A mole, sometimes known as a birthmark, is a non-cancerous disorder of pigmented skin cells. They can vary in color and shade and by and large, can be medium to dark brown, sometimes they can be skin-colored or black too. Most of them are regular in shape, flat to moderately even as well. Sometimes, they appear to be slightly raised above the skin, are delicate to touch and lighter in shade. Also, they may or may not cause any kind of pain.

You need to get your moles checked at least once in every three months, because of the following reasons:

In case you have noticed the growth of new moles or have a family history with medical background marked by melanoma.

You need to watch out for moles that do not look like your other moles specifically. Dysplastic moles are the ones that look different from the normal ones and may lead to melanoma. In case you have different dysplastic moles, you are in serious danger of getting melanoma.

In case you have any moles that are bigger than the others and are smudgy or have unpredictable edges, which are uneven in shading or have some pinkness, you need to see a specialist and get them checked. Also, if you notice a change in the color or shade or it gets itchy, agonizingly painful or begins to bleed, it can be a sign of something serious. Thus you must visit a specialist immediately. 

Although, most of them are non-cancerous and not that dangerous. However, there are some types that can convert into lumps and can be cancerous in nature. Although the chance of something like that happening is very rare, still it is a possibility.

In case you notice a liquid discharge or pus formation in the mole, you must consult a doctor immediately. 

Being proactive about your well-being is the best way to avoid serious health conditions and you must look out for moles that can be risky as they are connected to skin cancer. Self-diagnose and examine your skin in front of a mirror. Give careful consideration to the zones of your skin that are frequently exposed to the sun, for example, the hands, arms, abdomen, face and head. Along with limiting your exposure to sunlight and utilizing sunscreens, inspecting yourself for moles can help with early detection of melanoma (the deadliest kind of skin tumor) and hence, get treated for the same. In case you have a concern or query you can always consult an expert & get answers to your questions!

Important Reasons Why Should You Get Your Moles Checked!

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

Also known as contact dermatitis or contact eczema, allergic eczema is a condition wherein one experience symptoms of skin rash on coming in contact with an allergen. Other symptoms include a burning sensation in the eyes, coughing and a runny nose.

Causes-

This condition is caused when you come in contact with an allergen. Some common triggers that cause your immune system to react in this manner are:

Perfumes in cosmetics

Hair dyes

Metals such as nickel found in jewelry

Latex based products

Chemicals present in soaps and other cleansing agents

Certain antibiotic creams and lotions

Adhesives

Symptoms-

With allergic eczema, the most common symptoms include itching and pain around the affected area, and tender skin. Inflammation and dry skin are some other common symptoms that one may experience. Pus-filled red bumps are common occurrences along with this disorder. The skin may start to thicken and turn scaly. The symptoms may show up when one is exposed to sunlight.

Treatments-

The treatment for this disorder begins after a thorough diagnosis of the symptoms. Based on how severe the symptoms are, the treatment is prescribed accordingly. The first step is usually to wash the affected area with warm water to wash away the allergens. In case of mild symptoms, you may not need any treatment. It is also advised to use apply moisturizing cream to maintain hydration of the skin. To reduce inflammation and itching, use of corticosteroid creams is recommended.

In case of severe symptoms, strong corticosteroid pills may be prescribed.

If the treatments are carried out properly, the symptoms tend to clear up within 15-20 days. However, it is important to remember that the condition may erupt again if you come in contact with the allergen once more. Thus identification of the allergen is very important for long-term treatment and preventive measures. By seeing an allergist contact dermatitis can be ruled out by doing an Allergy Patch Testing.

Allergic Eczema: Causes, Symptoms and Treatments

Moles and Nevi are formed when there is a localized concentration of pigment cells on the skin or mucous membrane. They appear as colour growths and may appear anywhere. Colours may vary and can be brown, black, or natural skin colour. These growths usually appear in early childhood or adulthood, but there are some that may appear late. With the passage of time, these growths may change in appearance and become darker in colour or raised in appearance. Hairs may also develop among them.

Treatment for Moles:

Your plastic surgeon can advise to remove a mole when he/she has a clinical suspicion that it may transform into a malignant nevus. People may also want to go for mole removal if it bears an aesthetic dimension. If the patient wants to remove moles from sensitive areas like eyelids, eyes, mouth etc., he/she needs to consider meeting a Plastic Surgeon who is skilled and experienced in mole removal. Plastic surgeons can conduct procedures with minimal scarring.

Plastic Surgery for Mole or Nevi Removal:

There are many processes of mole removal. Some of the commons ones are listed below:

Shaving with Surgical Scalpel:

The plastic surgeon may shave off a small & superficial mole with a surgical scalpel. There are some moles which have cells underneath the skin which may need to make a deeper cut.

CO2 Laser or Electrocautery:

The plastic surgeon may also do cauterisation of the moles using radiofrequency cautery. Laser plastic surgical treatment encounters less scarring. Nevertheless, Laser treatment may be required in stages for satisfactorily removing the deeper moles.

Excision & reconstruction of bigger moles & nevi:

Giant hairy nevus or huge moles needs reconstructive surgery after complete excision of such bigger moles.

Benefits of Plastic Surgery:

Brings Down Risk of Melanoma - Though moles are benign in general, there is a risk of them turning cancerous over time and giving rise to melanoma. This is why plastic surgeon may monitor certain moles in patients and advise mole removal. While cosmetic reasons are attributed to the patient's concerns, doctors are concerned about the likelihood of melanoma. So, the best mole removal procedure can bring down the risk of melanoma.
Cosmetic Benefits - Some moles, especially those in the face, appear unsightly. Removing these moles can offer cosmetic benefits.
Conclusion:

In general, moles need to be removed with the help of a plastic surgeon for better cosmetic results & prevention of possible complications.

Moles & Nevus - How Can Plastic Surgery Remove These?

Wounds and bruises are both injuries. However, they differ widely in terms of the causing factors, the nature of the injury, the pain they cause and the kind of treatment they require. The following are a few of the myriad ways in which the two injuries differ from each other:

1. A wound causes quick damage - the skin tissue is cut or punctured while a bruise (also called a closed wound) is where the skin is not torn. 

2. A wound is usually caused by a sharp object but bruises are the results of blunt force or trauma.

3. A wound almost certainly bleeds due to ruptured tissue and blood vessels. Blunt injury also damages the blood capillaries of the skin and causes blood to accumulate under the skin tissue, creating a dark patch of skin. Blood vessels can also break due to lifting of heavy objects or overexertion of muscles.

4. A wound carries the risk of infection because the skin is open but a bruise does not get infected.

5. A wound has a burning or stinging sensation but a bruise is characterized by swelling and a blunt throbbing pain.

6. A wound can be healed by antiseptic and antibiotic medication. Large wounds need to be closed by stitching them up to avoid severe infection. On the other hand, a bruise usually heals by itself. A cold compress and pain killers may be used to ease discomfort. Heat can be applied to the injured spot to normalize the blood flow and dissolve the blood clot.

7. A wound can lead to complications like bacterial infections or the healing might be delayed by chronic diseases like diabetes. In case of a bruise, it usually does not cause complications but if there's a blunt injury to sensitive areas like the head, the tailbone or the eyes, medical attention is advised.

8. Wounds and bruises can also be differentiated on the basis of their subtypes. The different types of wounds are:

a. Incision (sharp objects cutting the dermis layer of skin)
b. Abrasion (the epithelial tissue is scraped off)
c. Avulsion (a body structure is torn off)
d. Penetration (a sharp object causes an entry and an exit wound)
e. Puncture (only an entry wound caused by a sharp object)

The different types of bruises are:
a. Hematoma (blood pools under the skin)
b. Purpura (tiny spots of blood on the inside of the mouth)
c. Contusion (similar to hematoma and caused by external trauma)
d. Crush injury (caused due to a large amount of force on the body part for a long time)

Wounds VS Bruises

Alternative medicine is fast picking up with its beneficial treatment for several skin disorders. Vitiligo or patchy skin is a common skin problem that can be effectively treated by the ancient Unani system of medicine.

What is vitiligo?
Also referred to as leucoderma, it is a patchy loss of skin colour that occurs due to acquired depigmentation of the skin. The absence of skin cells called melanocytes leads to nonproduction of the melanin pigment and as a result, manifests itself as patchy skin in several parts of the body. It can affect any area of the body including the face, neck, back, hands, and legs.

Unfortunately, conventional medicine has not been able to discover a full-proof treatment for this skin disorder, except for surgical intervention. Thanks to the yesteryear s Unani medicine system, which has its foundations in the ancient Greek, Roman, Persian, and Indian medicine, certain herbal formulations help to treat conditions of vitiligo or leucoderma. The Unani system of medicine aims to create the right balance in the body by stabilizing the four humours   blood, phlegm, yellow bile and black bile, which constitute insulin, hormones and other fluid releases.

Herbal powder and capsules are prescribed for the patient s consumption depending on the severity of the disorder.
Herbal ointment for external application   The affected individual must apply the topical ointment or balm before 10:00 am and then expose it to sunlight for around 10 to 15 minutes. After that, it should be shown back in shade and kept for one hour before washing it off.
Diet for vitiligo
Certain food items like banana, beef, sea food, poultry, citrus foods, pickles and dairy products are to be restricted during treatment. Foods with excessive tamarind and cashew nuts are also to be avoided. Recommended food includes all vegetables, fruits, eggs, and organic chicken.

How effective is Unani in treating vitiligo?
For years together, Unani compound formulations for systemic as well as topical usage are catering to the needs of patients. It helps to treat and induce re-pigmentation. There are several treatment modalities available to control the spreading of the disease and minimize the chances of a relapse of the skin condition.

There have been no reported side effects of Unani medicines and they are well tolerated even after prolonged use. It usually takes about 2 to 3 months to see a visible improvement of the condition. The disease tends to become stable after regaining pigmentation.

The Central Research Institute of Unani Medicine located in Hyderabad, India has taken several measures to eradicate Vitiligo. While conventional medicine does try to offer remedies to treat vitiligo, Unani medicine offers a cost-effective approach that is more promising.

Best Unani Medicine for Vitiligo Treatment

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