Do birth control pills help in controlling acne?

An outbreak of a pimple is perceived as a cause of embarrassment and concern as it gives rise to skin damage. Coming to the cause of acne, it generally occurs due to excess oil (sebum) production. The oil on your skin combined with dead skin cells, blocks your skin pores, thereby promoting bacteria growth and causing acne breakouts. 
The use of birth control pills to cure acne is usually recommended when topical medications and oral antibiotics don’t help in clearing up the problem. 
Here’s how they work on acne. 

Possessing properties that can regulate your hormone production, birth control pills contain the two hormones that your body naturally makes – oestrogen and progesterone. Present in different amounts in the pills, they act by lowering the amount of androgens (male sex hormones, which give rise to excessive sebum production) produced by your body. As a result, with a reduction in sebum production, there is also a decrease in the breakout of acne on your skin. However, you shouldn’t expect instant results from their use. 

Many a times, birth control pills can cause a flare-up of the problem before it can be contained. This can result in your acne getting worse before getting better. 
Although birth control pills can help to control acne, it’s still important to maintain a proper skincare routine comprising of washing, toning and moisturising for a healthy and glowing skin. 

If you would like to consult with me privately, please click on 'Consult'.

Do Birth Control Pills Help in Controlling Acne?

Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types   T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

Heartbeat
Body temperature
Breathing
Body weight
Metabolism of fat
Menstrual cycles in females
Functioning of Nervous system
Digestion
Burning calories etc.
What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc.   for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery   this is called Postpartum thyroiditis.
Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby s heel.
What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.
Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.
Who are at risk of developing Hypothyroidism?

Women have a higher risk of suffering from hypothyroidism than men.
Older people are at increased risk.
People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison s disease etc.
People with psychiatric conditions such as bipolar disorder
People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.
What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

Depression
Constipation
Hair loss
Dry hair
Dryness of the skin
Tiredness
Body pains
Fluid retention in the body
Irregular menstrual cycle
Increased sensitivity to cold
Reduced heart rate
Increase in size of the thyroid gland   called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
Weight gain
Carpal tunnel syndrome
Hoarse voice
Infertility
Loss of libido/sex drive
Confusion or memory problems especially in the elderly
What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
T4: A low level of thyroxine indicates hypothyroidism.
T3: these levels are generally not needed to diagnose hypothyroidism
Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
Ultrasound of the neck is done if the patient presents with a thyroid swelling.
What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30   45 minutes before breakfast. The treatment is continued for the rest of the patient s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
obesity
infertility
joint pains
depression
A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma.
References:

2013 ETA Guideline: Management of Subclinical Hypothyroidism; European Thyroid Association (Nov 2013)
Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee; British Thyroid Association (2015)
The diagnosis and management of primary hypothyroidism; Royal College of Physicians and others (June 2011)
Suh S, Kim DK; Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinology Metabolism (Seoul). 2015 Aug 4.
UK Guidelines for the Use of Thyroid Function Tests; British Thyroid Association (2006)
Gaitonde DY, Rowley KD, Sweeney LB; Hypothyroidism: an update. American Family Physician. 2012 Aug 1 86(3):244-51.
Bindra A, Braunstein GD; Thyroiditis. American Family Physician. 2006 May 15 73(10):1769-76.
Wilson GR, Curry RW Jr; Subclinical thyroid disease. American Family Physician. 2005 Oct 15 72(8):1517-24.
British National Formulary; NICE Evidence Services (UK access only)
Baumgartner C, Blum MR, Rodondi N; Subclinical hypothyroidism: summary of evidence in 2014. Swiss Medical Weekly. 2014 Dec 23 144:w14058. doi: 10.4414/smw.2014.14058. eCollection 2014.

Know Everything About Hypothyroidism

What Causes Eczema? Ways to Prevent Eczema Outbreaks

A skin inflammation, eczema, also known as atopic eczema, refers to the changes that occur in the upper skin layer. These skin changes can be thickened and cracked skin, skin redness, crusting of the affected area and swollen raw skin, among others. The exact cause of this skin condition is not yet known but a mix of factors have been found to be behind this health problem.

CAUSES :

The factors that play a role in causing eczema are:

- Dry skin brings down your skin's ability to fend off irritants as well as allergy causing substances from entering your skin, resulting in an inflammatory condition.

- Genetics is also one of the factors that may affect the proper functioning of your skin as a barrier against harmful substances. Therefore, if either one of the parent or both suffers from the condition, it is very likely that their children too will suffer from it.

- Abnormal functioning of your body's immune system can also lead to this skin condition. This is because it's your body's immune system that fights off infections as well as harmful intruders.

- The presence of the bacteria called Staphylococcus aureus, which brings about sweat buildup, inflames the skin considerably, leading to this condition.

- Even environmental factors like pollen, cigarette smoke lead to the flaring of eczema.

How can you prevent an eczema outbreak?

It is very common for this skin condition to flare-up from time to time. But you can avoid such outbreaks or reduce their severity by following these very simple ways:

- Keep your skin well-moisturized so that it doesn't dry out causing further irritation.

- Sudden changes in temperature can cause the skin condition to break out. So, when the weather is hot, keep yourself cool but during cold weather, use a humidifier to prevent the skin from drying out.

- Keep sweating in check as it can cause an outbreak very easily

- Avoid the use of harsh detergents and soaps, woolen materials as well as the consumption of foods that may lead to flare-ups



What Causes Eczema? Ways to Prevent Eczema Outbreaks

What are Stretch Marks? - Stretch marks are the off-coloured stripes or streaks formed on the skin as a result of swift stretching of skin or weight changes. They mainly appear on abdomen due to pregnancy or obesity. They are formed due to hormonal changes related to pregnancy, puberty, hormone replacement therapy, etc. Stretch marks can be commonly seen on waist, thighs, lower backs, hips, breasts, arms, and buttocks.

How are these stretch marks formed? - The skin of the human body consists of three main layers ? 1) Epidermis (the outer layer), 2) Dermis (the middle layer), and 3) Hypodermic (the deepest and third layer)

When the connective tissue is stretched due to the expansion and contraction of skin, the stretch marks starts developing on the dermis or the middle layer of the skin. With the stretch in skin, the collagen gets weak, and the elastin fibres start tearing. Due to this, its normal production cycle gets damaged or interrupted. This results in the formation of fine scars under the epidermis or the top layer of the skin. Initially, they appear red or pink, but gradually, they turned into thin silvery line.

Causes - Stretch marks are not a disease, which infects the human body, but are the scars formed due to contraction and expansion of skin. They are basically caused by stretching of the skin. Their appearance depends on the type of skin. These ugly stretch marks are caused due to:

- The physical stretching of the skin at the end of pregnancy.
- Extraordinary weight gain, specially on arms, thighs, etc.
- Use of certain medications, including lotions, pills, Corticosteroid creams, and steroids.
- Genetic disorders
- Muscle building
- Hormonal changes during puberty
- Heredity 

Symptoms - What are the signs of stretch marks? No one would ever like to have stretch marks on their skin. They commonly appear on the places where a large amount of fats is deposited. Some of the symptoms which help to recognize the development of stretch marks are as follows:

- The skin becomes pink, flattened and thin before the development of stretch marks.
- Development of red, pink, or purple lines on the skin.
- Affected area becomes soft in touch.
- At the initial phase, these lines appear wrinkly and somewhat raised.
- With the passage of time, these lines convert into silver or white in colour.
- They may also appear in patches of parallel lines.
- They appear as scar. 

Home Remedies for Stretch Marks - It is natural that every woman will develop stretch marks at some point of time in her life. Although they are natural, but have truly ugly looks. Here are some quick home remedies for stretch marks, which will undoubtedly reduce or remove the scars from the affected area.

1) Honey - Honey is the best natural moisturizer. Skin gets extra hydrated and supple when honey is used as a lotion.

2) Lemon Juice - Lemon juice is other easy treatment for stretch marks. The acid present in lemon juice helps in reducing stretch marks, acne, skin injuries, and scars. Take out juice from some lemons. Massage it gently for 10 minutes in a circular motion on the stretch marks. Clean the affected area with warm water.

3) Carrot Puree - Mash some soft steamed carrots and make a paste, apply to stretch marks and let it sit for as long as possible then rinse with lukewarm water. (Caution: In lighter skin tones it may temporarily turn you orange)

4) Aloe Vera - Aloe vera is considered to be the most effective homeopathic remedy for stretch marks and various other skin problems. It is known for its healing and soothing properties. Apply aloe vera directly on the stretch marks. After a few minutes, clean it with lukewarm water.

5) Egg Whites - To get rid of stretch marks, egg whites are beneficial as they are rich in proteins and amino acid. Extract whites of two eggs. Whip it with the help of a fork. After washing the affected area with clean water, apply a thick layer of egg whites with the help of a brush. Let it dry completely and wash it off with cold water. After this, apply some olive oil to moisturize the skin. For two weeks, continue the process daily for better results.

6) Essential Oils - They contain moisturizing properties because of their viscosity. Oregano oil, grape seed oil, and sage oil have amazing antioxidant properties. Castor oil and jojoba oil can lighten dark spots.

If you have any more questions on this topic, click on consult privately to ask me.

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6 Most Effective Home Remedies To Fight Stretch Marks

Gynecomastia is a condition where the tissues of the breasts swell in a boy or men. This is caused by the imbalance of testosterone and oestrogen. It might affect one or both the breasts depending on the level of hormonal imbalance. Although not considered as a serious condition, Gynecomastia can be a difficult condition to cope up with. There are multiple treatment options and surgery is one of them. In many cases, this condition goes as abruptly as it appeared. For cases that are complicated and difficult to get rid of, doctors suggest a medical procedure get rid of the condition.


Symptoms of Gynecomastia:
Some common symptoms of Gynecomastia include tenderness of breasts, swollen breast gland, pain in the breasts, discharge from the nipple etc.


Causes of Gynecomastia:
There could be many causes of this disease. If the condition is witnessed in babies, it could well come from the mother due to an overdose of oestrogen. Gynecomastia also appears during puberty resulting in the breast to swell up. The condition can again crop up after the age of 50 due to hormonal changes.
Certain medications can be a reason of Gynecomastia. Some of the common medications include certain antibiotics, anti-anxiety related medications, chemotherapy shots, HIV patients receiving HAART, cardiovascular medications such as Lanoxin, anabolic steroids etc.
Certain drugs such as heroin, alcohol, methadone, marijuana, Amphetamines etc.
Certain health conditions such as hypogonadism, hyperthyroidism, liver cirrhosis, ageing, certain tumours, failure of the kidney malnutrition etc.


Risk Factors Of Gynecomastia-
Certain risk factors of gynecomastia include older age, use of certain steroids, adolescence and other medical conditions such as Klinefelter's syndrome, tumour related to hormonal fluctuation and disease related to thyroid.
Diagnosis:
A doctor typically checks the history of drugs along with the health condition of the patient. He might also take a look at the health of the extended family. A careful tissue evaluation of the genitals, breast and abdomen are done. This is followed by a physical exam followed by prescribing certain tests such as mammograms, complete blood work, CT scan, biopsy of the tissue, MRI scan etc.


Treatment:
Most people suffering from Gynecomastia see a significant regression with periodic treatment. If however the condition arises from an underlying cause such as cirrhosis and malnutrition, a doctor suggests 2 option- medications and surgery:


Medications: Certain medications that are known to be helpful for breast related cancers are known to be effective in this condition. Some common examples of these drugs include evista, arimidex and soltamox.
Surgery: Only after exploring all medical options a doctor suggests surgery. There are 2 procedures namely mastectomy and liposuction. The latter removes the fat cells of the breast and the former removes the breast gland tissue.     


Gynecomastia - Is Surgery The Best Option?

Stretch marks, as the name suggest; appears when the skin is over stretched. These marks can also appear when the body loses its ability to stretch (use of certain steroids). Both the conditions affect the skin elasticity. As a result, white, red (turn pale over a period of time) or purple streaks appear on the buttocks, armpits, stomach, thighs and chest.

Many factors influence the appearance of stretch marks, also known as striae distensae
1. Elevated levels of cortisone hormone (produced by the adrenal gland) play a pivotal role in the appearance of stretch marks.

2. Stretch marks are common during pregnancy. As the foetus grows in size, the skin tends to stretch more and more. This stretching provides sufficient space to the developing foetus. A hormonal imbalance can also mark the appearance of stretch marks during this period. In some, the stretch marks appear after pregnancy.

3. Stretch marks are sure to appear when a person experiences a sudden change in the body weight (weight gain or loss). These marks can also be seen in children who are in their growing phase (teenagers).

4. Use of corticosteroids (steroid hormones produced by the adrenal cortex) can leave your body with the unwanted stretch marks. It is advisable to use corticosteroids (pills or cream) under medical supervision.

5. Stretch marks may be an outcome of some genetic disorders such as ehlers-danlos syndrome and marfan's syndrome. Striae distensae can appear in people with cushing's syndrome (the adrenal gland produces the hormone, glucocorticoids in excess)

Stretch marks often affect person's confidence. Most people find stretch marks extremely annoying and embarrassing. They try every possible trick under the sun to camouflage and get rid of the unwanted marks. The stretch marks are generally harmless and can be treated.

1. Drink plenty of water. It is important to keep the skin hydrated. Bio oils, vitamin e enriched oils, certain creams, can effectively fades the appearance of stretch marks. Use of moisturisers containing cocoa butter and shea butter will speed up the fading process.

2. Loss or breakdown of collagen protein (fibrous protein) can result in stretch marks. For stretch marks that are not very old, tretinoin cream comes across as a huge relief. Application of tretinoin cream helps in the restoration of collagen protein. For pregnant women, it is best to avoid this cream.

3. In case the stretch marks are a little older, a person can go for microdermabrasion.

4. Another great technique is the pulsed dye laser therapy. This therapy works by enhancing the growth of elastin and collagen protein.

All the preventive measures and treatments can help to fade the stretch marks. However, none can guarantee complete disappearance of the marks.

Stretch Marks - Causes and Prevention Tips

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