Psoriasis is a common autoimmune disorder of the skin that results in the formation of thickened and elevated plaques of cells that remain covered by scales (loose, whitish-silver scales). In psoriasis, the skin cells multiply at an alarming rate resulting in the scaling of the skin. Though non-contagious, psoriasis can be itchy and often painful. Psoriasis mainly affects the scalp, elbow, and knees. In some, the condition may also affect the palms, feet (soles of the feet), and the torso.

As per a survey, psoriasis is known to affect approximately 2.2% of the total adult population. Psoriasis can also affect children (children under the age group of 5-8 years are mostly affected by this inflammatory skin disorder).

Psoriasis Can of Different Types

Plaque Psoriasis: As the name suggests, this type of psoriasis results in the formation of plaques of cells (thickened and elevated) on the skin surface. One of the most common types of psoriasis, plaque psoriasis affects the scalp, knees, and elbow.
Pustular Psoriasis: Pustular psoriasis mainly affects the hands and the feet of the adults whereby white blisters (pus-filled) appear on the affected area of the skin. The skin also appears red and inflamed.
Guttate Psoriasis: This type of psoriasis usually affects the legs, torso, and arms. Common in children (sometimes young adults), Guttate psoriasis results in the formation of small red spots.
Inverse Psoriasis: In Inverse psoriasis, shiny red (bright red) inflammations or lesions appear on the armpits, groyne, breasts.
Erythrodermic Psoriasis: Though rare, this type of psoriasis is marked by extreme redness of the skin. There is also shedding of the scales (in the form of sheets). The skin more or less appears sun burnt.
Symptoms:
The symptoms associated with psoriasis include

Elevated and inflamed red patches covered by whitish- silver scales (plaques).
The nails appear thick and pitted.
There is a pain in the joints followed by swelling.
At times, the affected skin may crack resulting in bleeding.
Soreness, itching and a burning sensation around the red patches.
In psoriasis of the scalp,

There may be the formation of scales (usually mild).
In severe cases, there may be crusting (the full scalp) which can spread to the forehead, ears (inside and behind), in the beard or even around the nose.
Treatment:
Though there is no definite treatment for psoriasis of the body and the scalp, the following medications may prove to be helpful

Medications like Methotrexate and Cyclosporine (immunosuppressant drugs), Retinoids, and Biologics (injected intravenously) may provide some relief.
Patients may also benefit from light therapy, anthralin, topical corticosteroids as well as vitamin D analogs.
Precaution and care
For psoriasis of the scalp

Before the treatment, it is important to remove (and soften) the scales. Medicated shampoos that contain salicylic acid can be used to remove the scales.
Use of petroleum jelly or medicated oils and ointments (as recommended by the doctor) can be helpful.
For better results, you can keep the scalp covered (preferably with a shower cap) after applying the ointment.
For Psoriasis of the Body

Avoid the skin from getting dry. You can use a medicated lotion or a moisturizer.
Drinking and smoking can worsen the situation. Avoid these vices as much as you can.
Avoid using hot water while bathing. To keep your skin moisturised, you can add oil or salt to the water (bathwater).

Psoriasis - Types, Symptoms, and Treatment

Yauvan pidika or acne vulgaris is an inflammatory skin disorder which is prevalent in both males and females. When the sebaceous glands present on skin produce excessive sebum, the hair follicles present on skin get clogged leading to the formation of acne. According to ayurveda, kapha, pitta &amp; rakta and meda or fat dhathu are responsible for producing acne.

Ayurvedic treatment aims to eliminate the problem from its root. Herbs like lodhra (symplocos racemosa), manjishtha (rubia cordifolia) and kushta (saussurea lappa) are known for their properties to reduce acne. Turmeric (curcuma longa) and chandana (santalum album) are also effective in treating acne. The application of jaiphal (myristica fragrans) and khas-khas (vetiveria zizanioides) is believed to provide satisfactory results. Neem (azadirachta indica), guduchi (tinospora cordifolia) are known for their blood purifying properties, which can lessen the occurrence of acne and pimple in the long run.

The following are some of the ayurvedic remedies for treating acne:

1. To reduce the growth of pimple, rub water on jamun (syzygium cumini) seed and apply it on the pimple.

2. The peel of orange has medicinal properties that can be used effectively in the treatment of pimple. Make a paste of orange peel powder and rose water; apply it on your face on a regular basis. It is an effective remedy that cures acne and improves the skin tone.

3. To achieve an immediate result, apply a paste of lodhra (symplocos crateigodies), vach (acorus calamus) and dhania (coriander). Improvement will be noticed within 7 days.

4. A paste of red chandan (red sandalwood) and jaiphal (nutmeg) are also effective in reducing the appearance of acne and pimples.

5. Apply a paste of masoor dal (red lentils) with milk, ghee and camphor on your face. It reduces the appearance of acne and clears the scars which are left behind.

6. Prepare a paste of lemon, kalaunji (seeds of fennel flower) and milk. Apply it on your face on a regular basis before going to bed. Wash your face with lukewarm water in the morning. This remedy ensures speedy disappearance of acne.

7. Make a mixture of nimbu (lemon), extracts of tulsi (basil) and black kasundi (coffee pods), dry it in sun and apply the mixture on face. It is a powerful remedy that is known to cure the problem of acne.
Besides these home remedies, a balanced diet and healthy lifestyle will also enable you to reduce the risk of recurrent acne.

Ayurvedic Treatment for Acne

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

Conditioning Before Shampoo VS Post Shampoo - What's Ideal?

Conditioners and shampoos, you need both for an appropriate hair care regimen. Just like most other people, you might have the confusion about conditioner use - whether to use it before you shampoo your hair or when you're done with shampooing.

Read on to find out what you should be doing.

1. Hair Type: A factor that determines your use of a conditioner before you shampoo or after it depends on your hair type. For individuals who have dry or thick hair, using a conditioner after you shampoo is the most apt, especially during the winter months when complaints of flyaway hairs are very common. Conditioning before you apply shampoo to your hair is ideal if you've fine hair as it provides your hair with much needed nourishment. Additionally, it allows the shampoo to distribute evenly all over your hair.

2. Greasy Hair: Applying a conditioner before you shampoo your hair is most apt for individuals whose hair is prone to oiliness. This is because it helps you in thoroughly washing away the grease that gets build up in your hair when it's time to shampoo. The regimen of shampoo and conditioning afterwards doesn't ensure a proper elimination of the problem.

3. The Problem of Residues: if you condition your hair before shampooing, you can rest assure that no residues get left behind on the scalp. This is not the case when you condition your hair afterwards. Many a time, if you don't rinse properly residues of the conditioner used get left behind, thereby weighing down your hair.

Unless your hair is of normal texture, conditioning before shampooing can prove to be beneficial for your hair.

If you would like to consult with me privately, please click on 'consult'.

Conditioning Before Shampoo Vs Post Shampoo - What's Ideal?

We have for ages seen our parents and our grandparents reach out for a piece of jaggery at the end of every meal. Jaggery is healthier compared to refined sugar because of its deposition of phytochemicals and other important minerals. While many people do not choose jaggery because of its no-so-good-appearance, it is perhaps more sensible to consume it considering the host of health benefits it offers.

Here is a list of benefits that can be extracted from the consumption of jaggery.

Skin benefits: Jaggery nourishes the skin in the true sense of the word. Owing to the numerous amount of mineral and vitamin, it can eliminate common skin problems such as pimples and acne. It can negate dark spots, wrinkles delay the common signs of aging.
Digestive benefits: Jaggery plays a huge role in ensuring smooth digestion. It stimulates secretion of digestive enzyme. It, therefore, makes it easy for the body to quicken the process of digestion. It can also help to stabilize the bowl movement by keeping common digestion related disorders such as constipation, intestinal worms, indigestion at bay.
Blood: Jaggery does a great job in purifying the blood. It acts as a cleansing agent by filtering the blood from the toxic agents. It also keeps the hemoglobin count normal and help the body refrain from blood-related disorders such as anemia. Since the quantity of iron content in jaggery is plentiful, it successfully helps the body to stay healthy and negate deadly diseases. Furthermore, jaggery can help women to stay away from complicated menstrual related disorders, beat weakness and fatigue.
Weight loss: Jaggery s rich potassium content helps the body balance the electrolyte, build muscles and improve the metabolism of the body. Potassium also helps in managing water retention in the body. Both the factors coupled together helps in weight loss and beat fatigue, obese etc.
Blood pressure: The sodium and potassium content of jaggery helps the body maintain an effective adequate acidic level. This ensures that the blood pressure remains in the balance and the body refrains from undue blood pressure related disorders.
Antioxidants: Jaggery contains selenium, the latter is a rich source of antioxidants which can help the body to fight the free radicals and keep it at bay. The antioxidants also help the body to stay away from other ailments.
Respiratory health: Jaggery is a great source of food that can effectively fight various respiratory problems of the body. It can fight diseases such as bronchitis and asthma.
Body temperature: Jaggery helps to keep a normal body temperature. This is extremely beneficial for patients suffering from asthma since maintaining a steady body temperature is sacrosanct for patients suffering from this disease.

Jaggery (Gur) - 8 Amazing Reasons Why You Must Eat It!

*Most of the times try to protect your hair from rains, but that’s something impossible as we get caught in rains at least once in a while.
*As you reach home better wash your hair with mild shampoos and let it dry.
*Always apply shampoos in a gentle manner and do not forget to use a conditioner in this season after every wash.
*At night times, massage your hair with warm coconut oil and comb your hair for the even distribution of oil on your scalp and hair.
*You can also try applying warm oil mixed with curry leaves for your hair to remain thick and black.
*Usually in this season you invite itchy scalp because of dandruff or some other reasons. For such irritating scalp applying neem oil is the best remedy.
*Replacing herbal products in place of heavy organic shampoos and conditioners to maintain the natural glossy look of the hair would be best suggestible.
*Hair coloring is not a good idea in this season as it takes very long to wash your hair and dry. Keep it as natural as possible.
*Beer is a good conditioner. Initially wash your hair with beer and after few minutes wash it off with cold water. This tip helps your hair in adding glow to your hair.
*Use of hair dryers though necessary it is better suggested if you limit its usage. Instead opt for dry towels to remove moist from your hair.
*Till the end of this season it is better suggested to keep your hair as simple as possible and avoid elaborate hairstyles. Nothing can beat the natural beauty.

Simple Hair Care Tips for Monsoon

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