All posts by doctorhb

Dermatologist and Venereologist in Ajman and Dubai

Acne Triggers

What Causes Pimples to Appear or Worsen?

Though acne is one of the commonest diseases affecting the humanity, the triggering factors of acne have not yet been delineated conclusively.

Acne vulgaris is a common, chronic skin disease affecting almost everyone at least once in their life time.

In most people, acne appears during adolescence, though it could appear de novo at any age. In 2000, Layton AM, in an article in the Medicine titled ‘Acne vulgaris and similar eruptions’, noted that approximately 5% of women and 1% of men 25–40 years of age either continue to get acne lesions or develop acne (late-onset acne) after adolescence.

It will be interesting to analyze what triggers acne and whether the life style is also a deciding factor, in addition to the hereditary and hormonal causes.

Acne Triggering Factors: Age & Hormones

Acne is most prevalent among adolescents and young adults, affecting approximately 85% of people at some point between 11–30 years of age. Peak incidence is seen in females 14–17 years of age and males 16–19 years of age.

During puberty, androgen hormone production increases which induces an increase in the production of sebum and the development of greasy skin. This stimulates a cascade of events that cause acne formation.

In females, hormonal imbalance due to ovarian diseases (for example in polycystic ovarian disease) induces acne eruptions. There is a flare up of acne immediately before the menstrual periods in some women. Pregnancy, in some, clears acne; while in others, there is a worsening of acne during the expecting months.

Acne Trigger: Heredity

A hereditary predisposition for acne formation has been noted by most studies. It is well known that tendency to pimples and acne scar formations runs in families. These could be due to the inborn sensitivity of the sebaceous glands to hormonal actions during puberty.

Acne Triggers: Occlusive Cosmetics

In individuals with an acne prone skin, use of oil based greasy foundations and face creams may stimulate new acne eruptions by causing build up of sebum within by blocking the hair follicle pores. This is known as acne cosmetica. Such individuals are advised to use only water based, oil free cosmetics as make up.

Acne Trigger: Aggressive Washing

Acne is not caused by poor hygiene and aggressive and frequent washing with abrasive soaps can worsen the acne situation in most sufferers.

Acne Triggers: Topical and Systemic Steroids

Potent Steroids cause acne
Potent Steroids cause acne

Steroids, particularly the medium and potent strength topical halogenated steroids, can induce eruption of steroid acne, where sudden appearance of skin colored and pus filled bumps worsen the acne after an initial period of improvement for a few days. The initial period of improvement with steroids is because of their anti-inflammatory actions.

Prolonged periods of oral steroids can trigger pimples on the face and body in a majority of patients.

Acne Triggers: Medications

Many systemic drugs and topical applications may induce fresh acne eruptions, known as acne medicamentosa. In addition to the steroids, drugs like phenytoin, lithium, iodides and the anti-tuberculous medication INH are known to trigger acne. Topical agents like chlorinated hydrocarbons, coal tar derivatives, cutting oils and grease cause acne like eruptions even on body areas where normal zits usually do not appear.

Acne Triggers: Diet

Food as a cause of acne is still a controversial topic among dermatologists, despite patient’s anecdotal reports and a few studies which blame westernized dietary habits, milk and milk products, and food items containing high levels of iodine and, possibly hormones. More studies and research is required in this field, but it would suffice to state that if the patient notices exacerbation of existing pimples or new acne eruptions after certain foods, these should be eliminated from the diet.

Acne Trigger: Stress

Hormones and other neuro-endocrine mechanisms during stressful periods can trigger fresh acne eruptions. Recently many studies have proven beyond doubt that the acne condition worsens in teens during stressful periods like exams.

Acne Trigger: Sunlight?

Limited sunlight exposure has a positive effect on acne, though remaining longer duration in hot, humid daylight actually has been found to worsen acne. Those who are using retinoids and tetracycline to treat acne should avoid sun exposure, as this can cause photosensitive reactions on the skin.

Acne Trigger: Hair Products

An overlooked cause of acne eruptions, especially on the forehead is use of oils and greasy creams on the hair.

The above list is not all inclusive by any means. There would be many more unknown triggers for acne, as many individuals, even in adulthood, get sudden acne eruptions without any identifiable causes. There is certainly a need for more research in this field.

Published by Dr Hanish Babu, MD on 24th May, 2018

The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or the website will not be responsible for any consequences. The images provided are for illustration purpose only and are copyrighted.

Copyright 2018 © Dr Hanish Babu, MD

Pathogenesis of Acne or How Does Acne Develop?

How Acne Occurs
How Does Acne Occur?

The pathogenesis of acne or how acne forms  includes a combination of factors affecting the integrity of the hair follicle and its oil producing gland, the sebaceous gland.

The study of how acne develops is a fascinating one. There are many points to be clarified regarding the pathogenesis of acne. What is the basic cause of acne? Why does it appear only on some parts of the body? Why does acne have a course with waxing and waning? What is the role of hormones, skin oiliness and germs in the development of acne?

There are four major causes contributing to acne development –

  1. Increased sebum production
  2. Colonization of the hair follicle duct with the germ Propionibacterium acnes
  3. Thickening and plugging of the hair follicle walls and opening, resulting in comedo formation
  4. Inflammation of the pilosebaceous unit. Pilosebaceous unit includes the hair follicle and its associated sebaceous gland.
How Acne Develops
Stages of Acne Development

How Acne Develops: Increased Sebum Production or Seborrhea

Sebum is the oily secretion from the sebaceous gland lying alongside the hair follicle. Sebum is responsible for maintaining the oiliness of the skin and the hair. It keeps the skin supple and smooth. In infancy and childhood, the sebaceous glands are small and inactive. The sebaceous glands enlarge and become active during puberty under the influence of the androgen hormones secreted by the adrenal and gonadal glands.

The increased production of sebum, seborrhea, may be genetically programmed; some individuals are more acne prone than others. It is also seen that sebum secretion and sensitivity of the sebaceous glands to the action of androgens vary from follicle to follicle and area to area. This is the reason why acne severity varies between different follicles and hair bearing areas of the body.

How Acne Develops: Bacteria Colonization

 The increased sebum secretion predisposes to the overgrowth of the bacteria Propionibacterium acnes within the hair follicle and the sebaceous gland. The action of these bacteria on the sebum is thought to produce irritant products like free fatty acids within the hair follicle. These and other chemical mediators known as cytokines are thought to be responsible for the thickening of the hair follicle, plug formation and inflammatory events in acne.

How Acne Develops: Comedogenesis or Comedo Formation

 The thickening of the hair follicle walls, known as ductal hypercornification, and the keratinous plug formation is the cause for the formation of the comedo, better known as the acne whiteheads and blackheads. Comedo formation is the first stage of development of acne. When the follicular opening is closed with the keratinous plug, it is known as closed comedone or whitehead, and when it is dilated, the open comedone or blackhead. The black color seen in the blackhead is not dirt, but due to the sebum changing color when it comes in contact with the atmospheric oxygen.

How Acne Develops: Inflammation

 Inflammation of the hair follicle and the sebaceous glands and the surrounding dermis is the final event in the moderate to severe types of acne. Inflammation results in red, painful and pus filled bumps in acne. Acne gets inflamed by a combined action of P.acnes, the bye products of the action of the bacteria on the sebum, the corneocytes lining the hair follicle duct and the inflammatory mediators induced by the sebaceous glands.  

The inflammation weakens the follicular and sebaceous gland walls which rupture to discharge the sebum and part of the comedone into the dermis. This induces a severe foreign body inflammatory reaction resulting in formation of acne cysts and nodules.

Recent Advances in Acne Pathogenesis Information

 The 2009 acne update from the Global Alliance to Improve Outcomes in Acne throws some interesting insights to the pathogenesis of acne:

The inflammatory events in acne precede the hyperkeratinization (thickening of the follicular walls).

  1. acnes specifically activate special receptors on the cell membranes of inflammatory cells.

The sebaceous gland is a neuroendocrine-inflammatory organ that coordinates and executes a local response to a variety of neuro-endocrinological and stress induced stimuli.

Sebaceous gland plays an important role in hormonally induced aging of skin.

In addition to their action on sebaceous gland activity, androgens have influence on the follicular cells (corneocytes) also.

Oxidized lipids in sebum (possibly altered by P.acnes) induce the production of inflammatory mediators.

Sebum contains several matrix metalloproteinases (MMPs) which play important roles in the inflammatory process of acne. The levels of MMPs are significantly reduced in the acne lesions following treatment.

The acne information provided above is a short review of how acne develops. The degree of plugging of the comedones and the extent of inflammation decides the severity of the pimples. Different types of acne are categorized according to the severity of the acne lesions.


  1. Simpson NB & Cunliffe WJ. Disorders of the Sebaceous Glands in Rook’s Textbook of Dermatology. 2004; 7: 43.1-43.75.
  2. Diane T, Gollnick H et al. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group. J Am Acad Dermatol, 2009;60:S1-50.

    Published by Dr Hanish Babu, MD on 24th May, 2018

    The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or the website will not be responsible for any consequences. The images provided are for illustration purpose only and are copyrighted.

    Copyright 2018 © Dr Hanish Babu, MD

What are the causes of Acne?

How does Acne occur?

Acne vulgaris or common acne (also known as pimple and zits) is actually a disease of the hair follicle and its associated oil producing

Acne Cause: Hair Follicle
Acne Cause: Hair Follicle

sebaceous gland, as we have already discussed. The oily liquid produced by the sebaceous gland is known as sebum.

The sebaceous glands remain relatively small during infancy and childhood. At puberty due to the action of hormones known as androgens (which include testosterone and dihydrotestosterone), increase the size and activity of the glands. As a result, there is increased sebum production from the sebaceous glands.

How Acne Occurs
How Does Acne Occur?

A bacteria known as Propionibacterium acnes(P.acnes), which is a normal resident of the hair follicle and which thrives on a fatty food, increases in number during puberty due to the increased ‘food supply’ in the form of sebum!

The combined effects of activities of the increased sebum secretion and the P.acnes is the cause for the disease we commonly recognise as acne.

Let us examine how these two conspire together to disturb the normal milieu interior of the skin and damage the clear complexion of millions of teenagers around the globe.

How Acne Develops
Stages of Acne Development

Depending upon severity, there are 4 types of acne.

Grade 1: Mild (Comedonal) Acne

We have already seen that the combined effects of activities of the increased sebum secretion and the bacteria Propionibacterium acnes(P.acnes) is the cause for acne.

Comedonal Acne
Acne Grade 1: Comedone

Certain enzymes produced by the bacteria cause chemical changes in the composition of sebum, converting the triglycerides into free fatty acids.

These free fatty acids are potentially irritating to the epidermal cells lining the inside of the hair follicle. Some chemotactic factors are also released due to the action of the P.acnes on the sebum. These in turn attract certain white blood cells known as neutrophils to the vicinity of the hair follicle. This starts another chain of chemical and physiological reactions that results in what we know as inflammation.

The net result of all those changes are these:

How Acne Develops
How Acne Develops
  • The lining of the hair follicle above the sebaceous gland become thickened.
  • Because of changes in the keratinization of the follicular cells, there is accumulation of abnormal cornified cells inside the follicular lumen.
  • This sticky cells become adherent to the top of the sebaceous gland to form a plug known as microcomedone.
  • When this plug enlarges just beneath the small hair follicle(pore) opening on the surface of the skin, it become visible to our eyes. This is nothing but the (in)famous whitehead or the closed comedone!
  • An open comedone or blackhead occurs when, because of the pressure from the plug beneath, the hair orifice enlarge to reveal the black “dirty looking” plug. This black color is not due to dirt, but due to the action of atmospheric oxygen on the free fatty acids, the after products of sebum.

This, then, is how the comedones come into existence during puberty.

Some comedones are not as innocuous as they look. For many unfortunate teens, they are time bombs ticking, with impending catastrophe in later years to break into scar forming nodules and cysts.

Grade 2: Moderate(Papular)Acne

As the sebum continues to accumulate, the hair follicular wall become stretched and larger skin colored papules become evident on the skin surface. There is minimal inflammatory reaction due to the neutrophils attracted to the area in this moderate type of papular acne.

What is Grade 2 Moderate Acne?
Grade 2 Moderate Acne

The lesions are more pronounced and more in number than in the comedonal acne.

Grade 3: Severe(Pustular) Acne
Severe Inflammed Acne
Grade 3 Pustular Acne

When the sebum secretion is increased and the chemical breakdown of the sebum occurs due to the action of the bacteria P.acnes, neutrophils are attracted to the area. Neutrophils are the white cells involved in inflammatory reaction. These release certain chemical mediators and enzymes which further weaken the follicular walls. The wall and the sheath of the sebaceous gland thins and become inflamed leading to pustule formation.

These are numerous red, tender, pus filled lesions on the affected areas.

This is the severe grade 3 acne or pustular acne.

Grade 4: Very Severe (Nodulo-cystic) Acne

Acne Cyst
Acne Cyst Formation

When the follicular walls further weaken and get inflamed gradually the walls expand and become deep seated nodules. Further action of inflammatory mediators cause rupture of the wall and sebum, part of the wall and cornified cells and bacteria are released into the dermis. This causes an intense reaction known as foreign body reaction within the dermis resulting in the formation of deep seated cysts.

Nodulocystic Acne
Very Severe Grade 4 Acne: Acne Conglobata

This is known as the very severe scarring type of nodulocystic variety of acne.

Note: The grading is only facilitatory. There may be more than one or two kinds of lesions (comedone, papule, pustule, nodule) present at any time in acne patients. The grading is done when a particular type of lesion out numbers others.

Published by Dr Hanish Babu, MD on 23rd May, 2018

The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis

should be made or treatment undertaken without first consulting your doctor. If you do so, the author or the website will not be responsible for any consequences. The images provided are for illustration purpose only and are copyrighted.

Copyright 2018 © Dr Hanish Babu, MD

Acne 101: The Acne Basics


Acne 101 will discuss the acne basics in general. A basic knowledge of acne is important to learn how to effectively treat acne in its varied clinical presentations and avoid complications like acne scars.

The course of acne is punctuated with frequent flare-ups in the affected and hence acne is to be approached as a chronic disease which requires active treatment intervention and a maintenance program for optimal control of the inflammatory pimples. During the adolescent years acne can cause untold heartbreaks and psychosocial impacts, which makes it a disease to be handled with proper care and knowledge.

Is Acne a Disease or a Normal Physiological Problem of the Adolescence?

Acne is a disease of the pilo-sebaceous unit which includes the hair follicle and the associated sebaceous gland. It is not just a normal age related phenomenon, as hormone related pathological changes assisted by the bacteria propionibacterium acnes occur in acne and result in long lasting effects on the skin, like pigmentation and scars. The Global Alliance to Improve Outcomes in Acne in their report presented as a supplement to the May issue of Journal of American Academy of Dermatology advocates approaching acne as a chronic disease requiring initial aggressive therapy followed by maintenance therapy to avoid the complications and minimized the social and psychological fallouts of the acne.

When it is very mild and limited to a few numbers of comedones, acne can be considered physiological. The presence of inflamed papules, pustules or presence of nodules and acne cysts calls for active treatment of the acne.

How Common is Acne?

Acne is the commonest skin disease. It affects approximately 85% of young people. Previously thought to be a disease of the adolescents, acne is also common in adults from 20 to 35 years of age. The common acne is called acne vulgaris. There are many variants of acne like neonatal acne, drug induced acne, chloracne, acne excoriee, keloidal acne etc.

How Does Acne Occur?

Many factors play a role in the causation of acne, including a hereditary predisposition, effect of androgenic hormones and many other external and internal factors. After puberty, androgen hormones stimulate the sebaceous glands to increase their size and produce more sebum, an oily liquid intended to keep the skin smooth and supple. The sebum is a good growth media for certain bacteria, which in turn produces inflammation within the hair follicle and the surrounding dermal structures. Depending upon the severity of the inflammation, the types of acne also vary in different individuals and at different times in the same individual.

What is the Age Incidence of Acne?

Contrary to popular belief, acne can occur at any age, from neonates to old age. Mostly acne is seen in early puberty to early adulthood, i.e., the ages of 12 to 25 years. About 50% of teenage acne can continue to adulthood. Some people, especially females, tend to have an occasional flare ups into their 30s. At the age of 40, 1% of males and 5% of females still have active lesions of acne.

Does Acne Differ in Males and Females?

Males and females are affected equally in acne, though the severity of acne is more in males. Almost all boys and 90% of girls will have had an attack of acne during their teen age. Acne conglobata or nodulocystic acne is more common among males.

Moderate Acne: Type 3
Moderate Acne

What are the Common Areas of the Body Affected by Acne?

Acne can develop on any hair bearing area, though it is most common on face, as this is the area with the maximum density of sebaceous glands. In the face, the cheeks, nose, chin and forehead are mostly affected, in that order most of the time. Acne on face is most commonly known as the pimples or zits. Acne also occurs on the chest, shoulders, upper back, buttocks and thighs.

Is it True that Excess Dandruff is the Cause of Acne, especially on the Forehead?

Dandruff and acne has got some common features as their causes, like increased seborrhea, oily skin and the effect of the androgenic hormones. Hence both are complimentary; one is not cause of the other.

What are the Common Signs and Symptoms of Acne?

Whiteheads and blackheads are the earliest skin lesions in acne. Depending upon the severity acne is divided into different types of acne, the comedonal, papular, pustular and nodulocystic.

In presence of inflammation, in the pusutlar and nodulocyctic variety, the acne eruptions can be red, painful and hot and tender on touch.

The skin of acne sufferers is usually greasy and oily and most of them suffer from concomitant dandruff during the acne attack or later in their life.

Oiliness and sudden eruptions can sometimes cause an itchy feeling on the acne affected area.

Though the commonest skin disease affecting more than 85% of world’s population at least once in their life time, there are many misconceptions and myths regarding acne vulgaris.

Published by Dr Hanish Babu, MD on 23rd May, 2018

The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis

should be made or treatment undertaken without first consulting your doctor. If you do so, the author or the website will not be responsible for any consequences. The images provided are for illustration purpose only and are copyrighted.

Copyright 2018 © Dr Hanish Babu, MD

What is Acne?

What is Acne?

Acne, or pimples, is the commonest skin disease affecting almost 85% of teens at least once in their lifetime. It is a disease of the hair unit of the skin involving the oil producing sebaceous glands situated beside the hair. The sebaceous glands discharge their oily secretions into the hair canal.

Grade 3 or Papulopustular Acne
Moderate Acne: Grade 3 or Papulopustular Acne

Androgen hormones act on the sebaceous glands at puberty and increase their size and sebum (oil) production. The normal function of sebum is to keep the skin smooth and supple by providing an oily environment. Increased sebum secretion and the action of certain bacteria inside the hair canal results in acne formation.

The following series of articles will discuss about different types of acne and modalities of treatment of acne and its complications.

The links will become active as new articles are being added. Please visit this page regularly.

All About Acne

  1. Acne 101: The Acne Basics
  2. Causes of Acne
  3. Pathogenesis of Acne or How Does Acne Develop?
  4. Acne Triggers
  5. Who is at Risk of Developing Acne?
  6. What are the Different Types of Acne?
  7. Acne: Best Treatment Practices: Why Acne Should be Treated
  8. Acne: General Advices from Dermatologist
  9. Mild Acne: Frequently Asked Questions
  10. How to Treat Mild Acne
  11. Moderate Acne: Frequently Asked Questions
  12. How to Treat Moderate Acne
  13. Severe Acne: Frequently Asked Questions
  14. How to Treat Severe Acne
  15. FAQ on Very Severe Nodulocystic Acne
  16. How to Treat Very Severe Nodulocystic  Acne
  17. Does Food Affect Acne?
  18. Acne: Diet Recommendations
  19. Acne in Teens
  20. Acne in Adults: What it is and how to treat.
  21. Body Acne
  22. Acne Butt
  23. Skin Types
  24. Acne Mimics
  25. Acne: Frequently Asked Questions
  26. Topical Treatment for Acne
  27. Complications of Acne
  28. Acne Scar : Causes
  29. Acne Scar: Treatment
  30. Acne Scar: FAQ
  31. Acne Scar Solution
  32. Stress and Acne: Is it Real?
  33. Acne: Home Remedies: Are they Useful or Just Grandma’s Tales?
  34. Acne: Alternative Treatments: Are they Effective?
  35. Acne Myths
  36. Acne Products
  37. Acne during Pregnancy
  38. Skincare during Acne
  39. Chronic Acne: How to Deal with it
  40. Acne and Depression
  41. Acne Glossary
  42. Acne: Disclaimer

Published by Dr Hanish Babu, MD on 23rd May, 2018


The information given in this article is for educational purpose only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, the author or the website will not be responsible for any consequences. The images provided are for illustration purpose only and are copyrighted.

How to Prepare a Practical New Year Resolution

Tips on How to Set up Achievable Goals for The New Year

Who told setting up new year resolutions is a drag and useless exercise? 

Take the following step by step guide on how to draft practical New Year resolutions and you will be be pleasantly surprised to see that these simple steps will turn the annual ritual into an absorbing, fruitful exercise.

Here, then, is the step by step guide on practical new year resolutions:

Step 1: The SWOT Analysis- Review Your Last Year.

SWOT Analysis means analysis of your strengths, weaknesses, opportunities and threats. SWOT analysis is a very useful tool to use whenever you take up a task in daily life. Though you may not succeed every time, your failure rate is drastically cut down when you use SWOT analysis and act accordingly. Your confidence and self respect will grow because you know that you have done what you must. When you make the SWOT list, put them under the following headings- personal, family, social, professional and spiritual.

S for your strengths. Which were your best achievements last year? Which personal qualities helped you achieve those? What are your professional and financial strengths? Backups? Have you underutilized any of your strengths last year? Make a list of each.

W for your weaknesses: What were your failures?  What do you think were the reasons for those weak performances? Make a list. Do not cheat yourself.

O for Opportunities that knocked on your door during the last one year. Make the list of opportunities that you turned to your advantage and also those which you have missed. You may get additional points for your strength and weakness lists when you prepare this list.  Also prepare a tentative list of opportunities that you think may come up next year.

T for Threats. What were the challenges that you had to face during the last year? How many did you tackle head on? How many actually pulled you back? Make a list of the threats that you may have to face next year.

Step 2: Review your SWOT analysis list.

Now that you have your SWOT analysis list, go through it with a comb.

For each weakness, jot down the positive changes you would make (in your attitude and actions) during the next few months.

For each threat, note down the resources that you will have to mobilize so you can nullify their negative effects and practically convert them into advantages for the coming year.

Sort out the gems and pearls among your strengths and opportunities that you would like to retain and improve upon.

Convert challenges into opportunities for progress. Prune your list so that essential, even difficult tasks get priority over simple, not so essential tasks.

Chuck out the really difficult new year resolutions that you know you cannot and would not keep. How ever, if you feel that these are essential for your progress, give them a try. There is nothing to lose, only a little self respect maybe, but everything to gain!

Keep your ego aside and discuss the list with your spouse and/or close friends. They might help you realize some important personal characteristic of yours that you might have missed.

Step 3: Goal Setting: Prepare a Plan of Action.

Prepare a plan of action in black and white. Write down your short term (1-3 months), intermediate (3-12 months) and long term (1 year) goals. Group your selected goals into ‘very essential, essential and not so essential’ categories. Also try assorting into ‘easy, not so easy and difficult’ new year resolutions.  Look at the list again and prioritize them. Take a final bold step and strike off the resolutions or goals that you know are not going to materialize.

Step 4: Record Your New Year Resolutions in Black & White.

It is always advisable to have a vision of what you want to achieve during the next one year,

popular new year resolutions – colorful sticky notes on a cork board

5 years, 10 years and so on. At present, though, let us concentrate on the coming new year. Putting down your goals with a date and plan of action in black and white is the essential step forward in achieving your visions.

Remember: A vision is a goal with a date and plan of action.

Take a large size printout and paste it where you can see it first thing in the morning and last thing before going to bed at night, on the wall opposite your bed, on the fridge door, near the bathroom mirror.

Finally, review, and if necessary, revise the list periodically. There is no hard and fast rule that you cannot improve upon your new year resolutions!


Bald is Beautiful!

At the outset let me point out that this bit is not written to discourage those who have embarked on the enterprising trichological quests in pursuit of the hairy mirage. This is a fact : by no stretch of imagination can one consider Male Pattern Baldness a disease, though it does cause some dis-ease in the feeble minded! At the most it can be branded a cosmetically distressing ‘problem’.

Bald is Beautiful

An article in praise of the chrome dome by Prof. Raja Babu of Hyderabad, one of the doyens of dermatology in India, set me browsing the net and literature to get to the root of the scant hair scenario. And this search did prove to be quite fascinating.

Here was one web site by a group of merry ladies, a fan club of THE BALD:

Quote: What was it we liked about bald men? The sense of strength, confidence, intelligence, a well-seasoned maturity combined with a well-reasoned sense of self confidence. The way they simply radiate passion and masculinity. Did you know that there is a concept that some men are so brilliant and fiery that their overwhelming passion burns out the roots of their hair? Sigh.

……Meanwhile, all of us knew at least one sterling young man who was fretting over his hairline, and here we were trying to tell them DON’T DO IT! Agh! Toupees! Implants! Rogaine! Yuck! You might think it covers it up, but a woman always knows. Just be yourself, and be proud! Anybody who razzes you about it is either excessively immature, or just doesn’t have any idea what they are talking about. Baldness is sexy. Mrrrrowww! Unquote.

There is no historical record of how long baldness has been blessing men. A reasonable guess is that our cave dwelling ancestors were never bald, but were endowed with bearish overgrowth all over to protect them from the rough exteriors. Richard Harrison and William Montagna predicted long ago in their book ‘Man’ that men of future generations shall be even balder, ultimately a time will come when each and every single hair root will vanish into the oblivion of evolution. To put in a nut shell, the bald men are far ahead in the evolution tree than their contemporary hairy cousins. Wow! Something to be proud of, isn’t it?

Copy Right
Copy Right

Aristotle (BC 384-322 BC) associated baldness with “libidinous males” and Hippocrates (460-377 BC) observed that ‘eunuchs do not take Gout nor become bald’. A 1983 study revealed that bald men have high concentrations of testosterone in their saliva compared to their hairy counterparts. Lots of other studies also point towards a greater aggression, a greater virility or a greater reproductive ability in the Bald Machos!

Economically also the bald stands to gain. No hair cut expense, no oil, no combs. And heavy savings on grooming time and money!

Still a lot of deluded bald heads world over spend millions every year in vain search of the hairy mirage. Since time immemorial the obsession to regrow the lost vanity had bordered on pathological obsessions for the magical cure.

Look at this ancient Egyptian remedy for the baldness: Spread a mixture (on the bald head) of the fat of a lion, a hippo, a deer, a crocodile, a goose and a serpent. Hunting must have been a part of the medical curriculum in those days! Another ‘simpler’ remedy simply consists of equal parts of writing ink and cerebrospinal fluid.

Minoxidil and Fenestride compete with hundreds of alternate herbal cousins which promise miraculous cures for the distressed and the deluded. Many people who fall victims to the high profile, and most of the time unethical, advertisement gimmicks get temporary and scanty relief after years of scrubbing and rubbing.. By the time they realize the futility of the exercise they are poorer by thousands of dollars. Herman Melville in Moby-Dick (1851) puts it rather bluntly: “In truth, (if) a mature man who uses hair-oil, (then) that man has probably got a quoggy spot in him somewhere. As a general rule, he can’t amount to much in his totality!”. What can you say to that?

Back to the sowing days, transplanting hair roots was a fashion for a brief period, which lost its charms in the aftermath of huge chunks of gaping holes in the purse coupled with equally unbearable and prolonged pains that the courageous had to endure.

Concealment was taught to the humanity by none other than Julius Caesar the First who used to comb forward in a brave attempt to conceal his bald pate. We definitely know he was unsuccessful in his attempts as his apical activities have been carefully noted by his historians and passed on for the posterity as a’ piece de coupe’! With the eminently stylish wreath becoming an object de fashion , ancient Romans were also the forerunners of the multibillion dollar wig business; though the emperors kept the laurel wreath for themselves for many centuries. and denied their citizens the ‘pleasure’ of concealment.

god bald headWilliam Shakespeare, himself a respectable bald, was quick to recognize that baldness and wit go together. The Bard noted in ” The Comedy Of Errors”: “…and what he (God, that is) scanted men in hair he hath given them in wit..”.

We have many contemporary “greats” who adorn the Hall of Fame with natural and aided chrome pates: Yul Brunner, Persis Kambatta, Sinead O’Connor and not to forget Andre Agassi and Michael Jordan, the list is long and reads like a Who is Who in the world of the famous.Explore the ‘heady’ properties of the powerful leaders of the Nations , and , have no doubt, the Bald will shine far ahead than the hairy ones.

Forget the story of Samson and Delilah. What kind of wimp loses all his strength at the mere snip of his hair? Real men do their talking with chrome domes. Want proof? Just look at the world of professional wrestling, where the hottest and brightest superstars have smooth skin and don’t wear rugs to cover it up!

Ambrose Bierce in his The Devil’s Dictionary (1911), defines RESPECTABILITY as ‘The offspring of a liaison between a bald head and a bank account’. No doubt about it, yes, the bald scalp symbolizes Wealth and Wisdom. Cool!

“Skin is in,” claims John Capps, president and founder of the Bald Headed Men of America, with more than 20,000 gleaming members. “The few, the proud, the bald,” he says. The membership of BHMA is open to all “Bald-headed men who agree with the philosophy ‘Bald is beautiful’.

BHMA is dedicated to the belief that bald-headed men (whether chrome-dome, balding pate, or bald spot) have extra individual character. It strives to cultivate a sense of pride in all bald-headed men and to eliminate the loss of self-esteem associated with loss of hair and promotes National Rub a Bald Head Week.

During the week and the annual conference held in the second weekend of September, the Founder gives speeches and makes television appearances proclaiming ‘the fun of being bald.’ The organization also maintains speakers’ bureau and charitable programs; compiles statistics and operates a Hall of Fame.”

The Bald Pride slogans promoted by BHMA:bald-beauty

  • Bald is Beautiful
  • Bald is Bold
  • The Few! The Proud! The Bald!
  • Hairless Hunks!

The address of the BHMA is equally revealing: 102, Bald Drive, Morehead City, North Carolina,28557!

At last year’s annual convention of the Bald Headed Men of America in Morehead City, N.C., women were the judges in deciding the best “overall appearance” of a bald head. “First they caress and feel the shape of a head,” says Capps, “then they look at it from a distance to see the twinkle in the eye, and the twinkle in the smile. All this blends together and becomes as pretty as a full moon.”
Last year’s winner was a gregarious Leo Lane, an Australian Priest who celebrated his smooth victory by offering a blessing for every bald head at the convention.
Bald as the bare mountain tops are bald, with a baldness full of grandeur (Matthew Arnold ,1888), my Bald Brothers out there, what have we lost but our hair? The Creator could create only this many perfect heads, the rest he had to camouflage with hair! This is the age of the Vanishing Hair…. Be Proud! Be Happy! And go out there and SHINE!


Welcome to Skin Care Tips from Dermatologist!

Skin Care Tips from Dermatologist Dr Hanish Babu, MD
Dr Hanish Babu, MD, Dermatologist UAE
Dr Hanish Babu, MD, Dermatologist

Dr.Hanish Babu, MD is an Indian Dermatologist & Venereologist practicing in Ajman & Sharjah, UAE since 1996.

Dr.Hanish Babu Started his medicine practice in 1983 in India, first as a general physician and then as a specialist dermatologist since 1989. He worked as a general physician among the poor tribals of Wayanad in the southern Indian state of Kerala from 1983 to 1989.

As a dermatologist, Dr.Babu has come across all forms of skin diseases in his busy practice. His patients belong to all nationalities and cultures. He is an avid educator and spends quality time with his patients both in his consultancy and during the group therapy sessions he conducts for psychodermatoses like psoriasis, urticaria, eczema, neurodermatitis etc.

Dr Hanish Babu MD CME Talks
Dr Hanish Babu, CME Speaker, Alaska, US

He is also a well sought after speaker in the Continuing Medical Education programs for doctors and other healthcare professionals in UAE and abroad. Click Here for a list of Important Talks Dr Hanish Babu has delivered.


Dr.Hanish Babu, MD, is at present practicing in City Medical Centre, Ajman, UAE (Evening) and Cosmolaser Medical Centre, Samnan, Sharjah (Morning).

He  is available for consultation on all Days of the week except Fridays.

For appointments:  06 7441882 ( For Ajman) or 06 5678 200 (For Sharjah and Dubai)

Consulting Hours at Cosmolaser Medical Centre, Sharjah:
Appointments: 06 5678 200

  • Morning: Saturday through Thursday: 9.30 am to 1.30 pm

Consulting Hours at City Medical Centre, Ajman: 
Appointments: 06 7 441 882

  • Evening: Saturday through Thursday: 5.00 pm – 9.00 pm

Services Offered:

Outpatient Consultation and Treatment on all Skin Diseases and Sexually Transmitted Diseases.

  • All Skin, Hair and Nail Diseases
  • Sexually Transmitted Disease
  • Laser Hair Removal
  • Laser Acne Treatment
  • Laser Vein Removal
  • Laser Skin Tightening
  • Minor Surgeries like removal of Skin Tags, Sebaceous Cyst, Skin Blemishes, Warts, Ingrown Nail etc
  • Electrocautery, chemical cautery and Cryo-surgery for Skin Growths, Warts etc.
  • Specialty Clinics for Psoriasis, Vitiligo, Eczema, Psychodermatoses
  • Stress Management Seminars for psoriasis and patients suffering from other psychodermatoses.

Contact: 06-7441882 (Ajman) / 06-5678200 (Sharjah) for an appointment or Book an Appointment below.

Educational Articles on Skin Diseases by Dr Hanish Babu, MD

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