ultraviolet cure

My 10-year-old daughter has been suffering from leucoderma (smooth white spots on her skin) since she was three. Our doctor says it can be treated with ultraviolet rays. Please tell me if it is safe. Is there any other way to treat the disease'

The problem you have mentioned is not leucoderma, but vitiligo. Ultraviolet rays (UV) are traditionally used to treat vitiligo by skin specialists. Among the UV rays there are two treatment options ' UVA and UVB. Before UV exposure, patients are asked to take a medicine called psoralen. Which is why the therapy is also called PUVA. In PUVA the patient should be at least 12 years old, or else it can harm the eyes. If the patient is between eight and 12, he or she should be treated with a narrower band of ultraviolet rays (UVB-nb). So if your doctor has chosen UVB-nb, you need not worry about its safety. However, if your daughter does not respond to it, the doctor should opt for punch grafting, which involves taking bits of the skin from unaffected parts the body and grafting them on the affected spots.

dark patches

I am a 45-year-old housewife. Dark patches have appeared on both sides of my face. They surfaced years ago when I gave birth to my first child. Initially I ignored them but now they have spread across the face and have grown darker. Please help.

Probably you have melasma caused by overactive melanocyte cells (responsible for skin colour). It may run in families or may be a side effect of contraceptive pills. Even ultraviolet rays of sunlight may be the offending agent. Sometimes cosmetics are also held responsible for the problem. The most popular medical treatment is to apply a combination of tretinoin, hydroquinone and hydrocortisone at night. If this fails, the affected areas can be peeled with chemicals like glycolic acid. Keeping away from the sun is also necessary.

marks of acne

I am a 22-year-old man. My face looks ugly because of uneven scars on the cheeks caused by acne. No ointment or skin cream has been able to offer me any help. Please suggest a remedy.

Inflammation may have led to the uneven scars on your face. You might have pressed or picked your acne. There are several remedies like chemical peeling, dermabrasion (surgical removal of the topmost layer of the skin), chemical fillers, subcision of skin and laser surgery etc. They are used individually or in combination. Some of the procedures are invasive. For Indian skins non-invasive procedures (like chemical peeling) are preferred. For the deep depressed scars, laser surgery is the best treatment.

psoriasis hope

For the last 10 years I have been suffering from psoriasis. Large amounts of scales form in various parts of my body. They go away all of a sudden and then recur in a few days. No treatment works. Should I go for medicines at all'

Just because the disease appears and then goes away on its own doesn't mean you have to avoid all treatments. Psoriasis is one of those skin diseases which is characterised by remissions and exacerbations. For such ailments treatments need a regular follow-up. A lot of medicines (ditranol, topical steroid) can help cure the problem. In addition, tazarotene, oral methotrexate, oral retinoid, UVB-nb etc. can also help. Recently, some laser therapies have also been developed. Some new medicines are awaiting approval. I suggest you don't lose heart and carry on with the treatment.

black mark

My 18-year-old daughter has a bluish-black mark over her left cheek since childhood. Recently, it has deteriorated and spread to her forehead. Is there a remedy'

Probably she is suffering from a problem called nevus of Ota, which is caused by defective melanocyte cells. The mark can be removed by a special type of laser which destroys the melanocytes.