Tag Archive: psoriasis

Common nail diseases explained by a dermatologist

March 15, 2019

Nail abnormalities are often neglected. Patients tend to visit the dermatologist for skin-related concerns, such as acne or eczema. Yet, nail diseases can be common and require diagnosis and management.

The nail (or the nail plate) is firmed rooted to the nail bed. Our nails are made of modified keratin. It serves as a protective shield for our fingertips and toes. Fingernails take approximately 5 to 6 months to grow out, while toenails require twice the duration. The slow growth rate and the difficulty of getting drugs to penetrate the nail tissue make it hard to treat nail diseases.

Here, we share a few common nail diseases.

Onychomycosis

Onychomycosis is a type of yeast or mould infection on the nail. The infection causes a discolouration (white, yellow or brown). Other characteristics include thickening, splitting, roughening of the nail.

Common factors that place individuals at greater risk include humidity, heat, trauma and diabetes. Basketball players may be more predisposed due to the direct trauma of having their toes stepped on by other competitors.

Onychomycosis may also be a symptom of the following conditions: psoriasis, eczema, trauma or ageing.

Treatment for onychomycosis: Topical antifungal agents are less ineffective, due to its inability for deeper penetration into the nail bed. Instead, oral terbinafine or itraconazole is often prescribed.

Do my nails have a bacterial infection?

When your nails suffer from bacterial infection, it is termed as paronychia. Paronychia can be acute or chronic. In acute paronychia, it is generally painful with pus present, caused by the bacteria Staphylococcus aureus. Repetitive minor trauma, nail-picking and nail-tearing can cause a tear in the skin, allowing bacteria to invade.

In chronic paronychia, individuals in wet working conditions or cold environment are at greater risk. Compared to acute paronychia, chronic paronychia is generally less painful.

How to treat acute paronychia: Antibiotics and drainage of any pus if present.

How to treat chronic paronychia: Topical imidazoles are often prescribed. The patient should also avoid wet conditions, e.g. to use cotton-lined gloves when exposed to wet work. Manicuring or finger sucking should be avoided. Apply emollient creams regularly.

Ingrown toenail

Ingrown toenails can be hard, swollen and painful. Trimming your nails too short, especially on the sides of your big toes, can cause an ingrown nail. Trimming the corners of your nails may encourage your toenails to grow inwards, digging into your skin. Your skin then breaks due to the pressure, triggering an infection. Tight shoe wear or trauma can also cause ingrown nails.

If excessive inflammation and swelling are present, patients are advised to visit a dermatologist for proper treatment. Oral antibiotics may be prescribed, and the dermatologist will assess if there is a need for surgical removal.

To prevent ingrown toenails, wear proper-fitting shoes that have adequate room for the toes. Wear socks too. Cut your nails straight across instead of rounding the corners.

Tumours

Nail tumours can be benign or malignant. Warts are the most common type of benign tumour affecting the nails.

Dermatological diseases that can affect nail conditions

Psoriasis: Patients who suffer from psoriasis may notice that their nails are scaly or pitted, with debris collected under them. In severe cases, the nail plate crumples, along with thickening of the nail bed.

Generally, nail changes should improve with effective psoriasis management. There are no nail-specific treatments for patients with psoriasis.

Eczema: While eczema does not typically cause nail changes, certain patients may suffer from brittle nails. Nail plate may also be rippled and deformed, due to the body’s inflammatory process. Horizontal ridges can be seen across the nail, with thickening and sometimes discolouration.

Emollients

Nail abnormalities can benefit from the application of moisturizers, especially for patients suffering from eczema. Use a dermatologist-formulated emollient such as Multi-CERAM™ Moisturizer, with phyto-ceramides for skin barrier repair and multi-ceramides for skin lipid restoration.

© 2019 TWL Specialist Skin and Laser Centre. All rights reserved.
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Meet with Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.
To book an appointment with Dr Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.

How does your skin react to alcohol?

January 19, 2019

 

What happens to your skin when you drink too much?

To maintain the health of your skin, you may want to think twice before you reach for one too many drinks. Alcohol can be pretty harsh on the skin.

Here’s why.

Premature ageing

When broken down, alcohol produces molecules called aldehydes. Such molecules cause damage to the body’s cells by destroying their ability to function. When cells are damaged or die, our body produces new cells to replace them. However, a single exposure to alcohol can reduce the body’s ability to multiply cells.

Another effect of alcohol is the widening of small blood vessels in the skin. This allows more blood to flow closer to the skin’s surface, which produces the distinctive flush and feeling of warmth often associated with alcohol consumption. Over time, this can cause an unhealthy appearance including dullness, enlarged pores, sagging, discoloration and a lack of skin resilience. Such effects can last for days.

Excessive alcohol consumption can further limit the liver’s ability to remove toxins, which can also make you look older.

Dehydration

Alcohol interferes with the body’s ability to regulate water levels. Your brain produces a hormone called anti-diuretic hormone (ADH) that acts on our kidneys to control the amount of water secreted in your urine. When your body is dehydrated, your brain sends a signal to pump out ADH. ADH stops you from urinating as much, allowing you to retain your water levels.

Alcohol inhibits ADH levels. So even when you drink a lot of water alongside your alcoholic drinks, your body only hangs on to about a third of it while the rest goes out in your urine. In other words, alcohol increases urine volume and leaves your body dehydrated.

This dehydrating effect worsens skin elasticity, thickness and density. It also makes wrinkles and fine lines more noticeable. 

Itchy skin

Most itchy skin diseases are exacerbated by alcohol consumption. Alcohol causes eczema to be twice as common, likely due to its suppressive effects on the immune system.

Alcohol also makes psoriasis harder to treat. Psoriasis refers to the condition of red, itchy skin. While alcohol itself does not cause psoriasis, it increases the body’s susceptibility to infection and exacerbates the condition. Heavy drinkers are also more resistant to therapy.

Flushing and Rosacea

Flushing is a common after-effect of drinking and tends to go away the next day. It is more prevalent in individuals who do not have an enzyme that breaks down aldehyde. (Alcohol is broken down via two general steps, first into aldehydes and then to acetate.) An accumulation of aldehydes causes flushing and rapid heart rates.

An impaired alcohol metabolism can also worsen rosacea, a common skin disease with a tendency to blush or flush more easily than others. It can further cause an increased incidence of telangiectasia or the appearance of spider veins at the surface of the skin. 

Inflammation

When alcohol is broken down in the body, reactive oxygen species (ROS) is released as a by-product. ROS are important signalling molecules in the body.

However, excess ROS production can be harmful to the skin as it alters the body’s immune response, triggers inflammation and causes the body to attack itself. This can compromise the skin’s wound healing processes.

Consequently, alcohol can cause skin conditions such as eczema, psoriasis or, in some cases, acne to take much longer to heal than before.

Resveratrol in red wine

Resveratrol is an antioxidant often found in red wine. (Antioxidants work to fight against the oxidative stress that your skin cells encounter.) Resveratrol also has therapeutic benefits against various skin disorders and protects the skin against harmful UV rays. Given that UV radiation is a major cause of ageing, resveratrol is popular for its anti-ageing abilities.

However, there are other ways to get resveratrol that do not include the harmful effects of alcohol.

For a dermatologist-formulated anti-ageing serum, go for Elixir-V™ Total Recovery Serum. It contains a potent concoction of resveratrol, hyaluronic acid and oligopeptides that work together to give you the perfect V-face look.

Seek for help

If your skin condition worsens, schedule a visit with a dermatologist as soon as you can. The dermatologist can determine the best course of action and suitable treatment that would be effective for your condition and your lifestyle.

© 2019 TWL Specialist Skin and Laser Centre. All rights reserved.

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Meet with Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin & Laser Centre, for a thorough consultation to determine the most suitable treatment for your skin.

To book an appointment with Dr Teo, call us at +65 6355 0522, or email appt@twlskin.com. Alternatively, you may fill up our contact form here.