Dermatology in Clinical Practice

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That in and of itself gives me a greater connection. So, for example, if I have a patient coming in with eczema and Atopic dermatitis, we're talking about different management approaches. One of the things that can sometimes come up is if we're just taking a pharmacological approach and we're talking about steroids, a lot of people want to know, am I going to be doing these steroids for the rest of my life, is there any sort of way that I could do management that doesn't require the steroids to be used?

So then you have this rich knowledge in Ayurvedic medicine about all these different oils and how oils are used on the skin and, there's a rich, rich literature, rich history on different oil therapies and what they call oliation and what's known as abhyanga, so self massage or massage with oils. And it really opens up a conversation because you can start talking about moisturization but bringing in the science of natural oils and, this is an area that's started to really grow in dermatology, what's the role of coconut oil, what's the role of olive oil, what's the role of sunflower, safflower oil, this has now started to hit the medical literature.

What Ayurvedic medicine does is it goes one step further and you can do herbal infused oils and I have these conversations with my patients. I tell them, you know, why don't we talk about maybe some simple ways to make a herbally infused oil where you can have a moisturizer that is really based on an oil therapy. And what starts happening is, people start to become very engaged with themselves. Their skin becomes a part of them that they're not afraid of anymore and they're used to touching themselves in a way that's actually very therapeutic and then, you know, funny thing is, when I have these conversations then they realize that there's a holistic approach and then they're okay with using the steroids and they understand why we're using steroids and then it's part of a bigger picture approach to managing their symptoms.

Gazella: And now give us an example of a herbal infused oil. Like which herb would you put with the oil for which condition? Is it that simple? Sivamani: What you have is you have different dosha imbalances and different oils, there can be, some oils that are warming in tendency or they can be cooling, I mean, you have to balance that with the doshas but, I'll give you one example, which I think is a pretty good one.

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Coconut oil is widely used now as a moisturizer and sometimes what we can do is we can infuse, there's a herb called neem. Neem has both anti-bacterial and anti-fungal properties and we've been studying it. Actually, I have a basic science laboratory as well and we've been looking at neem specifically. But, one thing you can do is you can create an infused oil that has coconut oil as the base with a neem infusion and what that does is it gives you this oil that's not only going to be helpful for bolstering the skin barrier and nourishing the skin and, from that aspect but you also get that extra little antibacterial effect.

Now, I don't want to claim that it's an antibacterial like something that's been studied through the FDA but that being said, in eczema, sometimes, its smaller shifts in the microbiome and one of the things that we try to do is think about, from a practical perspective, can be infusing oil that might be able to touch upon those kind of aspects and then eventually it would be nice if we could start studying them in controlled studies and really looking at how, what is it doing to, for example, the microbiome?

Now what advice do you have to healthcare professionals who may be struggling to treat some of these difficult to treat skin conditions in their clinical practice? When it comes to treating conditions that are a little bit more difficult, I think it's important to realize that there's a team available and there's also the patient perspective. But I think the team approach is really important.

You're not alone and, what I mean is that, if you have someone that has a really bad itch, for example, we can do our best as a, myself, as a dermatologist, I can talk to them about what are some of the things they can do to help their skin not be as dry or are there some treatment options to help reduce the itch even from a pharmacological perspective. But then, I think it's really helpful to start thinking about the psychology of itch.

What are the other approaches that we can take so then, if we can get them to one of my colleagues in, for example, traditional Chinese medicine and they can take an approach where maybe they look at acupuncture, and that can channel in on a different aspect to itch and, you know, focusing a little bit more on some of the other approaches, I think that's where it really becomes important.


When you're struggling to treat a more difficult condition that may even be chronic, it's to start thinking about a team approach and I feel like that's the essence of integrative approaches anyway and so if we can start developing teams and developing good partnerships with other healthcare professionals then as a healthcare professional we won't feel alone and as a patient, the patient won't feel alone either and they see that there's a team working for them. Gazella: Yeah, absolutely, and that definitely is in line with the integrative approach that you described in the very beginning.

Now, you are an advisor to the company Dermveda. Why did you want to work with Dermveda and how is it different from other skincare companies? Sivamani: What I really like about Dermveda is it's focused on education and, if you look at the founding team, the founding team consisted of people that are really dedicated to dermatology, they're very good teachers and lecturers and, also they have a good education background and, I like education first approaches because I think if you can teach people to start thinking more deeply about their condition, and when I say deeply, not just about maybe the molecular mechanisms or some sort of cellular pathway but really understanding that that's important but, it's also important to think about things that may be affecting you emotionally or psychologically and allowing people the space to see that these are also important and by opening them up to have better conversations with themselves and their practitioners.

That's why I'm so passionate about this company. I'd personally really dedicated to education, I like education in all of its aspects and I think its really important to empower patients and practitioners and so, because of that approach, I really am drawn to the Dermveda's approach and also, the holistic and the integrative approach allowing us to learn about, not just conventional medicine but also thinking about Ayurvedic medicine, traditional Chinese medicine.

Our naturopathic colleagues have such great insight into the botanicals and into plant based approaches but I think that, giving a platform for this open discourse that's honest and credible is super important so that's why I'm so interested in this whole approach. He is a friend of the Natural Medicine Journal and on our editorial board. A very top-notch doctor so, that was exciting for us to see that as well. And now, Dermveda is also hosting an integrative dermatology symposium this October in Sacramento, California.

Can you tell us a little bit more about that symposium and why you feel it may be important for practitioners to attend. Sivamani: We are so excited about the symposium, the integrative dermatology symposium is going to be the first time where we're going to get all the different perspectives into the same room and have a good open discourse and really start talking to each other ina way that we can start building relationships. This symposium is going to really feature a wide variety of things.

You mentioned Dr Traub, he's going to be one of the speakers there.

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I still remember one of the first lectures that I saw with him and I was really impressed by, not only was he able to talk about the pharmacological approaches but it was so nice that he put in things about, and this was with eczema, we were talking about treating eczema, he had a lecture on that and, he put in things about a humor and what does that do for a child at the end of the night when they're about to go to bed, if you can have some way of getting them to laugh, does that make a difference?

I think its important to talk about these aspects and what we'd like to do in the symposium is really put that into a situation with all come together in a focused way where we have this combined goal of just making it better for each other to treat our patients and leaning what's new and what's coming out that's in the new literature and realize that any one perspective isn't the full approach. And, if you can start taking a different perspectives it really makes a difference and, I'll give you an example.

So one of the things that we're going to be talking about is like one of the lectures is going to talk about emerging approaches to eczema and there'll be conversations about all these new medications that are now coming out but then there's also going to be conversations about what is the latest science on the oils that are being used for eczema.

Which oils seem to be the best, which one's may not be the best. And then from there, they'll also swing into a conversation about diet and so, I think one of the things that sometimes we miss out on in just the medical education that we might go through is that you might get pieces and bits but when we start thinking about continuing education, you want to start really have good, honest discourse about all the aspects because that's really what the patient really wants.

They want to have a good, holistic conversation about everything. They want to know what can I do with diet or, what can I do with my lifestyle approaches. So, this is going to give practitioners, that attend, the chance to be empowered to understand what is the latest in that but not only that, I think the most exciting part about it is, we're going to get everybody in the same room and you just never know what's going to develop in those kind of situations. What kind of partnership and friendships are going to come out of that and I think that's the way to really push the boundaries of medicine so that when we talk about integrative medicine it really just becomes medicine and it's just the approach that we all would want to take with any patient that comes in.

Gazella: Yeah, that's a very good point and it sounds very comprehensive and we have a link to the conference. So, for our listeners who want to learn about more information about the integrative dermatology symposium, you can just click on that link and then you'll be able to find out more information. Well, once again, Dr Sivamani, thank you so much for joining me and I would also like to once again thank our sponsor, Dermveda.

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Dermatology Prescriptions for General Practitioners

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About the Sponsor Dermveda is an integrative skin care, beauty, and wellness site dedicated to inspiring and empowering people to develop a healthier, more holistic relationship with their skin. Transcript Karolyn Gazella: Hello. Before we begin, I'd like to thank the sponsor of this topic who is Dermveda. Dr Sivamani, thank you for joining me today. Raja Sivamani: Thank you so much for having me. It's a pleasure to be here. Gazella: Yeah, that would make a lot of sense. But, Ayurvedic medicine is really rich on the personalization aspect.

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  6. So that's one example that comes up very frequently in my practice. Sivamani: It's a little bit more nuanced. Gazella: Okay. But that's one of the examples of an infused oil that we might use.

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    Gazella: Yeah, that's a great example. Sivamani: This is such a fantastic topic to talk about. Sivamani: Thank you so much and it's been a pleasure to be here with you. Gazella: Great. Have a great day. Welcome to Player FM! Take it with you.

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    It's also a great way to discover new podcasts. So easy to find shows to follow. Six stars for Chromecast support. Diet Science is a fun 7 to 8 minute weekly program with insights and straight scoops on today's health and diet issues from Dee McCaffrey, CDC. Dee is an Organic Chemist who lost pounds, nearly half her body weight, and has kept it off for 20 years by staying away from processed foods. From archives of the National Wake Up Call, I Am Team Beachbody stories, and What I Know Now success tips from seasoned Coaches, this podcast is your one-stop source for personal development, business training and peer-to-peer inspiration.

    Forgot Password? Sign up for MyKarger Institutional Login. Itch - Management in Clinical Practice. Order this title. Albeit a very common symptom in dermatology, internal medicine, psychosomatics, neurology, and even oncology, itching was under-researched up until 15 years ago. Since then, the clinical aspects of acute and chronic itch have been examined extensively. As a result, some books on the topic have become available. Whereas most publications focus on experimental aspects and diagnostics, this volume of the series 'Current Problems in Dermatology' provides a comprehensive overview regarding the management of chronic itch.

    Select authors consider interdisciplinary aspects as well as age, body region, and specific diseases as they present a great variety of available treatments. All physicians with patients suffering from itch — especially dermatologists, general practitioners, gerontologists, nephrologists, hepatologists, neurologists, and palliative care doctors — will find this publication to be an essential source of information.

    Download PDF leaflet. Current Problems in Dermatology previous Vol.

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