Skin & cosmetic treatments

Dr M Khawar Nazir, a cosmetic laser and hair transplant surgeon from Lahore talks about skin & cosmetic treatments

SN: Dermatology is considered an easy field to specialize in. Is it true?sni

As far as practice is concerned, you can say it is easy because it does not involve emergencies. Patients often come with conditions that require thoughtful, long-term treatment rather than immediate intervention. As far as its study is concerned, it is one of the difficult specialties in medical field. There are more than 1000 diseases of the skin. It is a vast and diversified specialty with many sub-specialties like dermatosurgery, phototherapy, skin cancer specialty, dermatopathology. These sub-specialties exist in the west but there are few experts here in Pakistan.sni

SN: Why are there few experts in our country?sni

There are many reasons. Firstly, Pakistan’s focus on medical research is limited and the doctors get less rewards compared to abroad. Therefore, they prefer moving abroad and practicing as they get highly paid there. Secondly, many doctors of other fields are doing the job of a skin specialist. For example, many plastic surgeons and general practitioners treat skin patients although it does not come under their domain. Moreover, people lack of awareness and education about skin care and related treatments. They usually prefer self-medication and come to us only when things get complicated.sni

SN: People usually avoid going to dermatologists because they think skin treatments are expensive. Your take on this?sni

General dermatology treats diseases and is not very expensive. These treatments are essential for skin health and should not be overlooked due to concerns about expense. Cosmetic dermatology on the other hand, is expensive because it is not a need. It enhances the beauty so there is a price for it. Also, women prefer going to parlors in the neighbourhood or street and spend thousands on steroid based facials. But going to a doctor to get cosmetic treatment seems too expensive.sni

Mothers or grandmothers’ skin is much better than that of young girls nowadays because they did not expose it to unnecessary things

SN: Do you think beauty salons have taken up the role of skin specialists in many ways?sni

Beauty salons offer various skin and hair treatments that we do not recommend. They may provide immediate results but eventually damage hair and skin. For example, hair rebonding damages the hair and causes hair fall. Similarly, facials also give immediate results but eventually cause problems like melasma, skin sensitivity and excess hair. This is because salons use steroid based creams. Women must understand that beauticians may be skilled in their work but lack medical knowledge. They are not aware of the basics of skin, hair and nail problems and how they can be treated.sni

Mothers or grandmothers’ skin is much better than that of young girls nowadays. They do not have sensitivity issues or melasma because they did not expose their skin to unnecessary things. Moreover, media is also to be blamed for the way they project skin related issues. Beauticians come on morning shows and guide people about skin and hair issues and people follow them. Prefer a parlor when you require self-grooming, makeover for a party or function or blow drying. But if there is a skin problem then avoid doing experiments and consult a doctor. He will diagnose the problem and treat it accordingly.sni

SN: Why is white complexion a beauty standard in many cultures? Also what can be done to change this mindset?sni

Cultural preference for a lighter complexion is deeply ingrained in many societies. This is mainly due to family and societal pressure. Media and celebrities are also reinforcing this. Parents should teach their children to be confident and not pay attention to comments about their appearance. When anybody tries to put doubts in their minds, simply shun them off. Teach them that success and self-worth is not determined by skin tone. People get inspired by celebrities but many of them have dark complexion. They all look perfect on TV because of makeup and lights. Also natural skin color is a unique characteristic and altering it artificially can lead to complications.sni

SN: Exposed areas of many people are dark whereas unexposed areas are light. So which is the natural color of body?sni

The color of unexposed areas of body is actually the natural color. Every individual has a different skin type and only a doctor can determine what suits best. He can help achieve natural color using safe medical techniques and medicines.sni

Women aged 30 to 35 want to look 15 years younger than their age. They are ready to go through every procedure to look young which is not possible 

SN: Other than complexion, what other problems do brides-to-be come with?sni

Their main concerns are acne, scars, pigmentation, unwanted body and facial hair. Some get pimples near to the wedding day because of stress. We recommend medicine to control acne. For facial and body hair we use laser. Some of them have unrealistic demands. So, we counsel and educate them on what is achievable and healthy for them. We also assess the kind of social pressures they have and try to neutralize them by making them understand the importance of self-acceptance.sni

SN: What are some unrealistic expectations of patients?sni

Patients with unrealistic expectations are never satisfied with their bodies. They want to keep changing them. This is called body dysmorphic syndrome. Some demand extraordinary big lips despite our guidance on what will look natural and what not. Also, they are ready to pay more for it. We try to convince them and sometimes even refuse such patients. Because we know they will never be satisfied and cause problems for us too.sni

Similarly, if we recommend one injection for skin whitening they demand making it five. Women aged 30 to 35 complain they are not young enough, are out of shape and their color has faded. They want to look almost 15 years younger than their age and are ready to go through every procedure to look young which is not possible. We explain to what extent improvements can be made. But we cannot reverse their age.sni

SN: What is the biggest misconception regarding laser?sni

There are many misconceptions regarding laser in Pakistan. Commonest one is that it removes hair permanently. There is just one kind of laser which is suitable and recommended for Asian skin. Unfortunately, it is too expensive and sometimes substituted with less suitable alternatives which can be ineffective and potentially damaging to the skin. Moreover, lack of proper training (to use the equipment) can be dangerous for the patient. Laser is definitely useful if done with proper machine and by an expert.sni

biggest misconception regarding laser-shifanews

SN: Organic shampoos and skin products are very popular nowadays. Are they really effective?sni

Not all of them are safe to use because they can cause irritation or allergy. However, some are effective for some people whereas they may not have same impact on others. If you do not have any skin problem and want to use over-the-counter products, then initially do patch testing; apply a small amount of product on your arm, neck or behind your ears and wait for 24 hours. If it does not cause redness or any other symptom, then it is safe to use.sni

If you have skin issues like eczema, psoriasis, dandruff or fungus in the skin etcetera, it is better to avoid these products because they can worsen the condition. Consult a skin specialist for proper guidance.sni

SN: What causes hair fall in men and women?sni

Hair loss in men and women is different. In men, it is usually androgenic; the body’s hormones and genes play a role. This type of hair loss is mostly irreversible. Women usually experience hair fall due to internal and external stress factors like pregnancy, breast feeding and weight gain or loss etcetera. Hormonal fluctuations causing weight gain and acne also impact hair health. Anemia is another cause of hair fall in women. Treatment depends on the cause.sni

SN: What are the ways to keep skin healthy?sni

Firstly, admire yourself and consider yourself as the best. Otherwise, no one else will. Stand in front of the mirror and be grateful for what you are instead of picking faults in your looks. People who are internally satisfied are the happiest and this reflects on their face too. No one is perfect in the world.sni

If you want healthy skin, hair and nails, just stop stressing yourself. Secondly, start skincare routine. Moisturize your skin otherwise it will become dry and wrinkly and lead to premature aging. Also, use a sunblock and reapply it every two or three hours as it becomes ineffective after that. Choose a sunblock with at least 30 SPF (sun protective factor). Thirdly, drink plenty of water to keep your skin internally hydrated.sni

Exercising also has a positive effect on skin. Furthermore, face is the most important part of our personality. It also reflects your health. So do not take any chances with it. In case of any skin problem, always consult a dermatologist.sni

SN: Suggest ways to maintain hair health.sni

For hair health, avoid extensive treatments and chemical based shampoos. Use any regular shampoo daily or every other day. In case of medical issues like dandruff or hair fall, consult a doctor.  Avoid hair treatments like keratin, protein, rebonding and ironing. Many patients complain of hair loss after such treatments. Use a conditioner depending on your hair type. Those with dry hair can use it daily or every alternate day. Ensure the conditioner does not touch the scalp. Just apply it on the hair.sni

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