 Good morning. Welcome back to the Y254 channel. You are watching the Y in the morning show and this show actually runs every single day from 7 a.m. until 10 a.m. and particularly for today we're going to focus on health. It is my favorite day and right now we have a wonderful doctor on set with us, a very abled, very experienced doctor who has done medicine for actually the past 20 years and then decided to focus and specialize in dermatology or what we call skin doctor. She'll actually explain that. Let me not even try and explain that and actually you guys want to talk to us. We encourage you to do so. Please reach out to us on our social media pages on Facebook and Twitter. You can find them right at the bottom of the screen and also want to subscribe to our YouTube channel and also you can find me enjoy underscore much higher if need be on Twitter alone. And let's dive right in. Curry Boussana, doctor. Thank you very much. Thank you. Yes, and actually you're based at the doctor's park. That's right. Yeah, I'm based in Parklands at 3rd Avenue Parklands at Doctors Park. All right. And yes, I briefly mentioned that you had done medicine for 20 years and then specialized for five years. That's right. And so you've been doing dermatology for approximately the five years. That's right. That's wonderful. All right. And so maybe we can start off by the basics. We have some viewers that are not very familiar with the term dermatology. Maybe we can make it a bit simple for them by having an expert explain to them exactly what it entails, dermatology. Right. So dermatology is a special branch of medicine where the doctor specializes in the treatment of diseases affecting hair, skin and the nails. But dermatology also encompasses cosmetology, which addresses people's cosmetic concerns. And then venerealogy, which deals with venereal diseases. So some sexually transmitted diseases. And then leprosy, which is the treatment of leprosy. So all of that is actually management. Dermatologists will manage all of those conditions. I see. And when we were chatting a little bit earlier on, you made it clear to me that right now the number of certified and people who are allowed to practice dermatology here in Kenya with certificates are around the number of 25 thereabouts. That's correct. And maybe we can touch on why that's the case before we dive in to the various skin conditions. Right. So about 25 board certified dermatologists in Kenya, which means that you've done the proper degree, come back, you've worked under supervision with the government, and then they've approved you to be a consultant dermatologist in the country. It's an expensive specialty. So all the dermatologists are trained outside of Kenya, some in Europe, some in the United Kingdom. And so obviously because it's expensive and there are not many people that have done that, we're only 25 serving a population of about 50 million, which is the latest estimated population of Kenya in 2019. So it's very few doctors that are dealing with such a large population and conditions that affect skin, hair, nails are big. And a lot of people may not even know where they must go and get help and can they even get help and which specialty will sort their issues out for them. So this is a prime opportunity for me to educate people that, you know, dermatology, there are dermatologists in and around, well in Nairobi and around in major cities. So you can get help for conditions that are bothering you. Right. And before we, before we get to let our audience know where they can get all the help for the skin conditions that they may have. And also towards the end, we're also going to touch on, is it a factor that maybe people don't know about skin conditions and dermatologists, or maybe is it just kind of an expensive treatment? But that's towards the end. Right now, I kind of wanted us to open up the world of dermatology and to touch on the areas that you focus on because you mentioned quite a whole list, hair, nails. You mentioned, I think, cosmetology, venereal diseases. And so do you work on all of these on a daily basis or have you decided to specialize in a couple? So we generally deal personally, I deal with all of them. Okay. Most patients are seen by a general practitioner who will then know that this condition will best be managed by a dermatologist. In my own, in my own practice, obviously most commonly we treat conditions of the skin. And there are lots of common skin conditions. I mean, just to give examples to the youth, you know, acne is one of the major problems. In little children, eczema, they can start developing eczema from about the age of three months. Nappy rashes are big. And then as you get older, aging is an issue that affects a lot of people. And then other conditions that can come up because of other systemic problems in the body. Psoriasis is one of those that we deal with, vitiligo, where people lose color, excessive sweating, hives. So the nice thing about dermatology is we deal with the population starting from day one right through to people's last days. So we will deal with pediatric dermatology and then adult dermatology. And then there's the medical aspect of dermatology, which is the treatment of conditions. And the surgical aspect of dermatology where we perform surgery to remove suspicious things on the skin, lumps and bumps, and we're worried about skin cancers and things like those. So with regards to the medical side of it, we're trained to deal with all conditions affecting skin hair and nails. Any venereal diseases, yes, we will link up with, you know, specialists in other fields if it's gynecology or urology to sort those out. So we'll work as a multidisciplinary team and not just alone. And then cosmetology, a lot of people are concerned now about wrinkles and, you know, wanting to look youthful later on in life. And apart from the advice that we give on nutrition and, you know, alcohol and things like those, there are cosmetic procedures that are done. So chemical peels and microdermabrasion and Botox, which is big, just to make, you know, people comfortable in their own skin. That's why, you know, we've done, we're trained in this specialty. I understand. And this is quite an interesting specialty because I understand that the skin is actually one of the, is it the largest organ? It is the absolutely joy. It's the largest organ. In case you youngsters didn't know that this top layer of your body is the largest organ in your whole entire body. And so, obviously, that means that there's some care that has to be put into it. It just can't be left to an owner. And so that's why we have specialists like Dr. Rube come on and tell us about some of these things. And now that you said the areas in which you specialize in, let's talk about most common ones right here in Kenya, and then we can slowly zero in. So when we're chatting, you discuss things like psoriasis, eczema, and you also mentioned aging as a factor. And yes, I can understand why people want to stay youthful forever. You know, you have to, and also because of so much the things we watch in the entertainment news with people literally not aging. And you're looking at your age, man, and thinking to yourself, why do I have these wrinkles? My age, man, doesn't. Oh, there's a way I could fix it. Maybe I can get a couple injections here and there. And I think it's a fascinating field that you're actually involved in. And right now in Kenya, I think acne is such an issue for youngsters. Acne, psoriasis, as well as eczema. And maybe you can shed some light on others, which are a problem. I think a little bit of hair loss here and there when it comes to middle age people. But at the moment, maybe we can discuss the most common issues in this region. So if we start with acne, what a lot of people will say is it's one of those teenage conditions. It'll disappear. Unfortunately, you do need to get treatment for it because the problem with acne is there is a genetic predisposition. So somebody in your family must have had acne. Youngsters will confirm that their siblings might have acne as well. And basically, because of the hormonal changes going on at puberty, the sebum gland under the skin on the face, especially chest, back and shoulders, produces too much sebum. So they have oily skin. And those pimples come up and they think they can sort it out themselves. A lot of people use a lot of home remedies. Now I'm a Kenan Indian, but I'm not clear on how turmeric and things like those will help. I've seen those on YouTube. So I can only comment on the medical treatment. The problem with acne is you can scar. That's the biggest problem. And which is why we would recommend that you be seen by a dermatologist. There are lots of treatment options available, starting from topical treatments to oral medication and obviously just general skincare. Now a lot of people will say there's a myth that people that have acne are unclean and things like those. That's not true because the sebum is produced from within. So obviously we do recommend washing your face, you know, twice a day. But the thing that I think most people need to know is where the diet is linked with acne. And for many, many years, a lot of people had linked up many things to acne, including nuts and dairy products and things like those. But the latest research has shown that a very high glycemic diet, which means very high diet in sugar actually worsens acne. So in a study where some patients with acne were on a low sugar diet, Ashley showed better improvement than the ones that were on a high sugar diet. But those are things that we discuss with you when you come in. The thing with the skin is it's the largest organ in the body that's right. It's the organ that everybody sees. You don't see your kidney, but you can see the skin. And it's associated with a lot of psychological issues if there's a problem on the skin. And people will try and hide it. And that's fine for areas that you can hide, but you can't cover your face. So if there are children that are being affected by acne, I would highly recommend that you go and see a dermatologist and get help because there is a lot of help that's available. And once they get clear skin, it improves their performance in school and their social interactions, things like those. And we'll talk a little bit more about the effects that some of these conditions have on our people because not only does that happen, but not only do they feel bad about themselves if they have acne, other kids bully them. They lose concentration. They can't focus in class. They keep thinking about how terrible their skin is. And like you said, the grades do go down until things are dealt with and treatment is given. And things start to blossom again. And that's because the child cannot focus. The child is not being bullied. They're happy in school and they're comfortable in their own skin. And maybe I could just talk about, because I have eczema and they called it specifically adult eczema. And yes, I have been given treatment for it, but I don't use it because I don't know what's wrong with me. I should use it because I did try it the first two weeks. I did see a difference. But thank God and thankfully, and not to bash anyone that has eczema on the face, I do tend to get on my hands and below my knees. And so that's where that is. And I did suffer a lot wearing a lot of leggings, wearing a lot of pull necks, wearing a lot of long sleeve clothes. And maybe we can touch a little bit about what eczema is because we talked about acne. Now we can chat about eczema and what some of these things. And then we can talk about the psychological effects that these skin conditions have on people. Because I know for me, I wasn't a happy kid just because of that. Like if it's gotten to a place, you're seeing me in a short skirt and short sleeves, that means I have overtone. I'm good now. Yeah. I don't mind if you see. Yeah. It's nice to listen about someone's journey with the skin condition. And you're absolutely right. It has a huge impact on the psychological aspect of that individual. So it's been called adult eczema because it came up in adulthood. But generally eczema, known as atopic dermatitis, will come up around about three months of age. So it'll come on the face where you get dry, itchy areas on the skin that weep. So you can have eczema. And the itching is quite, quite severe. And so babies, it'll be on the start up on the face and then it'll show up on their arms and on their legs. And a lot of mothers at that point get rather startled and they will switch to the internet and Google things on how to manage that the skin. And some people get it wrong because the problem is the skin is your first barrier. So it protects you from infections and things like those. Now if there's a dysfunction of that barrier, then we're worried about infections getting under the skin. And when you're itching the skin and there's this disruption, applying irritants on the skin can actually worsen that eczema. So if you come and if you're reviewed by a dermatologist, they'll make the diagnosis first of all confirm that it is eczema. There are 3,000 diagnoses in dermatology. So it's not that simple that anything that appears on the skin that 3 months must be eczema. It's not. So it's first of all a clinical diagnosis has to be made. And then moisturizing the skin is probably the most important thing in eczema. After moisturizing and giving you tips on bathing, a lot of people don't even know that you shouldn't over bathe the baby. Over bathe the baby. So like take them in for a bath like three times a day because bathing a baby will dry the skin out even more. A lot of adults go into the shower for 20 minutes, 30 minutes to dry the skin out. That's scorching hot water. That's scorching hot water, exactly. So hot water also dries the skin. So you've already got a dry itchy condition and then you're further drying the skin. And a lot of it is just because I suppose people haven't been educated about how to manage that skin condition. But dermatologists are quite clear with atopic dermatitis. There is a genetic history. There's allergies in the family or a predisposition to allergies. So in the family somebody might have itchy eyes or rhinos or asthma and the eczema. So if you have any one of those. I have all those four. Yeah itchy eyes, runny nose, yes. People with allergies are very intelligent Joyce. So you must be one of them. One can get all of them or different individuals in the family can get the different variants of it. So if you have got eczema, it's very dry skin. It needs to be moisturized with a proper moisturizer. There are obviously products out there in the market that claim that it moisturizes the skin, but a dermatologist will do what clinical studies have confirmed. So good moisturization and then obviously when it's active they need treatment. So the medicines that need to be applied to the skin, if it's very severe eczema, they will need oral medication as well. And something to knock out the itching because it is a very itchy condition. As you progress on in life and go into adolescence the location of the eczema changes. So it might not be on the face. It'll now be sort of within the folds. And then as you get older again and if you've never had eczema before, you can end up getting it on the extremes of your body. So on your hands, on your feet, on your face, on your scalp, things like those. Eczema's management is more about patient education and teaching them how to deal with their condition because eczema comes and goes. So it waxes and wanes. Not because we don't know what we're doing. It's because that's the nature of the condition. So if there's no triggers like cold weather, a lot of people will overdress during cold season and wear the wrong clothes. So we recommend obviously wearing cotton clothes, but if you're wearing synthetic material that'll irritate the skin and the eczema will worsen. Very hot weather will make you sweat and sweat is ineditant. Using the wrong soap can worsen eczema. So we teach you on all those aspects in the management of eczema so that at a home you're doing the right thing and the medication that we're prescribing puts you on it and