Vitiligo is a skin condition that causes loss of pigmentation of the skin. Melanocytes, the pigment cells, within the skin are destroyed. This causes these parts of the skin to lose color and turn pale. It might affect different parts of the body including the arms, legs, face and even genitalia. It can affect a person of any age, ethnicity or gender.

Causes
The exact cause of vitiligo is not definitively known. However, there are a number of risk factors that might contribute towards the condition. These include-

Autoimmune disorders- Vitiligo might be a result of an autoimmune disorder where the overactive immune system destroys the pigment cells of the skin.
Exposure to Chemicals- Exposure to certain chemicals can increase the risk of vitiligo by causing depigmentation.
Hereditary factors- There might be a genetic pre-disposition towards vitiligo. Though a person can exhibit symptoms of the condition at any age, it is most commonly found to manifest itself around the age of 20 years.
Symptoms
Vitiligo may start with a simple spot of pale skin but over time, this spot expands and turns paler until it is white in color. Irregular in shape, the edges of these spots may inflame and cause itchiness.

Treatment
The treatment of vitiligo will be determined by a number of factors such as the number and the extent of the white patches and where they are located. Vitiligo treatment includes cosmetic, medical and surgical methods.

Cosmetic Treatment- Cosmetic and skincare products such as sunscreens, dye or makeup can help relieve and hide signs of the condition.
Medical Treatment- Oral medication or medicated ointments may be prescribed to treat Vitiligo. Photochemotherapy which involves the use of PUVA rays to induce re-pigmentation may also be prescribed. If the condition has spread to a considerable extent then the physician might advise that the color from the remaining areas of the skin also be removed in order to match the affected areas.
Surgical Treatment- Surgical treatments are at times prescribed which involve skin grafting or tattooing. This is usually prescribed for those with small patches of affected areas.
With ongoing and extensive research being conducted on this skin condition, we will in the near future be able to both understand and treat it better.

Vitiligo - What Causes It and How Can It Be Treated?

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

Anal herpes and anal warts are sexually transmitted diseases. These both diseases affect the genitals. As these are sexually transmitted diseases, these are transmitted through sexual contact.

Anal Herpes:

It is an infection caused by herpes virus, which is caused by the sore or blisters formed around the anus. This infection is caused by the herpes simplex virus (HSV) type 1 or 2 viruses.
The symptoms of anal herpes include red bumps or white blisters, itching and pain around the anal area, development of ulcer at the site of blisters, a coating that covers the ulcers ruptures or is bleeding, any change in the bowel habit.
Treatment

Antiviral therapy is one of the primary treatment for anal herpes. The virus responsible mainly for herpes is herpes simplex virus type II. Antiviral medications are given to patients, these medicines fight the virus. The symptoms of herpes are reduced with this therapy.
Regular use of antiviral medication is referred to as suppressive therapy. As the name suggests, people on suppressive therapy, reduce the risk of passing the infection to their sexual partner.
In severe anal herpes, the doctor might give intravenous antiviral therapy to control the infection.However, the herpes virus cannot be cured as it is considered a lifelong infection. The virus stays in the nerve cells for lifelong and is inactive for long periods of time. It only outbreaks when it is triggered by an externalfactor such as illness, stress, or sun exposure.
Prevention
As anal herpes is transmitted through sexual contact, one can lower the risk of this disease. Safety measures can be used are:

Wear a condom or use barrier protection during every sexual intercourse, including anal or oral sex.
Reduce the number of sexual partners.
If one maintains monogamy, the risk is minimal for transmitting anal herpes.
One should abstain from sex altogether, if possible.
Anal Warts:
Anal warts are small warts that occur around the anus. Another name for anal wart is condyloma acuminate. In many cases, anal warts don t cause any pain or discomfort. But, they cause irritation when they grow in size and might be itchy and/or bleed. However, if there are no symptoms seen, people suffering from anal wart might not even know that they have warts. Anal warts might occur only at a spot or even spread to different parts of the genitals such as buttocks, anus, and inner thighs over a period of time.

Symptoms
The anal warts are small bumps initially, a size of the head of a pin, which is not even noticed. However, as they grow, they can develop to a size of a cauliflower-likean appearance, when several warts are clustered together to form a huge lump. These warts are peach colored and the color may vary from yellow, light brown, or pink and it might even blend with the skin color. Usually the anal warts are without any pain or discomfort, however, other rare occurring symptoms are itching, discharge from the anus, or bleeding. Anal warts in women might appear on vagina, vulva, or at the cervix, whereas in men it can develop on penis, scrotum, groin area, or thighs.

Treatment
Topical medication can be used to treat anal warts, such as imiquimod, podofilox, podophyllum, etc. Another treatment of anal wart that depends upon the location and severity of the condition:

Cryotherapy
Electrocautery
Laser treatments
Surgery can be recommended for larger warts that do not respond to medications.

Anal Herpes & Warts - Possible Ways They Can Be Treated!

One of the most common cosmetic procedures performed in the world today is that of breast augmentation or reduction. This is a fairly common surgery wherein depending on the requirement of the patients; the breasts are either made bigger with the help of implants or reduced in size by excising fat and tissue. Although a majority of these patients are female, there are an increasing number of male patients, who opt for male breast surgery as well.
The need for male breast surgery-
The requirement for male breast surgery arises due to the occurrence of Gynecomastia or the development of male breasts. In this condition, fat and glandular tissues are stored within the male chest in the pattern of female breasts, thus giving it a feminine look. This is a common occurrence among men and can be a cause of social embarrassment for the man as well as affecting his self esteem. Some of the causes for gynecomastia or male breasts would be  
Excessive Weight Gain.
Hormonal changes within the body where testosterone levels drop due to conditions such as  Hypogonadism  (in men, the inability of the testicle s to function correctly) and estrogen levels increase.
Medications used to treat other disorders such as certain anti -depressants, cancer medication, and anti-anxiety medications among others.
Excess consumption of alcohol and certain drugs.
Hyperthyroidism (excess thyroid secretion by the thyroid gland).
It isn t always just fat!
While many people tend to blame male breasts due to the accumulation of fat, this may not be the case always. Even skinny or people with an athletic build may notice misshapen chest that has more of a feminine appearance and thus would like to correct that. This is obviously caused by hormonal factors and genetics of body shape as well rather than just being obese or overweight.
Types of Male Breast Surgery-
Male breast surgery revolves around breast reduction and contouring to give it a more flat and toned look. This can be achieved in either of these ways:
Liposuction   This is a fairly common procedure and is minimally invasive; meant to suck out the fat through a small opening on the skin. With the help of liposuction, doctors can easily contour your chest to have a more masculine look by removing the excess fat. This procedure is a very popular one as it takes less time to recover and also isn t invasive. However, this is used as an option for male breast surgery when the problem isn t acute.
Surgery to remove excess tissues and fat   If the male breasts have excessive glandular tissue and the problem is acute, a more extensive form of surgery wherein the glandular tissue is excised may be required. However, this is also not very invasive and you can get back to your regular routine within a few days after surgery.


Male Breast Surgery

300 Calories is the average calorific value of our daily sugar intake. It's no wonder then that dietician and weight loss gurus across the world will advise you to quit added sugar as the first step of a weight loss program. Added sugar refers to processed sugar in the form of cubes, sugar crystals or powdered sugar and does not include natural sugars found in fruits, vegetables etc. Apart from cakes and sweets, we eat added sugar in a number of ways including a number of packaged foods like sauce and salad dressings.
If you consume a lot of sugar on a daily basis, quitting added sugar could leave you with withdrawal symptoms. Quitting added sugar is not easy, but here are a few reasons it is well worth the effort.
1. You'll have fewer pimples
Sugar has inflammatory properties. This can trigger systemic inflammation leading to the acne. Thus quitting sugar can instantly reduce the number of pimples on your face and give you clearer skin.
2. It improves the health of your heart
Added sugar can raise insulin levels. This activates the sympathetic nervous system and increases blood pressure and heart rate. Stopping your consumption of added sugar can lower cholesterol levels and decrease the amount of triglycerides in the body. This lowers blood pressure and boosts cardiovascular health.
3. A friendly weight scale
Replacing toffees with dry fruits will considerably reduce your calorific intake. Similarly switching packaged salad dressing for fresh homemade dressing can also make your salad healthier. Given that we eat added sugar in so many forms, making a conscious decision to quit added sugar can have a big impact on your daily calorie intake. Studies show that this simple step can lead to a weight loss of up to 10 pounds in six months.
4. It'll make remembering names easier
Added sugar can hinder learning and memory. Over time, it can also damage communication between brain cells. Quitting sugar can boost both your short term as well as long term memory. You will also find it easier to focus on will be able to be attentive to something for longer periods of time.
5. A good night's sleep
You don't just need 8 hours of sleep a day; you need 8 hours of restful sleep at the right time. Sugar makes blood sugar fluctuate and the crash that follows a sugar high can make you feel sluggish around mid-day. Many people find that if they have an afternoon nap, it becomes more difficult for them to fall asleep at night. Sugar also releases cortisol that interferes with sleep. Thus quitting added sugar can keep you alert through the day and help you fall asleep easier at the end of the day.

See What Really Happens to Your Body When You Stop Eating Added Sugar

Corns and calluses refer to the hardening of the skin to form a layer over an area where constant pressure and abrasion is experienced. This thickening of the skin is known as a corn or callus. One will usually experience pain and tenderness in the area where this thickening happens. While corns are thick and tender coatings, a callus is usually the flattened thick area on the skin. As far as shape goes, corns are conical and sharpened while calluses are flat. They are most typically found on the hands and feet. There are various ways of treating this condition. Let us find out more.

What causes corns and calluses?
To understand how to treat these corns and calluses, it is important to first of all understand what causes the same. These corns and calluses are usually formed as a natural defence as the body tries to strengthen the skin when it meets too much friction or pressure. This condition may occur when the toes are pressed together constantly with an abnormal elevation. This can also happen when there is prolonged use of high heels as well as sports training footwear. Bone deformities in the toes and fingers can also be one of the causes of this condition. In many cases, the gait and movement of the patient can cause corns and calluses. Also, when a person plays musical instruments that require constant strumming like a guitar or other instruments, it may result in formation of corns and calluses in the fingers.

1. Medical intervention for complications: if a patient is suffering from conditions like diabetes or peripheral arterial disease, it may lead to poor circulation and delicate skin. This can cause the development and growth of corns and calluses. It is important to see your doctor in such cases so that such symptoms may be treated at the onset before they become too painful and end up spreading.

2. Medication: a patient will have to ingest salicylic acid based medicines and even resort to the use of sulphur in order to cure these corns and calluses. One must ensure that a skin specialist or dermatologist prescribes the medicines so that one can apply and administer as per the correct dosage.

3. Home remedies: personal hygiene is one of the primary factors that can help in treating and curing this condition. Keeping the affected area clean can increase the chances of the growth to clear up soon. Also, one may have to avoid wearing high heels and constricting footwear for a while until the corns and calluses clear up or fall off. This will also ensure that there is less friction between the feet and the footwear for better recovery chances.

How to Treat Corns and Calluses?

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