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Creams should be applied just enough to cover the affected area. Generally, creams are applied twice daily and the best time is soon after a shower or bath. Use the one finger tip unit (FTU) to help you determine the amount of cream required.
| Affected Body Area | Quantity of Cream/Ointment to Use for Adults |
|---|---|
| Both sides of one hand | One fingertip unit |
| One foot | Two fingertip units |
| One arm | Three fingertip units |
| One leg | Six fingertip units |
| Chest and Abdomen | Seven fingertip units |
| Back and Buttocks | Seven fingertip units |
For larger areas of involvement, use the following guide:
Psoriasis is a common skin condition that affects about 1%-2% of the world’s population. In Singapore, it appears to be more common among the Indians than the Chinese or Malays. It affects both sexes equally and can occur at any age, especially under the age of 35. The prevalence varies between countries and race.
Psoriasis often presents as well-defined salmon red plaques covered with silvery scales on the elbows, knees, shins and lower back. Many patients also have scalp involvement presenting as a bad dandruff. Sometimes, there may be joint pains or changes in the nails. Psoriasis tends to come and go with varying severity.
It appears that psoriasis occurs when the immune system sends out faulty signals that speed up the multiplication of skin cells, causing thickening of the affected skin. The pro-inflammatory signals also cause dilatation of the blood vessels in affected areas giving the red colour that we see.
Psoriasis is not contagious i.e. you cannot catch psoriasis by being near to someone with psoriasis.
It has been shown that psoriasis is associated with the metabolic syndrome including heart disease, hypertension, diabetes mellitus and gout.
It is believed that psoriasis is a genetic or hereditary disease although not everyone with psoriasis has a family history. How it is inherited is not clearly understood. In susceptible individuals, psoriasis appears after an outside event or trigger occurs, e.g. infection, injury to the skin, stressful event or certain medication
Treatment depends on the type of psoriasis, age of the patient, the extent of the condition, whether the joints are involved and the preference of the patients. The following are the various methods of treatments.
AD is an allergic and inflammatory skin condition that results in eczema. It is characterized by intense itch, eczema in facial location in infants and in flexures in older children and adults. It tends to be recurrent or chronic relapsing.
In AD, the primary defect is the dysfunction of the skin barrier. This allows environmental inflammatory stimuli, allergens as well as bacteria to enter the skin and promoting inflammation which results in eczema. Stress can worsen the skin and cause itching. Scratching damages the skin further and allows more inflammatory stimuli to enter and worsen the eczema.
Not all white patches are vitiligo. In children, eczema on the face can also cause a lightening of the skin colour. Bring him to a dermatologist for diagnosis and advice on skin care.
First, you need to find out the cause of your itch. If necessary, you may need to change the things you use or your lifestyle. Not all itchy rashes are due to allergy. Allergy tests are only useful in special circumstances, and different allergy tests are suitable for certain conditions. Get your doctor’s advice on this.
Hair fall can be due to many reasons. It may be caused by a recent illness or after delivery of a baby, it may be related to the general health of the individual, or it may be familial in origin. Only by seeing the doctor can the doctor help to decipher the problem and advise on the appropriate treatment.
Although it is more common for pimples to start at adolescence, pimples can occur in babies and may have a late onset in adult-onset acne. There are various reasons including hormonal change and the use of cosmetic products that may exacerbate the problem. Pimples can be treated at any age and the treatment depends on the severity and the lifestyle of the patient. Common treatments include the use of creams, lotions or gels, oral antibiotics, oral contraceptives or isotretinoin. A consult with the doctor will help to address your specific issues.
Chemical peels can be used to treat a variety of conditions, e.g.,
1. Acne, to reduce inflamed lesions, loosen and reduce white and black heads. It can be used to compliment the creams or tablets used to treat pimples.
2. Sun-damaged skin, to remove the sun-damaged outer layers, thus making the skin smoother.
3. Minimize wrinkles.
4. Pigmentation where the use of chemical peels enhances the lightening effects of lightening creams.
A chemical peel is the use of certain acids or chemicals to cause the peeling or exfoliation of old or damaged skin, thus allowing the new skin to grow or to rejuvenate. It may stimulate new collagen to form. This results in an improvement of the skin texture and skin tone resulting in a glow.
Phototherapy is the use of light to treat diseases.
Narrowband UVB phototherapy is the use of a specific wavelength (311 nm to 312 nm), in contrast to broad band UVB (290 nm to 320 nm), to treat certain skin diseases. Narrow band UVB has been shown to be more effective than broad band UVB in the outcome of the treatment with shorter and less exposure times.
Narrow band UVB is used to treat skin conditions like psoriasis, vitiligo, atopic eczema, pruritus, polymorphous light eruption, cutaneous cell lymphoma and lichen planus.
The treatment involves standing in a specially designed light cabinet with tubes emitting UVB light. The patient is undressed and stands in the centre of the light box with his eyes and face protected. Light is emitted and the treatment last for a short time from seconds to minutes. Treatment is usually given at least three times a week at the beginning and for maintenance, the treatment frequency is reduced to once or twice a week. The amount of UVB delivered depends on the condition, the skin type of the patient, and other factors.
Side effects are not frequent and tend not to be severe. There is a possibility of getting a burn, like a sunburn and the skin condition may sometimes get worse in the initial part of the treatment. Long term exposure can cause skin ageing and increase the risk of skin cancer just like prolonged exposure to sunlight.