An uncanny ability to diagnose skin diseases with the naked eye.
“I derive happiness when my patients appear more attractive or confident, as this has the potential to radiate or invigorate their lives.”
Undeniably, people have become more self-conscious about their body physiques and looks, given that exercise, dietary supplements, and cosmetic surgery are increasingly popular. To answer the needs of beauty-conscious people, the Dermatology and Aesthetic Clinic at MedPark Hospital provides consultation and treatment for skin diseases and deploys technologies for skin care and body contouring.
In this issue of MedPark Stories, we talk with Dr Bo – Dr Nutthamon Bowornsathitchai, a dermatologist with experience in laser aesthetics and treating dermatitis, contact dermatitis, autoimmune skin diseases, and skin cancer. Beneath the radiant smile of Dr Bo, every moment is replete with the joy of providing consultation and care for patients. We believe Dr Bo must have some valuable insights to share with those embarking on a journey toward beauty. Let's follow along!
Most skin diseases are diagnosable with naked eyes.
Dr Bow has been interested in dermatology since she was a medical student. In year 5, a clinical year, she had no hesitation in choosing dermatology for elective clinical rotation.
“For other organs, you may need instruments or an X-ray machine to help make the diagnosis. As for skin lesions, they are out in plain sight and tangible. Therefore, skin diseases are unique in a way. Patients come with various types of rashes. The same disease may give rise to different types of rashes, but rashes that look alike may not be due to the same disease. So, I feel that dermatology is intriguing.”
After graduating from the Faculty of Medicine, Siriraj Hospital, Mahidol University, Dr Bo practices at an upcountry hospital during a devasting flood, leading to an influx of patients with skin complaints.
“I was a general practitioner back then with no expertise in dermatology. Most patients came with fungal skin rashes. It was difficult to differentiate the rashes; I was not confident. Skin conditions like red rashes or scaly skin may look similar, but the causes can vary. They could be due to different diseases. So, I realized I should have a residency training in dermatology.”
Dermatology residency is not as easy to get into since it is highly competitive. In addition, dermatology residency programs certified by the Thai Medical Council require four years of training and are only open for 20 applicants per academic year. The exam was not the only difficult thing; the training was vigorous. There were plenty of things for her to learn.
“I took several courses. I was a dermatology resident at the Institute of Dermatology of the Ministry of Public Health for two years. Then, I continued with a clinical fellowship in dermato-surgery, involving laser, dermatologic procedures, botulinum toxin and filler injections, skin surgery, and skin cancer treatment at Siriraj for a year. Afterward, I was a dermatology fellow at Chulalongkorn for four years. All in all, it was quite a long journey.”
Staying up to date with beauty trends is a must for a dermatologist.
Rashes that look alike may be due to different diseases. That is why being observant with a knack for details is an essential attribute of a dermatologist.
“There are subtle differences between each type of dermatitis. However, since I have treated numerous cases, I can make a spot diagnosis without additional tests if I encounter rashes and scaly skin of specific types or on specific areas of the body, which is a special skill for a trained dermatologist. Moreover, you need to have strong attention to detail. You must be very meticulous when performing a procedure.”
When discussing 'skin,' it inherently intersects with the concept of 'beauty.'
Dermatologists should remain current with trends in skin and appearance care. This involves staying informed through journal readings, experimenting with new instruments, and carefully evaluating the advantages and disadvantages of dermal fillers.
“In my years as a medical student, botulinum toxin and fillers were novel concepts. Today, they have become immensely popular. The market now offers numerous skin and collagen stimulators. It is not limited to women; even men over 30 have likely experimented with these injectables. The desire for a youthful and attractive face extends to everyone, aiming to enhance their appearance and boost confidence in professional and social settings.”
Dr Bo encounters patients who present with adverse effects resulting from counterfeit fillers or dermatologic procedures administered by non-professionals. Additionally, some patients experience allergic reactions attributed to low-quality soaps, creams, and cosmetics.
“I frequently come across instances of counterfeit instruments and fake medications being employed in laser treatments or injections, resulting in severe skin infections, the formation of lumps, or even tissue necrosis. Everyone must prioritize the safety of medications and adhere to the standards of cosmetic instruments. Moreover, dermatologic procedures should be exclusively the domain of physicians with significant experience in performing them. Addressing problems that arise from such procedures can be challenging, often requiring extensive measures to reverse their effects.”
“It is strongly advisable to thoroughly evaluate any cosmetic products before making a purchase decision. Opting for cosmetics supported by research studies or possessing FDA approval is prudent. Unauthorized cosmetics may contain harmful ingredients that can result in skin irritation, allergic reactions, or other adverse effects. Seeking guidance from dermatologists is advisable to ensure both safety and long-term skin health.”
Nurture your skin, hair, and body physique with the comprehensive care available at MedPark Hospital.
MedPark Hospital upholds stringent treatment standards by administering quality, safe medications backed by thorough research. Our facility utilizes cutting-edge tools that adhere to international standards for treating skin diseases and beauty care. To provide a more comprehensive understanding, Dr Bo guided us on a tour showcasing the advanced laser equipment employed in the 'Dermatology, Aesthetic, and Hair Clinic.'
“We possess picosecond laser equipment designed to address blemishes and enhance skin condition, currently in high demand. Additionally, for red marks, port-wine stains, or vascular lesions removals, we rely on the Vbeam laser that delivers effective results despite its age. Should you seek the elimination of skin tags, enlarged sebaceous glands, or moles, our facility has CO2 laser units for this purpose.
“A Fotona laser device is for hair depilation and skin tightening. It is versatile laser equipment capable of tightening the vagina with various probes emitting different wavelengths. In addition, we also have ultrasound equipment called Ulthera for facelifts and skin tightening without surgery. It has immensely gained in popularity as well.”
“For body contouring, the clinic deploys a trendy SculpSure laser device that accurately reduces fatty tissues or stubborn fat refractory to exercise and dieting. The clinic also employs Emsculpt, which stimulates thousands of muscle contractions, provides buttock-toning treatment, and helps build a six-pack abs. The clinic utilizes laser treatments, platelet-rich plasma injections, and transplant surgery for hair restoration. We can say that we provide treatment from head to toe.”
Psoriasis misconception
Speaking of chronic, incurable skin diseases, Dr Bo mentioned psoriasis, a disease with many causes, such as genetics or environmental factors that compromise the immune system, like stress, certain medications, and alcohol.
“Psoriasis is inherently not curable. However, more than 90% of patients can manage and keep the disease under control. Apart from phototherapy and topical and oral medications, treatment modalities for psoriasis include biologics, which target specific cells or substances like interleukin and tumor necrosis factor (TNF). Biologics deliver highly effective treatment outcomes and help keep the condition at bay. The disadvantages of this modality are the high price and the need for continuous use. Skin plaques are likely to recur once patients stop using biologic drugs.”
Despite having access to advanced tools for treating psoriasis, there is a misconception that the condition is contagious or infectious. It becomes the responsibility of physicians to address and rectify this misunderstanding for both patients and their families, assuring them that psoriasis is non-infectious. Dr Bo also provided another example of a skincare misconception.
“Some patients with dermatitis think that their skin is dirty, so they clean their skin with alcohol, which only worsens the inflammation, leading to more rashes. Dermatitis is due to improper skin care. People with dry skin and weakened skin barriers are prone to dermatitis. Regular use of cream and moisturizer can improve the health of your skin and attenuate the rashes, preventing inflammation in the long run.”
Fair skin complexion galvanizes your life.
There were many remarkable cases throughout her career in treating patients with skin diseases. Treatment difficulty varies from case to case. Dr Bo provided one example of a patient seeking skin consultation who ended up with a psychiatrist referral.
“For this patient, the skin condition was secondary to their state of mind, stress, or psychiatric disorders, causing them to scratch their skin subconsciously. This kind of case is quite rare. I had to calm the patients by talking to them, trying to help them, and listening attentively. Solving the problem step by step improved the rashes.”
“Some people may have a severe psychiatric condition called delusional disorder. Patients may believe that there are bugs or something inside them. We must listen to them and not try to interrupt. However, if the patient does not improve, we may need to refer them to a psychiatrist.”
The joy for a dermatologist is the ability to deliver effective treatment for patients and level up their quality of life.
One notable case involves a patient under my care for an extended period, attending regular follow-up appointments spanning several years. This patient was so satisfied with the quality of care, vouching my services to their entire family, including the father, mother, brothers, and sisters. It was a gratifying experience as I felt a sense of responsibility for their well-being, akin to caring for members of my own family.
“When my patients experience an enhancement in their appearance or newfound confidence, it brings me great joy. Witnessing their beauty radiate and empower them to lead more fulfilling lives, engage in activities, and work with increased confidence fills me with pride.”
In her leisure time, Dr Bo prioritizes spending quality moments with her family, enjoying outings, engaging in various activities, practicing yoga, and swimming. Regardless of the activities she pursues, Dr Bo consistently prioritizes the protection and care of her skin.
“Skin is the outfit that we always wear. What is beneficial for your skin in the long run is to protect your skin from the sun by applying sunscreen regularly. Because sunlight not only leads to dark spots on your skin but also destroys collagen in it, which will cause you to have wrinkles early and may be at risk for skin cancer. Also, do not forget to take a holistic healthcare approach, which includes having healthy dietary habits, getting enough sleep, and staying hydrated. This approach improves your skin from the inside out.”
