Winter Care for Skin

Winter is the time of the year, when the humidity levels drop significantly, which cause the skin to become dry. One should take special care during the winter, so that skin remains soft and supple. Dry skin tends to appear dull and wrinkled. I am sharing few tips on how to manage skin during the winter.

  1. Apply a light oil on your body before you take bath. You can apply coconut, olive or sesame oil. Oil forms a gentle barrier between the harsh effects of soap/water and skin. This is especially important if the water supply is hard water from boring wells.
  2. Minimize your bath duration and keep them as short as possible. Do not indulge in long baths as the drying effect of water will damage the skin. Do not use very hot water as that damages the skin too. Use sparingly warm water which feels just comfortable.
  3. You can also add a few drops of oil like Olemessa oil in your last rinse. This will leave behind a moisturizing film on your body.
  4. Use a mild soap, preferably liquid soap. Use soap also sparingly, specially on the legs and hands. Soap cleansing is more important in the folds like under arms, groin and under the breasts because in these areas bacterial growth occurs and leads to odor.
  5. Immediately after bath, apply a generous amount of thick cream or even plain petroleum jelly. You will feel sticky for sometime but as the skin absorbs the moisturizing agent, your skin will feel soft and comfortable. Lotions are useless as the effects disappear after a few hours and skin tends to feel dry again.
  6. Wear cotton clothes and keep yourself protected from excessive wind and sun exposure.
  7. Consume almonds, flax seeds and healthy nutritious diet daily to keep your body healthy, which will reflect in healthy skin and hair as well.
  8. Lips also tend to get dry and chapped. Apply a rich lip balm or chap-stick, through out the day. Women who like to wear lipsticks should avoid matt lipsticks completely and instead opt for gloss.
  9. Hands and feet are usually ignored. Massage a good rich cream specially formulated for hands and feet at night and leave it on. You can also wear socks some nights so that the cream works better on your cracked feet. Moisturex cream is a very good brand for hand and feet care.
  10. Drink plenty of water, even if you don’t feel thirsty. Lack of water causes dehydration and leads to further dryness of skin.

A white patch on the body does not always mean Vitiligo/Leucoderma!

There are various conditions, which can cause white patches on the body. Briefly, I have mentioned below common conditions.

1. Pityriasis Alba:

The most common being Pityriasis Alba, which is seen among school going children, occurs on the face. Many parents get worried and start to wonder what’s happening to their child, but this condition is absolutely benign and self-limiting. It goes away on its own over a period of time and should not cause unnecessary concern. These patches are not absolutely white but definitely lighter than rest of the skin and they are almost circular always. They tend to appear more during summers when rest of the skin gets tanned. If it bothers you a lot, please see your dermatologist who can prescribe creams to rectify it. It can be sometimes seen even in adults.

2. Sun allergy:

Also known as polymorphic light eruptions, sun allergy can cause white scaly and itchy patches on the face and hands. These appear suddenly and cause alarm in the patient. If they are very itchy, do not get worked up! See your dermatologist and get help. Meanwhile, you can apply a soothing moisturizer and take tablet Cetrizine to control the itching. Use sunscreen regularly to prevent sun rashes.

3. Post-Inflammatory Hypo-pigmentation:

Mostly seen in babies and infants, these rashes appear after a rash or some injury has occurred to the skin. Specially, it has been noticed that in infants who suffer from eczema rashes, when the rash goes away, it leaves behind the white discoloration, which can cause worry to already worried parents. Do not worry, in a matter of time, the skin does get back to normal and this is just a transient phase. It is similar to when adults get injured and develop dark areas after injury; infants are prone to developing hypo-pigmentation. Many a times, even adults can get this after injury or rash. Prolonged use of topical steroids also causes localized hypo-pigmentation.

4. Leprosy:

The sinister disease dreaded since ages! It starts with a light colored patch anywhere on the body. If you feel lack of sensation there, then immediately see your dermatologist. Leprosy is not just limited to lower socio economic class but sometimes even economically better class of people can get it. Do not delay and get it checked up right away. It is a treatable condition.

5. Vitiligo/Leucoderma:

The most important reason for white patches is a condition, which is auto-immune in nature. These appear as absolute white colored patches and can occur anywhere on the body. They can spread rapidly or slowly or sometimes they may remain localized. It is not an infection and will not spread to anyone who comes in contact with the person suffering it. It’s caused when your body’s immunity rebels against your melanocytes. Melanocytes are cells, which produce the melanin pigment responsible for the color of our skin. When your own anti-bodies target melanocytes, they get destroyed and so melanin is lost, leaving a white discolored area. We still do not understand auto-immune disorders completely. Various applications, phototherapy and surgical grafts can treat the white patches. Speak to your dermatologist.

6. Idiopathic guttate hypomelanosis:

It is seen in elderly people as small white dots around the hands and legs. Not a concern at all; it is a part of aging but sometimes it is seen even in young people.

By Dr. Sofiya Rangwala

Vitiligo- A skin condition which affects not just the skin but also the psyche.

Vitiligo- A skin condition which affects not just the skin but also the psyche.

Known commonly as the white patch disease or leukoderma or vitiligo, this is a condition of the skin. The skin in small or big patches start to turn white. The condition may be slowly progressive or may rapidly progress. It affects 0.5-2% of the world’s population.

What causes Vitiligo?

Let me give example of our defence forces. Their job is to protect us from external forces like our enemies. Now imagine our own defence forces turn rogue and start to work against us by killing us. This phenomenon in medical science is known as ‘Autoimmunity’, in which our antibodies turn against our own body cells. These antibodies as we all know function normally to protect us from external bacteria, viruses and parasites. Why do these antibodies turn against our own cells is poorly understood. In vitiligo, antibodies work against the melanin producing cells called as melanocytes. So when melanocytes get destroyed, melanin is not produced and hence no color, which leads to white patches. Melanin is the pigment in our skin responsible for our skin color. Indians have more melanin than Caucasians and Blacks have the maximum melanin pigment. Melanin also increases in production on sunlight exposure, which we commonly refer to as tan.

Can it be treated or cured?

So far, medical science is inadequate to treat autoimmunity but in severe cases in which progression occurs rapidly, we try to control it by giving oral steroids. However, oral steroids can also only control the progress of the disease and may not be able to cure it. Good news is that we can treat vitiligo patches. We have multiple treatment options to get back the color. It takes time to see the results but there is definite hope and one has to be regular with the treatment. Phototherapy plays a significant role in getting back color. I personally have been able to get visibly good results in many patients with the help of phototherapy, but as many as 30-50 sessions of phototherapy sessions may be required. Phototherapy is a form of light therapy; can be in the form of narrow band UVB or UVA light. Along with that, certain creams and ointments will also be prescribed which the patient has to use regularly. There are different types of surgical options, in which normal colored skin is implanted at the site of white patches. The results will depend on the skill of the surgeon and how well your skin takes up the graft. Usually surgery should be opted after phototherapy also has failed.

Social impact:

Stress contributes majorly in vitiligo in my opinion. Getting worried and depressed about it does not help but only aggravates the condition. The social stigma attached to this condition is severe. Some people may suffer depression or lack of self-worth even if they have small patches. Young people find difficulty in finding suitable partners for marriage. Even the most accomplished ones suffer emotionally and parents play a significant role here. Most often it’s the parents who are responsible in making their child feel inferior. In India, sadly so much emphasis is given to skin color. If one is dark then also it’s a problem and if one suffers from vitiligo then it’s the biggest problem! It’s saddening that we all give priority to external beauty and blindly ignore all other positive attributes of a person like their intelligence and pleasant personality. It is not contagious and so there is no reason for people suffering from vitiligo to isolate themselves from others. If you know someone who suffers from vitiligo, be kind and sensitive towards them. Color of the skin does not determine the true value of a person. Let us not judge people based on their skin color as external beauty is only skin deep.