends to recur.
Frequent shampooing and washing are very helpful and your dermatologist may prescribe topical medications,
including low-strength cortisone preparations and special shampoos.

Varicose Veins – These are enlarged leg veins that appear blue and bluging. They are common in older
individuals. The veins become twisted and swollen when blood returning to the heart against gravity flows back
into the veins through a faulty valve. This condition is rarely dangerous.

The aching associated with varicose veins can be eased by avoiding standing for long periods, by keeping feet
elevated when sitting or lying down and by wearing support hose or elastic bandages. More severe cases can be
treated with surgery. Injections or laser therapy may remove smaller varicosities.

Varicose Ulcers- The same sluggish blood flow that results in varicose veins can cause varicose ulcers,
also known as venous or stasis ulcers. When a crack or cut occurs in the skin of the leg, it may fail to heal
because of poor blood flow. The injury can develop into an ulcer or a shallow wound that may contain pus or
infection .The ulcers may last for months or even years, healing poorly.

Varicose ulcers often develop at the ankles. They may be accompanied by swelling and red, itchy, scaly skin
around the ulcer. Another cause of ulcers on the legs is poor blood flow in the arteries. This condition is
associated with medical disorders such as arteriosclerosis, hypertension and diabetes.

Bruising (Purpura) – Many seniors complain of black and blue marks or bruises, particularly on the arms
and legs. These are usually a result of the skin becoming thinner with age and sun damage. Loss of fat and
connective tissue weakens the support around blood vessels, making them more susceptible to injury. Bruising
in areas always covered by clothing should be evaluated. Bruising sometimes is caused by medications that
interfere with blood clotting or internal disease.

Itching – A very common problem with aging skin is itching. Although often associated with dry skin, itching
also has other causes. Elderly skin appear to be more sensitive to fabric preservatives, wool,plastics,detergents,
bleaches, soaps and other irritants. Identifying and limiting exposure to the cause is important. Prolonged
itching may lead to lack of sleep and fatigue. Your dermatologist can often offer some medical remedies for
itching if moisturizing alone is ineffective.

Although most of the changes we experience in our skin as we age are harmless, there are certain signs of
more serious problems that shouldn’t be ignored. See your dermatologist if you notice any of the following
symptoms:
Symptom 
A scaly red spot
A change in color,
Shape or size of a mole
Any new skin growth
Bleeding in a mole or
Other growth

Excessive dryness
and itching that
doesn’t respond to
moisturizers

Vague or sharp local
pain or headache followed
by the formation of groups
of blisters

Bulging or tender veins in
Leg

A sore that fails to heal
May Indicate
Skin cancer






Dermatitis,
Psoriasis,
Internal
problems

Shingles




varicose veins


Skin cancer,
Circulatory
Problem.
Diabetes
















Acne Scars


“Don’t worry there is no need to treat the pimples!
Leave them alone!
They will go away! They are a part of growing up!”
How often have you heard these words? Unfortunately, quite often!
It’s truly sad, because pimples do not really go away. Maybe only the mild ones do so!
The other pimples and the large zits definitely do not heal spontaneously. They need active
treatment otherwise they leave behind the Legacy of horrendous scars!
Acne scars are no joke - and if you suffer from them, you will agree that they
undermine your self-confidence and dampen your social life. The anxiety from these
scars can dominate your personal and professional life. The agony of always wanting
to continuously hide your face is with you at all times.

What are Acne scars?

Acne scars are the skin’s reaction after large acne or pimples have healed.
When pimples or acne spots heal it can leave “brown flat spots” or “pseudo-scars” in some
people, which heal in about few months. But in some other people, especially when there are
deep nodules and cysts, there can be very deep holes or thick scars after the pimples heal.
Some people are more prone to scarring because of hereditary factors.

What is the treatment for Acne Scars?
Early and prompt treatment is the mantra to prevent scar formation.
The only sure method of preventing or limiting the extent of scars is to treat acne early in its
course, and for as long as pimples or acne spots exist. The more that inflammation can be
prevented, the more likely it is that scars can be prevented.
.
Years ago, there was really very little that could be done for acne scars, but today,
there are multiple treatment options available depending on the type of acne
scarring seen on the face

.
Treatment—
There are multiple treatment modalities available, depending on the type of acne scars.

-TOPICAL FADING CREAMS
-
Topical hydroquinone or fading creams are effective for post acne brown spots or “pseudo-scars”.
It will take at least six weeks to see any noticeable improvement. If there is still no improvement
after two months, a stronger hydroquinone-based bleaching cream is to be used in conjunction
with a topical retinoid cream. The retinoids will help prevent further acne breakouts and will peel
and exfoliate the skin cells deep within the skin and hasten the fading of the marks.

- CHEMICAL PEELS
Chemical peels are another effective option today.
Soft superficial scars do well with this type of treatment. Glycolic acid, Trichloro-acetic acid or
Salicylic acid are the commonly used substances.
The first peels will be 35 per cent glycolic acid peel, which can gradually be increased to a 70 per
cent peel at an interval of about 2 –3 weeks.
If there are active breakouts in addition to the scars, a salicylic acid peel, which will help clear up
acne while treating the scars is used. It will take three to four months on average to see results.

-MICRODERMABRASION

Our skin is prone to pigmentation; therefore the treatment options, which are available for the
white skin in the West, like Laser resurfacing and Dermabrasion are not advised for us. So the
next best option is Microdermabrasion.
Basically, microdermabrasion entails blasting the face with sterile micro-particles to abrade or
rub off the very top skin layer, then vacuuming the particles and dermabraded skin. The skin
procedure may also be used on the chest, neck, arms and hands with virtually no complications.
It polishes and smoothes out the margins of acne scars, which ultimately appear less obvious,
and gives the skin a smoother appearance.
This treatment usually requires 10 visits at an interval of 2 weeks.
This treatment is non-invasive; produces minimal discomfort; requires no topical or local
anesthesia; and involves practically no recovery or downtime.
Microdermabrasion also helps to contract enlarged pores that are seen in people with oily skin.

-MINOR SKIN SURGERY

This is a very minor surgical option, to be used in certain types of acne scars, which is performed
under local anesthesia.
Ice pick scars are deep-pitted scars that make the skin look like it had been jabbed with an ice
pick. A “punch excision” is done whereby the core of scar tissue is removed. This can also be
combined with “punch grafting” at the same time. Many of these types of scars can be treated in
one session.
Another type of acne scar technique called "punch elevation”, sometimes called a “punch float” is
used.
Some people have groups of very small acne scars. In this situation a needle is used below the
skin, to cut the fibrous collagen bands that attach the scars. This “subcision” technique will allow
the skin to pop back up.
Thick, raised or hypertrophic scars from acne damage are treated by injecting steroid drugs into
the skin around the scars.

All these treatments are safe and give you back as near normal skin as you originally once had!

Myths about Botox


They say – ‘Wisdom comes with age’. Unfortunately, so do wrinkles. Life’s experiences become
the laugh lines around your eyes and mouth, and the wrinkles on your forehead.
In the 21st century, people are living longer, and are healthier, but they want their skin to look
younger as well. Although we cannot turn back the clock and make them younger, but, we can surely
make them ‘look’ younger.

Men and women seeking to reverse the flow of time are constantly seeking quicker, safer and less
invasive options than the traditional face-lifts. Botox is that option. It is a ‘Face- Lift’ in a bottle.


Q: What is Botox?
A: Botox in its natural state is a toxin. But the Botox which is used for the treatment of wrinkles is
a purified form, which is non-toxic i.e absolutely not harmful.

Q: How does it remove the wrinkles?
A: Botox is injected in minute amounts into the muscles which cause crows feet, frown lines, and
the lines on the forehead. These lines on the skin are caused by the over activity of the muscles. When
Botox is injected into these muscles, it temporarily relaxes them, hence preventing their contractions.
This prevents the formation of the lines on the skin. Therefore Botox is very effective even before the
frown lines are formed.

Q: After the Botox injections, is it necessary to stay indoors?
A: No! Botox injections only take 10 minutes to be administered. After the Botox injections, a
mild swelling may occur, which goes down in 10-20 minutes. The wrinkles start disappearing within
3-7 days. A person can come in, take the injection and go shopping or to the office immediately
thereafter.

Q: Is it painful? Is Botox given under anaesthesia?
A: Botox injections are given with a very thin needle. The pain is described as an ‘ant-bite’. No
local anaesthesia is required.

Q: Where is Botox injected?
A: It is injected into the muscles that are responsible for the wrinkles. It is very effective for the
horizontal forehead lines, frown lines and crow’s feet at the sides of the eyes.
Nowadays, it is proving effective in treating the neck lines too.

Q: Does the effect of Botox last forever?
A: No! The effect of Botox injection lasts for 4-6 months. Generally Botox injections need to be
given 2-3 times in 1 year. Repeated treatments need to be given at longer intervals and lesser amounts
of Botox is needed with every successive treatment.

Q: How long does the procedure take?
A: It takes about 10 minutes. Therefore it is known as the ‘lunch time’ procedure. It’s like coming
to the clinic looking tired and worn out and going out looking fresh, rested and with softened facial
expressions.

Q: What are the side effects?
In less than 2% of the patients, Botox can produce drooping of eyelids. This is temporary and
lasts up to 10 days to 2 weeks. Some may get bruising at the site of injection and headache which is
temporary and disappears within a few days.

Q: Will Botox cause an expressionless face?
A: No! The amount of Botox used is just enough to relax the muscles. The face is always under
treated and not over treated, so as to give an expressionless face. Therefore it is imperative to take
Botox from a trained Dermatologist or Plastic surgeon.

Q: What is the cost of the Botox injection?
A: The cost depends on the area where Botox is injected. It approximately costs between Rs. 5000
– 7000 per sitting.

Q: How popular is Botox?
A: It is very popular, since it does not involve any anaesthesia or surgery. It is quick, safe and
very effective in temporarily removing the wrinkles and giving the face a smoother, softer and
younger look.