Physiotherapy In Dermatology conditions.pptx

PHYSIOTHERAPY IN
DERMATOLOGICAL CONDITIONS
Dr. Peteti Sairam
MPT(Neuro)
Asst. Professor

sairamphysio@gmail.com 2
INTRODUCTION
OVERVIEW OF DERMATOLOGICAL CONDITIONS
• Dermatological conditions are disorders
affecting the skin, which can impact
appearance, comfort, and overall health.
• They range from chronic conditions like
psoriasis and eczema to infectious diseases
and cosmetic concerns like acne.
THE ROLE OF PHYSIOTHERAPY
• Physiotherapy can complement medical
treatments by addressing symptoms,
improving skin care routines, and enhancing
overall well-being.

COMMON DERMATOLOGICAL CONDITIONS
PSORIASIS
It’s a chronic disease in which the immune system
becomes overactive, causing skin cells to multiply too
quickly. Patches of skin become scaly and inflamed,
most often on the scalp, elbows, or knees, but other
parts of the body can be affected as well.
Physiotherapy Role
• Stretching exercises to improve skin flexibility.
• Education on moisturizing to manage dry patches.
• Techniques for reducing discomfort.

Eczema (Atopic Dermatitis)
• Atopic dermatitis (eczema) is a condition that causes dry,
itchy and inflamed skin. It's common in young children but
can occur at any age. Atopic dermatitis is long lasting
(chronic) and tends to flare sometimes. It can be irritating
but it's not contagious.
• People with atopic dermatitis are at risk of developing
food allergies, hay fever and asthma.
PHYSIOTHERAPY ROLE
• Moisturizing techniques to prevent flare-ups.
• Education on avoiding irritants and triggers.
• Exercises to improve overall skin health.

Acne Vulgaris
Acne is a common skin condition that happens
when hair follicles under the skin become
clogged. Sebum—oil that helps keep skin from
drying out—and dead skin cells plug the pores,
which leads to outbreaks of lesions, commonly
called pimples or zits.
PHYSIOTHERAPY ROLE
• Advice on proper skincare routines.
• Potential benefits of laser therapy for scarring.

Rosacea
It’s a long-term inflammatory skin condition that
causes reddened skin and a rash, usually on the
nose and cheeks. It may also cause eye problems.
PHYSIOTHERAPY ROLE
• Education on gentle skincare.
• Laser treatments to reduce redness and improve
appearance.

Skin Infections
Infections caused by bacteria, fungi, or
viruses leading to symptoms like rashes,
itching, and inflammation.
PHYSIOTHERAPY ROLE
• Wound Care and Healing
• Improving Mobility and Function
• Reducing Scar Tissue
• Pain Management
• Education and Prevention
• Managing Complications

Vitiligo
It’s a chronic autoimmune disorder
that causes patches of skin to lose
pigment or colour. This happens
when melanocytes are attacked and
destroyed, causing the skin to turn a
milky-white colour.

Role of Physiotherapy in Dermatological
Conditions
Physiotherapy plays a supportive role in managing dermatological conditions by
addressing issues related to function, mobility, and overall well-being. While it isn't
a primary treatment for skin conditions it can complement medical or
dermatological interventions.
WOUND CARE AND HEALING
• Management of Chronic Wounds: Physiotherapists can assist with wound care
for chronic dermatological conditions like ulcers or post-surgical wounds. They
can provide guidance on proper wound dressing techniques, pressure relief, and
moisture management.
• Promoting Healing: Techniques such as specific dressings, compression therapy,
and the use of therapeutic modalities can enhance wound healing.

SCAR MANAGEMENT
• Scar Tissue Mobilization: Physiotherapists can use manual techniques,
massage, and stretching exercises to reduce the formation of scar tissue and
improve the elasticity and appearance of scars.
• Preventing Contractures: In cases of extensive scarring, especially from burns,
physiotherapy can help prevent contractures and maintain range of motion.
MOBILITY AND FUNCTIONAL REHABILITATION
• Post-Surgical Rehabilitation: Following skin surgeries or dermatological
treatments, physiotherapy can assist in restoring normal movement and
function. This includes exercises to improve strength, flexibility, and
coordination.
• Adaptive Techniques: For individuals with significant dermatological issues
affecting mobility, physiotherapists can recommend adaptive devices and
strategies to improve daily function.

PAIN MANAGEMENT
• Pain Relief: Physiotherapy can use modalities such as heat/cold therapy,
electrical stimulation, or ultrasound to manage pain associated with
dermatological conditions.
• Education: Teaching patients techniques for pain management and self-
care can also be part of physiotherapy.
MANAGING SECONDARY EFFECTS
• Muscle Weakness and Atrophy: Conditions like severe eczema or
psoriasis can lead to reduced physical activity, which might cause muscle
weakness. Physiotherapists can develop exercise programs to address
these issues.
• Reduced Range of Motion: Skin conditions that affect mobility or cause
joint stiffness can benefit from stretching and strengthening exercises.

PSYCHOSOCIAL SUPPORT
• Body Image and Confidence: Chronic dermatological conditions can impact
self-esteem and body image. Physiotherapists can provide support and
encouragement, helping patients adapt and cope with their condition.
• Stress Management: Techniques such as relaxation exercises or mindfulness
can help manage the stress that often accompanies chronic skin conditions.
EDUCATION AND PREVENTION
• Skin Care Education: Physiotherapists can educate patients on skin care
routines and preventive measures to avoid exacerbating their condition.
• Exercise Recommendations: For conditions that benefit from physical activity,
physiotherapists can design exercise programs that are safe and effective.

ELECTROTHERAPY MODALITIES

Ultraviolet (UV) Therapy
It’s a specialized form of light therapy used in the treatment of
various dermatological conditions. It utilizes specific wavelengths of
ultraviolet light to target skin issues.
• Types of UV Therapy
• UVB Phototherapy:
• Narrow-Band UVB: Uses a specific range of UVB light (around 311-313
nm). This is the most commonly used form for treating skin conditions.
• Broad-Band UVB: Uses a wider range of UVB light. It is less commonly
used due to a higher risk of side effects compared to narrow-band UVB.
• PUVA (Psoralen + UVA):
• Application: Combines the use of a photosensitizing agent called
psoralen with UVA light. The patient takes psoralen orally or applies it
topically before exposure to UVA light.
• Mechanism: Psoralen makes the skin more sensitive to UVA light,
enhancing the therapeutic effects.

Applications in Dermatology (UVR)
Psoriasis: UVB phototherapy is often used to slow the rapid growth of skin cells
characteristic of psoriasis. It helps reduce inflammation and plaque formation.
Eczema (Atopic Dermatitis): UVB phototherapy can be used to reduce inflammation
and itching in chronic eczema. It helps to stabilize the immune response in the skin.
Vitiligo: UVB therapy can stimulate repigmentation of the skin by promoting
melanin production in areas affected by vitiligo. Often combined with other
treatments, such as topical corticosteroids or calcineurin inhibitors, for improved
results.
Chronic Dermatitis: UV therapy can help reduce chronic inflammation and itching in
various forms of dermatitis.
Acne: UVA and UVB light can be used to reduce acne inflammation and bacteria.

Benefits of UV Therapy
• Provides focused treatment to affected skin areas, minimizing exposure to healthy skin.
• Can be an alternative to systemic medications, reducing the risk of systemic side effects.
• Offers significant benefits for chronic skin conditions that do not respond well to topical
treatments alone.
Risks and Considerations
• Prolonged UV exposure can increase the risk of skin cancer, so therapy must be carefully
monitored.
• Overuse or improper use can lead to skin damage, including premature aging and increased
risk of burns.
• Some conditions or medications can increase photosensitivity, so precautions are necessary.
• Short-term side effects may include redness, itching, and dry skin. Long-term effects need
careful monitoring.

LASER Therapy
Types of Lasers Used in Dermatology
Fractional Lasers
• Erbium YAG Laser: Targets the epidermis and upper
dermis for skin resurfacing and rejuvenation.
• CO2 Laser: Targets deeper skin layers and is used for
resurfacing, removing skin lesions, and treating scars.
• Fractional Laser Systems: Deliver laser energy in a
fractional pattern to create micro-injuries in the skin,
promoting healing and collagen production.
Non-Ablative Lasers
• Laser: Penetrates deeper into the dermis without
damaging the surface, used for vascular lesions, hair
removal, and skin tightening.
• Pulsed Dye Laser: Targets blood vessels and is effective
for treating conditions like rosacea and port-wine stains.

Types cont..
Ablative Lasers
• CO2 Laser: Removes the outer layers of skin (ablative) and is used for deeper
resurfacing, treating wrinkles, and removing precancerous growths.
• Erbium Laser: Less invasive than CO2, used for superficial resurfacing and
reducing fine lines and wrinkles.
Laser Hair Removal Devices
• Diode Laser: Targets melanin in hair follicles for long-term hair removal.
• Alexandrite Laser: Effective for hair removal and treating pigmented lesions.
Blue Light Laser
• Photodynamic Therapy (PDT): Uses a photosensitizing agent and blue light to
treat acne and precancerous skin lesions.

Applications of Laser Therapy in Dermatology
Acne and Acne Scarring: Lasers can reduce acne inflammation and kill bacteria.
Fractional lasers and other resurfacing techniques can improve the appearance of
acne scars. Reduces active acne and improves skin texture and pigmentation.
Hyperpigmentation and Melasma: Lasers such as Q-switched lasers and fractional
lasers target melanin in pigmented lesions or melasma. Helps to lighten dark spots
and even out skin tone.
Skin Rejuvenation and Wrinkles: Ablative and fractional lasers stimulate collagen
production and improve skin texture and elasticity. Reduces fine lines, wrinkles,
and improves overall skin appearance.

Application cont…
Skin Cancer and Precancerous Lesions: Lasers can be used to remove
precancerous lesions and early skin cancers. Offers precise removal
with minimal damage to surrounding tissue.
Stretch Marks and Scars: Fractional lasers and other resurfacing lasers
can improve the appearance of stretch marks and scars by promoting
collagen production. Helps to reduce the visibility of scars and improve
skin texture.

BENEFITS OF LASER THERAPY
• Precision: Targets specific areas with minimal damage to surrounding tissue.
• Minimal Downtime: Many laser treatments have relatively short recovery periods.
• Non-Invasive: Provides a non-surgical option for skin issues.
RISKS AND CONSIDERATIONS
• Side Effects: Potential side effects include redness, swelling, and temporary
changes in pigmentation.
• Skin Sensitivity: Some patients may experience increased sensitivity or discomfort
during and after treatment.
• Sun Sensitivity: Post-treatment skin can be more sensitive to sunlight, requiring
diligent sun protection.

Iontophoresis
Iontophoresis is a technique used in dermatology to deliver medication
through the skin using a small electric current.
How Iontophoresis Works
• Electric Current Application: A low electrical current is applied to the
skin via electrodes.
• Medication Delivery: The medication, usually in a gel or liquid form, is
placed on the skin or within a special electrode pad.
• Penetration Enhancement: The electric current helps the medication
penetrate the skin barrier more effectively than it would through
passive application.

Common Dermatological Applications
• Hyperhidrosis: Iontophoresis is often used to treat excessive sweating (hyperhidrosis) of
the hands, feet, and underarms. The procedure helps deliver anticholinergic drugs or
other treatments that reduce sweat gland activity.
• Psoriasis and Eczema: For these inflammatory skin conditions, iontophoresis can deliver
corticosteroids or other anti-inflammatory medications directly to the affected areas,
potentially reducing inflammation and itching.
• Atopic Dermatitis: Similar to psoriasis and eczema, iontophoresis can be used to
administer medications that help manage this chronic condition.
• Warts: Some treatments for warts involve using iontophoresis to deliver antiviral or
other topical medications that help in wart resolution.
• Acne: Though less common, iontophoresis can be used to deliver anti-acne medications
such as antibiotics or retinoids.

ADVANTAGES
• Targeted Delivery: Medication is delivered directly to the affected area, which can
enhance efficacy and reduce systemic side effects.
• Reduced Systemic Absorption: By focusing treatment locally, there's often less risk
of side effects compared to oral medications.
• Non-Invasive: It is a non-invasive method compared to some other treatments like
injections.
CONSIDERATIONS AND SIDE EFFECTS
• Skin Irritation: Some patients might experience redness or irritation at the site
where the current is applied.
• Temporary Discomfort: The procedure can sometimes cause a mild tingling or
burning sensation.
• Not Suitable for Everyone: Individuals with certain medical conditions or those with
pacemakers might not be suitable candidates for iontophoresis.

Electrical Stimulation
Electrical stimulation therapy primarily aims to enhance tissue repair, reduce inflammation, and
improve skin health through electrical currents.
Types of Electrical Stimulation Therapy
• TENS (Transcutaneous Electrical Nerve Stimulation): Often used for pain management, TENS
uses low-voltage electrical currents to relieve pain by stimulating nerves.
• EMS (Electrical Muscle Stimulation): EMS targets muscle contractions to enhance blood flow and
promote muscle tone, sometimes used in conjunction with other therapies for skin rejuvenation.
• Microcurrent Therapy: This involves very low electrical currents to stimulate cellular repair and
regeneration. It's commonly used in cosmetic treatments for its rejuvenating effects.
• Pulsed Electrical Stimulation: This type of therapy uses pulsed electrical currents to stimulate
tissue repair and reduce inflammation.

Applications in Dermatology
• Wound Healing: Electrical stimulation is often used to promote the healing of chronic wounds, such as
diabetic ulcers or pressure sores. The therapy can accelerate the healing process by stimulating cell
proliferation and improving blood circulation.
• Skin Rejuvenation: It’s used in aesthetic dermatology to improve skin texture and reduce signs of aging.
Electrical stimulation can enhance collagen production, leading to firmer and smoother skin.
• Acne Treatment: In some cases, electrical stimulation is used as part of acne treatment. It can help reduce
inflammation and bacterial activity, though it is typically used in conjunction with other acne therapies.
• Scar Treatment: Electrical stimulation can be used to improve the appearance of scars by promoting
collagen remodeling and reducing scar tissue formation.
• Pain Management: For conditions like post-surgical pain or chronic skin-related pain, electrical stimulation
may provide relief by interfering with pain signals and promoting endorphin release.

ADVANTAGES
• Non-Invasive: Electrical stimulation therapy is generally non-invasive and requires no surgical
procedures.
• Enhanced Healing: It can speed up the healing process and improve outcomes in wound care and skin
rejuvenation.
• Reduced Pain: It may provide relief from pain associated with various skin conditions.
CONSIDERATIONS AND SIDE EFFECTS
• Skin Irritation: Some individuals may experience mild skin irritation or discomfort at the electrode sites.
• Contraindications: It’s not suitable for everyone, including those with pacemakers, certain types of
implants, or specific skin conditions.
• Temporary Results: In aesthetic applications, results may be temporary and require ongoing treatments
to maintain benefits.

Current Research and Innovations in Physiotherapy for dermatological conditions
Bioelectrical Impedance Analysis (BIA)
• Application: Assesses body composition and skin hydration levels.
• Innovation: Development of portable, non-invasive BIA devices for home and clinical use.
Photobiomodulation Therapy (PBMT)
• Application: Uses low-level lasers or LEDs to reduce inflammation and promote wound
healing.
• Innovation: Enhanced light sources and delivery systems, optimization of wavelengths and
dosages.
Cryotherapy and Thermotherapy
• Application: Manages inflammation and pain, promotes blood flow and healing.
• Innovation: Improved temperature control and exploration of varying temperatures for
specific conditions.

Regenerative Medicine
• Application: Includes PRP therapy and stem cell treatments for accelerated skin
repair.
• Innovation: Enhanced processing techniques and efficacy of regenerative
therapies.
Tele-rehabilitation and Remote Monitoring
• Application: Delivers physiotherapy services remotely and monitors conditions.
• Innovation: Development of platforms and wearables for real-time data and
personalized care.
Integrative Approaches
• Application: Combines physiotherapy with pharmacological treatments and
lifestyle interventions.
• Innovation: Holistic models integrating physical therapies with diet and stress
management.

THANK YOU

Physiotherapy In Dermatology conditions.pptx

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