OUR CARIBBEAN SKIN SERIES / Discolouration

Practising dermatology in the Caribbean gives us the opportunity to treat a beautifully diverse range of people, all with different skin types.

Skin of colour, despite its amazing range – Indigenous, African, Indian, Chinese, Mediterranean, Middle Eastern and Latino – tends to have specific conditions to which it’s susceptible. A few general skin conditions also produce different effects in pigmented skin.

Over the next few months, we’ll offer a quick guide as to what to look out for – and how we can help you treat it. We’ll start off with a common complaint: discolouration.

Where you notice it

This tends to happen especially on joints like the knees and elbows, though it can also show up in more private areas, like derrieres and inner thighs. In addition, discolouration can be an unwanted side effect of skin conditions like acne (which leaves behind dark spots once the pimples disappear), or eczema (which can leave darker and/or lighter patches on the skin).

 No quick fix

Treatment can be quite difficult, as discolouration is stubbornly persistent and can be caused by a multitude of factors, including hormonal changes, certain medications and harsh skin care products. Laser treatments, chemical peels and serums can help, but they are not guaranteed.  

The good news? Simple at-home remedies can often improve (not eradicate) the condition, but you must be diligent about maintenance:

·       Limit sun exposure, as UV rays worsen the appearance of dark spots

·       Tell us what medications and/or skin products you’re taking so we can advise whether they may be contributing to the problem – birth control pills are a common offender

·       Keep the area moist by rubbing it with petroleum jelly

·       Gently exfoliate dead skin

·       Avoid putting undue friction on joints (e.g. don’t rest your elbows on the table)

What not to do

Alternative treatments (e.g. the use of citrus, turmeric, oats or certain essential oils) are not clinically tested and often create further problems in our tropical climate. The use of lemon juice, for instance, can cause burning and heightened discolouration when exposed to harmful UV rays, and Vitamin E oil has the potential to cause true allergic reactions in some patients.

We generally do not recommend using over-the-counter skin lightening soaps and creams, as many of them contain harmful ingredients like mercury, which can further exacerbate the condition and cause far more serious side effects, including kidney and nerve damage.

Be safe, not sorry

If the discolouration is serious (or seriously bothering you), it’s best to come in and see us to get a proper assessment, coupled with safe treatment options. 

SCREENING YOUR SKIN

When it comes to skin cancer, good habits (a skincare routine, the regular use of sunscreen) are important, but so are proper skin audits. You should do a monthly self exam, a perfectly adequate preventative measure once you are not at high risk.

However, if genetics, lifestyle, age or previous health conditions predispose you to skin cancer, it’s a good idea to book a screening with one of our dermatologists every six months to a year.

Basal and squamous cell carcinomas, the strains of skin cancer identified in this Mayo Clinic report, are typically not as critical as melanomas, but they’re significantly more common and can present in various ways (scaly, bumpy, or waxy), so it’s best to be sure. As with all other cancers, early detection puts you in a better position regarding removal and/or treatment.

When we want to see you

·       Your skin falls under Types I or II on the Fitzpatrick scale

·       You have a family history of skin cancer or have suffered from it yourself

·       You tend to have a lot of moles and/or notice changes in spots on your skin (irritation, itching or bleeding)

·       You burn easily when outdoors

·       Your job and/or hobbies expose you to an inordinate amount of UV rays

·       You are immunocompromised or undergoing serious medical treatment like chemotherapy or dialysis

How to self-check

At least once a month, follow the ABCDE rule…

A simple way to check for possible signs of skin cancer.

If there are any positive responses on your ABCDE checklist, it’s a good idea to book an appointment with us. At least half of all cancerous skin conditions are first noticed by patients, so your first line of defence is self examination. When caught early, treatment usually involves non-invasive therapies like topical chemotherapy creams and liquid nitrogen, or simple, in-office surgical procedures.

WOW TO THE WEBINAR!

On November 25, Serpentine Dermatology, in conjunction with Ames Medical and gynaecologist Dr. Sandra Boxill, hosted a free webinar about women’s intimate well being. Scores of women attended the session, asking very pertinent questions about some of the challenging conditions that can affect vaginal health.

Dr. Boxill, along with general practitioner Dr. Alexandra Ames and dermatologist Dr. Tonya Abraham-Ali, discussed everything from post-partum and menopause issues, to frustrating conditions like age-related urinary incontinence – including the ways in which Serpentine Dermatology’s CO2RE Intima laser treatments can offer relief.

Here’s a quick recap of the key questions participants asked:

• How old do you have to be to do theCO2RE Intima treatment?

There’s no real age limit; the treatment is just as effective for post-partum as it us for peri- or post-menopausal women. It can also be used to give the vaginal area a more youthful appearance.

•  How long after post-partum should one wait to do the treatment and is there any scarring?

Women should wait until at least six weeks after giving birth to have the treatment done. It does not leave any scarring.

• What about downtime and potential side effects?

There is zero downtime with the CO2RE Intima treatment, and side effects are limited to what some patients describe as slight discomfort to the area, usually on the first day.

• Are there any long-term effects to consider?

All reported long-term effects have been advantageous. Several studies have been done in which scientists have biopsied the epithelial lining of the vagina ten years after the CO2RE Intima treatment, and the area still shows benefits from CO2 lasering.

If you’d like to book a consultation, or find out more about the treatment’s suitability to your situation, give us a call us at (868) 622-7340.

STRESS AND YOUR SKIN

We all know when we’re feeling stressed: our bodies tense up, we’re more short-tempered, we may experience headaches, pain, or even insomnia – but stress also takes a toll on your skin, creating a chemical response that makes the management of certain skin conditions more challenging – and there’s been a lot of stress in 2020.

Since the advent of the COVID-19 pandemic, doctors have been concerned about how people’s mental health has been holding up as a result of job losses and financial worries, not to mention the psychological weight that the prospect of contracting COVID-19 carries. As they juggle increased demands, people must find creative ways to do more with less, even as they struggle with the effects of isolation.

At Serpentine Dermatology, we’ve been seeing a marked increase in cases of stress-induced dermatoses like itching and hives, anxiety-provoked disorders, and flare-ups of conditions like psoriasis and eczema, which thrive under stress. In fact, because so many skin disorders have been linked to emotional well being, it’s started a whole new field: psychodermatology.  

RASHES /

The first thing that stress attacks is your immune system, throwing it off balance and making you more susceptible to rashes, redness and itching. Such rashes usually appear as raised bumps or hives and can appear anywhere on the body, most typically the face, neck, arms and torso. Some go away almost as quickly as they begin, while others can persist for weeks at a time.

There are initial steps that you can take to soothe symptoms, like applying ice packs to the affected area, or taking an over-the-counter antihistamine. If you don’t get relief, however, it’s a good idea to come in and see us. For elderly, immobile or immunocompromised patients, we continue to offer virtual diagnostic consultations.

Part of our approach will include recommending stress-management strategies, including regular exercise or meditation practice, family time and time spent in nature, and the pursuit of enjoyable hobbies.

ECZEMA, PSORIASIS, ROSACEA /

There are scientific links between stress and these types of skin conditions, for which anxiety is a common trigger. Here’s how it works: when we’re under stress, our bodies produce increased levels of hormones like cortisone and adrenaline, which can cause an inflammatory response in the skin.

Relaxation techniques, however, can be quite effective in reducing these types of flare-ups, though serious outbreaks require medical attention. Also helpful are good lifestyle practices like engaging in regular exercise, maintaining a balanced diet and getting adequate amounts of restful sleep.

DELUSIONS OF PARASITOSIS /

Since COVID-19 began, there has been an uptick in patients experiencing itching, mistakenly convincing them that some type of parasite – fleas, mites, lice, etc. – might be present. In such cases, patients will scratch their skin for relief, damaging the epidermis.

Unfortunately, this battling of bugs (which aren’t actually there) happens more frequently when people are under stress. We can quickly determine whether your skin condition has a medical foundation or if it’s happening because of the powerful of the mind/skin connection by doing a physical exam along with relevant lab tests.

The skin is our largest organ, comprising millions of nerve endings – no wonder it’s so closely linked to our mental and emotional well being!

WEBINAR ON WOMEN'S WELLNESS

This month, to facilitate a conversation on women’s well being – and as a gesture of thanks to all our loyal patients who continue to place their faith in us in challenging times – Serpentine Dermatology will host a free webinar on some of the most common but debilitating conditions affecting vaginal health.

The webinar will cover everything from post-partum issues to changes related to menopause, as well as things like urinary incontinence due to ageing. We’re keeping numbers small and limiting invitees to our patients in order create an environment in which participants feel comfortable to ask questions, so it’s best to register early.

Date: Wednesday November 25, 2020

Time: 6:00 – 6:30 p.m. AST

Panel:

·       Dr. Alexandra Ames – specialist general practitioner with a DFSRH diploma in family planning and reproductive healthcare and an interest in women’s health

·       Dr. Sandra Boxill – gynaecologist

·       Dr. Tonya Abraham-Ali – dermatologist

Call us at (868) 622.7340 to reserve your spot today!

*Please note that you will need to complete a contraindications questionnaire to determine whether the treatment is right for you.