My favourite Earl Grey cup of tea in my hand, a gentle breeze from Mumbai’s cool weather thanks to global warming, and my new parrot green Chanderi sari on me!
Could life get better I was thinking on a break when the receptionist announced the next patient and I hurriedly gathered my pleats as I rushed to my room.
One look at Bina Shah and I was instantly reminded of the talented actor Om Puri! The exact same pitted scars landscaped her face!
Here was this smiling, almost cherubic 35 year old but oh-my-goodness what deeply cratered skin!
I sat her down in my clinic and without wasting any time embarked on listing a series of treatments
I could do to bulldoze acne scars away!
You can start with a moderate strength salicylic peel or a stronger retinol peel I informed her.
Then move onto dermaroller therapy, showing her a pinwheel needled instrument much like a mini lawn mower!
It’s an age old French technique to
produce pinpoint bleeders and incite collagen production in the scars I explained.
Or you could avail of the latest fractional lasers, these also fill up scars more or less permanently with a 70- 80% improvement.
Of course, slowly but steadily over a couple of months, I will simultaneously prescribe some scar diminishing creams for a more efficacious result. Just ready yourself for a longish treatment I cheerfully told her, you will get the smoother skin you desire!
She listened patiently, then shyly said,
‘Actually these scars are my friends.
I am used to them.
If I didn’t have them no one would recognise me !
They don’t trouble me in the least!’
I squirmed, mentally kicking myself for forgetting the first rule in medicine – Listen carefully to what the patient has to say!
Rather than smugly listening to the sound of one’s own voice!
She gently continued,
‘All I want is a general skin care routine for my oily skin and the itchy oily scales I have on my scalp.’
I rushed to do a thorough assessment of both face and scalp and then a tad selfconciously pronounced that she had mild seborrhaeic dermatitis .
Simple creams and shampoos on a daily basis would sort the problem.
I wrote these out, then spoke of this, that and the other, everything under the sun other than acne scars, before bidding her goodbye.
We met again two months later, this time for a papular urticaria she had developed.
Since then I have treated her, her husband, her only daughter, her in-laws and extended family, her friends, all for their various skin and hair issues, sometimes a herpes simplex, at other times a stress eczema, a contact dermatitis here to a sebaceous cyst there!
It’s been 15 years and Bina is still bright and ever-smiling, her face still pockmarked with pitted scars.
Though newer and progressive treatments to treat scars have emerged (like Botox and PRP with micro needling) I have never suggested them.
Neither has she ever complained!
A woman in total equanimity,
content and happy in herself!
A woman who within a year of her daughter’s marriage, in the blink of an eye, donated her healthy kidney to save the life of her
son-in-law in acute renal failure.
‘Beauty begins the moment you decide to be yourself’ famous words by the timeless Coco Chanel rang in my mind as I reminisced my first encounters with Bina Shah, a BEAUTIFUL woman indeed!
A Second Learning 