Ladakhs high-altitude environment,which makes it so attractive to tourists,also leaves them prone to skin diseases,something local residents and temporary settlers have already been suffering from,a study has shown.
The only dermatology department in the area,the one at the military hospital in Leh,conducted a year-long study that identified various forms of environmental dermatoses in people exposed to the conditions for both prolonged and brief periods.
Between July 2009 and June 2010,the hospital had over 1,500 patients with skin problems that were attributed to environmental factors. These included 965 lowlanders,512 native Ladakhis,and 90 tourists. The study,published in the latest issue of the Indian Journal of Dermatology,defines lowlanders as people who stay in the high-altitude regions for brief periods for work like soldiers,labourers,and businessmen.
The study says conditions in Ladakh reduces the water content of the skin. Citing previous studies,the authors describe these conditions as low oxygen content,over three times the standard exposure to ultraviolet rays than in plains,low humidity levels,subzero temperatures in winter and high-velocity winds.
As skin is the largest interface between humankind and the environment,it is one of the targets of the unique,adverse environments of high altitudes, the authors note. Other health conditions triggered by the peculiar climate of Ladakh mountain sickness,neurological and respiratory problems,and cardiovascular conditions have been well analysed,the authors add,but until this study there had been hardly any work on its impact on the skin,and possible preventive and curative measures.
Leh,where the study was conducted,is situated at 12,000 feet. The definition of high altitude is still arbitrary. The Army defines it as more than 9,000 feet, says Lt Col G K Singh,corresponding author of the study and a graded specialist in dermatology,venereology and leprosy at Command Hospital,Eastern Command,Kolkata.
Few areas are inhabited at this height, Singh says. Most such regions are in Ladakh,and a few in Arunachal Pradesh,Uttarakhand and Himachal Pradesh. The high altitude dermatoses we have studied at Ladakh may hold good for other areas too,because of a similarity in the physiological changes that people who come here encounter.
Ladakhis were found more susceptible to problems from exposure to ultraviolet rays,while ailments attributed to the extreme cold were commoner among those who stayed in the region for shorter periods.
Locals are exposed to factors like ultraviolet rays for a prolonged period of time,so chronic effects on the skin were commoner in them, Singh says. However,compared to the west,cancerous skin conditions like squamous cell carcinoma,basal cell carcinoma or melanomas,were fewer. Exposure to ultraviolet rays increases as one gains height. Singh added injuries triggered by extreme cold were almost negligible in the local population,possibly because of their genetic makeup and protective lifestyles.
Xerosis,or extreme dryness of the skin caused due to a drop in water content in the skin,was one condition that was seen even the Ladakhis who are accustomed to the weather of this region. Over 39 per cent of the locals had this problem.
The study notes that often this condition was mistaken to be a result of poor hygiene,which made people wash the affected areas with soap and antiseptics frequently,which aggravated the problem.The authors say lotions and oils are more suited than soaps,which are low in fatty acids,in the dry climates.
On possible preventive measures,Singh said,For protection from ultraviolet rays,sun-protective measures that include a large-brimmed hat,full-sleeved shirts,broad-spectrum sunscreen,and avoiding the outdoors between 10 am and 3 pm ,when UV rays are highest in intensity,can help.
Vitamin C too has a considerable sun-protective role. And Singh said sunscreens in gel form should be avoided at such heights.
Had skin conditions caused by exposure to ultraviolet rays
those affected with melasma (discolouring of skin)
Ladakhis among those affected by a condition called CAD,marked by chronic skin inflammation
All those affected with actinic cheilitis (inflammation and discolouration of skin near the border of the lip) were Ladakhis
Patients had inflammation,redness and scabies,typically caused by insect bites. Study says afforestation of barren land has brought ants,wasps,and moths
Locals among those with cold-related injuries
Were lowlanders,or people settled in Ladakh temporarily,the remaining 16% being tourists