Ask the Doc
Dr. R. Murlidhar, Consutant Dermatologist, Apollo Hospital, Chennai, replies to this week's queries:
I am a 21-year-old engineering student. My problem is dark circles below my eyes. This becomes quite bad during exam time. Even otherwise the dark patches are quite visible. My skin colour is fair but these dark circles make my face look bad. Why is this happening and what can I do to get rid of it? Abhinav Pabby
Answer: Dark circles around the eyes are probably the most common complaint. These are actually quite normal and are not an increase in pigmentation. Hence depigmenting creams do not work. Sludging of blood flow in the veins below the eye usually causes them. This is worsened by stress and sleeplessness. As the skin there is thin, the colour looks dark.
Gentle massage with a moisturiser itself should help relieve this problem. Exercise, sleep, multivitamins also help.
If all fail, there are specific drugs available that your dermatologist can prescribe.
I AM 41. I suffer from severe itching all over the body. Big patches of the skin also swell but subside after some time. I was told it is Urticaria. But no medication seems to help. Is there a permanent cure for this problem? Narshiman
Answer: Transient itching of the skin with reddish patches, which disappear in some time, is called urticaria.
If it is less than six weeks in duration, we call it acute Urticaria; more than six weeks old it is chronic urticaria.
In the acute stage, it is usually possible to find the underlying cause and treat it. This may be an infection, a drug, insect bite or even an underlying disease. In chronic cases, one may not be able to find a cause but your doctor will have to look for one nevertheless, especially thyroid related and autoimmune causes.
Even if a cause is not found, a controlled use of antihistamines so that a good blood level is maintained for at least six to 10 weeks, helps most patients get rid of the problem. Sometimes doctors combine different types of antihistamines.
The bottom line: the antihistamine used should not interfere with your daily life. Hence new generation drugs, which are non-sedating, are used. So don't get frustrated. Discuss these issues with your doctor, and get the right help.
I am 22years old and have been suffering from psoriasis for about five years now (in my knees, elbows and legs). I have tried ointments like Dermovate and ternovate but it keeps recurring. Is psoriasis curable? What can I do to lessen the chance of recurrence? Jane Wambui
Answer: Psoriasis occurs because the cells in your skin divide too fast and produce patches. The stimulus comes from the body's own immune system. If the patches are limited to the joints or frictional areas, it should not be a problem to get rid of the disease.
At present the creams you are using are purely steroid-based and hence target the inflammation alone. This will lead to recurrence whenever you stop the cream. Try using these creams only once or twice a week, and use ointments like calcipotriol, which have a direct effect on cell division daily.
In addition, use a moisturiser everyday, even if you don't have any patches. This will help reduce the chance of recurrence too.
I am a 44-year-old male, keeping good health. I am a non-smoker. A dark-coloured patch (about 2 inches in diameter) appeared on my back about one and a half years back. Sometimes I get a tingling sensation at that spot, but there in no itching, nor any pain. On January 1, 2005, I had a sebacious cyst surgically removed from my back, about six inches above, and two inches to the left of the dark patch. The biopsy of the removed cyst did not show any malignancy. I have no reason to feel that the black patch is related to the surgery, except that the patch appeared some six months afterwards. Though I am in no way bothered by the dark patch, I am worried that it could be a symptom of some other problem like skin cancer. Please advise. Ashok
Answer: I do not think that the patch has anything to do with the cyst that was removed but I cannot judge unless I see you.
Skin cancer also does not usually present like this. However no dermatologist will stick his neck out without seeing the patient.
It is likely that you are suffering from a very harmless condition called notalgia paresthetica but please see a dermatologist. Notalgia paresthetica is easy to treat.
Readers can send their medical queries to Ask the Doc, Magazine, The Hindu, Kasturi Buildings, 859-860, Anna Salai, Chennai - 600 002. Or e-mail: askthedoc@thehindu.co.in
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