Saturday, 20 February 2016

Seven tips for sun protection

As a Dermatologist in Bangalore, I routinely see a rush of patients suffering from sunburn and sun allergy during summer time. Bangalore despite its pleasant weather boasts of a very high UV Index (The strength of the sun's ultraviolet (UV) radiation is expressed as a Solar UV Index or Sun Index). No doubt Sun protection is my area of priority when it comes to treating sun allergy and sunburn. I would like to share few tips on sunprotection to be followed daily in Bangalore.

  1. Protect your skin with clothing, and don’t forget to wear a hat with minimum 4 inch brim that protects your face, neck and ears, and a pair of UV protective sunglasses
  2. UV protective sunglasses are a must
  3. Spend time in the shade between 11am and 3pm when it’s sunny
  4. When choosing a sunscreen look for a high protection SPF (SPF 30 or more) to protect against UVB, and the UVA circle logo and/or 4 or 5 UVA stars to protect against UVA.
  5. Apply plenty of sunscreen 15 to 30 minutes before going out in the sun, and reapply every two hours and straight after swimming, towel-drying and strenuous exercise. 
  6. Sunscreens should not be used as an alternative to clothing and shade, rather they offer additional protection. No sunscreen will provide 100% protection. Keep babies and young children out of direct sunlight as far as possible. 
  7. It may be necessary to take Vitamin D supplement tablets as strictly avoiding sunlight can reduce Vitamin D levels. (You should ask your doctor or dermatologist Dr. Divya Sharma about this)
Dr Divya Sharma is a practicing dermatologist at Whitefield Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion

Tuesday, 29 December 2015

Diaper Rash: Five questions answered by Dermatologist

As a first time parent, one is perennially busy  changing diapers especially during the first year. The bottom involves special care as the skin is delicate and exposed to a lot of irritants and cleansing. We often see lot of parents complaining about the diaper rash in their children.Here are a few commonly asked questions that I encounter in my daily practice. I have shared the answers and some useful tips to avoid diaper rash.

Q-1) How do I clean the diaper area of my baby?
Ans . This is the most important of all the steps to prevent diaper rash. There are a few basic precautions like
  1. Always clean the area from front to back, especially in girls to prevent urinary tract infections from the faecal bacteria near anal canal.
  2. Never try to pull apart the foreskin in boys which is fused for the first two to three years.
  3. Make sure to clean the creases and the folds making sure that there is no hint of moisture left. Moisture is a breeding ground for infections.
  4. Please use a sheet whenever you change the diaper in public places to prevent transmission of infections.
  5. Air drying is better than pat drying. The latter is still preferred over rubbing or not drying at all.
  6. DONOT use wipes which contain alcohol or fragrance. The wipes should be used only when cleaning with water is not available. Minimise their use as much as possible.

Q-2) What causes rash or ‘eczema’ on  my baby’s bottom?
Ans- Multiple factors predispose this area to irritant diaper rash. Prolonged contact with faeces, urine and repeated cleaning disturbs the sensitive skin in this area, hence causing rash. Improper cleaning practices or neglect can cause diaper rash.

Q-3) What should I do to treat the diaper rash?
Ans- First and foremost try to adopt proper cleansing practices as outlined above.
  1. Avoid using harsh soaps and hot water. Prefer a gentle cleansing lotion ( pH of around 5.5) to a soap bar.
  2. Prefer washing the area with cleanser and water than a wipe whenever possible.
  3. Apply a skin moisturiser first followed by a barrier cream. The latter which generally contains zinc oxide in higher percentage forms an occlusive film to prevent contact of the skin with faeces.

This should be done at every diaper change.

Q-4) Should I prefer a cloth diaper or disposable ones?
Ans- Actually a disposable diaper is preferable to cloth diaper. The cloth diaper should be promptly changes once soiled. The disposable diaper can be changed every four hours or so. There is no difference in rash if either is used.

Q-5) Will changing the type of diaper help my child?
Ans- The chances of getting a rash are same for all the types whether stick–on type or pant sized diapers. The only type of diaper that is slightly better than others is the one which are superabsorbent as they can be used for a slightly longer duration.

As a Dermatologist and a first time parent, I was bewildered too while making the right choice for my child. I hope this addresses few of those doubts and concerns. Please feel free to ask any queries related to the diaper rash and I shall be happy to help you.

Stay skin healthy and skin wise!!

Dr Divya Sharma is a practicing dermatologist at Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion

Saturday, 3 October 2015

Hair to Stay: Dos and Don't for healthy hair

Hair is the most beautiful accessory bestowed by nature. Every morning , the very first thing that we notice is our hair. A good hair day certainly brings freshness not only to our face but mood as well

Read latest column by Dr Divya Sharma in completewellbeing magazine, October edition.

Sunday, 26 April 2015

Hair loss treatment not working? Losing hair or losing peace of mind

I see a lot of patients with an agonizing query- I am losing a lot of hair these days, what is wrong with me? I have tried so many things but no hair loss prevention treatment is working? I am losing my peace of mind.

What needs to be understood is that the hair is a mirror of the inner ecosystem of our body.

Q- I am losing lot of hair these days? What is wrong with me? Is it the borewell water?
Ans – Losing hair in bunches does not happen because of the wrong shampoo or using borewell water. In such cases a comprehensive blood profile and thorough physical examination to rule out deficiencies or disturbances in metabolism should be done. Hair loss of this kind is generally referred as ‘Telogen Effluvium’ and is reversible and seldom leads to baldness.

Q- Why I am getting bald at such an early age? My father started balding in late 40’s?
Ans- A rise in sedentary lifestyle and growing obesity especially around the abdomen is becoming increasingly common in the younger population. Male – pattern baldness is seen in younger age groups now. It is also seen as a risk factor for heart problems and Diabetes. Doctors sometimes do not emphasise this important fact. Simple changes in lifestyle like exercise and following with other hair a regimented diet (preferably recommended by a qualified dietician) is mandatory with other mandatory treatment for hair fall. This surely can ARREST the balding process.

Q- Which Diet would you recommend for Hair loss?
Ans- I generally recommend a qualified dietician/nutritionist but in general a diet:
  • High in protein and
  • High in essential fatty acids is very helpful.

Tuna , Sardines , olives and avocadoes are a rich source of the latter, oats, lettuce, parsnips, asparagus,  strawberry, cabbage, cucumber, celery, cauliflower and green leafy vegetables also prevent hair breakage. A nutritionist should plan these food items depending on your lifestyle ( whether sedentary or active) and metabolic status( diabetic / non diabetic) in conjunction with the Dermatologist.

Q – Are herbal or professional shampoos (the  salon ones) better than the regular shampoos to arrest hair loss?
Ans- Natural surfactants ( as claimed by herbal or organic shampoos)  come from plants such as sarsaparilla, soapwort, soap bark, and ivy agave. They have excellent lathering capabilities, but are poor cleansers thus must be present at high concentration. Usually, they are combined with other synthetic detergents. The so called ‘organic product’ hence remains as a marketing gimmick.
Then we have these special shampoos designed for use with hair coloring procedures are generally only available to licensed cosmetologists, as they are not appropriate for daily cleansing. Other than for colored hair , I do not recommend professional salon shampoos as they have  high concentration of surfactants and hence colored hair specific shampoos are inappropriate for daily use.
Your dermatologist is best placed to help you choose the best shampoo after carefully understanding what works best for you and your hair

Q- Any dos and don’ts to prevent hair loss?
Ans- Like everything else in life- prevention is better than cure.
  • ·         Start hair fall arrest early, it works best- physically (looks), emotionally and financially. See a qualified dermatologist.
  • ·         Maintain good hair hygiene
  • ·         Assess your dietary and other habits and make healthy changes.

  • ·         In general you must avoid chemical treatments to hair including the herbal ones which are designed to change the way your hair looks.
  • ·         Avoid salon treatments or alternate therapies which have no proven scientific evidence

For hairloss key is to act early and prevention. In the end remember hair is a reflection of inner ecosystem and in most cases hair loss can be arrested. 
Angeline Jolie, Vin Diesel look extremely attractive without hair
However, your physical attribute should never be a cause of stress. There are many renowned personalities including in showbiz who have excelled and look extremely handsome/beautiful without hair. Talk to your dermatologist if hairloss is bothering you.

Stay skin healthy and skin wise!!

Dr Divya Sharma is a practicing dermatologist at Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion

Sunday, 27 April 2014

How to prevent photoageing: premature ageing of skin on exposure to UV rays

Photoaging is premature aging of the skin caused by repeated exposure to ultraviolet radiation (UV) primarily from the sun, but also from artificial UV sources. Photo means light so photo ageing means ageing of skin caused by light.

Q What is photoageing?

Ans. Changes in the skin caused by years of long, uninterrupted exposure to sunlight or Ultraviolet rays to be precise.

Q How does exactly photoaged skin looks like?

Ans. A photoaged skin looks clinically different from normal ageing skin. Apart from fine and coarse wrinkling, it shows laxity, sagging, prominent blood vessels, mottled pigmentation, leathery feel and increased fragility. The lips lose their color and the entire face is lusterless.

Q What are the causes?
Ans. – 

Ultraviolet light (the major source of which is Sun) is absorbed by the skin especially the second layer of dermis. Dermis is formed by a tightly formed network of collagen and elastin fibers. This arrangement which is responsible for the resilience of the skin gets disturbed by chronic sun exposure. The fibers change their composition and abnormal material starts getting deposited leading to age spots and pigmentation.

Chronic sun exposure also leads to accumulation of toxins and free radicals which can even make skin prone to malignancy. UV A is the major culprit as it is absorbed deeper into the skin along with a little contribution from UV B wavelength.

Q How to prevent photoageing?


1. The first and most vital step is patient education and awareness about the importance of sun protection.

2. Avoid going out between 11 am to 3 pm.

3. Sun protective clothing, head gears and even UV protected sun glasses are a must have.

4. Sunscreen usage- A particularly daunting challenge is to choose the right sunscreen. Most of the sunscreens do not offer broad spectrum protection because of the unavailability of good UV- A Sunscreen agents. A Good SPF only ensures protection against UVB while there are no accepted standard criteria for UV-A protection. 

5. Right usage of sunscreen– The sunscreen has to be applied in generous amounts at-least half an hour before going out in the sun and should be reapplied every three hours.

Minimum SPF of 30 with Adequate UVA protection is must.
Patients who have already started developing changes suggestive of photoageing can opt for glycolic peels or alpha hydroxy acids.

Since sun damage is cumulative it is never too late to start! so start your regimen of preventing photoageing now!
Stay skin healthy and skin wise!!!

Dr Divya Sharma is a practicing dermatologist at Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion

Saturday, 8 March 2014

8 womanly tips to a beautiful YOU!

Woman is one of the most beautiful creation of nature. Her life is a canvas full of shades of love in its vivid forms. A daughter, sister, wife and a mother. Bestowed with the highest honors of motherhood, a woman strongly anchors the household and family together. But in playing multiple roles, sometimes she forgets to feed her very own existence . On this day of celebrating womanhood, I want to encourage all womenfolk to take up charge of their own selves. Here are a few tips to a beautiful and a wonderful ‘You’      

     1. It all starts with fitness

The real secret to a glowing face is the glory of complete physical and mental fitness. A stroll in the morning for half an hour followed by deep breathing sessions in the garden of your apartment complex can be the most refreshing start to your day. Remember this makes a huge difference in the long run.

   2. Cleansing – toning – moisturizing

A good non –comedogenic, fragrance and parabens free cleanser followed by an alcohol free toner followed by a good moisturiser after twenty minutes of application of former is the minimum you can do as a daily routine.

3. Sunscreen every day keeps ageing away

Daily application of sunscreen with minimum SPF of 15 (Ethnic skin ) upto 50 ( fairer skin type) twenty minutes before going out everyday is a must –have on your dressing table. Donot forget  to apply it before the lunch trips to your son’s school  or bus stop.

4. Hair conditioning

A good hair conditioner containg hydrolysed proteins after head wash at-least once a week.

5. The night cream

A good anti ageing cream with retinol ,  anti ageing peptides after washing face is a good routine to follow. Remember every woman after achieving 30 years should start the night regime. A good serum containing Vitamin C is an added benefit.

6. Anti – Oxidants

A vitamin supplement containing omega three fatty acids and Calcium -Vitamin D should be on the menu everyday.

7. Genital hygiene

Simple cleaning with hot water and gentle soap at bath is enough for cleaning the intimate area. Addition of antiseptic agents and vaginal douching is a strict no as they destroy the good bacteria which aid in natural cleaning and maintaining vaginal health. Cleaning should be done front to back side. Cotton – Linen undergarments are desirable.

8. Keep a ‘ me – time’

      Me time- when you do what you love to do . It could be listening     to a beautiful song, paint or dance to your favourite tune. You are   more than the roles you play.

A Great thanks to all the women who have been a part of our journey and make this world a better place to live. HAPPY WOMANHOOD TO ALL. 
Stay skin healthy and skin wise

Dr Divya Sharma is a practicing dermatologist at Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion

Wednesday, 26 February 2014

Dry skin or Atopic Dermatitis in children

I see a lot of parents in my practice who are anxious and worried about the recurring dry skin of their children or Atopic Dermatitis. This not only is a cause of concern but can be a distressing condition for the children as well. In this blog post on pediatric dermatology, We shall discuss the causes and care required for alleviating the discomfort associated with this under recognized but important skin condition affecting children. I would be glad to answer your queries and comments.

Q – What is the cause of dry skin of my child?

Ans – Our skin has a ‘brick and mortar’ arrangement where the skin cells are the bricks and they are fused with each other by “Natural Moisturizing Factors’ (NMF). NMF is made up of free fatty acids and Ceramides. It is believed that deficiency in this NMF leads to ‘Dry Skin condition’ or “Atopic Dermatitis”. Atopic dermatitis simply can be put as ‘an itch that rashes’. It includes a tendency to have allergies at places where body is in contact with the external environment like allergic rhinitis, hay fever and eczemas.

Q – What are the risk factors for atopic dermatitis?
Ans- A positive family history of similar dry skin, asthma, hay fever or eczema can predispose the children to this condition. It is more found in urban areas than rural. It is largely believed that a cleaner environment and healthier diets to pregnant mothers exposes the child in utero to very few infections. As a result of which their immunity is hyperactive and shifts to a tendency for allergies. (HYGIENE HYPOTHESIS”).

Q – What can I do to alleviate my child’s discomfort?
Ans – There are a basic set of precautions and special care that I advise my patients to reduce the frequency and severity of dry skin in children.
a)      SHORT Bathing time – reduce the shower time to less than five minutes.
b)     SOAP USAGE – Minimal application of soap to the entire body and choose a moisturizer containing soap. (For further reading read my blog on this link ).
c)      LUKEWARM water – instead of very hot water. Water and soap further dry and reduce the lipid layer of ski , hence they aggravate the condition.
d)     MOISTURIZE with a recommended moisturizer within three minutes of bath after gently patting the skin dry. Don’t handle skin in a rough manner at all.
e)      CONTACT with woolen garments, fur and dust should be minimized.
f)       COTTON or LINEN garments should touch your child’s skin.
g)      MINIMIZE things which catch dust like carpets and soft toys around your child.
h)     PREFER vacuum cleaning at least once a month.

Q- Which moisturizer should I use for my child‘s skin?
Ans- Moisturizer is the lifeline to prevent this condition as they seal the fissures and improve the disturbed barrier function. They are of different types-
a)      Emollients - They are naturally found in palm and coconut oil. They replenish the natural moisturizing factors. Shea cocoa butter containing products belong to this category.

b)     Occlusives- They serve to seal the gaps between skin cells and make skin ‘slippery’. They are greasy, messy and have allergic potential.  Petroleum jelly is an ideal example. I would rank them lower in my choice of moisturizers. 

Q- What is an ideal moisturizer?
Ans - Patients who are confused by media hype often ask this question. The ideal moisturizer should be:

Q – Which type of moisturizer do you recommend?
AnsThe following is a quick guide for choosing a moisturizer     
1)Moisturizers designed for the face are typically non-greasy, non-comedogenic emollients, with an emphasis on skin feel and aesthetics with maximal skin benefits.
2) Silicone derivatives in particular are targeted for consumers with oily skin. Kaolin and Talc containing compounds are good for oily skin.
3) Moisturisers marketed as anti ageing should include sun protectants, alpha hydroxy acids (e.g., glycolic acid), and retinol and its derivatives.
4)Prefer lotions for day time use while creams are thicker and should be applied at night.
5)Emollients containing moisturisers like shea butter , squalene should be preferred for very dry skin over body and hands. Avoid them on face as they can trigger ‘acne’ or ‘pimples’.

Q- Which oil should I use for my child?

Ans – Coconut oil has been shown to improve the skin barrier which is deficient in atopic children. Olive oil and other oils are harmful than helpful for skin.It has been proven by studies that the barrier function is best restored with the coconut oil. Coconut milk is equally desirable.

Atopic Dermatitis tends to improve with age. It should not cause unnecessary anxiety and concern. There are simple and effective treatments available which can remit or at-least maintain results. Consult your dermatologist today for daily skin care regimen. 
Stay skin healthy and skin wiser!!

Dr Divya Sharma is a practicing dermatologist at Bangalore. The data shared in this blog is her personal opinion based on her knowledge and experience. The author is not responsible for any adverse event that arises out of following blog opinion

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