Vitiligo is a long term skin condition characterized by patches of the skin losing their pigment. The patches of skin affected become white and usually have sharp margins. The hair from the skin may also become white. Although this disease is not life threatening or contagious, the disfigurement of vitiligo can be devastating to its sufferers, especially the ones with darker skin tone.

There are certain treatment options that can help.

Topical preparations of immune suppressing medications, creams and steroids are considered to be first-line vitiligo treatments.
Next option is to expose the affected skin to UVB lamps with the phototherapy treatment at home or get the Ultra violet (UVA) treatment at a hospital.
In extreme cases of extensive vitiligo the option to de-pigment the unaffected skin may be considered to render the skin an even colour.
However, in mild cases, vitiligo patches can be hidden with makeup or other cosmetic camouflage solutions. If the affected person is pale skinned, the patches can be made less visible by avoiding tanning of the unaffected skin.
Camouflage Treatment In Vitiligo
Camouflage is derived from the French word,  Camoufler  which means  to blind  or  veil . Also known as protective concealment, it means to disguise an object in plain view, for the purpose of concealing it from something or someone. Cosmetic camouflage is the application of make-up creams and/or powders to conceal color or contour irregularities or abnormalities of the face or body. It was pioneered during the Second World War to help pilots who were badly burnt by making use of plastic surgery and camouflage cream. These creams did not camouflage the person but were used to conceal blemishes on the skin so that they were not obvious. This kind of remedial cosmetic skin camouflage is defined as being the  the art of concealing a discoloration, blemish or scar with the application of specialist camouflage creams that are matched to the surrounding skin tone.  Nowadays, it is used to conceal abnormalities from various dermatological disorders, especially vitiligo.

Types of Camouflage
Camouflage may be permanent or temporary.

Remedial cosmetic cover creams help conceal the blemish of vitiligo at least temporarily. A high concentration of pigment is incorporated into water free or anhydrous foundations to give a color that matches the patient s skin, thereby concealing vitiligo patches.
Permanent camouflage is obtained with a cosmetic tattoo. Unlike pigments used for ritual or symbolic tattoos, cosmetic tattoos are inert iron oxides that are available in more than 15 shades. The color is implanted into the dermal layer with specialized techniques and cannot be washed off.
Camouflage improves the appearance of the individual, as the focus is no longer on the discoloration that the person wishes to hide, thereby improving their confidence and self-esteem. This makes camouflage the most popular treatment option in vitilgo.

Camouflage Treatment In Vitiligo!

While injuries of any form can be painful, burn injuries are one of the worst to suffer from. While cuts and bruises can be temporarily assuaged with a proper dressing, burns are quite different in this regard. With burns, the damaged tissues will stay on the body and may cause continuous pain. Thus, burn injuries are difficult to treat and they require different strategies for pain management as well.

Treatment methods available for treating pain arising due to burn injuries

Apply an anesthetic cream or aloevera gel to soothe the burnt skin. Avoid exposing the skin to air as that will cause painful sensations.
Loose gauze or antibiotic ointment must be used to protect the influenced area.
Soak the burnt area wound in cold water for about five minutes or more.
If the burn escalates or affects a widespread area, seek medical attention immediately.
Pain management factors for burn injuries:

Relaxation: During the phase of recovery, burn injuries put immense stress on your body and continue for a long period. Muscle tension is caused by stress that increases pain. Some relaxation techniques are proven to be beneficial to reduce the stress on body.
Coping with your pain: Different people have different ways to cope with physical discomfort. Look out for situational aspects which are currently under your control and take it positively. The  what ifs  or wishing that the burn didn t occur in the first place will not help with your current situation. You should focus on things what you can control like self-rehabilitation, doing your daily exercises, physical therapy treatment or following a doctor s suggestion of pain management strategies. This will help you cope with your pain to a greater extent.
Sleep medications: If your normal sleep routine is hampered, consult your physician for safe sleep medications. Proper sleep is very important for the healing process and even more so in the case of burn related injuries.
Antidepressants: Some people may not be suffering from depression, but they might still need antidepressants for relief and sound sleep. A health care provider might prescribe antidepressants as a way to deal with acute pain from burn injuries.
Increase the pace of your activities: If you want to rebuild your health and stamina and get back in form soon, focus on the regular physical and mental activities. Exercise regularly, but don t push yourself too much. Increase your physical activities gradually over time. Unless and until you are fully comfortable, don t strain yourself too much. Occupational and physical therapists can help you with an appropriate activity program.

Burn Injuries - 5 Ways to Manage Its Pain

Psoriasis is a chronic dermatosis characterised by an unpredictable course of remissionn & relapse. It is an non-infectious skin disaease chracterised by scaly, silvery patches mainly on the scalp and extensior surface of the body. Its exact cause is unkown. In ayurveda, it is closely resembles with ekakushta. The features of ekakushta explains in ayurveda classics resembles with the symptoms of psoriasis. Psoriasis is the challenge for modern science. There is no definite treatment for psoriasis in modern science till today. The drug available in the market use to treat psoriasis are not very effective and have local and systemic effects.

In ayurveda, vata pitta and kapha dosha is the main contributory factor for the disease. Due to vitiation of three dosha, the disease manifest and main line of treatment for psoriasis is panchkarma and internal medicine. It is considering the best approach for skin disorder in ayurveda. A case report of 42-year old male, presented with well demarcated red scaly, silvery patches mainly on both legs, hands, scalp, chest and back with itching, and also nail and joint involvement has been presented in this article.

Etiology of Psoriasis: 

Unknown but many factors have been associated-

Genetic: may be autosomal dominant

Triggers: physical trauma ,infection and drugs.

Biochemical change: like increase level of arachidonic acid and Cgmp.

Immunological factors: helper T cells PLAY A KEY ROLE.

Epidemiology: 

Roughly, 1% of population is affected. Can occur at any age and affected both sex. Most patients as worse in winters.around 7 million people are affected in developed country.

Histopathogenesis:

Increased epidermal cell proliferation.

Retention of nuclei in stratum corneum.

Proliferation of fibroblast.

Dilated and tortous capillary loops.

Shortened epidermal turnover time from normal of 60 to 10 days.

Clinical features: Usually chronic indolent lesions which persist for month. Lesions are mildly papule or plaque.erthematous plaque lesions with characteristic slivery, large, loose scales. The patients of psoriasis may also suffer from depression and low self-esteem.

In a patients with psoriasis always check for nail and joint involvement.

Nail: 10 to 15% of the patients have nail involvement. Pitting, nail plate thickening, subungual debris, discolouration of nail plate and oil spot seen in the nails.

Joints: 10% patients have joint involvement.

Sites: Scalp, pressor points & extensor. Sometimes generalised.

Chronic recurrent psoriasis is difficult to treat. Modern science treat with PUVA and corticosteroids but these drugs having local and systemic side effects like liver and kidney failure etc. So, it is the time to find out the effective and safe treatment for Psoriasis. Medicines which are used in ayurveda are safe and practised since many years. A huge numbers of drugs are prescribed in ayurveda for the treatment of kushta.

Case details: A 42-year old male patient, hindu brahman by religion, presented on 10 april 2016 with well demarcated raised red scaly, silvery patches on chest, back and both legs and hands. He complained of itching all over the body and on scraping, white powder like substances fall down and leaves a bleedy surface. On history, patients had complaints since 20 years and diagnosis of psoriasis by allopathic physician. Since 20 years he has been taking allopathy and homoepathy patients from various practioners of U.P and delhi. He is brahman and lives in well known temple of delhi and visit homes of peoples for religious ceremony. He is afraid that if the disease is spreading continously, then he is unable to work as priest because people neglect him due to disease. The disease is spreading all over his body and also involves nail and joint. Destruction of nail plates of hand and legs was also developed. For this, patients took allopathic treatment for such a long time but do not get relief.

The patients visit our clinic for the first time. He told use that his problem not solves since 20 years and spreading continuously. So, he is unable to trust us. So, we first give him counselling because reassurance and emotional support are invaluable. Physical and mental rest enhance the effects of the treatment. It is also important to tell him that the disease is not contagious and is benign.

SYMPTOMS OF THE PATIENTS :

Itching all over body

Silvery patches, especially, on legs ,chest ,back but now spreading in his hand and scalp.

Destruction on nail plates

Swelling and pain in left middle fingers and flexor deformity in proximal interphalangeal joint

Swelling in right middle metatarso phangeal joint and pain

Some blood test of the patients were done like CBC, LFT, KFT, SR, URIC ACID to assess outcome.

His general health was good and both physical and all blood test were within the normal limts.we advise patients for panchkarma and oral medication but patients refuse for panchkarma so we start his oral or internal medication. 

Investigation Done :

CBC(Complete Blood Count)

LFT(Liver Function Test)

KFT(Kidney function Test)

Sr. Uric Acid

Investigation was done to rule out any other pathology. Investigation were within normal limit.

Internal Medication :

Medication are given into two phase. In First Phase, we are given panchsakara churna - one spoon two times daily for anulomana and pachan, Panchnimba churna- one spoon two times daily with luke water, panchtikta ghrita gugulu - two tab two times daily, and one oil for local application containing jyotishmati,bakuchi, and chakramad for five days. We told patient to apply the oil firstly only on legs for 5 days. Patient taking the same for 5 days and come on 5th day, we see the fabulous result, the rashes which are developed within 4 to 5 months just disappear and other rashes are also subsiding.

After 5 days, in second phase, we continue the same treatment and also added haridra khand - one spoon two times daily, gugulu tiktam kashaya - three spoon two times daily (one hour before food for 15 days). The patient came back on 20th day, with great result, the rashes were almost 60 % subsiding and pain and swelling in finger and ankle also reduce to great extent. Now, patient is not taking any pain killer for pain. Patient also get improvement in nails of legs.

We prescribe the same medicine for one month that time and ask him to do some physiotherapy additional for finger deformity. After that patient came with 70 to 75 % relief in symptoms and patients also tell that during the treatment, he will not develop any additional rashes.

During the treatment, we also told the patients to follow some dietary changes and live according to the rules of Ayurveda.

Result: Psoriasis is a disease with unkown etiology and triggered by many factors. In modern science, treatment of psoriasis is a challenge. They do not have any safe and proper medicine for psoriasis. But, ayurveda treatment gives satisfactory results as well as the quality life to the patients. Ayurveda removes toxin out of the body and corrects the formation of aama. Ayurveda gives the prevention as well as the treatment. So, by following the dietary and lifestyle change we prevent the reoccurrence of the disease.

Ayurveda For Psoriasis 

Having a cosmetic surgery is quite a big deal. It is an expensive surgery, which causes alteration of your body features. Although cosmetic surgeries are usually effective and provide satisfactory results, you should keep several things in mind before a cosmetic surgery. You should know all important facts about cosmetic surgeries, their procedure and results before undertaking one.

Here are the things you should consider and keep in mind:

Cosmetic surgeries are permanent: You would like the idea of perfecting several features of your body using a cosmetic surgery. However, you must keep in mind that such a surgery is permanent and your features would be altered forever. You should not undergo a cosmetic surgery half-heartedly and must think over and over before finalizing.
You should know why you are having a surgery: You need to have proper reasons why you want to undergo a cosmetic surgery. You should consider the exact reason why you feel that a cosmetic surgery is required. There are several physical and emotional changes which occur after a surgery and you should be prepared for the same.
You should know the results you want: Before having a cosmetic surgery, you should know exactly how the results would appear. Having a rough idea will not do and you should know beforehand how you are going to look post-surgery. You must make the doctor understand your requirements and desired results perfectly so that he or she can give the best results. You may use pictures and illustrations to explain your objectives to the surgeon.
You should know about the outcomes: Knowing about all the possible outcomes of the cosmetic surgery, which you have opted for is very important. For this, you need to surf the internet and do some research. Read from trustworthy medical care websites and also consult people who have had a cosmetic surgery before. You should also keep in mind the consequences which may arise if you do not like the results of a cosmetic surgery and be prepared mentally, in case some complications occur.
You should choose the best surgeon: Choosing a capable and efficient surgeon is an important thing to do, before thinking of having a cosmetic surgery. You should consider the location, experience and approach, while choosing the right surgeon. You should also make sure that the surgeon is qualified and registered to practice.
A cosmetic surgery is a serious surgery, which will change the way you look in certain ways, depending upon the type of cosmetic surgery you have chosen. Before deciding on having a cosmetic surgery, you should consider the above-mentioned factors and then only go for it.

Going for a Cosmetic Surgery - Things You Must Consider Before it!

What is the real reason behind the surgery?

The decision to have breast augmented surgery should be a woman s alone. Friend s advice or pressure from your partner should not play a role in this. Since this is a complicated procedure, getting the surgery done with external pressure can lead to disappointment.

How expensive are these surgeries?

Breast augmentation surgeries are slightly expensive compared to other plastic surgeries. However, the price of the surgery varies depending on the procedure chosen and the doctor who is performing it. It makes sense to consider a clinic which fits the budget and has a very good reputation of its own. Planning your finance well in advance should be one of the top priorities of a woman.

The Risks-

While most breast augmentation surgeries are harmless, there are potential complications that go with it. Bruising and swelling are common risks that are involved with this procedure. This might even last for a week. If surgeries go wrong there is a potential risk in getting a second surgery to set things right. The candidate might have to take antibiotics and pain medication for quite a few weeks till things become normal.

Think about a realistic size-

There is this general notion that breast augmentation surgeries do not give a natural look to a woman. To ensure that one gets a natural look, it is very important to choose the right size of the implant. While it remains a personal choice, the appropriate breast size makes a woman more attractive.

Set the expectation right-

Most breast augmentation surgeries give people a positive outlook towards life. They feel more confident and happier than before. Having said this, there are chances of potential changes in the physiological and physical front. Before the surgery, a detailed discussion with the doctor is recommended.

Where should you have the surgery from?

While there are many places that offer cheap implant options, money should not be the only consideration. A surgery as important as this should have various parameters weighed such as the experience of a doctor, the success rate of the doctor, talking to people who have undergone the same procedure from the same facility etc.

Is a night stay at the clinic mandatory?

A night stay at the clinic is not mandatory. While some clinics emphasize for a night stay so that the patient can be kept under observation, some prefer that their candidates go home and heal at the privacy of their homes.

Pregnancy-

If a person is planning to get pregnant after the surgery, there is a potential risk of breastfeeding. While most women do not face this, there are considerable ones who come across this problem. A prior consultation with the doctor will help to take an informed decision.

Things To Consider Before Having Breast Augmentation Surgery

Rhinoplasty, more commonly known as Nose-Job, is a cosmetic procedure designed to change the shape and size of the nose. 

A Rhinoplasty can effectively change the size and shape of the nose to complement the facial balance. It also helps improve nasal symmetry efficiently enhancing your facial features.

How is the surgery performed?

We prefer General Anaesthesia for the surgery to make patient pain free and most comfortable. It s a Day-care procedure or may need overnight stay.

The operation involves an incision which is made for easy access to the cartilage and bones of the nose. These incisions are generally placed inside the nose, so that they do not appear as scar marks after the surgery is done. Moulding, removal or replacement of the bone or cartilage depends on the demands of the restructuring of the nose. Once the reshaping of the nose is done, the nose tissue is put back into place and a splint is temporarily placed to support the new structure of the nose. The splint is removed at 5-7 days. 

Precautions to take after a nose surgery

After a nose surgery, the area around your nose will stay swollen and bruised for around 10-15 days. Thus you have to ensure that-

You get adequate period of rest.

Use cold compresses over the swollen face, this will reduce the swelling and ease the pain.

Do not indulge in relatively vigorous physical activity for 15 days. 

Take you medicines regularly.

Risks of nose surgery

Every surgery or medical procedure involves certain risks, and so does Rhinoplasty. Along with some puffiness and bruising around the eye and nose region, you may also experience-

Some amount of bleeding 

Injury to the septum area

Irritation of the skin and skin problems 

Infections 

Nasal blockage due to swelling in the inner nasal area 

Complications resulting from anaesthesia 

Although there are certain risks to Rhinoplasty, the surgery is considerably safe if done by a qualified expert plastic surgeon and the results are quite permanent.

Rhinoplasty - Things You Must Know!! 

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