Soft growth occurring on the genitals are known as Genital Warts. Genital warts are infections that are transmitted through physical intimacy (STI). These are caused by certain behaviours of the human papillomavirus (HPV). These growths on the skin cause discomfort, pain and itching. They are particularly harmful for women since certain types of HPV might also cause cancer of the vulva and cervix. HPV is one of the most common sexually transmitted diseases. Due to this, sexually active people are most vulnerable to various health complications, including genital warts. Prevention of this infection requires essential protection and treatment.

Symptoms:

Transmission of genital warts occurs through sexual activity. Development of warts occurs several weeks after the infection. Sometimes, it is not possible to view them with the naked eye. The top of the growths might resemble a cauliflower and might feel slightly bumpy or smooth while touching. The person who is infected may have a single wart or a cluster of warts.

In males, the genital warts may appear in the following regions.

Groin
Scrotum
Penis
Thighs
Inside or around the anus
In females, they might occur in:

Cervix
Outside the vagina or anus
Inside the vagina or anus
In a case where the person has had oral sexual contact with the infected person, the genital warts might appear on the mouth, lips, throat or tongue of the person. In case the genital warts are not visible, the other related symptoms include:

Itching
Vaginal Discharge
Bleeding
Burning
Treatment

Even though the genital warts disappear with time, it is not possible to eliminate the virus once it is in the bloodstream. This would result in several outbreaks during the entire course of life. This is a vital reason why the symptoms should be managed so that transmission of the disease is prevented. Treatment is possible only for relieving symptoms that are painful or for minimizing their appearance. Some topical wart treatments prescribed by the doctor may include:

Podofilox and Podophyllin (Condylox)
Trichloroacetic Acid (TCA)
Imiquimod (Aldara)
Some surgeries that the physician might conduct to remove genital warts that do not disappear with time include:

Interferon injections
Laser treatments
Cryosurgery, or freezing warts
Electrocautery, or burning warts with electric currents
Excision, or cutting off warts
Periodic Pap smears after the initial treatment is recommended for women with genital warts to monitor changes in the cervix.

Genital Warts - Can They be Treated? 

5 hidden causes of acne, revealed!

Acne is a skin condition that occurs when the openings of oil glands become clogged with oil and dead skin cells. Acne usually appears on the face, neck, chest, back and shoulders. The pimples and bumps heal slowly, and when one begins to disappear, others seem to crop up. Depending on its severity, acne can cause emotional distress and can also scar the skin. But what causes the recurrence of breakouts?

These are attributed to certain hidden causes, which are:

1. Your drug prescriptions

Steroids found in prescription drugs are a key offender, whether taken internally or topically. If taken internally, the offending ingredient will be listed as prednisone, which is the tablet form of steroid. Prednisone is used to treat inflammatory diseases like poison ivy, allergies and arthritis. If medications are taken topically, it could aggravate acne or cause steroid acne. Oral contraceptives are also a common cause of acne.

2. Your beauty routine

Acne caused by topical lotions, creams and makeup are known as acne cosmetica, commonly appearing on face, neck, hairline and scalp. Applying a product regularly to an acne-prone area can do more harm than good. Some people go to bed with ointments or oils in their hair that can get on the pillowcase and then rub on your face. It's best to put a clean towel over your pillowcase every night to prevent buildup.

3. Your cell phone

Cell phones gather all kinds of dirt and bacteria and are a big cause of acne on the chin and around the mouth. Wiping down the screen of your smartphones every day with alcohol or cleaning wipes will keep your phone and your face clean.

4. Using toothpaste to treat a zit

Certain toothpaste can actually cause you to develop acne or an acne-like eruption on the lower parts of your face, including your chin. Fluoride and other whitening and anti-cavity ingredients are quite abrasive and could potentially burn your skin, cause irritation and initiate breakouts.

5. Your workout gear

It's not the act of exercising that is causing breakouts but other issues. If you are using a communal yoga mat, you may be on the side that someone else's feet or perspiration had touched before, with the physical contact causing breakouts. It's best to put a clean towel over it before working out, even if it is your personal mat.

Also, workout gear that constantly rubs in a certain area can cause frictional acne. Constant rubbing ends up making you sweat, causing skin irritation and eventually developing into tiny red bumps. Though it looks like a heat rash, it is actually acne.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Do You Know that Dandruff Causes ACNE?

5 Hidden Causes of Acne, Revealed!

A common skin condition, which causes the discoloration of your skin in patches across the face, melasma is more of a social embarrassment and cause for distress rather than being a serious condition. Although it affects men as well, studies have shown that over 90 percent of patients are women. It is also known as the mask of pregnancy as many pregnant women develop this skin condition.

Causes of Melasma
Primary causes of melasma have been attributed to various hormonal changes within the body. Let's look at some of the factors that may cause this disorder:
1. Pregnancy: This is often attributed as the leading cause of melasma, the primary cause has often been attributed to hormonal changes that a woman may experience due to pregnancy.

2. Treatments that may change hormonal balance: Women on contraceptive pills or who have implants such as intrauterine devices may also develop this disorder. This is due to the balance of estrogen and progesterone being changed within the body.

3. Sun exposure: Continued sun exposure may also lead to melasma. This is due to the activation of melanocytes within the body which start producing more melanin.

4. Stress: Long periods of stress on the body can also trigger hormonal changes and cause melasma.

5. Thyroid problems: If someone suffers from Hypothyroidism or low levels of the thyroid hormone, it can trigger other hormonal changes and also cause this skin disorder. 
It has also been noticed that people with generally a darker skin tone tend to get melasma and it is less common in people with fairer skin.

Certain characteristics of Melasma
Melasma develops in certain patterns which can be easily diagnosed either as spots on the skin similar to freckles or brown patches of skin that grow bigger. Some of these patterns are:
a. Malar pattern: This grows on the nose and cheeks
b. Mandibular pattern: Starts growing around the jaw line
c. Brachial melasma: This grows on the upper arms and shoulders
d. Lateral cheek pattern: Grows on the cheek on both sides of the face
e. Centrofacial pattern: Nose, upper lips, forehead and cheeks

Treatment of Melasma
Most women who develop melasma during pregnancy report that it goes away after childbirth. However certain forms of melasma may appear in non-pregnant women due to hormonal changes. Treating the underlying hormonal changes usually resolves the problem. However certain other methods may be required to resolve the issues such as skin creams, chemical peels, dermabrasion and microdermabrasion.

All About Melasma

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

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!

Eczema of the scalp, which results in itching, flaking, or crusting of the scalp, is called scalp peeling or is commonly referred to as  dandruff . This condition causes increased shedding of normal scalp skin cells. Dandruff may also be caused by a fungal infection, other than just dehydration of the scalp.

The causes of an extremely dry scalp, thereby causing dandruff or even bigger flakes falling from the head onto shoulders and clothes, may be due to scalp psoriasis, eczema, poor nutrition, generalized dehydration, exposure to too much direct heat, and using too much of shampoo.

The three types of dandruff that need to be treated are those resulting from fungal growth, dry scalp and the one resulting from product build-up.

Fungal growth: This kind of dandruff is a chronic condition, caused by increased oil content on the scalp or an off-balance pH of the scalp. It may also be due to poor cleansing habits, or even an allergic reaction to the hair products one uses. Try switching shampoos, conditioners, or styling products to sulfate-free formulas to cure this condition.
Dry scalp: Sometimes, the skin of the scalp is literally so parched and dry that it is flaky and falls away like snakeskin. People with this kind of dandruff usually have drier hair and notice a tightness in their scalp. To treat dry-scalp dandruff, it is wise to indulge one s hair with moisturizing and hydrating shampoos, cut down on or space out harsh chemical treatments like relaxers, permanents, or dyes, and take in more moisture from the inside - drink at least 8 eight-ounce glasses of water a day, and your skin (including your scalp) will show you results that you want. Eliminating sulfates from your shampoos or other hair care products will also help with dry scalp, since these ingredients help strip away natural oils. Brushing hair or massaging the scalp - either with bare fingertips or a few drops of oil - is another great treatment, since massage helps stimulate circulation and bring blood, nutrients, and oxygen to the scalp and hair.
Product buildup: The most common type of dandruff is due to product buildup. This is what happens when people with otherwise healthy manes and scalps use too many styling products, such as layering gels, hair serum, hairspray, wrap lotions, scalp oils, heat-protecting serum, and so on. Dandruff caused by product buildup usually looks more like small clumps or balls of dirt. It may have a brownish color, since all those products attract and trap plenty of dirt and sweat. Product-buildup dandruff also tends to appear sporadically, only when hair is in need of a wash, whereas other types of dandruff show up more quickly and regularly.
To treat this kind of dandruff, one should wash hair more often or simply aim for using minimum chemical-rich hair products. 

Scalp Peeling - It Can Be Of 3 Different Types?

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