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!

Breast lift surgery or Mastopexy is a form of plastic surgery used for lifting or raising sagging breasts in women. The size, contour and elevation of the breasts are modified or corrected using this procedure.
The position and shape of the breasts in women change after pregnancy, breastfeeding, suffering weight loss or with age. A breast lift surgery is effective in treating sagging breasts.

During a breast lift surgery, extra skin is removed from the breasts, and the surrounding tissues are tightened for reshaping of the breasts. The nipples and areola are also reshaped to a better location. A breast lift surgery may involve the procedures of liposuction and abdominoplasty for an even better rejuvenation.

Breast lift surgery is undertaken by many women for different reasons. Some women do not like their breast shape or volume after pregnancy and have this surgery done.

A breast lift surgery offers various benefits. They are:

A breast lift surgery improves the body image of a woman and also boosts her self-esteem. Women feel their breasts have been affected negatively after pregnancy and undergoing this surgery enables them to have satisfactory breasts again. A breast lift surgery does not cause the breasts to increase in size. They appear bigger because they are higher in position and firmer than before.
Having a breast lift surgery can push you to make better and healthier choices about your lifestyle. For undergoing any form of surgery, it is recommended that you stay as healthy as possible. This includes proper diet and eating habits along with regular exercise.
A breast lift surgery improves the quality of life in women. Body image is improved, and the woman feels good about her breasts and body as a whole. According to studies, 92% of women having a breast lift surgery had improved self-esteem and a better, healthier life than before. Women become less conscious about their breasts after the surgery, as the breasts become satisfactory.
As a result of this surgery, some clothes may fit better, and a woman can experiment with trendier outfits, and may also not wear a bra at times.
A breast lift surgery gives women a better proportion between their breasts and buttocks. The contrast is better and makes a woman more attractive. More cleavage is created, and the breasts get more projected.
A breast lift surgery is an efficient procedure to improve the breasts of women. Sagging breasts are corrected by a surgery which gives certain benefits to women.

5 Benefits Of Breast Lift Surgery

Skin inflammation caused due to overexposure to the harmful rays of the sun is known as sunburn. UVA and UVB are the ultraviolet rays that cause maximum damage to your skin. Overexposure to the sun triggers the development of melanin (color imparting pigment) on the upper layer of your skin or the epidermis, resulting in the formation of a tanned skin. Severe sunburn can damage your DNA also.

The most common symptoms of sunburn include:

Your skin may appear reddish in color
You may notice wrinkles
On touching, your skin may feel hot
Frequent itching sensation may make you feel irritated
Blisters may pop out due to sunburn
You may suffer from fever too and that may result in nausea
Your blood pressure can also reduce which can make you feel week
Your skin may be swollen
Some of the risk factors are mentioned below:

Fair skinned people are more prone to sunburns.
Working outdoors for prolonged hours can cause severe sunburn.
Sunburn can hasten your process of aging.
The blisters can result in infections.
Sunburns can also result in the formation of skin lesions.
Sunburn can sometimes lead to skin cancer.
Sunburn can be treated in the following ways:

Bathing in cold water can give you some relief.
Aloe Vera creams have cooling properties; applying aloe vera cream or gel on the affected areas can offer temporary relief.
Sometimes, sunburn can make you feel dehydrated, so it is advised to drink plenty of water to keep yourself hydrated.
Anti-inflammatory medicines like aspirin can help you to treat skin inflammation.
Home remedies like applying orange peel paste on the affected areas can help you to treat mild cases of sunburn.

Sunburn - 8 Signs That You are Suffering from it 

Exposure to the sun for a long period of time can result in several skin problems. They occur on the basis of heat, humidity and the rays of the sun. Here are the most common skin problems caused due to sun exposure:

Sunburn: Sunburns occur as a result of overexposure of the skin to the harmful ultraviolet rays of the sun. Melanin in the skin protects it from the sun s rays, but in case of overexposure, melanin fails to work and sunburn is caused. The symptoms of sunburn include the skin turning red, burning in the affected areas, skin tightness and a sensation of itching. Severe symptoms are blisters, chills, fever and fatigue.
Age spots: Age spots are caused due to overexposure to the sun. They are brown marks, which appear on the surface of the skin, especially in the arms, hands and other body parts. Age spots get more prevalent with ageing. Symptoms of this condition include brown and gray pigmentation on the skin surface. The pigmentation occurs in a circular shape and is flat on the skin.
Photosensitivity: This condition is also known as sun allergy. People with photosensitivity are likely to get burned from sun exposure very easily, and symptoms of sunburn are observed. Symptoms include red and pink skin rashes accompanied by itching and burning. The area gets scaly and blistered.
Moles: Moles occur commonly due to sun exposure. They may appear on any part of the body. Moles may vary from being harmless to cancerous. Common symptoms include raised skin and the skin tone changing into reddish brown or black. Moles are round in shape, and some moles are painful.
Solar elastosis: This condition is commonly known wrinkles and occurs when the elastic tissues of the skin get deteriorated due to sun exposure. The skin turns limp on account of no strength of the tissues and collagen. Wrinkles appear, and the skin seems loose and sagging. Deep lines are formed on the skin.
Skin cancer: Skin cancer accounts for being the most severe and fatal result of prolonged exposure to the sun without any kind of protection. There are many forms of skin cancer. The most primary skin cancers include Melanoma, basal cell carcinoma and squamous cell carcinoma.
Polymorphous light eruption: This condition, known as PMLE in short, affects women between the age group of twenty to forty. It also occurs in light sensitive people who spend more time under the sun. Symptoms include a red or pink, bumpy rash and raised areas on the skin surface. Itchiness and dry patches are indicated.
A large number of skin problems occur due to long hours of sun exposure. Some of these are chronic problems, which require proper treatment.

Skin Problems Caused due to Sun Exposure

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

 Hives , also known as urticaria, is the outbreak of pale red, swollen bumps on the body. It can occur on any part of the body including the face, back, arms or legs. It is a type of hypersensitivity reaction in which the cause for the reaction is idiopathic (unknown). Also, it can come in various shapes and sizes. Hives can be associated with redness, itching, and a burning and stinging sensation. These can last for more than a minute or even more than that; up to days.

What causes hives?
Most of the times, hives are idiopathic, i.e. the reason that causes this type of hypersensitivity reaction is unknown. The bumps are caused by the action of histamine that makes the plasma in the blood leak out of the small blood vessels. Histamine is a substance that is released from a specialized cell and is what causes allergic responses in general. There are three types of hives- namely, acute, chronic urticaria and physical urticaria. Acute urticaria is when the hives last for less than six weeks. Chronic urticaria occurs when the hives last for more than six weeks. 

Physical urticaria refers to the condition when the hives are triggered due to causes such as heat, cold, sun exposure, sweating, pressure and exercise. Although, this condition is mainly idiopathic, there are common causes that may trigger this condition such as:

Foods such as nuts, fish, chocolates, milk and milk products
Environmental triggers such as pollen grains, dust etc
Medications such as ibuprofen or paracetamol
Insect bites
Latex
Blood transfusion
Bacterial infections including strep throat and urinary tract infection
Pet dander
Plants such as poison oak or poison ivy
What are the symptoms of urticaria?
Hives are usually self-diagnosable. The various symptoms of urticaria are:

Swollen red bumps known as weals
The red bumps can occur suddenly and subside all of a sudden as well
 Blanching which is characterized by the whitening of the swollen red part.
They occur on any part of the body and can change shapes, and sizes. It can become larger or it can reduce in size; it can also move around in the body.

Hives - Most Common 9 Reasons Behind It!

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