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Submitted by PatientsEngage on 7 July 2016

says Dermatologist Dr Subhro Bhattacharjee as he takes a look at chronic skin ailments, the treatment that should be extended in such cases and how to manage side effects of steroids 

How high would you say is the percentage of people with skin ailments? Is it on the rise or not?

According to data in 2013, skin ailments is about 10 per cent, but, it also depends on the environment, socio-economic conditions, the general health of the population, etc.. Awareness about skin ailments has definitely increased, and people are taking specialist opinions on even the slightest doubts, which are all very positive signs. With ‘Multispeciality hospitals’ having full-fledged Dermatology departments and ‘Speciality Clinics’ providing skin treatment on a sustained basis, more and more patients are reporting for treatment even from rural areas.

What are the most common forms of chronic skin ailments and why? 

Psoriasis, ezcemas and vitiligo are a few chronic skin conditions. These are associated with immune systems, which makes these conditions chronic. Studies have shown that there is a genetic preponderance which occasionally makes it difficult to treat and cure. Few other chronic skin ailments like Discoid lupus erythematosus, Scleroderma, Vesico-bullous disorders like pemghigus and pemphigoid, though not very common, but are very chronic form of disorders which need prolonged course of continuous treatment.

Is there any specific age group which is more affected by these?

Skin ailments can happen at any age. Few skin conditions do have an age preference. Though Acne can happen at any age, but evidently more visible during adolescence. Hand eczema is more common with working housewives. Atopic dermatitis may be present at any age but, more commonly present during childhood. Stasis Dermatitis  more frequently affects the legs of those who usually have long standing or sitting positions. Few benign conditions are keratosis pilaris which occurs in teenage and early adulthood and Pediculosis capitis (Head lice) which is more prevalent in school going students.

Are steroids the main form of treatment for chronic skin conditions? What are the side effects?

Though steroids are used as quick-fixes, but dermatology has evolved beyond steroids. We now use ‘immuno-suppressors’ and ‘biologicals’, to name a few.

Steroids do have side-effects, but proper monitoring can reduce the side-effects. Topical application in the form of lotions, ointments and creams are the most abused form of steroid use. Skin atrophy/thinning, hair growth and infections are most common side effects. Increase in blood sugar, blood pressure, acne-like eruptions and transient weight gain are frequent with systemic use. Other more serious side-effects like avascular necrosis, HPA axis suppression, infections, Gastric/duodenal ulcers can occur as a result of unmonitored and high doses of systemic steroids.

What can people do to address the side effects?

Patients should understand their ailment and treatment properly. All instructions given by the treating physician should be followed religiously. If any other ailment develops within this period, then share all the treatment records with the other physician. At any period of time the treatment should not be stopped suddenly. Any discomfort felt or any new symptoms developing during the treatment should be notified to the treating physician and no self-medication should be done.

Are chronic skin problems usually also accompanied by psychological problems? Is it always important to address the mental issues also?

Chronic skin problems, rather all medical problems, are associated with a feeling of un-well. We as doctors want the patient to be calm and co-operative, because that is very important for rapid recovery of health. It is the duty of the doctor to maintain the confidence which the patient has shown in him/her. Providing a positive attitude, educating the patient and helping him in the journey of the treatment go a long way in attaining a rapid positive result.

Any lifestyle recommendations that you would recommend to prevent or manage chronic skin conditions?

  • Diet, positive attitude, exercise and life style modifications are also an adjuvant in treating chronic ailments.
  • Acne, psoriasis, eczemas, etc. do show positive changes with life style modifications.
  • Avoiding junk food and including fresh fruits and vegetables in the diet plan also show good end results.  

Dr Subhro Bhattacharjee is an Aesthetic Dermatologist and Laser Specialist who is at present associated with AMRI Hospitals, Kolkata, Desun Hospital & Heart Institute, Kolkata as well as Medica Superspeciality Hospital, Kolkata.