Dermatology

Skin is the largest organ in the human body, providing protection to the body from external factors such as sunlight, germs, and injuries. Globally, skin disorders are considered the fourth prevailing cause of human illness, impacting 30–70% of the world’s population. It is noted that the majority of people experience some type of skin problem at any stage of their life, spanning from infancy to old age, making it one of the primary intentions for obtaining medical advice.

What is dermatology?

Dermatology is a specialised branch of medicine focusing on the comprehensive study, diagnosis, treatment, and management of conditions affecting the skin, hair, fat, nails, and associated tissues, including fat. The speciality involves multifaceted therapeutic approaches to address various disorders, from medical to surgical treatment, aiming to maintain and restore the health of these vital structures. The field of dermatology includes several subspecialties, including:

• Medical dermatology: This speciality focuses on diagnosing and treating skin conditions with medications

• Surgical dermatology: It involves surgical procedures to treat skin conditions, including the removal of cells of skin cancers, moles, and other skin growths

• Cosmetic dermatology: This branch deals with aesthetic procedures to enhance appearance with the use of several techniques, such as Botox, fillers, and laser treatments

• Dermatopathology: It combines dermatology and pathology to study skin diseases at a microscopic level

• Paediatric dermatology: It specialises in treating skin conditions in children.

• Tele dermatology: It uses telecommunication technologies to diagnose and treat skin conditions remotely

• Lifestyle dermatology: A new emerging field of Dermatology where focus is on treating the root cause of the disease and focusing on the holistic healing of human, hence preventing the recurrence and complications of skin diseases by working on all 6 pillars of lifestyle – Nutrition, Exercise, Sleep, Mental Health, No-harmful addiction and Social Support

Common causes of skin problems

• Bacterial, fungal and viral infection

• Genetic and autoimmune disorders

• Exposure to allergens and sunlight

• Exposure of allergic individuals to irritants or allergens

• Hormonal disease like acne

• Pigmentation like melanoma

The medical conditions present in the body might also contribute to skin problems, some of which include:

• Diabetes

• Lupus

• Inflammatory bowel disease

• Thyroid conditions

• Autoimmune conditions

• Cancers

Which diseases are treated by a dermatologist?

Dermatologists are specialised doctors who treat conditions affecting the skin, hair, and nails. Apart from treating skin conditions, dermatologists can also play a vital role in identifying underlying health issues. For example, a skin condition might be an early sign of diseases like diabetes or heart problems, which can manifest through changes in the skin. This ability to recognise early signs makes the intervention of dermatologists a necessary step for early detection and management of systemic health conditions. 

Common skin conditions treated by a dermatologist

Acne: Acne is the most prevalent skin issue that leads to pimples, blackheads, and cysts. It occurs when hair follicles become blocked with oil and dead skin cells. The primary causes include hormonal changes, bacterial infection, and excessive sebum production. 

Dermatitis or eczema: Dermatitis is the inflammation of the skin, resulting in a swollen, itchy rash. Atopic dermatitis, contact dermatitis, and stasis dermatitis are some of the types of dermatitis. Among them, atopic dermatitis is the most commonly occurring dermatitis that causes dry, scaly patches on the skin, particularly in children.

Fungal infections: Fungal diseases develop due to infection with some of the fungal species, and the most common infecting fungal type is yeast, such as Candida. The body areas that are affected can be the skin, the nails, and the hair. Common types include: 

• Ingrown nails: When the nail grows and protrudes into the surrounding skin, causing pain and swelling

• Fungal infections: An infection commonly affecting toenails, leading to discolouration and thickening

Hair loss: Hair loss can be hereditary or due to other medical problems. Androgenetic alopecia, known as male pattern baldness, is the most common type of hair loss. It can be induced by factors such as genetics and age. Other causes of baldness include depigmentation due to autoimmune disorders like alopecia areata, malnutrition, and lice infections, which predominantly affect children.

Cellulitis: This is a condition caused by a bacterial infection that affects the deeper layers of skin, causing swelling, redness, and tenderness of the skin. It also includes other symptoms, such as fever, chills, and fatigue. 

Warts: These are small, harmless tumours that appear on the skin due to the infection caused by human papillomavirus (HPV). They are aggressive and can spread through direct contact and may show up on any part of the body, like the hands, feet, and genital area. 

Nail problems: Nail problems are the result of infections, injuries, or underlying health problems. Common issues include:

• Ingrown nails: When the nail grows and protrudes into the surrounding skin, causing pain and swelling

• Fungal infections: An infection commonly affecting toenails, leading to discolouration and thickening

Vitiligo: Vitiligo is an autoimmune disorder wherein the immune system attacks melanocytes, the cells that produce melanin, which is responsible for skin colour. This condition causes depigmentation, and the skin becomes lighter than normal with light-pigmented areas. The exact cause is unclear, but genetic and environmental factors might play a role.

Psoriasis: This is a chronic autoimmune disease that induces a rapid growth of the skin cells. This leads to the formation of crusty and thick layers of the skin that can be red, purple, or silvery. Some of the common types of psoriasis are plaque psoriasis, guttate psoriasis, and pustular psoriasis. It is also a disease often linked to other illnesses, such as arthritis.

Rosacea: This is a long-term skin condition that causes facial redness, visible blood vessels, and sometimes pus-filled bumps on the face. It can also cause eyelids to sag and spread to other areas like the forehead and chin. Triggers include sunlight, stress, and certain foods or beverages. 

Shingles (Herpes Zoster): This condition is caused by the reactivation of varicella-zoster virus, which causes chickenpox. It presents with a painful rash that usually affects the body from one side. 

Skin cancer: This refers to the uncontrolled growth of abnormal skin cells. The most common skin cancers are melanoma and basal and squamous cell carcinomas. 

A dermatologist will carefully evaluate the symptoms and diagnose the condition accordingly. By completely examining medical history and understanding recent lifestyle changes of the patient, the dermatologist will check the skin in real-time and advise some diagnostic procedures that might include:

• Dermoscopy: This is a non-invasive technique wherein a handheld medical device called a dermatoscope is used to identify skin lesions.

• Patch testing: This test is used to detect skin allergies, wherein a patch containing allergens is applied on the skin to check for any allergic reactions. 

• Skin biopsy: Skin biopsies are invasive tests wherein a part of the skin is removed with a suitable biopsy tool. This test is mainly recommended to diagnose skin cancers.

• Culture: This type of test is used to detect a microbial infection that causes skin infection.

Signs and symptoms of dermatological problems

The signs and symptoms of dermatological problems can vary significantly with different conditions. However, the changes in skin texture do not indicate that the individual has skin issues, as skin changes can also be linked to environmental and other underlying conditions. Here are some of the general symptoms of skin disorders:

• Skin peeling

• Rashes with pain and itching

• Ulcers or open wounds 

• Red or white pus-filled bumps

• Rough or scaly skin

• Dry skin

Treatments

The treatment of different skin conditions varies and is decided by a dermatologist based on the severity and nature of the condition and patient-related factors. Here are some of the standard treatment approaches:

• Topical preparations: These are the medications that are applied to the affected skin area. Some of the formulations of topical preparations include ointments, gels, powders, lotions, moisturisers, creams, and oils.

• Topical and oral antibiotics: In certain cases of skin infections, oral antibiotics are prescribed along with topical medications to provide systematic treatment for a consistent flow of medications into the bloodstream. These oral antibiotics might include different class of antibiotics, such as antifungals and tetracyclines.

• Topical and oral retinoids: Retinoids are the derivatives of vitamin A used to treat acne and psoriasis. These medications are prescribed only for a short duration due to their side effects.

• Corticosteroids: These are the class of drugs used to reduce inflammation, redness, and itching caused by conditions such as eczema and psoriasis. 

• Immunosuppressants: These are the class of drugs used to treat an autoimmune disease affecting the skin and suppress inflammation.

• UV light therapy: UV light therapy is commonly used for psoriasis and vitiligo. It involves exposure to UV light under controlled conditions for a limited duration under the guidance of a doctor. UV therapy can reduce inflammation and promote skin healing. The three main types of UV treatment include PUVA, narrow-band UVB (NB-UVB), and UVA1.

• Laser therapy: Light therapy is another way to treat acne scars, wrinkles, and pigmentation disorders with the help of light beams. Different lasers are used to treat different skin problems. For example, the ablative lasers eliminate the epidermis layer of the skin to stimulate collagen and improve skin texture. 

• Mohs micrographic surgery: This is a type of surgical procedure that removes the skin layers to treat skin cancers. Further, the skin is examined under a microscope to check whether cancer cells are eliminated. This method is effective for the treatment of basal and squamous cell carcinomas. In India, this surgery is usually done by Oncosurgeons.

• Cryotherapy: This therapy employs a freezing process wherein extremely cold liquid nitrogen is utilised to freeze and remove skin lesions like warts and precancerous growths. This freezing process causes the affected cells to die and shed off. Cryotherapy is quick, minimally invasive, and often doesn’t require anaesthesia. 

• Cosmetology and aesthetic procedures: PRP, Lasers, Radiofrequency, Dermal Threads, Botox, Dermal Fillers etc.

Benefits of early intervention

Early intervention by dermatologists can offer numerous benefits for skin health. Here are some of the benefits:

• Dermatologists can identify signs of skin cancer, including melanoma, which can be life-threatening if not caught early. Regular check-ups can lead to early detection, treatment, and improved outcomes.

• Dermatologists can provide tailored treatment plans to control symptoms of conditions like eczema and psoriasis with an early intervention. 

• Early treatment of acne and skin infections can prevent complications such as scarring and bleeding. Dermatologists can recommend appropriate treatment regimens to reduce damage and promote healing.

• Dermatologists can provide personalised skincare advice on skincare routines and products, which help maintain healthy skin and prevent future issues. They can educate about skin health by providing tips to protect the skin and minimise future skin problems.

• Addressing skin issues at the right time can promptly improve the quality of life and boost self-esteem, enhancing confidence, which positively reflects on general health.

• Dermatologists can also suggest advanced treatments and technologies that are more effective and ensure better outcomes. 

How does team Fortis help you during your treatment journey?

The dermatology team at Fortis provides comprehensive care throughout the treatment journey. The team of experienced dermatologists at Fortis is skilled in diagnosing and treating a wide range of skin conditions, from common issues like acne to more complex disorders. Starting from initial consultation to devising a treatment plan, the team ensures that each patient who visits the hospital for consultation receives personalised and attentive care. 

Conclusion

Skin conditions are said to be common among many people. Recognising the signs and symptoms of skin conditions and seeking medical advice from a dermatologist is essential for early diagnosis and treatment as well as to prevent complications associated with a condition.