Q. Tell us about yourself

I have been raised and brought up in Chuchot. I did my schooling from Imamia Mission School, Chuchot- Leh and did my 11th and 12th class from Luthra Academy-Jammu. After the completion of my high school, I prepared for MBBS.  In the year 2005, I completed my MBBS and did a one-year internship from Medical College –Jammu.  I pursued my Post Graduation in Dermatology from Medical College Srinagar. And since from, 2011 I have been working with SNM Hospital as a dermatologist. 

 

 

The reason for choosing my profession as a dermatologist is because of my interest in the subject & also looking at the scope as there was no dermatologist in Leh. 

 

 

Ladakh being on a very high altitude definitely have a bad effect on the skin of the people. The ultraviolet radiation is very high in this area which causes many skin problems. The problems saw frequently in the OPD’s includes, sun allergy, pigmentation, photo ageing, wrinkles. If we talk about sun allergy there are different types of sun allergy. One is PMLE (Polymorphic Light Eruption) that is the irritations appear upon or shortly after exposure to sunlight and the second one is the Chronic Actinic Dermatitis which is most commonly seen in the OPD. The patient suffers from this because of the exposure in the sun for a longer period of time. Another problem can be a skin Cancer also.

 

 

Usually, the skin problems in Ladakh are almost the same as seen in other parts of the world. But the common problem faced by almost all Ladakhi is the skin complication caused due to the sun rays of high altitude.  Mostly farmers and people who work outside are more prone to the sun related problems. The problems faced are sun allergy, pigmentation, ageing etc. 

 

 

Precaution is the prime important thing people should follow.  A person should avoid himself/herself from the direct exposure to sunlight. A good-medicated sunscreen is highly recommended for the people who usually work outside.  Basically, all the sun protection cream is of half-life, the cream applied in the morning will not be effective till the evening, and thus, it should be repeated after every 3 or 4 hours. Proper clothing, use of round hats, sunglasses are the other precaution a person should take while getting exposed to the sun. 

 

Talking about the treatments, it depends on the cases or type of diseases faced by the person. The important point is that for every skin problem the patient should consult a doctor at the earliest. 

 

 

To have a healthy skin one should consume a proper healthy food.   As we all know a balanced diet is very important for a healthy lifestyle, for a healthy skin a person should consume foods rich in vitamins like green leafy vegetables and fruits.  Apricots which are found in abundance is one of the best fruit for skin because of the rich antioxidant.  In winter, consumption of a balanced diet is very difficult. In this case, the vitamin supplements can be taken but not for a continuous prolong period. It can be taken for a one month after a gap of 3 months. Vitamin supplement is more important for women after 40 years because of the high risk of bone weakness. 

 

 

Different skin issues arise with the change of season. Skin dryness is one of the common issues that are faced by the people of Ladakh. This is because of the low humidity. The best precaution is to avoid hard soaps and regular baths in winters. Use of mild soaps and a good moisturizer is important to prevent against the dryness.  In summer times, the sun rays cause rashes, allergies and many more.  One should use sun protection cream with SPF, proper clothing, hats etc.

 

In winters, frostbite and chilblain or (Perniosis in a medical term) is the most common skin issue seen among the students who stay in hostels, people who come from the lower area or with less altitude. Chilblains are itchy, tender red or purple bumps that occur as a reaction to cold.  It is most commonly seen on fingers, toes, nose, and ears. A person suffering from this should keep the affected parts warm. 

 

 

We do have skin cancer cases in Ladakh and only 1 to 2% suffers from this.  If we talk about the symptoms, it can be started or appear from any part of the body, moles can also be converted into cancer. Moles are one of the common symptoms. Usually, moles are uniformly coloured, either black or brown. When the mole has a sudden change in the colour, itchiness, the frequent increase in the size and bleeding are seen, it is important to consult a doctor. The sudden appearance of the new spot on the skin that is changing in size, shape, or color that looks different from all of the other spots on your skin can be another symptom. Skin cancer is of different types with different causes. An exposure to Carcinogen (is a substance or agent that can cause cancer or it increases the risk of developing cancer. Known carcinogens include viruses (e.g. Hepatitis B), hormones (e.g. estrogens), chemicals (e.g. benzene), naturally occurring minerals (e.g. asbestos), alcohol, and solar radiation (e.g. ultraviolet radiation), chronic exposure to the sun is other causes of skin cancer. For e.g., many people of Kashmir suffers from skin Cancer because of the use of Kangri. This happens because of the chronic exposure to the heat and generally develops on the inner side of the thighs.  Skin cancer can be treated if it is medicated at the very stage. Complication will increase if it remains ignorant for a long time.  A person should consult a doctor, the moment a symptom is suspected. 

 

 

A medicated sunscreen is the best option, depends on the skin type a person got. For e.g.  Dry or oily skin. SPF stands for Sun Protection Factor, 20 -25 SPF is suitable for the people who work indoors and the high power SPF for the people who usually work outdoors. SPF is basically to protect or prevent from sunburns, thus, a person who is exposed to the sun for longer duration like the trekkers, farmers etc. should apply sunscreen with higher SPF. The habit of applying sunscreen from a young age is very important and beneficial. 

 

 

UVA and UVB are the spectrum of simple lights. UVA (Ultraviolet A) and UVB (Ultraviolet B) rays cause many skin diseases. UVB is responsible for the sun burns and UVA for the pigmentation and wrinkle.  The best option is to buy a sunscreen which blocks both UVA and UVB. 

 

 

Acne is usually seen in the adolescence. Common acne in teenagers starts with an increase in hormone production. Testosterone is a particular hormone found in both male and female. Testosterone signals the body to make more sebum, the oil produced in the skin's oil glands. It starts when greasy secretions from the skin's sebaceous glands (oil glands) plug the tiny openings for hair follicle. Acne has many subtypes-mild acne and severe acne. The mild type of acne can be treated with antibiotics and a good face wash. A severe type of acne lasts longer and leaves scars which takes a year to get rid of it. Early medication and treatment are best for this type of acne.

 

 

The simple thing is wrinkle comes with age. But premature ageing and wrinkle comes because of the photodamage to the skin. It is one of the common issues in Ladakh and high altitude places.  Ultraviolet rays are directly related to the wrinkle. The sunrays cause damage of collagen which is mainly responsible for the elasticity of the skin.  For the prevention of wrinkles, use of sunscreen at an early age proves to be better. All the anti ageing products contain retinol. The standard amount or percentage of retinol present in the anti ageing cream should be 0.19%. Use of sunscreen at the early stage can prevent photo ageing and the best I would suggest is to use medicated creams.

 

 

To halt ageing, I would suggest, use of good medicated sunscreen at an early age. The sunscreen should be applied frequently, twice or thrice a day.  In European countries, people use sunscreen at night also, this is because the fluorescent bulbs also emit ultraviolet radiation. 

 

 

Vitamin D is very important and the Ladakhi people have a low level of Vitamin D. We had a study done in the Orthopedic department and found that most of the patients have a low level of vitamin D which causes weakness of bone, joint pains, bone pains and even fractures. Vitamin D is best obtained from the sun. People who are not allergic to sun rays can sit in the sun for an hour or two daily or alternate days. It is difficult for a person to obtain vitamin D from the sun if he /she are allergic to sun exposure. The only option is the consumption of vitamin D supplement.

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