Skin drugs being sold as bleaching cosmetics

Some unscrupulous traders are making a kill through selling wrong bleaching agents to unsuspecting Ugandans.

The Sunday Monitor can reveal that some of the drugs meant to be strictly sold by hospitals and licensed clinics for the treatment of skin diseases, are now being promoted by traders as cosmetics that can lighten dark skin.

For instance, creams such as Diproson and Betasol can now be found in local shops in the country.

Dr Sam Opio, the Secretary Pharmaceutical Society of Uganda, said the creams are “only supposed to be used under prescription of a doctor for the right quantity and duration for it to be applied”. The medical officer said these creams were used to bleach leather material.

Kikuubo flooded with cosmetics
This newspaper found these creams in cosmetic shops around Kampala being sold by shopkeepers. They were found in nearly all cosmetic shops in Kikuubo, a retail corridor in Kampala, and also in some suburbs like Namuwongo. Diproson cream goes for Shs1,500 while the liquid one costs Shs2,500. Betasol, on the other hand, was a little more expensive at Shs3,000.

The low prices mean a better part of the population is able to access these creams and use them. In fact, Betasol was scarce because stock had run out, according to the shopkeepers.

However, abuse of these drugs can cause the skin to crack, exposing one to several skin disease and even cancer.

“These drugs being steroids are anti-inflammatory and are supposed to be prescribed for skin rushes, itchiness or irritation. Using steroids without specification lowers the body’s immunity system as some of them are absorbed into the skin and lowers its ability to fight infections,” Dr Opio said, adding, “For example, even a simple cough may refuse to go away or take very long to cure.”

Other harmful ingredients in skin products that people should be aware of, according to Dr Opio, include; Mercury and Hydroquinone. These have been linked to blood diseases, muscle weakness, acne and many other skin disorders.

Although not qualified to give prescriptions, shopkeepers go ahead to give instructions on how to use the creams, well aware of their bleaching aspect. One shopkeeper, without specifying the quantity, for instance, said a reasonable amount of liquid Diproson can be mixed with ordinary lotion to achieve a desired lightening effect. Another told this reporter to first apply a layer of diproson tube on the skin before applying any other lotion to get good results.

According to the Uganda Revenue Authority Enforcement Performance report for July to December 2012, some 2,448 tubes of Diproson and Betasol creams have been intercepted in the past two years.

Leaflets of the two creams indicate that they are supposed to be used to treat Eczema, Psoriasis, Lichen simplex, contact dermatitis and other skin diseases.

A source at National Drug Authority said they at times ambush these retailers in Kikuubo and impound the cosmetics but are currently looking for their suppliers.

http://www.monitor.co.ug/News/National/Skin-drugs-being-sold-as-bleaching-cosmetics/-/688334/1682828/-/7a1aiz/-/index.html

Uncommon skin disease has no uniformly effective treatment

Very often we are too uncomfortable to ask our healthcare providers questions about our own health. Sometimes we ask the question and do not understand the answer or don't want to challenge the answer given. Recognising this, Body & Soul has partnered with Johns Hopkins Medical Centre to provide you with answers to questions you have about your health.

If you have such questions please e-mail them to gazettehealth@yahoo.com and we'll have an expert from Johns Hopkins answer it.

Body & Soul will feature a question with its answer once a month. To protect your privacy no names will be published.

The question for this month was answered by Ginette Hinds of the Department of Dermatology at Johns Hopkins Bayview Medical Center. Dr Hinds was assisted by Natalia Vlassova of Johns Hopkins Mercy Hospital.

Q: I often develop boils in my armpits and groin area. I have no idea why this happens. I thought it might be because I am overheated, but the boils occur even in cold weather. What causes them?

A: The boils in your armpits and groin area are most likely the result of an uncommon skin disease called hidradenitis suppurativa, an inflammatory skin condition that usually begins after puberty and is more common in females than males. HS is characterised by frequent boils in the places you mention, and also on the buttocks, and they tend to leave scars. The boils can be very painful as they enlarge, but once they “come to a head” and leak their contents, the pain subsides. Some people with HS also have severe acne, cysts on other areas of the skin and painful boils on the scalp.

Q: What causes HS?

A: HS is caused by inflammation of the hair follicles that reside deep in the skin. Although scientists do not yet know exactly why this inflammation occurs, they do know that HS can run in families, and that obesity, sweating, smoking and stress can aggravate it. HS is not caused by poor hygiene, and it is not contagious.

Q: How can you prevent HS flare-ups?

A: There is no cure for HS at this time, but here are a few things that can help minimise the frequency and severity of the boils:

l Stop smoking

l Lose weight

l Avoid tightfitting clothing, antiperspirants and shaving if you notice that they incite flare-ups of the condition.

Q; How is HS treated?

A: There is no uniformly effective treatment for HS, and physicians will likely try different therapies depending on the severity and extent of disease.

Common treatments may include hot compresses applied to the boils; antiseptic washes with chlorhexidine or benzoyl peroxide, topical and systemic antibiotics, zinc supplements, steroid injections into the boils, laser hair removal and surgery to remove the boils.

HS can be debilitating and can cause embarrassment and social isolation. It's important to discuss symptoms and treatment options with your physician. There is still a lot to be learned about this disease, and several research studies are being conducted by Dr Hinds. Johns Hopkins Bayview also hosts a HS support group that meets three to four times a year. For more information on the support group meetings e-mail stovecat@yahoo.com.

http://www.royalgazette.com/article/20130129/ISLAND05/701299999

Sensitive skin problems aren't skin deep

SINGAPORE: Most might assume that sensitive skin is mainly due to in an intake of the wrong food, or the application of the wrong product. However, the main reason for sensitive skin lies on the surface of the skin, and what that layer is subjected to from the daily environment. In a sensitive skin survey held by Curél, the dermatological research oriented brainchild of Japanese chemical and cosmetics giant Kao, almost half of the respondents from various countries claimed to suffer from sensitive skin. And within this number, Singaporeans make up a whopping 70 percent. Part of the reason lies in Singapore's tropical climate –from wet and rainy, to sunny but humid – coupled with hours spent in drying air-conditioned environments whether at work, home or even shopping. More precisely, as explained by Curél's skincare expert Koicihi Ishida, skin in the Singapore environment is subject to "enhanced blood circulation and skin dryness due to the rapid change of the temperature and humidity within a short time frame". "At high temperatures and humidity, skin cells swell when sweat is produced, reducing the skin's barrier function" he explains. "On the other hand, low temperatures and a humidity level of 50 percent or less will cause the skin's moisture to decrease directly and become dry. Either way, the skin becomes sensitive and easily irritated." In other words, the root of the problem of sensitive skin isn't skin deep. In fact, it lies with the outermost layer of the skin, known as the stratum corneum (SC). It is the first barrier between the skin and the external environment, and offers protection to the underlying tissue from infection, dehydration, chemicals and physical stress. The top layer stratum corneum is largely held together by ceramide. According to Curél, about half of all sensitive skin cases is due to the SC's impaired function, making it the main cause, as well as solution, to various sensitive skin conditions. As skin expert Ishida points out, sensitive skins possess low levels of ceramide, a key element in the SC. In developing a skincare range that targets sensitive skin, Curél therefore focused its attention on ceramide and replenishing the skin's supply of this intercellular lipid. Tackling the problem from within also helps, with an intake of naturally occurring ceramide in food stuffs such as soya beans, spinach, rice, wheat flour and the high-fibre, jelly-like konjac or konnyaku, as the product is known in Japan where it's often served in oden or as noodle strips. Ceramide works by fusing with the skin's moisture and oil to prevent moisture loss while holding skin cells together, similar to a brick and mortar structure that creates a barrier function for the SC. With ceramide care, sensitive skin is directly treated to improve and replenish the impaired SC barrier which will in turn suppresses the sensitive symptoms and conditions, making the skin more resistant to external irritants. But this is not a one-hit, one-week solution as the experts will point out. The newly recovered skin can revert to its troubled state without proper maintenance, or in the case of more serious skin conditions such as atopic dermatitis, where ceramide drops to its original low state. The Curél skincare range for sensitive skin runs a gamut of applications, from face and body to scalp and hair, and everyone from adults to babies, are supposed to be able to use the products. How could so that be so? "Although the two skin types may differ in thickness, appendices and sensitivity, the fundamental structure and function of the skin is common for the young and old of both sexes," explains Ishida. "For the elderly, they have dry skin due to old age and it's usually accompanied with itchiness, which can be seen especially on the lower thigh area. In many cases, their SC's barrier function is damaged." The same concept of reinforcing the SC's protective function applies to babies and the young, as the risk of sensitive skin is in fact higher in the young, than when a person ages. "After birth, a baby's skin tends to be influenced by the environment and thus its skin condition might worsen as it is naturally delicate and sensitive," Ishida points out, while adding that "it is proven by the mild skin care from an early stage that a baby can maintain the healthy skin after growing up." "Therefore, it is important to have a skincare regime from an early stage to prevent skin issues during their growing up process" he advises. So even if you don't suffer from sensitive skin, there's little reason not to protect your skin the way it has been protecting you all this while. -CNA/fl

Darier's Disease

What is Darier’s disease?
It is a rare inherited skin condition, in which the skin in certain areas develops large numbers of small brownish warty bumps.
What causes Darier’s disease?
In the outer layer (epidermis) of normal skin, the skin cells are held together like bricks cemented in a wall. In Darier's disease the sticky junctions that hold the skin cells together are not made properly, and the skin may become scaly or lumpy or even form blisters.  It is not due to an allergy and it is not contagious (catching).
Is it hereditary?
Yes. It runs in certain families, being inherited in a pattern known as dominant inheritance. This means that there is a 1 in 2 (50:50) chance that each child of an affected parent will inherit the condition. It affects both men and women. Its severity may vary considerably within a single family; and if a person is badly affected it does not necessarily mean that other family members who inherit the condition will also get severe disease.
What are the symptoms of Darier’s disease?
Itching is very common.  The affected skin may smell unpleasant, particularly in moist areas. This is probably caused by increased numbers of ordinary skin bacteria growing in the affected skin. The appearance of the rash, and its smell, can be embarrassing.
A quarter of patients notice that the condition improves as they get older. Some people find that the sun causes their Darier’s disease to flare up. Some women notice that it worsens around the time of their periods.
What does it look like?
The first signs of the condition usually appear somewhere between the ages of 6 and 20. Little brownish, rough-topped bumps develop on the skin. The severity of the condition varies a lot and is unpredictable. The rash is often on the chest, neck or upper back at the start but warty bumps may occur on any part of the body including the skin creases and skin under the breasts. It is unusual for people to have much trouble on the face except for the skin on the forehead near the hairline.
The fingernails are usually affected. They tend to be rather fragile, split easily and look as if they have been bitten or appear dirty. There may be very obvious long red or white lines running the length of the nails. Nail changes and/or flat "warts" on the backs of the hands are often present in childhood, well before there are any other skin changes. Pits or small areas of hard skin occur on the palms of the hands and less often the soles of the feet. Occasionally there may be small spots inside the mouth and these may give the roof of the mouth a rough feeling.
How will it be diagnosed?
The diagnosis can often be made on the appearance of the rash and the fact that it runs in families.  To confirm it, a small sample of skin (a biopsy) can be removed under a local anaesthetic and examined under the microscope in the laboratory.
Can Darier’s disease be cured?
No, there is no cure, but there are many ways of helping it.
For information about available treatments please visit this page on the website of the British Associaton of Dermatologists

 http://www.britishskinfoundation.org.uk/SkinInformation/AtoZofSkindisease/DariersDisease.aspx

Hailey-Hailey disease

What is Hailey-Hailey disease?

 

Hailey-Hailey disease is also known as familial benign chronic pemphigus. It is a rare inherited skin condition, in which red scaly areas or small blisters appear at sites of friction.

 

What causes Hailey-Hailey disease?

 

A small error in the DNA code for a gene on chromosome number 3 (one of the 46 chromosomes that we all have) has been shown to cause Hailey-Hailey disease. Normally this gene plays a part in ensuring that the cells in the outer layer of the skin (the epidermis) stick together properly. In Hailey-Hailey disease, this adhesion of cells is impaired, resulting in separation of the cells in the epidermis, especially in areas of skin prone to friction such as the groin and under the arms. The altered gene runs in families and affects both men and women. Hailey-Hailey disease is not contagious, or a result of allergies. There is a tendency for Hailey-Hailey disease to get worse with sweating and friction, as well as in hot weather.

 

Is Hailey-Hailey disease hereditary?

 

Yes – see above. The condition is inherited in a pattern known as 'dominant inheritance', which means that there is a 1 in 2 [50:50] chance that each child of an affected parent will inherit the skin problem.

 

What are the symptoms of Hailey-Hailey disease?

 

Affected skin may become uncomfortable and itchy if the skin surfaces are continually rubbing against each other, such as in the groin when walking. Outbreaks tend to settle down in a few days with appropriate treatment (see below), and may improve without treatment. Very rarely, a severe flare-up in an area such as the groin, genital area or in the crease of the buttocks may make walking and working so uncomfortable that a patient might need a few days rest.

 

What does Hailey-Hailey disease look like?

 

The first signs of the condition usually appear between the ages of 15 and 40 years, but it may begin outside this age range. The severity varies enormously and is unpredictable. Red, scaly areas or small blisters appear at areas of friction, especially at the sides of the neck or in the skin folds under the arms, the groin or under the breasts. The skin looks entirely normal inbetween active episodes, and does not scar. Many patients notice that their condition improves as they get older.

 

How will Hailey-Hailey disease be diagnosed?

 

It is very common for the condition to be mistaken for eczema, contact dermatitis (due to an allergy), a sweat rash, a fungal infection or impetigo (a bacterial skin infection). If required, the diagnosis of Hailey-Hailey disease can be confirmed by examining a sample of the skin (a biopsy) under the microscope.

 

Can Hailey-Hailey disease be cured?

 

No. The underlying genetic defect cannot be altered; however, treatment does help and long remissions are common.

 

For further information about Hailey-Hailey disease please see this page on the website of the British Association of Dermatologists

 

http://www.britishskinfoundation.org.uk/SkinInformation/AtoZofSkindisease/HaileyHaileydisease.aspx

Skin diseases on the rise

THERE is an increase in the number of people suffering from various forms of skin diseases in Fiji.

And the Ministry of Health has called on members of the public to take extra care of their personal hygiene.
The ministry deputy secretary for Hospital Services Doctor Metuisela Tuicakau confirmed the PJ Towmey Hospital in Tamavua — the only hospital providing specialised treatment for skin diseases — has been inundated with patients.
"Doctors here at the hospital see more than 2000 patients per month presenting themselves with various forms of skin diseases," Dr Tuicakau said.
He said skin diseases on the rise were fungal infections, bacterial infections, dermatitis and Eczema.
"The skin diseases are not only affecting children but adults as well but more are commonly found in children from one week old to two weeks," Dr Tuicakau said.
He said the risk factor of the increase in skin disease was that it could severely affect people with diabetes and high blood pressure. Dr Tuicakau said the quickest and safest care for skin disease was observing proper hygiene.
"People are advised to use soap and water to wash their skin," he said.
Dr Tuicakau said with Fiji currently experiencing hot weather conditions, people were advised to wear clothes that kept heir body cool.
He said it was also important to take care of one's diet and advised people to consume a lot of vegetables.
"If the sickness is getting worse and cannot be contained at home then those affected should immediately seek medical assistance," Dr Tuicakau said.

http://www.fijitimes.com/story.aspx?id=223738

Home Editions Queenswide Skin Cancer Treatment without surgery: Cut-less Dermatology

osted: Thursday, January 17, 2013 10:30 am | Updated: 9:52 am, Fri Jan 18, 2013.

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According to the Skin Cancer Foundation, one person dies from skin cancer every hour in the United States — a good reason why everyone should schedule regular skin examinations. But you may ask, how do dermatologists know when a skin growth or mole needs to be removed?
In the past, every worrisome skin lesion required a biopsy, meaning a small piece of tissue was surgically removed and sent to a pathology laboratory. If the biopsy showed cancer, additional surgery was needed. Even today, surgical biopsy and removal continues to be the standard of care for skin cancer. Fortunately, we have newer techniques that enable us to not only catch skin cancers earlier but also to help us prevent unnecessary biopsies. Total body photography, digital dermoscopy mole monitoring as well as handheld dermoscopy lesion evaluation are some examples of this vital technology. Dr. Orit Markowitz speaks around the globe on these topics and each year directs the Mount Sinai Greater NY Dermoscopy course for dermatologists in the New York and New Jersey area who are trying to hone in on these new important diagnostic tools.
How we approach skin biopsies and cancer surgery is therefore changing for the better. There are even newer devices being developed each year and Dr. Markowitz is at the forefront. An example of the most recent laser tool is called Optical Coherence Tomography (OCT). Dr. Markowitz, a pioneer in OCT research, recognizes its potential to eliminate the need for surgery in many cases. Dr. Markowitz is the Director of Pigmented Lesions and Skin Cancer at Mount Sinai, and she is also the newly appointed President of the International Optical Coherence Tomography Society.
“An important component of OCT is the laser’s ability to take live black and white pictures of deeper skin layers. By combining this technology with other lasers, I am discovering successful ways to both diagnose and treat skin cancer bloodlessly,” said Dr. Markowitz. The earlier a skin cancer is caught, the better the prognosis and outcome. Dr. Markowitz, through the use of non-ablative lasers, has been able to successfully treat — without cutting — both early and even more advanced non-melanoma skin cancers. Non-melanoma skin cancers are not as deadly as melanoma but they are the most common type of cancer and frequently occur in cosmetically sensitive areas such as the face. The possibility of using noninvasive lasers to both diagnose and treat without cutting is very appealing.
Among the advantages of OCT are improved comfort, greater convenience and less scarring. Dr. Markowitz’s research has enabled Mount Sinai to become the country’s leading center for the development and use of OCT.
According to Dr. Markowitz, “I’ve also found OCT to be useful for benign skin growths, thus preventing the need for unnecessary biopsies.” She notes some examples: harmless moles, warts, hemangiomas, seborrheic and actinic keratoses and cysts. Other dermatological diseases that can be diagnosed with OCT include psoriasis, scabies, and blistering diseases.
Dr. Markowitz currently offers OCT and other noninvasive diagnostic techniques to patients at the Mount Sinai Doctors Faculty Practice.
For more helpful tips from Mount Sinai dermatologists, visit the Faculty Practice website:
http://www.mountsinaifpa.org/patient-care/practices/dermatology and view the seasonable Skin Health Newsletter publication.

http://www.qchron.com/editions/queenswide/skin-cancer-treatment-without-surgery-cut-less-dermatology/article_3acfeb34-b89f-52fd-b247-da21c3e5bd99.html