Doctor Murtuza is Dermatologist Doctor in Dubai and Specialists for Rashes. A rash is the term to describe a change in the skin that affects its color, appearance or texture. Rashes may cause the skin to become red, itchy, bumpy, dry, cracked, blistered, or swollen, and may be painful. Rashes can affect localized areas of the body, or may spread throughout the body.

Causes:
The causes of rashes vary widely. Symptoms of many rashes are similar, often making them a challenge to diagnosis. Because the causes are numerous, they are also often difficult to treat. Treatment will focus on relieving symptoms after a sometimes-estimated diagnosis. Often rashes will disappear on their own in several days, or may be relieved with simple lotions and creams.

If you suffer from a rash, Dr Bandukwala will try to determine the cause by asking questions about what you may have been exposed to and what your family health history entails.

Some causes of rashes include:

• Contact Dermatitis: Contact dermatitis refers to a variety of rashes that are brought on by skin contact with something that irritates the skin, or that causes an allergy. Rashes will generally appear within 48 of contact with the irritant.A common example of contact dermatitis is poison oak or poison ivy. These plants contain oil called “urushiol,” which evokes a rash-causing allergic response in 65-70% of the population. Other common materials causing rashes include: soaps, detergents, perfumes, cosmetics, jewelry, certain fabrics, or latex. Usually rashes caused by allergy or irritants only affect the area of the skin exposed to the rash-causing material. Symptoms generally include: inflammation of the skin, redness, small bumps, and itching. Treatment may involve avoiding the allergen that caused the rash, as well as using topical steroids, such as over-the-counter 1% hydrocortisone.
• Bacterial Infections: The most common bacterial infection is impetigo, which is caused by staph or strep germs. It is more common in children than adults, and is contagious. The rash may appear as small blisters or scabs, with swollen glands nearby. Impetigo is not serious, and may go away on its own. If not, prescription antibiotic ointment or oral antibiotics will be prescribed.
• Viral Infections: Viral infections such as herpes, shingles, or chicken pox, are contagious conditions that may produce a rash, generally characterized by red, itchy bumps all over the body. Patients with vial rashes will usually have other viral symptoms such as nausea, sneezing, and coughing. These infections usually last a few days to a week and go away on their own. Treatment is generally not necessary, but may include cream for itch relief.
• Fungal Infections: Final infections affect the skin and often cause rashes. For more information, see the section of the website “Medical Conditions” and click the “Fungus” link.
• Skin Conditions: Other types of skin conditions such as acne, hives, eczema, rosacea and psoriasis, may also cause rashes. See the section of the website “Medical Conditions” for more information about these diseases.

What is Psoriasis?
Psoriasis is a chronic, non-contagious, skin condition in which skin cells grow too quickly, resulting in thick, white or red patches of skin to form. Usually the skin cells grow gradually and flake off about every 4 weeks. As this occurs, new skin cells grow to replace the outer layers of skin as they shed. When an individual is afflicted with psoriasis, new skin cells move rapidly to the surface of the skin in days rather than weeks. This gives the appearance of the thick skin patches, or “plaques.” Plaques range in size, and most often appear on the knees, elbows, scalp, hands, feet, and lower back. Psoriasis can sometimes spread and lead to inflammation of the joints, which is referred to as psoriatic arthritis. 10-15% of people with psoriasis have psoriatic arthritis. Psoriasis is most common in adults, but can affect children as well.

The exact cause of psoriasis is unknown, but most doctors believe it occurs when the immune system overacts, causing inflammation and flaking of the skin.

Treatment:
There is currently no known cure for psoriasis. However, there are many available treatment options. Dr Bandukwala will help you determine which method is best for you. Treatment aims to slow the rapid growth of skin cells and reduce inflammation.

• Topical Medication: Treatment for mild psoriasis, or only a few patches, is usually treated with over-the-counter creams, ointments and lotions to keep the skin moisturized. Mild psoriasis of the scalp can be treated with shampoos and oils. For more severe cases, or when over-the-counter products fail, topical medications such as vitamin D compounds, cortisteroids, anthralin or retinoids may be prescribed.
• Phototherapy: Another availably treatment for psoriasis affecting less than 20% of the body, is phototherapy. During phototherapy, the affected areas are briefly exposed to intense ultraviolet A or B light (UVA, UVB). UVB treatment is completed 3 times a week, and when used in combination with medicine such as calcipotriene, is quite effective. Psoralen and UVA light therapy (PUVA) combines exposure to a chamber of UVA light with medication called psoralen to treat psoriasis. It must be completed for many weeks before symptoms will improve, but the results are generally better than UVB treatment. However, UVB treatment remains safer.
• Oral Medication: When topical medications and phototherapy do not effectively treat moderate to severe psoriasis, oral medication may be prescribed. Methotrexate, retinoids, or cyclosporine are all used to treat psoriasis. However, these drugs can have serious side effects, such as weakening the immune system, and liver or kidney damage, which is why they are generally reserved for more severe cases.
• Biologics: Biologics are medications similar to the proteins made by the body. They block the harmful response of the body’s immune system that causes psoriasis. Biologics are generally used for people who cannot use other treatment. They are generally as effective as other oral medications, but may have fewer side effects. However, the long-term safety of biologics is unknown. Therefore, for patients who require treatment their whole lives, Dr Bandukwala will likely recommend rotating or changing treatment periodically.

Prevention:
There is no way to prevent psoriasis, but you may be able to reduce flare-ups and improve symptoms by abiding by the following guidelines:

• Keep your skin moisturized.
• Avoid extreme cold or dry climates. While cold weather can make psoriasis symptoms worse, sometimes heat and humidity can improve symptoms.
• Avoid scratching or picking skin.
• Avid infection. Strep throat in particular can cause psoriasis to appear suddenly, especially in children.
• Limit alcohol intake, and do not smoke. Alcohol use can cause symptoms to flare-up, and smoking may make psoriasis more severe, or cause the symptoms to last longer.

Chemical peel is helpful for wrinkles, light acne scarring and irregular pigmentation such as freckles and age spots. Pre-cancerous conditions such as keratoses (thick, rough, reddish growths) also respond well to this procedure.

There are several types of chemical peels:

• Light peels to remove superficial wrinkles
• Medium peels
• Deep peels for more severe conditions.

After thoroughly cleansing the skin, a small applicator is used to apply the chemical solution to an area of the face. Excess solution is removed and the procedure is repeated on other areas.

The amount of improvement varies and depends upon the initial condition of the patient’s skin. Significant improvement of damaged skin has been achieved, which can produce dramatic results.

Skin Rejuvenation
A skin rejuvenation program is often used in conjunction with either chemical peels or laser wrinkle removal to reduce the fine wrinkles of the face, lighten areas of hyperpigmentation and produce a softer texture to the skin. The program can be accomplished separately or in conjunction with the other procedures listed here and is followed at home by the patient after a consultation and a treatment plan is established for the patient’s cosmetic needs. Our skin care department is dedicated to providing you with the latest and most effective skin treatments available.

We invite you to inquire about laser skin resurfacing and hope it can help you achieve smoother, fresher, younger-looking skin.

Hyperhidrosis, or excessive sweating, is a somewhat rare disorder affecting about 2.8% of Americans. It most often affects the palms, feet and face, causing embarrassment, staining clothing, and complicating social interactions. In some cases, hyperhidrosis can affect a person’s ability to perform simple tasks such as holding a pen, gripping a steering wheel, or shaking hands. It is estimated that over half of sufferers of hyperhidrosis do not seek treatment, in some cases because they do not realize it is available. Fortunately, there is hope. If treated properly, the symptoms of hyperhidrosis can be eliminated entirely for most patients.

Cause:

There are two types of hyperhidrosis, primary and secondary. In primary hyperhidrosis, emotional stimuli are believed to trigger excessive sweating. It is unknown why this occurs. Secondary hyperhidrosis is associated with an underlying medical condition. Conditions triggering excessive sweating may include: infection, malignancy, spinal cord injury, and neurologic or endocrine disorders. Because the sweating is caused by these disorders, treatment for secondary hyperhidrosis focuses on determining and resolving the underlying condition.

Treatment:

There are many treatment options for sufferers of hyperhidrosis. At our clinic we will help you determine what method is best for you.

• Antiperspirants: For mild to moderate cases of hyperhidrosis, a clinical strength, over-the-counter antiperspirant applied to affected areas, is usually recommended. If this treatment does not succeed in reducing symptoms, the next step is a prescription antiperspirant containing aluminum chloride. Prescription antiperspirants are applied to affected areas before bed and should be removed in the morning. Possible side effects include red, swollen, and itchy skin where applied.
• Oral Medications: There are several types of oral medications used to control hyperhidrosis. Anticholinergics, for example, block nerve impulses to sweat glands, thereby blocking sweat output. Carbonic anhydrase inhibitors inhibit sweating. Clonidine reduces nerve stimuli, thereby reducing sweat. Some types of antidepressants or anti-anxiety medication may also control excessive sweating.
• Iontophoresis: Iontophoresis is a procedure that uses a battery-operated device to deliver electricity to the hands, feet, and sometimes armpits, through water-saturated pads. This alters the outer surface layers of the skin to prevent sweat form coming to the surface. The process of iontophoresis must be performed twice daily for 3-4 weeks. The results will last for several weeks before the procedure needs to be repeated. With the proper device, you can complete the treatment at home. Although safe, iontophoresis can be painful, and may be no more effective than a topical antiperspirant.
• Botulinum toxin: Botulinum toxin is a protein produced by the bacterium clostridium botulinum, and when injected into the problem areas, most commonly armpits and palms, temporarily blocks the nerves that trigger your sweat glands. The treatment lasts for up to six months before needing to be repeated.
• Surgery: There are two approaches of hyperhidrosis surgery. One involves interrupting the nerve signal triggering sweat. The other is to remove some sweat glands entirely. Surgery is generally considered for extremely severe cases of hyperhidrosis, and only after all other treatment options have failed. If you are a candidate for hyperhidrosis surgery, we  will discuss all the risks and benefits with you.

Starch Iodine Test - Black point shows hyperhidrosis

Starch Iodine test for Hyperhidrosis in Axilla

Skin discoloration is a common condition that occurs mostly from sun exposure, and leads the skin to become darkened in certain areas or patches. These areas, usually brown, are a collection of pigment called melanin. Melanin is produced by the skin, and absorbs ultraviolet rays to protect the body from the sun. Increased melanin leads to increased discoloration. Anyone can be affected by skin discoloration, but generally lighter-skinned individuals are at greater risk for discoloration and cancer.

Some common forms of skin discoloration include freckles, melasma, and age spots:

• Freckles: Freckles, medically known as are small brown spots found on the skin, most commonly on the arms and face. Freckles are extremely common, especially among light-skinned people, and those with red or light hair. Freckles are caused by genetics and sun exposure, and tend to darken in the summer or when exposed more often to the sun. People with a lot of freckles should avoid the sun and always wear sunscreen, as they are more susceptible to skin cancer. Because freckles are harmless, they do not need to be treated. However, if you are unhappy with the appearance of your freckles, there are several steps you can take to prevent further development, and to fade existing freckles. Talk to Last Name(s) about available treatment plans for freckle-fading, and remember to always wear sunscreen. Protecting yourself in the sun will prevent freckles from darkening, and new freckles from developing.
• Melasma (“Pregnancy Mask”): Melasma is a dark skin discoloration that occurs on sun-exposed areas of the face. It is generally characterized by a brown color over the cheeks, forehead, nose and/or upper lip. It is often symmetrical, matching on both sides of the face. Melasma is sometimes referred to as “pregnancy mask,” because it has been linked to the female hormones estrogen and progesterone. Therefore, pregnant women, or those taking some forms of birth control pills are most likely to develop melasma. For these women, melasma generally disappears after delivery, or when pill taking is terminated. If melasma does not go away n its own, it can be treated with chemical peels, and some creams or topical steroids. These measures are not generally necessary, and wearing sunscreen and protecting the face during sun-exposure can help prevent melasma.
• Age Spots: Age spots are flat gray, brown or black spots found on the skin, and caused by sun exposure. Please refer to the Age Spots tab under the Medical Conditions section of our website for more information.

Rosacea is a chronic, non-contagious, inflammatory skin condition affecting about 14 million Americans, usually between the ages of 30 and 60. It is characterized by a flushing redness of the cheeks, chin, nose and forehead, and may produce small, red, pus-filled bumps or pustules. Rosacea appears to affect more fair-skinned people than dark, though it can affect any skin type.

As the condition progresses, flushing becomes more persistent and noticeable. In severe cases, most of the face is affected. The disorder affects more women than men, but is generally more severe for men. Sometimes, permanent facial changes can occur for men, such as thickening of the skin on the nose.

Cause:

The cause of rosacea is currently unknown. However, researchers have several ideas about what may cause rosacea. Often, rosacea runs in the family, suggesting a genetic predisposition combined with environmental factors may be the cause. It could also be caused by a disorder of the blood vessels that triggers them to swell, leading to flushing.

Treatment:

There is no known cure for rosacea, but treatment is available, and  at our clinic we can help you determine which method is best for you. Typically, improvements should be noticed within 1 to 2 months of treatment.

• Topical Medications: Medications you apply to your skin once or twice daily, such as antibiotics, benzoyl peroxide, and azelaic acid can help reduce inflammation and redness. These creams and lotions are generally used in combination with other treatment, such as oral medication.
• Oral Antibiotics: Oral antibiotics may be prescribed to reduce inflammation. Oral antibiotics tend to work faster than topical antibiotics, so they may be beneficial for severe cases, or if the physical appearance is interfering with the patient’s normal activities.
• Isoretinoin (Accutane): Isoretinoin is a very strong oral medication usually used to treat cystic acne. In some extremely severe cases of rosacea, isoretinoin may be prescribed if all other methods of treatment fail. Isoretinoin works by inhibiting the production of oil by sebaceous glands. Because isoretinoin has many serious side effects, Dr Bandukwala will closely monitor your use.
• Surgery: Enlarged blood vessels may become permanent. If this occurs, surgical options such as laser therapy may help reduce the visibility of these vessels, and removal of extra tissue buildup around the nose can improve overall appearance.

Prevention:

There is no known way to prevent rosacea, but you can take steps to reduce or control symptoms.

For example:

• Remember to continue your treatment plan even after rosacea clears or improves to ensure it does not reappear.
• Always be gentle with your skin. Only use mild cleansers, and avoid products containing irritants such as alcohol.
• Avoid rosacea triggers such as sun exposure, extreme temperatures, spicy food and alcohol.

Acne is a general term for eruptive skin disease. There are many types of acne including blackheads, whiteheads, papules, pustules, and cystic. Acne is the most common skin disease in the United States, affecting 40 to 50 million Americans. Acne generally occurs in teenagers and young adults, though it can affect anyone. 85% of teenagers in America will develop acne each year.

Causes:

Though the exact cause of acne has not been determined, research has shown that four key elements contribute to acne. They are: excess oil, clogged pores, bacteria, and inflammation. During adolescence, the body begins to develop more sebum oil, which is produced to ensure our skin does not dry out. When sebum cannot flow freely to the skin, clogged pores result. Bacteria already found on the skin’s surface, flourishes in the excess oil, and causes inflammation.

The degree of inflammation determines what type of acnes appears on the skin. A small amount of inflammation results in a blackhead or a whitehead. This means oil flow is blocked right at the surface of the skin, and is the least serious form of acne. If the pore is blocked deeper within the skin, a papule, or pimple, forms. If the pore becomes blocked deeper still, a pus-filled pimple, or pustule, forms. The most severe type of acne lesions are cysts, which occur when very deep blockage causes intense inflammation. Cysts, sometimes called nodules, are very painful bumps.

Treatment: There are many treatment options available for reducing your acne. Because every case is different, and treatment effectiveness depends on your skin’s reception, talk to Dr Bandukwala about finding the right treatment for you. Fortunately, when can acne is properly treated, it can restore the confidence and positive self-image that often wane in people afflicted by acne.

If scarring from acne occurs, some options such as laser therapy may help reduce the appearance of scars. Talk to Last Name(s) if you are interested in this type of treatment.

Prevention:

Research has proven that heredity, hormones, menstruation and emotional stress can trigger acne, or make it worse. Although many of these factors cannot be avoided, it is recommended that patients not wash or scrub the skin excessively, which can irritate the skin and make acne worse. Diet does not generally contribute to acne, although if greasy foods are ingested often, oil from the food may transfer onto the skin, particularly around the mouth, and worsen acne. Likewise, if you have oily hair, shampooing often may help reduce the risk of oil from the hair transferring onto the skin.