Skin problems can have a huge impact on our emotional well-being, sometimes in complete disproportion to their seriousness. Even a relatively harmless case of acne can leave a teenager shy and ashamed to go out, let alone the more severe forms of eczema or psoriasis. This week we speak with Dr. Chalukya Gunasekera, a Consultant [...]


The Sundaytimes Sri Lanka

The science of skin


Skin problems can have a huge impact on our emotional well-being, sometimes in complete disproportion to their seriousness. Even a relatively harmless case of acne can leave a teenager shy and ashamed to go out, let alone the more severe forms of eczema or psoriasis. This week we speak with Dr. Chalukya Gunasekera, a Consultant Dermatologist about some of the most common skin conditions and how they can be treated.

Acne: Can be treated effectively. Image Source (CC BY 2.0 via flickr by UrbaneWomenMag)

Symptoms of eczema can vary quite dramatically for each person and may even affect different parts of your body at different times. Often, the creases in the body, such as the inner side of the elbow or the backs of knees are affected says Dr. Gunasekera explaining that eczema causes itching and redness and in some cases the affected area will blister, weep or peel. It can also affect the face and some eczema types can cover most of the body.

Eczema is also infamously associated with an intense itching sensation. This might be so bad that patients scratch until their skin bleeds, making their rash even worse and triggering a cycle of even greater inflammation and itching. However, the condition goes through different phases – at times the skin flares and at other times, it’s clear.

There are many different kinds of eczema but atopic dermatitis is the most common type. It often begins in childhood, usually during infancy. Symptoms include dry, itchy, scaly skin, cracks behind the ears, and rashes on the cheeks, arms and legs. Often the problem fades as patients grow older, says Dr. Gunasekera. Other common forms of eczema include contact dermatitis. Unlike in the case of atopic dermatitis, the cause of this is not internal but external. It occurs when the skin comes in to contact with certain substances. Common allergens include hair dyes, industrial chemicals, detergents, fumes, tobacco smoke, paints, bleach and some soaps and fragrances.

Treatment depends on the underlying cause. For instance in the case of contact dermatitis at least, avoiding the irritant will provide relief. Many of Dr. Gunasekera’s eczema patients complain of dry, sensitive skin. Which is why moisturizing your skin regularly is often recommended by doctors along with gentler soaps and shampoos.

This chronic skin problem has no cure, but the good news is that it can be managed. Also known locally as ‘pothu kabara’ psoriasis causes skin cells to multiply too quickly, which results in thick, white, silvery, or red patches of skin. Instead of skin cells growing gradually and then flaking off over weeks, in psoriasis new skin cells move rapidly to the surface of the skin in a matter of days. They build up and form thick patches called plaques. These plaques come in a range of sizes, appearing most often on the knees, elbows, scalp, hands, feet, or lower back.

Psoriasis is most common in adults, but children and teenagers can get it too says Dr. Gunasekera. It is believed to be caused by an overreaction of the immune system and in some cases, psoriasis runs in families. Like eczema, psoriasis too has its phases. Flare ups can be caused by a cold and dry climate, infections, stress, and dry skin, along with certain drugs. Smoking has been known to exacerbate the condition as does excess consumption of alcohol.

While the disease isn’t contagious, patients still find it deeply embarrassing. Many patients feel their quality of life is significantly affected by it. Fortunately, there are many types of treatment that can help keep psoriasis under control. Like any other long term illness – such as diabetes or hypertension – it requires long term management, says Dr. Gunasekera.

As many horrified adults discover, the pimply faced teenager isn’t the only person vulnerable to an acne outbreak. Hormonal changes in adulthood can cause acne flare ups in people who thought they were well past it. Typically, pimples form on the face, neck, back, chest, and shoulders, the result of clogged pores. These lead to whiteheads, blackheads and red, inflamed bumps on the skin. When acne occurs deep in your skin, it can cause hard, painful cysts and is known as cystic acne.
Acne tends to run in families and has been associated with hormonal changes related to puberty, menstrual periods, pregnancy, birth control pills, or stress. Women who use a great deal of make-up, particularly thick foundation, may also find themselves vulnerable to an acne outbreak. Dr. Gunasekera says she sees increasing number of patients, including teenagers seeking help for the condition. The swelling number of patients may hint at the pressure people are under to have perfect skin but seeking treatment for acne early on is actually a good idea – early intervention can help prevent scarring which is much harder to deal with. It helps that there are many effective treatments for acne.

Fungal infections:
In our hot, humid climate, fungal infections are very common, says Dr. Gunasekera. She sees many cases of athlete’s foot, jock itch, ringworm, and yeast infections. Some people are particularly vulnerable – athletes who spend a lot of time engaged in physical activity often develop fungal infections in the groin because the area stays moist and sweaty. People who wear closed shoes may develop fungal infections of the nail because their feet aren’t kept dry. Certain diseases, such as diabetes, make it more likely that a patient will develop a fungal infection.

Symptoms vary: in athletes foot for instance, patients complain of peeling, cracking and scaling of the feet along with an intense sensation of itchiness and inflammation of the skin. Treatment typically consists of an anti-fungal cream but in more severe cases can include oral medications. Symptoms of jock itch or tinea cruris are similar but is often distinguished by a red, circular rash with raised edges. While treatment here also usually takes the form of an anti-fungal cream, patients with the condition are encouraged to keep the area clean and dry and to change their underwear at least once a day. Ringworm, also known as tinea corporis, is not actually a worm. Instead, this fungal infection of the skin can appear anywhere in the body. It usually takes the shape of a red, flat sore and is often accompanied by scaly skin.

Ringworm can be spread via direct contact, not just through skin but through clothing or furniture. This is not a serious issue and can usually be dealt with by prescribing a cream. Finally, yeast infections claim their fair share of patients.

Symptoms of yeast infections include red patches, pimple-like bumps and an itching or burning sensation. When yeast infections affect the vagina, they can cause redness and itching, a white or yellow discharge and a burning sensation. Yeast infections affecting the nail bed are associated with pain, pus and white or yellow nail that separates from the nail bed and in the mouth, an oral thrush infection often results in painful white patches on the inside of the cheeks and on the tongue.
Although, yeast infections may affect nearly any skin surface on the body, they are particularly partial to warm, moist, creased areas including the armpits and the groin. Luckily, effective treatments are available. Obesity and diabetes are among the conditions that put people more at risk of developing a yeast infection. People taking antibiotics are also more at risk.

Share This Post


Advertising Rates

Please contact the advertising office on 011 - 2479521 for the advertising rates.