Dr Rajan is a prolific writer and his articles are published in various newspapers, websites, journals and online magazines.
One of his latest articles got the homepage coverage on April 12, 2020 in the popular Online magazine Complete Wellbeing is Has Mankind Finally Met God?
Recharge your batteries in Speaking Tree as well as Economic Times also got good reviews:
Dr Rajan TD writes
Spare a thought for the Physician in the Covid clinic. Dermatologists are the lucky ones.
Dr. Rajan T.D.
Doctor deaths in India upto July 1, 2020
After a 1 ½ month break due to lockdown, I have been attending the clinic since the past 6 weeks. The consulting practice of about 6 hours per day was drastically curtailed to less than two hours a day. The bustling OPD of BC (Before Covid) days were deliberately reduced to 4-6 patients seen at a 15-minute interval who were booked by advanced appointment. The receptionist takes special care to interrogate (harsh word, no?) the patient, rechecking that the patient is not coming from a Covid family or a Containment zone etc.
It took me and my staff about a week to get used to our new fashion: mask, goggles / face shield, long aprons and double gloves. This was sufficient for just skin consultation from a 3’ distance using illuminated magnifying glass and torches. Being a dermatologist I was lucky to postpone all skin procedures on the head, face, neck and other body parts due to which donning the cumbersome PPE could be avoided. Even wearing this was a huge task with the face shield or goggles getting foggy under the N95 mask and the unclear vision in an AC-switched off clinic. Seeing 4 patients in an hour, the head starts aching and it feels that it has been a whole day’s work.
The driver is paid salary but is asked to stay at home as he may be coming from a less than comfortable surroundings which scares everyone ranging from the clinic watchman to my residential neighborhood. Reaching home, the endless task begins… of telling family members to stay away as the door gets opened and the shoe gets sanitized, one darts straight to the bathroom where the ritual of spraying sanitizer on the wallet, comb, keys etc begins and ends with a scrub bath.
A quick meal and then, like never before, off to bed to relieve the stress of seeing less than a dozen patients – mind you, without any back breaking surgery. Aha, that is a great deal of work for the dermatologist.
The Real Workers
Now just imagine what must be happening to the chest physician, the ICU staff, the nurse and the wardboys who actually handle Covid-19 patients! Oh, one cannot thank them enough. I pray for their continued good physical and mental health. We all must say a small prayer for the silent Paramedical staff: the cooks, ward boys, laboratory technicians, ayahs, nurses, mortuary attendants, ambulance drivers etc. whose efforts ensure that the doctors are actually able to help their patients.
Also you all should be aware that over a hundred doctors all over India have lost the Covid battle themselves and are no longer with us. Let us also pray for the sustained good health of the families of each of the martyrs who gave up their life in order to save ours.
Let this post be a reminder to disbelieve all those news items which make a mockery of the medical profession as there are more angels around us than black sheep. May God give you all the courage to face this Covid challenge and emerge victorious both physically and emotionally.
Do Soaps Enhance Beauty?
Dr. Rajan T.D., MD, DVD, DNB
Until recently soap advertisements were confined to the press, and not many people paid much attention to them. However, ever since television advertising became popular everyone wants a soft and glowing complexion. Soap advertisements have done more harm than good as it has confused the customer. Many of our ancestors were as healthy as modern men even without using soap at all. Today everyone feels that they should use a particular type of soap as it will transform their skin dramatically.
Skin is the outermost protective shield of our body. It has to brave not only the ravages of heat and cold but also defend itself from environmental pollutants, insects and micro-organisms. A large number of microbes live on our skin without causing any discomfort or producing any infection.
Soaps are used to cleanse the body. They contain a mixture of fatty acids and other chemicals, which help in washing off grime, dust and microbes. Perfumes and colouring agents are added to impart pleasing odour and make it look attractive.
Specialised soaps contain glycerine and related substances in addition to the regular components. These chemicals help to retain water within the skin and hence, they are useful for people with dry skin. Oilatum, Dermadew, Glyfresh and Dove are examples of such moisturising soaps. Most baby soaps also have a similar composition so that they do not cause any harsh effects on the baby’s delicate skin.
Dry, Oily and ‘Normal’ Soap
Until about 2 decades ago, other than doctors, hardly anyone knew about dry skin and oily type of skin. With a strong media blitz, people were informed by soap manufacturers that they should select soap depending on the nature of their skin. Suddenly people were in a tizzy trying to find out what kind of skin they possessed. Until they identify their skin type, they would have to go without a bath, it seemed!
Yes, it is a fact that the nature of skin varies from one person to another. People whose skin produces a lot of sebum (the oily secretion from certain glands in the skin) possess “oily skin” while those who lack it are said to have “dry skin”. Some may have oily skin in some areas of the body whereas at other areas of their skin is very dry. This has been termed combination skin. The most fortunate one is the person with a good balance between oily and dry skin, i.e. “normal” skin.
Most of the soap manufacturers have modified the composition of their regular soaps and incorporated specific moisturisers in them so as to reduce the dryness of the skin. These soaps come with additional labels suggesting that they can reverse the dryness completely. Unfortunately they do not mention the exact composition of these soaps on the wrapper, since it is not required by law, and therefore doctors are unable to recommend them.
Lately pharmaceutical companies have started manufacturing soaps containing antifungal agents and anti-scabies medications which are to be used only on a doctors’ prescription, if there is a skin disease. There are also soaps for people with oily and pimple-prone skin. These are available under several brand names such as Acnil, Acne Aid etc. The cosmetic industry has also launched soaps like Pears Oil-control which are meant for oily skin
A modern stunt among soap manufacturers has been to promote ordinary soaps as ‘medicated’ soaps. They claim to “clear the skin of bacteria and make your skin stay young and healthy, forever”! Advertisements thrive on exaggerated claims. Even though the customer may not really believe the entire advertisement he is still tempted to “try out” the new product. There is no harm in experimenting with a new soap they feel.
Do these ‘medicated’ soaps really help?
Genuine medicated soaps are those that are prescribed by doctors for specific skin disorders. There are soaps containing medicaments which help in the treatment of fungal infections (Keto, KZ), scabies (P-scab), pimples etc. There are also moisturising soaps containing moisturising agents which help people with dry skin to some extent. However, most ‘medicated’ soaps advertised for the general public do not contain any significant medicine! That is because these ’medicated’ soaps contain mild antiseptic agents in addition to the regular group of chemicals.
Manufacturers claim that these substances remove bacteria from the surface of the skin. Whenever a portion of the skin is washed with soap and water, it remains clean and relatively bacteria-free for hours if kept clean. As the hours go by once again microbes start accumulating till the area is washed again.
Even if a medicated soap is used, the story is no different. Microbes will start growing the moment the effect of the antiseptic agent wears off. Therefore, using expensive medicated soaps only provide a false sense of security. Quite often parents’ question, “how can my daughter develop so many boils when she takes bath with medicated soap”? The answer is clear: any soap, whether medicated or not will provide absolute hygiene only for a short period. Boils or infections can develop despite using medicated soaps.
Soaps containing antibacterials, antifungals etc. are promoted freely even though medical professionals themselves debate over whether something that is rubbed on the skin and washed off in 30 seconds is really doing something? Yes, it does something good – to the manufacturer and the distribution chain!
Soap manufacturers have capitalised on the confusion among the public, which has been party of their making, and produced soaps containing varying grades of moisturisers and antiseptics. Those containing more moisturiser are recommended by them for people with dry skin and vice versa.
The type of soap to be used on the skin depends on the nature of the skin as well as the weather. As a rule of thumb, those living in places like Mumbai where the humidity is high and have oily skin or young men and women with a lot of pimples should not use moisturising soaps. Similarly people with dry skin should not use any soap too often for fear of aggravating their dryness.
In winter none of the soaps should be used excessively, particularly the elderly whose skin is dry. Soaps, therefore, hardly affect beauty. It surely helps to clear the skin of dirt and microbes.
Ageing gracefully with soap!
Age Skin type Soap or cleanser
Infants Sensitive skin Use baby soaps or those with moisturiser
Below 5 years Normal skin Baby soaps preferred, not compulsory in summer
5-12 years Dry, itchy skin Baby soaps preferred, not compulsory in summer
Normal Any soap during humid weather
Adolescence/Adult Normal skin; Any soap for body;
Oily skin on face Avoid moisturising soap for face in summer
Dry skin and dry face Moisturising soap all over
Above 50 years Dry Moisturising soaps during humid summer
Very dry, itchy skin No soaps in winter. Use minimal lather for sweaty body folds