OUR CARIBBEAN SKIN SERIES / Vitiligo

Your skin is as individual as you are – Caribbean skin even more so, thanks to its beautiful diversity. Vitiligo, which is characterised by a gradual loss of skin pigmentation that typically occurs in sharply defined patches, equally affects people of all ages, races and genders, but it is more noticeable in people of colour.

Links to autoimmune diseases

The condition may first manifest itself in parts of the body that are exposed to the sun, but other areas are soon affected, getting larger, whiter and more pronounced. There is currently no cure, but as work continues into determining precisely what causes vitiligo, this may someday change. Doctors suspect a genetic predisposition, perhaps triggered by environmental factors, or an autoimmune disease link, whereby the immune system attacks the cells that create skin pigment. In most cases, the loss of pigmentation happens on both sides of the body. As with other autoimmune conditions, vitiligo can be brought on by stress or other types of trauma. We can usually diagnose the condition from a skin biopsy.   

Social ostracisation

Sadly, vitiligo tends to attract a lot of social stigma, which is why having role models like Winnie Harlow is so important, as it helps people to understand the condition and hopefully, change their mindset. She advises young women to “make [their] own mould for what beauty is”.

Still, many patients – particularly younger ones – may grapple with self-esteem issues after diagnosis, including depression. We’ve therefore found that any treatment plan should ideally include psychological support. Public outreach at the national level would also be useful, as patients should not be made to suffer from greater societal ignorance or intolerance about the condition.

Other than the psychological distress and impact on quality of life – which are real issues – vitiligo is considered a benign condition, although patients are more easily prone to sunburn. In severe cases, it might contribute to vision problems and hearing loss, though these side effects are much less common.

Treatment options

The approach to treatment may differ depending on the patient’s age, as well as the extent and progression of the condition. Other than the regular sun protection advice, vitiligo treatment may involve a combination of topical creams, medications that control inflammation or regulate the immune system, and light-based therapy.

The hope is that future treatments may include drugs that stimulate the melanocytes, to either prevent loss of pigment or control the spread of vitiligo. While come people report results with alternative remedies, it’s important to let your doctor know what you’re taking, in case there are contraindications with some prescribed medicines.

If you notice lighter patches on your skin that you’re concerned about, have a family history of the disease, or feel that you may be at risk because of stress factors or underlying autoimmune conditions, just give us a call or schedule an appointment.

YOU'RE BEAUTIFUL

March 8 is International Women’s Day. Women are reportedly being most adversely affected by the pandemic, but we’ve noticed that instead of focusing on the real and urgent issues women face, there continues to be a disproportional interest in how women look rather than who they are.

This is partly what drives the multi-billion-dollar cosmetics industry, but to what end? While some products can definitely boost skin health, caving in to mainstream and social media pressure can sometimes lead to women – often the youngest and most beautiful – having body confidence issues.

To honour the spirit of International Women’s Day, we’ve asked a few outstanding ladies, all part of our Serpentine Dermatology family, to tell us what real beauty means to them. We hope it helps you to look at yourself with gentleness and see just how amazing you really are.

BEAUTY IS STRONG /

“Beauty and strength are synonymous — one cannot exist without the other. I feel most beautiful when my children make me smile. Motherhood has been the most powerful, empowering and sacred part of my life. It is, in essence, compassion and sacrifice that makes us all so potentially beautiful. Once we realise this, nothing can stand in our way! The world can be our palette to paint a masterpiece so exquisite, that never could we have envisioned we had the ability to create such beauty.”

— Tonya Abraham-Ali, Dermatologist

BEAUTY IS AUTHENTIC /

“We as women are designed to be a pillar of strength to our family, friends and community. It is important as women to lift each other up and stay focused in our faith. It is also fundamentally important to be aware that beauty comes from within and not what is deemed by society. In a world full of clones, it is important to be oneself. Let’s continue to love and spread light.”

— Cynthia Rennes, Nurse

BEAUTY IS KIND /

“Beauty is independence — being able to stand on your own two feet. A beautiful woman stands out amongst the crowds; you can always tell she’s caring and kind, and you would love to be her friend.”

— Savannah, 11 years old

BEAUTY IS CONFIDENT /

“What makes a woman beautiful goes far beyond what meets the eye at first glance. A woman’s beauty is reflected in how she lives her life and the outer display of her inner qualities. This confidence results in her seeing it unnecessary to compete with others, but rather, owning her unique light.

A beautiful woman leads a life of integrity, compassion for all, and generosity of spirit toward all living beings.
Among the most beautiful of characteristics is a woman who marches to the beat of her own drum — a capacity she gains through a deep sense of being independent, though having faith in the power of collaboration.

A sense of humour is always a beautiful trait and is something I think women should keep, especially as they strive to be the most powerful and successful version of themselves.

I admire women who treat others with fairness and equality. We are all one regardless of creed, race or circumstances.

A beautiful woman is one who takes care of her health and is willing to age gracefully, while, of course wearing her unique, beautiful smile as much as possible, even amid the many challenges that may come her way.”

— Meiling, Fashion Designer

Make sure to check in with us on Instagram and Facebook on March 8, when we’ll have a super-special beauty message for you!

OUR CARIBBEAN SKIN SERIES / Melasma

Caribbean skin is unique; the way we treat it must be too. Not only is it diverse in terms of colour, but different skin types naturally respond differently to environment, stress, hormonal changes, etc., making them more susceptible to certain skin conditions. 

Also called the “mask of pregnancy”, melasma is a specific and quite common form of discolouration. It tends to plague women of colour, though men can get it too. It generally happens on the face and is often symmetrical (hence the mask comparison), but it can also appear on other parts of the body, especially those exposed to sunlight, which aggravates the condition. People with darker skin are more at risk.  

The discolouration may be caused by hormonal changes (pregnancy, menopause), certain medications (birth control pills, hormone therapies), stress, and even harsh skincare products.

While we can generally diagnose melasma by sight, a clinical exam will also determine how many layers of skin are affected. Melasma caused by birth control pills or pregnancy usually resolves on its own, but there are cases that would benefit from treatment.

Treatment options include:

·       Topical steroids and other prescription medications

·       Microdermabrasion

·       Chemical peels

Melasma can be persistent, so there is no guarantee it will completely go away. Sometimes, the only solution is to be consistent with managing it: establish a treatment routine that keeps it under control, stay vigilant with the sunscreen and avoid UV exposure wherever possible. Proper makeup can also be effective with evening out skin tone.

If you’re experiencing skin discolouration and are concerned about it, just give us a call or schedule an appointment.

GO PRO!

Taking control of how good you look and feel is wonderful, and you should absolutely advocate for the good health of your skin – but there are simply some procedures that need professional supervision in order to keep you safe. Here’s a quick look at some treatments that are best left to us!

MICRODERMABRASION /

What’s involved

This is a cosmetic procedure in which we remove dead skin in order to counteract things like acne scarring and hyperpigmentation. It also boosts skin texture and reduces the appearance of pores.

Be aware

This kind of exfoliation can really keep your skin looking rosy, but at-home kits can be too aggressive and end up harming the skin.

Risks

·       Damage to sensitive areas, like the skin around the eyes

·       Discolouration

·       Allergic reactions

·       Breakouts

Learn more about our microdermabrasion treatments here.

PEELS /

What’s involved

No matter how appealing these may be to try at home, this is a skin resurfacing procedure – which means a chemical solution is applied to the skin to remove the top layer and allow smoother, younger-looking skin to shine through.

Be aware

Chemical peels are great for improving the apperance of light wrinkles or other skin imperfections, including discolouration and superficial scarring, but it’s a delicate balance. You have to know:

·       Which depth of peel is right for your skin

·       Which ingredients may or may not interact well with your skin

·       How certain medications can affect the outcome

Peels are not recommended for pregnant women, for instance, or for people who have skin that is prone to keloids or cold sores.

Risks

·       Burning and/or scarring

·       Changes in skin colour (sometimes irreversible)

·       Infection

·       Organ damage

 Check out our range of professional peels here.

TONING /

What’s involved

In terms of tightening and toning skin, lasers do the best job – but there are do-it-yourself products on the market that promise similar results via LED lights used in conjunction with a microcurrent.

Be aware

You won’t get the same results and any gains will be temporary.

Risks

·       Damage to the eye area

·       Uneven treatment

 Learn more about our laser treatments here.

Bottom line? When it comes to the health of your skin, it’s always better to err on the side of safety, knowing we’ll be here to support you through every step of the process, from consultation to recovery.

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.