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Tuesday, November 8, 2022

Do you have atopic dermatitis? - Manila Bulletin

This dry skin problem affects quality of life 

Atopic dermatitis or atopic eczema is a dry skin problem that stems from the mutation of the profilaggrin gene, which is responsible for the skin barrier protection of the skin. With this mutation, there are higher chances of reacting to environmental factors, such as heat, stress, and products.  This makes the atopic skin prone to scratching, skin infection, and even changes of the skin color due to the response to inflammation. Some rashes will develop pigments as a response to continued and repeated cycle of irritation, resulting to formation of post-inflammatory hyperpigmentation. Some atopic patients, however, respond by not producing pigments in the problem area, thus forming hypopigmented lesion, which we call post-inflammatory hypopigmentation. 

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These are some treatment for post inflammatory hyperpigmentation.

*Topical agents such as Hydroquinone, topical retinoid, topical corticosteroid, glycolic acid and other fruit acids, azelaic acid, L-ascorbic acid (vitamin C)

*Resurfacing laser such as Dermablate laser, Baby skin laser, and Pico ablative laser.

 *Chemical peels such as Coquille peel, Citrine peel, and Tresare peel.

Hypopigmentation due to inflammatory skin disorders and infections usually resolves by itself over weeks to months and even years, once the underlying disorder has been cleared. 

Hypopigmentation can affect the quality of life and self-esteem, as patients refuse to leave their house, and feel inferior to others. 

As physicians, we aim to improve pigmentary changes but also improve quality of life and self-esteem. There are a lot of convincing studies to prove that antioxidants and growth factors can help improve these cases, but patience is very important. For most patients from the beginning, we know that it will take them at least six months to have that improvement on post inflammatory hyper/hypopigmentation. 

These are some of the treatments that can be done at medical clinics.

*Medical hydration via lasers and machines every two weeks

*Application of superoxide dismutase, the only antioxidant enzyme that scavenges the superoxide anion by converting this free radical to oxygen and hydrogen peroxide, thus preventing peroxynitrite production and further damage.

*Topical immunomodulators such as calcineurin inhibitors are the best option during flareups Patients can avoid steroid in the meantime to prevent steroid-induced hypopigmentation.

* Emollient moisturizer helps rebuild the skin barrier to help prevent flareups.

*Microtherapy + Growth factor + Hyaluronic acid + Neurotoxin (Refreshed micrococktail) – This special concoction aims to help augment skin color by promoting healing mechanism of injured skin, PRP releases growth factors (healing and regeneration) adhesion molecules and chemokines interacting with the local environment, promotes cell differentiation, proliferation and regeneration, while Hyaluronic acid induces remodeling of dermal extracellular matrix and reduced inflammation, which is suitable intradermal delivery, and lastly, neurotoxin which has melanin protective property.

To every skin problem, there is a solution.  One must be patient and consistent to be able to see results.  Consult your dermatologist or cosmetic surgeons for the best options for you today.

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Do you have atopic dermatitis? - Manila Bulletin
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