The basics of skin care

Published On: July 21, 2017 01:05 PM NPT By: Republica  | @RepublicaNepal

We all want good skin but to have it requires some basic knowledge about skin care. And we aren’t just talking about facials and elaborate nighttime routines. We need to stay sun safe for good, healthy skin. The Week spoke to Dr Amit Amatya, associate professor of dermatology at Patan Hospital, to understand how we can protect our skin from the harmful effects of the UV rays and keep it beautiful and healthy naturally.  

How does sunburn occur?
Sunburn is an inflammation of sun-exposed skin due to excessive exposure to sunlight. Each beam of sunlight consists of various wavelengths of rays. Sunburn is basically caused by the ultraviolet (UV) rays whose wavelength is less than 400nm. To be more particular, UV-B is the main culprit of sunburn. However, UV-A can also cause sunburn especially in patients taking phototoxic drugs. UV-C barely reaches the earth’s surface due to the ozone layer in the atmosphere so is not that important where sunburn is concerned, however, cumulative UV-C is incriminated as a cause of skin cancers.

What are its signs and symptoms?
Sunburn is initially manifested by redness of skin. The redness is not apparent right away; it may take hours to be seen. But it may be evident earlier if the exposure to sunlight is prolonged. Along with redness, skin becomes painful especially after touching it. In severe cases blisters similar to the ones seen after burns can erupt. One may have severe discomfort, chills, fever, and fall sick. The heart rate may become faster and the blood pressure may drop. According to the severity, these symptoms may last for a week.

Why is it harmful?
First, sunburn is a painful condition. The sunburnt area may become infected with microorganisms and leave a whitish or dark pigmentation after healing. And second, compared to the normal skin, skin cancers can arise more frequently in the sunburnt areas, years after it first occurred.

Are there any cures or medications for this problem?
Patients with sunburn should take rest. Further exposure to sunlight should be avoided. Painkillers can be given to reduce inflammation and pain. Calamine lotion or mildly potent corticosteroid creams can be applied. If secondary infection is present or is highly probable, topical or oral antibiotics can be added. Oral corticosteroids may be required in severe cases. In rare cases, hospitalization may be necessary.

What is skin tan and and how can it be prevented?
Tanning means darkening of skin color. Darker the skin type, darker and faster will be the tanning. Tanning may be immediate or delayed. Immediate tanning is due to UVB and visible light. Delayed tanning is only due to UVB and begins in two to three days after exposure and may last for two weeks. Avoiding mid-day sun can prevent skin burn or tan. One can watch the weather news or use apps in smart phones to check the UV index. If the UV index is high, avoid avoiding going outdoors or use maximum sun protection.

How much sun does our skin need?
There have not been many studies regarding it in Nepal. On top of that, Nepal has a varied geography. As far as Kathmandu is concerned, the weather is usually pleasant and sunny, even in winter. Among dermatology colleagues, we came to a rough conclusion that maybe five to twenty minutes of sun exposure is enough. But that depends on how strong the sun is on a particular day and parts of the skin being exposed. However, if one has skin diseases due to sunlight, it is not recommended to undergo sun exposure.

What do those prone to sunburn need to keep in mind?
First of all you need to know your skin type. Also, fairer skin is more prone to sunburn and tan minimally whereas the darker skin burn less and tan more. But sunscreen is recommended for everyone. You should also use black-colored umbrella and broad-brimmed hats and wear protective clothing that covers sun-exposed areas when stepping out on a sunny day.
If you think you have sunburn, please consult a dermatologist. Many skin diseases are caused by sunlight and they may look like sunburn. One particular disease called Lupus Erythematosus may mimic sunburn but is much more severe disease than sunburn. The therapy may differ. Sun burn and sun allergy is also different.

Your advice to people to be sun-safe?
In my practice, I come across a lot of sun allergies but rarely sunburn. Sun allergy called Polymorphic Light Eruption (PMLE/PLE) is very common in Kathmandu valley. Even if one has normal skin, consult with a dermatologist to find out which sunscreen, face wash and moisturizer are good for you. Also, those prone to sun related skin diseases should apply sunscreen religiously. But even sunscreens can cause allergies. It may also give rise to pimples and cause sweat rash. In such cases, non-comedogenic and aqua gel formulations can be used.

The doctor’s note on sunscreen
Apply sunscreen that gives protection from both UVB and UVA lights. While buying, choose sunscreens having proper proportion of both physical and chemical agents. For children, it is better to use sunscreens with only physical agents. Generally for Nepalis skin, sunscreen with SPF (sun protection factor) 15 is sufficient. However, people with fairer skin need sunscreen with more SPF. People prone to sunburn, sun tan, and sunlight induced skin diseases also need sunscreen with more SPF. Most sunscreens work for up to three hours after application. So reapplication is necessary three hourly during daytime as well. This may sound impractical but it’s highly recommended.

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