Author Archives: Dr Madhuri Agarwal

HOW TO TACKLE AND TREAT ADULT ACNE

One of the most prevalent skin problems is acne. Many people have experienced it or may experience it in the future. But to further confuse matters, teen acne and adult acne are two different conditions. Everything you did to defend yourself the first time you battled acne in your teens won’t necessarily work for you as an adult. Teenage acne is frequently caused by a change in hormones that comes with maturing, although adult acne can be caused by a variety of factors. Forget what you believed to be true and pay attention.

WHAT CAUSES ADULT ACNE?

Acne is mostly brought on by excessive sebum production and clogged pores. The expression “clogged pores” keeps coming up in conversation. A discussion on acne would be incomplete without mentioning it, at the risk of repetition. You may be sure that there are clogged pores wherever there is acne.

Millions of tiny holes (pores) connect our skin’s surface to the sebaceous glands that are located beneath the skin. In a healthy amount, they generate sebum, an oily material that keeps the skin moisturised and forms a waterproof layer to keep the body’s water content as high as possible.

Dead skin cells, germs, and sebum all pass through a follicle on their way to being washed away. The follicle becomes clogged when it is straining to work overtime while being overflowing with sebum and debris. This might cause an infection. The body then switches to self-healing mode and sends an SOS (save our skin) signal to the rest of the body to send more blood cells to the part that is inflamed. Because of this, when you pop a pimple, pus and blood come out. It’s a physically remarkable as well as disgusting motion.

However, we can’t totally put the blame on clogged pores. The way we live can also be a factor in those bothersome pimples. Because stress, food, and insufficient sleep are all connected to hormones, they can directly affect the chemical balance of your skin, making it more susceptible to acne.

THE DIFFERENT TYPES OF ACNE

Identifying the type of acne you have is the first step to treating it. Acne can be flat on the surface of the skin or raised and fit into the following categories:

Comedones – These are tiny papules that are skin-coloured. Blackheads are closed comedones, whereas whiteheads are open comedones. Most people mistake blackheads for dirt, but when comedones are open, melanin interacts with oxygen and oxidises, darkening in colour.

Milia – Dead skin cells that become caught on their way out of the body, also known as milk spots, usually form a tiny cyst. They may spontaneously remove themselves over the course of a few months, depending on how near they were to the skin’s surface.

Papules – the kind of acne that is most closely associated with skin conditions. Red lumps without a pus centre are called papules. They typically take a few days to fill up with pus, during which time we have repeatedly prodded, stabbed, and pricked them in order to get that pleasurable pop. However, we strongly advise you to resist any temptations because having beautiful skin is much more pleasurable than popping a pimple.

Pustules – When papules contain pus, they become pustules.

Nodules – are the hardest form of acne to overcome. They typically remain solid beneath the skin and don’t form whiteheads. Nodules, which can be very painful, are signs that an infection from a blocked pore has migrated deeply into the layers of the skin. You must absolutely refrain from attempting to pick at these.

Cysts – essentially nodules, but softer because they contain pus. Since they will hurt just as badly, you won’t feel the need to play with them.

HOW TO TREAT ACNE

REDUCE YOUR STRESS LEVELS
It seems unjust that stress-related acne development or aggravation would add to our stress levels. Our bodies respond to stress by creating the hormones cortisol and androgens as a form of defence. The problem is that they increase sebum production.

We have little influence over many factors that cause stress, but we do have some control over how we choose to deal with it. You can achieve this by engaging in self-care activities, engaging in regular exercise to increase your feel-good endorphins, and starting a journal to help you better process your emotions.

IMPROVE YOUR DIET

Although we know it’s harder said than done given the poor food habits we’ve developed during lockdown (you’re not alone if you got into contact with your fridge more than anybody else), our diet is a little easier to control than stress. Foods heavy in sugar and refined carbohydrates raise insulin levels, which subsequently trigger the body to generate more oil, increasing the likelihood of a clogged pore.

We hate to be the ones to encourage you to cut back on your intake of carbohydrates and sugar, especially if you have a very sweet appetite. You need a healthy quantity of each, but moderation is key. This doesn’t mean eliminating it altogether (we’d never be so harsh).

How to choose the right hair transplant procedure?

There are not too many options to choose from types of hair transplant procedures. The surgeon doing the procedure generally decides the right hair transplant procedure. So rather than the type of procedure, it is essential to look at the qualification of a hair transplant doctor and select the right doctor. Ideally, only dermatologist and plastic surgeons are qualified and certified to do hair transplant procedures. Do not opt for centres were technicians, therapists, or other medical specialities do hair transplants.

Currently, the popular and patient-friendly hair transplant procedure is Follicular Unit Extraction or F.U.E. At Yavana Aesthetics Clinic we do the hair transplant by the ‘No Root Touch’ technique.

How exactly is the treatment done? Step-by-step procedure pls?

The ‘No Root Touch’ Hair transplant treatment usually takes a whole day and is a comfortable patient-friendly procedure. Before the procedure, there will be multiple consultations to understand and decide the exact areas of the ‘No Root Touch’ transplant in discussion with the patient.

• Anaesthesia – This is done with local sedatives and anaesthesia only in the areas to be treated. The anaesthesia is delivered so that the scalp is numb and the patient does not feel discomfort or pricking during the extraction and transplant procedure. The patient goes back home immediately after the session is done.
• Extraction of grafts – The follicle unit is removed by the performing doctor depending on the number of follicular units required in the individual patient. It is removed using sharp micro punches one at a time with care and precision. After separating the selected follicle from the surrounding hair, it is extracted by the doctor using forceps without disturbing or touching the viable root of the follicle. The micro spot or hole caused after the removal of extracted hair heals by itself in the following week due to the body`s natural healing response and becomes practically invisible at the end of 10-15 days.
• Implantation of grafts – This is a fine, artistic visionary job as the recipient site has to be selected with care that the transplanted hair looks natural. In ‘No Root Touch’, the recipient site is created by making slits according to the orientation of the natural existing hair so the transplanted hair blends in well. Then the extracted grafts are placed in these slits. The placement of grafts is done with precision to ensure appropriate desired results. The slits heal rapidly with time and there is no evidence of them in a few days after the ‘No Root Touch’ procedure. Finally, the donor area is bandaged and the dressing is removed on 3rd day after the procedure. A detailed post-transplant care list is given.

How many sittings does it take?

Ideally in one sitting, 1500-2000 hair follicle units are transplanted into an individual. Depending on the areas of hair loss a patient is desirous of getting treated,1-3 sittings can be required for complete hair coverage.

What is its recuperation time?

In ‘No Root Touch’, there are no long periods of downtime. You need about 3-7 days to recuperate. Most of our patients resume work by the 5-7th day. You can start working from home the next day itself.

What should one expect after surgery?

Swelling may occur (especially after your first transplant), usually on the forehead and usually beginning around day 2-4 following surgery. This usually resolves completely in 2-3 days. The patient is advised to sleep in a semi-reclining position for 2-3 days after surgery. Few patients may experience minor symptoms like itching, and decreased sensation (mostly on the top of the head), but rarely are a problem and resolve quickly.

What is its cost in India? Also, are there any recurring costs?

The cost of treatment is variable as it depends on the number of follicle grafts done in a patient. The hair transplant procedure does not have any recurring cost as it is a one-time treatment with long-term results.

Who is the right target audience for this treatment?

The right audience for FUE is listed below:

• Ideally patients with age 30 years and above are excellent candidates for hair transplant. An early age between 25 to 30 yrs the doctor will decide on an individual basis whether it can be done or not.
• Individuals with inadequate response to medication.
• There has to be sufficient donor area in the individual and average hair calibre of the donor graft. This can be decided by the treating doctor.
• Individuals looking for frontal hair loss or hairline recreation.
• Individuals with temporal hair loss or complete hair loss on the top and crown area.
• FUE is also done for correcting a poorly transplanted area from the past transplants
• Body FUE hair transplant is also done in areas like beard, moustache, eyelash, eyebrows etc. if the growth is sparse and affects the cosmetic appearance.

Who is not a good candidate for this treatment?

Individuals with large bald areas with very small poor donor areas are not good candidates for FUE. Again individuals with unrealistic expectations of the results are not eligible for this treatment.FUE or any form of hair transplant is also not done in individuals with excessive scarring tendencies.

How different is this treatment from a Non-surgical hair transplant?

There is no such thing as a non-surgical hair transplant. Any hair transplant is a surgical procedure. The advantage of ‘No Root Touch’ is it is a minimally invasive hair transplant procedure. There are other non-surgical hair growth treatments such as PRP however their results are different and not comparable to a hair transplant.

Right age of getting this treatment done?

Anyone above 18 years can opt for a ‘No Root Touch’ hair transplant. However, the recommended age is for individuals who are 30 or above age.

What are the top 3 advantages and top 3 disadvantages of this treatment?

The top 3 advantages are it is scarless, and sutureless surgery. Hence there is no visible linear line scar after ‘No Root Touch’ unlike other hair transplant methods. There is less discomfort and faster healing in ‘No Root Touch’. Another top advantage is it is possible to take hair from other body areas like the chest and beard in case the scalp donor area is poor.

The top 3 disadvantages of ‘No Root Touch’ is it can time consuming and expensive. It requires scalp trimming for larger harvesting. At a time multiple balding areas cannot be done in a single sitting so requires multiple sittings.

What causes dark circles?
The common cause of dark circles is hereditary wherein you inherit the tendency to get dark circles as early as childhood and it generally responds poorly to any treatment. Sun exposure is another common culprit causing dark circles.
Dark circles can be only pigmentation or caused by damage to underlying blood vessels. The blood vessels under the eyes are very fragile and easily break on the insult of any kind whether it is internal or external factors. Once the blood vessels break or leak, the pooled blood shows a purple colour or darkish hue. Loss of volume and fat pouching under the eye with age can also worsen or make hollows under-eye prominent. Other causes are lack of adequate sleep, erratic sleeping patterns, stress, frequent cosmetic use, frequent eye rubbing, and vision issues like myopia not being detected on time.

Do certain beauty habits (for example, not taking off kajal before sleeping at night) leads to increased dark circles?

Few of the daily beauty habits can unknowingly aggravate dark circles.
• Not removing your eye makeup properly or sleeping with eye makeup on. This can lead to dryness and irritation around eyes.
• Sunexposure – regular daily sun exposure, even for a short time specially in the peak 12-4 hours, can lead to damage of skin around eyes and worsen dark circles.
• Smoking worsens dark circles because of nicotine, it hampers sleep and adds to dark circles.
• Wrong application of eye serums –the skin around eyes is delicate and the small capillaries easily break on trauma. Massaging or rubbing the eye area too much or incorrectly while applying the eye creams or serums can lead to rupture of tiny blood vessels and worsen the bluish hue under eye.

What beauty regimen should I follow to avoid premature dark circles?

• From the mid-20s start using a good moisturizing eye cream containing vitamin Carotenoids, hyaluronic, seaweed extracts, active peptides, Q10 coenzyme, etc. These ingredients reduce puffiness and dark circles.
• It is important to use sunscreen daily on top of the eye cream and to re-apply every 3-4 hours, to prevent sun damage which is one of the foremost causes of eye ageing.
• Wear sun-protecting shades which have UVA & UVB protection when outdoors.
• Also avoid consuming salty foods and alcohol late at night as it will worsen the eye bags and dark circles.
• Ensure a good 6-8 hours’ sleep preferably from 11 pm-7 am as it balances your stress hormones and reduces dark circles.
• Sleep with your head slightly elevated to reduce puffiness when you wake up.

What beauty treatments should I avoid?

Beauty treatments when done properly and professionally do not cause undereye issues. The most common error is steaming of the eyes during facials as it can cause dryness and irritation. Make sure you cover your eyes with wet cotton pads before any steam on the face. Eyelash extensions is another popular treatment that can go wrong or worsen skin issues under the eye when not done with professional or cheap quality products are used. In case eye peels are done for dark circles, ensure you do it with a certified dermatologist to avoid skin burns and worsening of pigmentation under the eye.

What treatments can be safely opted for to control dark circles?
What’s the best way to treat dark circles?

The first step is to determine whether the dark circles are caused by pigmentation or damage to underlying blood vessels. A simple trick is to press the skin under the eye. When the skin colour remains unchanged it is pigmentation due to hereditary or sunlight and in case it reduces on pressure, it is mainly due to damage of underlying capillaries. In case it is pigmentation under eye (discolouration will be more brownish or blackish hue), choose creams containing kojic acid, licorice, sabiwhite, niacinamide and Vitamin C. The other treatments done by dermatologists are that are done are fruit acid peels under the eye. The sessions are done once in 15 days, results are seen starting from first session and about 3-4 sessions are required for good results. The Yavana Radiante eye treatment is a popular treatment that utilizes TriPollar radiofrequency to drain the under toxins, improve oxygenation and reduce puffy eyes. Fractional Q-switched laser Helios III and the Fraxis Duo are other laser technologies used to reduce dark circles.

In case the underlying blood vessels are damaged (discoloration will be more purplish hue), use creams containing retinoids and hyaluronic acid to build collagen and elastin under eye and minimize eye irritation. Dermal fillers like Juvederm under the eye are more helpful to conceal and reduce the dark circles in such cases. Dermatologists deposit the filler in the hollows under the eye to improve the fatigued appearance. Results are immediate, only one session is adequate and lasts for 10-12 months. High intensity Focussed Ultrasound therapy such as Ultra former and Ultherapy is a newer treatment to reduce under eye puffiness and fine lines under the eye. Single session is required, results take about 1-3 months and last upto 6-9 months.

What’s the best way to disguise existing dark circles?

Concealers are the best temporary fixes for dark circles. Use a cream based concealer under the eye. Choose a colour according to the skin discoloration. For a purplish or bluish hue, choose a yellow or peach colour concealer. For a darkish black discolouration use a skin colour matching concealer. Apply a light weight moisturizer and primer as base and then apply the concealer.

Are there any home remedies that can be used to treat the same?

There are many home remedies that can be used to temporarily reduce dark circles.
• The best quick fix is apply cold pack, or chilled tea bag and if nothing is available chill your teaspoon in the freezer and apply it to the eyes. This will immediately relieve your puffiness and the eyes look fresh.
• Grate potatoes and apply the grated pulp around eyes for 5-10 minutes. This can be done at least 1-2 times a week.
• Rose geranium, lavender and chamomile essential oils few drops can be mixed with coconut oil and rubbed around eyes regularly to reduce dark circles.
• Mix a paste of buttermilk and turmeric, apply it around eyes and wash it off after 10 minutes with cold water.
• Have a diet rich in Vitamin A, C and antioxidants.