Skin tags: causes and treatments

Skin tags, also known as acrochordons, are small brown or darker-than-skin tone growths on the surface of the skin. Tags are very common and harmless growths and tend to occur on the neck, under the breasts, armpits, eyelids and folds of the groin. They generally take place after midlife. About 25% of people report having skin tags after they cross the age of 50.

What causes skin tags to occur?

Skin tags are very common among diabetics and obese individuals. Pregnant women also develop skin tags, as a consequence of changes in the body's hormonal levels. Skin tags tend to occur when your skin rubs against clothing or skin. They are normally caused by blood vessels and collagen that gets trapped inside the thicker portions of the skin. For this reason, they are typically found in folds and creases of the skin. Sometimes, they reduce on their own if blood supply to the tissue has been disrupted due to them getting twisted.

What procedures are involved in their treatment?

Skin tags are generally removed for purely cosmetic reasons but when they do become troublesome, as in, they rub against jewelry, skin or clothing, doctors recommend their removal as the area can end up becoming irritated.

The following procedures are performed to remove these annoying growths on skin:

1. Excision - in this procedure the skin tag gets removed using a scalpel.

2. Ligation - the procedure involves the cutting off of blood supply to the skin tag.

3. Cauterization - the procedure involves the burning off the skin tag using electrolysis (process that involves decomposition of a matter by electric current)

4. Cryosurgery - in this procedure, the skin tag is frozen before removing it. An instrument containing liquid nitrogen is used to do the removal.

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Related Tip: How does salt help in clearing skin?

Why are SKIN TAGs so annoying?

Prevention of leprosy: Leprosy is caused by the bacterial infection of Mycobacterium leprae and it is classified into multiple types. Leprosy is communicable through contact with common objects or a person by infected droplets within their nose. It primarily affects mucous membranes and the skin and the nerves on the hands, feet, and in extreme cases may cause disfigurement as well. There are no specific ways to prevent leprosy as no specific correlation between transmission and development has been found so far. Leprosy can happen through one time contact or through contact over extended period of time within the same household. Thus preventive measures will primarily include the following:

Regular checkups by going to the doctor
Ensuring that surfaces are kept clean if you share a household with a leprosy patient
Skin biopsies at regular intervals just to check if you may have contracted the bacteria
If a rash has developed, then it is urgent that you visit the doctor. Earlier the leprosy is detected, quickly it can treated and resolved
Incidences of leprosy have reduced over the last few decades due to improvements in medicine and early detection. This has allowed people to nip the problem in the bud and does not allow it to spread within their bodies or to other people.

Treatment of leprosy: The primary weapon that modern medicine has against leprosy is known as MDT or multidrug therapy. Multidrug therapy is the combination of multiple drugs, which attack the various aspects of leprosy, such as skin problems, nerve damage, loss of sensation, deterioration of skin conditions etc. This is the proven way to not only reduce symptoms, but also cure the problems in the long run.

Some of the drugs in the MDT used are as follows:

Rifampicin and dapsone
Rifampicin and clofazimine and dapsone
Rifampicin, minocycline and ofloxacin
However, the combination will depend on the type of leprosy the person is affected with, such as paucibacillary leprosy or multibacillary leprosy and thus can only be prescribed by the doctor after the thorough and detailed examination.

Leprosy - Treatment And Prevention!

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

Ringworm of the scalp usually affects children. This is a common type of a fungal infection of the scalp and has nothing to do with the worms as the name suggests. This is treated with antifungal medications and though the antifungal shampo-is not to-effective, it might be advised along with medication.

Causes of scalp ringworm:

 Most of the times a ringworm infection is transfered from person to person through sharing towels and touching. The fungi and its spores can remain alive on brushes, combs, sheets, furniture and unwashed towels for long. Some people are only carriers of fungi, meaning that they carry the fungi and its spores in their hair and skin but do not have any infection and symptoms. But they might pass the fungi to others who may develop the symptoms.
 It spreads from pets like cats and dogs who are very prone to fungal infection of the skin. They easily pass their infection to children and other family members. Farm animals are also a source of fungal infection and if the farm gate is touched from where the infected cattle passes, it is enough to cause infection.
 Also at times there is no reason and fungi infection can just happen out of the blue. Like for example, the fungi spores can get transmitted through air, they might get into the air by an infected person and land on someone else's head. This can develop into fungi and can cause infection.

Symptoms of scalp ringworm:

 The infection looks more like dandruff, a severe form of dandruff in different parts of the scalp. This is often mistaken to be psoriasis.
 In some infection there is loss of hair leading to bald patches. These patches become scaly and inflamed. The patches might have broken off small hair.
 Several painful pustules and boils occur on the scalp
 In severe infection there is boggy swelling on some part of the scalp, which is known as kerion. This might be tender and oozing and if not treated can lead to hair loss and permanent scarring.
 In severe infections like with pustules and kerion, one might develop high fever and the glands of the neck might swell. 

Treatment of scalp ringworm:
The treatment of the fungal infection of the scalp involves the following:

 Antifungal medicines: these are usually taken in the form of tablets and following are advised:
 Griseofulvin: this is often the first choice and a course of 8-12 weeks is required. The tablet can be crushed and taken with water.
 Terbinafine: the course for this is four weeks and is important to complete the course in order to get rid of the infection.

Fungal Infection on Scalp: How to Treat It?

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

Washing your skin with water is something that you probably do daily, but you may not know at what temperature the water should be. Using water at the correct temperature is advantageous for the skin. Water at extreme temperatures is harmful for the skin as your skin is not designed that way.

The temperature of the water should also depend on the purpose for which it is being used. Here are some tips on how to set the temperature of the water depending on the purpose: 

1. Showering: while showering, if you are using hot water, then it may strip your skin of its essential oils and make it vulnerable to dryness. This may cause various skin complications, such as cracked and rough skin. Hence, use lukewarm water while you shower.

2. Washing your hair: using hot water to wash your hair may lead to hair damage as it rids your hair of all the essential oils and makes it limp and dull. Lukewarm to normal water is recommended while washing your hair as it will allow the hair to retain its natural oils.

3. Brushing: the right temperature of water while brushing your teeth should optimally be lukewarm. Too cold or hot water can lead to teeth sensitivity and cause oral problems.

4. Washing your face: before you apply a cleansing agent on your face, use warm water to wet the face as it helps to open up your pores. After the cleansing agent is applied, then use cold water to wash your face. Cold water helps in closing the pores after the impurities are removed from the skin.

5. Shaving: if you are going to shave, then opt for warm water as it opens the pores up and thus makes it easier for the blade to glide through the skin. This also reduces the risk of razor burns on your skin.

6. Washing your feet: wash your feet with lukewarm water as it facilitates dead cell removal and also helps in getting rid of warts.

Hot vs Cold: Which Water Temperature is Best for Your Skin

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