europa skin care : natural, organic & science-based skin care
Showing posts with label Wood's lamp. Show all posts
Showing posts with label Wood's lamp. Show all posts

Sunday, November 12, 2023

Wood's lamp

Wood's lamp

Wood's lamp and vitiligo
Woods light can be used to detect vitiligo at a very early stage for preemptive treatment. It can similarly be used for an early assessment of the success of treatment. This article explains the working of wood’s lamp and its use.


Woods lamp is a simple and safe device which emits Ultraviolet rays in the wavelength range of 320 and 400 nm with a peak at 365 nm. This light is invisible to the human eye. It was invented by Robert W. Wood, a physicist from Baltimore in 1903.It is being used in dermatology since 1925, and examination under woods light can be useful in the diagnosis of many skin conditions like infections, and pigmentary disorders like vitiligo. It has recently been found to be helpful even in the diagnosis of certain skin cancers.

Principle
Certain tissues of the human body can absorb the woods light and then emit a light which is visible to human eye (fluorescence). This light is however so faint that it can only be seen when examined in a darkened room and the observer is dark adapted. The tissue hence appears bright in the darkened room.
Light emission from normal skin is very faint or absent. But diseased skin may start emitting visible light, and the appearance of such emitted light is usually different in different disease, which can be very helpful in diagnosis of such diseases.

Technique
Woods lamp is very simple to use in the skill technique can be learnt very easily. Here are a few basic things to know about it
  • Woods Lamp examination must be carried out in absolute darkness. There should either be no windows in that room, or they need to be covered very heavily.
  • The lamp needs to be warmed up before the examination and should be switched on at least 1 minute before examination
  • The examiner should be dark adapted, which means he / she should have been staying in the dark room for at least 20 minute before the examination. It helps to appreciate the contrast more easily and avoids errors.
  • The light should be held 10 to 12 centimeters from the skin
  • Medicine, ointments and grease should be wiped from the skin, not washed to prevent false negative interpretation.

Medical Applications of Woods Lamp  
Woods light was first used in medicine to help in the diagnosis of fungal infections like Tinea capitis and Pityriasis versicolor, but it has also been found to be helpful in other infectious disorders like, Pseudomonas infections, Erythrasma, and Acne vulgaris. We shall however limit ourselves to the use of woods light for the diagnosis of Vitiligo.

Wood's Light and Vitiligo:
Loss of pigment from the skin is the hallmark of vitiligo which can usually be easily seen by the naked eye in dark skinned people. It may however be very difficult to appreciate in fair skinned people because the difference in color of normal and abnormal skin is hardly any. This is where woods lamp can be very handy. The normal function of melanin is to block and absorb the light. Since there is less or no epidermal melanin in the vitiligo affected patches, it can not block the light emitted from deeper layers of the skin. The vitiligo affected skin appears like window of blue white light with sharp margins. Woods lamp s hence helpful in the diagnosis of vitiligo, especially in the fair skinned people.

Woods light can be used to detect vitiligo at a very early stage for pre-emptive treatment. It can similarly be used for an early assessment of the success of treatment.

Saturday, November 11, 2023

Top 4 Causes of Melasma, Best Treatments

Melasma is a benign skin condition characterized by excessive pigment deposition in the skin. Hyperpigmentation is most common in the area of the upper cheeks, forehead, and jawline.

The top 4 causes of melasma:
  • Hormones (estrogen, progesterone)
  • Genetics
  • Sun exposure
  • Inflammation of the skin
Treatment is based on reducing the production of pigment in the melanocytes. Although there are several alternative natural treatments, the most effective are the following:
  • Hydroquinone. Creams containing a combination of tretinoin, kojic acid, and azelaic acid have also been shown to improve the appearance of melasma.
  • Chemical peels
  • IPL
  • Fractionated Laser (Fraxel)
However, be careful as the last three treatments, although effective, can actually worsen the melasma if not done by an experienced physician.

Hydroquinone + tretinoin 
The best approach for treating melasma is a combination of a prescription topical regimen and chemical peels. The topical regimen should include a hydroquinone product with a minimum of 4% strength, and a tretinoin product at a strength appropriate for your skin type and condition. Hydroquinone helps to suppress the overactive pigment-producing cells, and tretinoin exfoliates the skin and repairs cellular damage while helping to drive the hydroquinone deeper into the skin.

Laser treatment for melasma : a Wood's lamp test should be used to determine whether the melasma is epidermal (upper skin), dermal (lower skin) or mixed (dermal and epidermal).
Wood's lamp
If the melasma is dermal, Fraxel laser has been shown in studies to provide improvement in many patients.

However, Intense pulsed light(or "IPL") will actually darken the spots. Dermal melasma is generally unresponsive to most treatments, and has only been found to lighten with products containing mandelic acid (such as Triluma cream) or Fraxel laser.


Prevention
Daily sunscreen use not only helps prevent melasma but is crucial in the prevention of skin cancer and wrinkles. Zinc oxide or titanium oxide physically block the sun’s rays.

Warning
By Harold J. Kaplan, MD - Los Angeles Facial Plastic Surgeon
We believe that IPL (and Fraxel for that matter) treatments are the worst choice for melasma for the vast majority of those that have it. Melasma can be an epidermal (upper skin), dermal (lower skin) or mixed (dermal and epidermal) condition. We have found that the only results we have achieved for treating melasma were achieved with Q-switched laser technology and only in cases for epidermal melasma.

But so few patients have just epidermal melasma that many actually get worse after light based treatments such as q-switched lasers, Fraxel and IPL treatments. Every patient that has come to our office after receiving Fraxel or IPL treatments elsewhere has had their melasma worsen after treatment.

Fraxel Dual a real breakthrough to improve melasma


Melasma -- treatment options
Topical
  • Lotions/creams/ointments
  • phenols (i.e. hydroquinone, mequinol)
  • retinoids (i.e. tretinoin)
  • azelaic acid
  • corticosteroids (i.e. dexamethasone, fluocinolone)
  • Chemical peels
  • trichloracetic acid (TCA)
  • glycolic acid
  • salicylic acid
  • tretinoin
  • phenol retinoid
  • phenol retinoid corticosteroid
  • phenol retinoid chemical peel
  • phenol retinoid corticosteroid chemical peel


Surgical
  • cryosurgery
  • lasers (i.e. er: YAG, Q-switched ruby, dye 510 nm,
  • CO2, argon, Nd: YAG, and frequency-doubled
  • Q-switched Nd: YAG)
  • dermabrasion