Dermatologists Not Only Acquire Knowledge to treat Patients but Also Care for Themselves.

“Regular laser treatments and Botox are essential for a youthful complexion.”

Ultraviolet (UV) radiation is a pollutant that causes sunburn, skin darkening, melasma, freckles, dark spots, and many other skin problems. Although skincare products and supplements can help soothe the skin, “avoiding sunlight” remains the primary preventive measure recommended by dermatologists.

This issue of MedPark Stories is set at the Dermatology and Aesthetics Center at MedPark Hospital, featuring Dr. Nicha Rungsimanond, a dermatologist specializing in skin disease, skin cancer, skincare, aesthetics, and the “laser” for skin rejuvenation, which is currently very popular. Let us delve into her story and discover some fun facts and tips.

Dermatologists Can Diagnose Diseases with the Naked Eye

After graduating with first-class honors in Medicine from Chulalongkorn University, Dr. Nicha pursued further studies at Boston University in the United States, obtaining a doctorate in Dermatology. She also pursued a fellowship in Mohs surgery for skin cancer & dermatologic surgery & laser treatments. She worked as a dermatologist at Bumrungrad Hospital for over 13 years before joining MedPark Hospital.

When asked what sets dermatologists apart from other medical specialists, a typical response is that they can diagnose diseases just by looking at a skin lesion for a few seconds.

"In the beginning, all seems hard. Each rash looks red, yet with exposure to various types of rash, you discern it is not merely a red rash; it might indicate this or that ailment. For example, skin wounds or irregularities are visible, whereas abnormalities in other organs are internal, mandating special diagnostic tools."

What may appear to be an ordinary rash can be skin cancer. However, from the perspective of dermatologists, skin cancer is not as scary because it can be diagnosed quickly through surgical biopsy.

“The advantage of dermatology is that a skin biopsy is straightforward. If the skin shows changes indicating a risk of skin cancer, we can take a tissue sample for testing. If the rash is a fungal infection, we can easily scrape it for testing. It is an external procedure, readily accessible than other specialties that require endoscopies or internal surgical biopsies for diagnosis.”

For sunscreens, a higher SPF number is not as essential as the amount used

Lifestyle behaviors can be a cause of skin diseases, as well as genetic and hereditary factors. Dr. Nicha explains

“Asian people and individuals with darker complexion are at a lower risk of skin cancer compared to fair-skinned Europeans. However, everyone can be at risk of developing skin cancer. Therefore, prevention is crucial. Sunlight not only causes skin cancer but also leads to premature aging. If you ask how to prevent it, avoiding sun exposure is the best method. There is no need for sunbathing; it is not necessary.”

When it comes to the SPF of sunscreens, many people are curious about the best SPF level.

“Most people look for sunscreens with high SPF, thinking the higher, the better. Sunscreens with an SPF of 30 and over are sufficient to protect against UVA/UVB rays. The key is not the SPF number but the amount used. Even if the SPF is high, using a small amount would not provide much protection. Plus, the types of sunscreen, physical and chemical, matter. Chemical sunscreens contain chemicals that absorb radiation, while physical sunscreens, which reflect radiation, offer better protection.”

Apart from SPF, many have heard that one should apply a two-finger-length quantity of sunscreen. Let us find out what Dr. Nicha has to say about this notion.

"When testing for SPF, this (two-finger length) is the amount they use, known as the standard dose. However, in real life, we might swim, sweat a lot, or wipe off our sweat, which can reduce the amount of applied sunscreen. Hence, SPF is not the definitive measure since testing does not replicate real-life conditions. The amount used is more important than the SPF number.”

Skin cancer is not as concerning as it may sound.

When it comes to treating "cancer," people often think of chemotherapy, surgery, and radiation, all of which can be painful and distressing. However, skin cancer is different, and Dr. Nicha does not want patients to worry too much.

“Skin cancer is eminently treatable. The most common type is basal cell carcinoma (BCC), which is not harmful and seldom metastasizes to other organs. If there is any skin abnormality, especially a wound that does not heal for months or years, bleeds, or suddenly grows, it is best to see a specialist. If untreated, it can grow larger, making surgery more challenging.”

Some skin cancers, like certain types of melanoma, are not easily cured as they can spread to other organs. However, early detection allows for effective treatment.

“Not all dermatologists can perform Mohs surgery. Only those with specialized training can. In this procedure, we excise with a one mm. margin around the cancerous cells and examine the tissue under a microscope. If cancer cells remain, we excise more from the specific area before closing the wound. Thus, the excised area is quite small.”

From her 13-year experience as a dermatologist, Dr Nicha has noticed an increase in patients with hives recently.

“What is surprising is the increase of hives. Upon testing for antibodies against parasites, many tested positive. So, if you have hives, it might be worth checking for parasites. Nowadays, more restaurants serve raw or undercooked food, even premium ones. It is important to prioritize your health.”

The signs of aging on uncared-for skin become more noticeable as you age

Let us get back to the topic of skin and aesthetics. The desire of Dr. Nicha to become a dermatologist was not just to care for patients but also to take care of her skin. During her time as a medical student at Chulalongkorn University, most people focused on treating acne using AHA acid products or CO2 lasers, which were not widely known back then.

“Laser therapy has gained popularity in the last 20 years. In my youth, it was non-existent. Upon immersing in this domain, I learned that it involves not just acquiring expertise to aid patients but also for self-care. I wish to convey that neglecting your skin will accentuate aging appearance with time."

“For glowing skin, regular skin laser and Botox are essential. It is not a one-off thing. If a patient wants a single laser treatment for skin rejuvenation, that is impossible. However, we can maintain skin condition. Over ten years, the difference between someone who takes good care of their skin regularly and someone who does not will be substantial.”

Dr. Nicha always emphasizes to patients that the best time to start maintaining youthful skin is as early as possible. Do not wait until you feel old to start. The truth is we age every day. Starting maintenance early on helps delay aging.

“I am not saying patients will be wowed immediately after treatment. It does not produce a miracle. However, if you continue over time, in ten-year time, the difference from someone who has not done anything will be evident.”

Lastly, Dr. Nicha shares her skincare tips.

“Avoid sun exposure as much as possible. Apply sunscreen liberally, cover your skin well, and maintain skin youthfulness with regular laser treatments. Because I have trust in this technology.”