How To Manage The Rise In Skin And Hair Related Issues Post-COVID?

New Delhi: While recovering from COVID-19, many patients suffer from hair and skin-related issues like hair fall, acne, body pimples, skin peeling, and herpes among others. According to Dr Sachin Dhawan, Senior Consultant Dermatologist, Fortis Hospital, Gurgaon and Co-founder, Skin n Smiles, there has been an increase in number of patients reporting skin and hair-related issues. People have been losing a lot of hair post getting COVID and generally, the skin is getting very dull. There has been an increase in the number of ailments as a result of either COVID or medicine used in COVID treatment and recovery, he said. NDTV’s Banega Swasth India team spoke to Dr Dhawan in detail to understand post-COVID issues and how long these last. Here is an excerpt from the interview.

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NDTV: What is mask acne and how common is it?

Dr Sachin Dhawan: Mask acne is a newly recognised subset of acne. When you wear a mask for a long time, your skin tends to sweat a lot and the bacteria and fungi get the right kind of environment which is moisture and heat to grow. Pimples are a result of it but not everyone gets it; people who have had pimples earlier get an aggravation as a result of this. Certain types of masks like if you are wearing a very rough mask, typically N-95 masks are very rough in nature, trigger it. My suggestion is, wear a soft cotton mask underneath an N-95 which is well fitted. Secondly, after taking off the mask, wash your face with water; take a little cold compression and cool your face down. It’s the heat that causes it so if you cool down, mask acne will be under control.

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NDTV: Do steroids taken as part of COVID treatment cause body pimples? How to treat them or how long do they take to go away?

Dr Sachin Dhawan: We know a subset of acne is triggered by steroid intake. Steroids increase the hydration of the skin and undermine the immune system. As a result of moisture being present and because of the immune system getting slightly suppressed, bacteria and fungi which cause pimples to grow more and cause pimples on the back, shoulders and chest and sometimes on the foreheads and sides also. It happens more to people who get dandruff because fungus causes dandruff and the same fungus causes pimples also. It is slightly different from normal body acne because this is slightly itchy. The good news is that, typically, it settles down on its own after three to four weeks. You can take anti-allergic if it’s very itchy. You can consult a dermatologist and take an anti-acne antibiotic course if it’s very uncomfortable or pus formation is there. But simple home remedies like putting calamine lotion over there would also be helpful.

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NDTV: Is it normal to get skin peeling after COVID? What’s the reason behind this and how long will it take to get better?

Dr Sachin Dhawan: During COVID, a lot of people get a small rash that is barely visible; that rash results in skin shedding. In the area where the skin is thin like face, and arms, a little bit of peeling happens and the skin recovers. Just use a moisturiser. But, in areas where the skin is thick like palms and soles, there the skin sheds two to three times and that starts two to three weeks post-COVID. It’s a normal thing. Important thing is to use a good hypogenic moisturizer two to three times a day and the skin will recover on its own.

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NDTV: Does one need to take supplements to maintain skin and hair post COVID? If yes, which ones?

Dr Sachin Dhawan: Supplementation is needed in case you are facing a problem. You have to maintain a good diet, a healthy lifestyle, stay away from stress and get back to doing moderate exercise as soon as possible as that will improve your circulation and in turn your skin and hair. But, if you are facing an issue like hair fall, then a Biopin and amino acid containing supplement will be required. For skin, it’s a good idea to take anti-oxidants. Most of us end up having sullen skin post-COVID so supplements containing vitamin A, C, and E; Selenium can be taken. A lot of us end up having dry skin post COVID as well, so vitamin E and omega-3 supplements would also be helpful.

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NDTV: Some people have complained of severe hair fall, losing as much as 50 per cent of the hair, post-COVID. What is the reason and will hair regrow?

Dr Sachin Dhawan: There is a kind of condition called telogen effluvium which used to happen before COVID also, after viral infections, major stress, surgeries, and others. In this condition, 40-70 per cent of hair follicles go into a shedding phase. The hair is just lying there; you pull/comb/ wash/apply medicine and they come out. This has increased post-COVID because COVID batters your body quite a bit and hair is not produced for a little while. However, the good news is that this cycle lasts for about 100 days and then the body automatically starts to produce hair. I have seen that it’s proportional to the intensity of COVID that you have had. If you had a very mild infection then it happens for a few days or maybe a week or two. In case of moderate infection, hair shedding will last two to three weeks. If you have had severe COVID, it takes three to four months to get better and in that situation, one can take the help of a dermatologist, take the right nutrients and use some hair serums which contain protein-binding agents.

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NDTV: How should the issue of dry scaly scalp post COVID be addressed?

Dr Sachin Dhawan: Dry scalp could be because of two reasons – increase in dandruff and COVID battering immune system. The fungus which causes dandruff tends to grow more; you can take one part of tea tree oil and put it on the scalp for about 10 minutes before wash. The second type of dry scalp would be as a result of general dryness of the skin. For this, putting organic oil like a cold compressed coconut oil half an hour before wash will be helpful. Don’t put oil for too long otherwise, it tends to let the fungus grow even more and dandruff tends to increase. Also, hydrate your body and take vitamins.

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NDTV: How to treat an increase in dark circles post-COVID?

Dr Sachin Dhawan: Dark circles happen because of the general loss of fat in the area around the eyes when you are ill. The skin around the eyes becomes thinner and the veins under the skin tend to become more visible so it gives a blueish-blackish look to it. Plus, if you are not sleeping well and worry a lot that aggregates the dark circles. Most people, who are quarantining at home, watch a lot of screens and that makes dark circles even worse. So, cut down upon your screen time. You need to do a gentle massage in the under-eye area to improve circulation. For that, take any moisturiser, anything that suits you, place it under the eye and just tap gently on the lower and upper eyelid for about two to three minutes every day on both eyes. If dark circles are more than mild, using vitamin K or C based creams or serum would be helpful. But one has to do it for two to three months for things to get better.

NDTV: Water bubbles like blisters on the right arm, which are painful emerge after three weeks of COVID recovery, what can be done to address these?

Dr Sachin Dhawan: Herpes Zoster is an infection that happens in certain parts of our body because of the reactivation of the Chicken Pox virus. It has been seen that after COVID or after taking the COVID vaccine, the intensity of this reactivation increases. It’s important to identify this earlier and get treatment from a dermatologist. There is a window of 72 hours in such conditions and if we start the antiviral treatment early, there will not be lasting nerve damage and the patient will get better in 15 days. But if we delay this and especially people who are diabetic, or have low immunity in general, they can experience pain for a long time.

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NDTV: Can people with eczema get vaccinated?

Dr Sachin Dhawan: Everyone should take the vaccine; whether they have a skin problem or not, unless, somebody is allergic to a vaccine. A mild allergy post-vaccination is manageable. Keep your dermatologist in the loop, consult them and they will give you counter-measures that can prevent the flare of the reaction from happening.

NDTV: COVID-19 has aggravated psoriasis which was under control with medicines. How soon can one go back to immune-suppressive medicines?

Dr Sachin Dhawan: One has to stop immune suppressive during COVID and one can go back to immune-suppressive after two weeks of recovery from COVID under the expert guidance of a dermatologist. Similarly, stop taking immune-suppressive for two weeks after vaccination so that antibody formation can happen.

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NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.