Vitiligo is a skin disorder where white patches of depigmentation develop on the skin and keep enlarging. This disorder is long term and continuous in nature. The patches appear due to the death of melanocytes within the skin. Melanocytes are skin pigment producing cells, which produce melanin. Vitiligo can affect the skin of several areas, including the eyes, hair and the portion inside the mouth.

Causes
The causes of this disease are as follows:
1. Autoimmune disorders in which the immune system of a patient becomes over reactive and the melanocytes are destroyed.
2. This disease may also occur due to genetic oxidative stress imbalance.
3. Stressful events may also lead to vitiligo.
4. Harm or damage to the skin from sunburns or cuts also leads to vitiligo.
5. Exposure of the skin to several harmful chemicals may be a cause.
6. Neural disorders are also responsible for vitiligo.
7. Vitiligo may also happen from viral causes or may be hereditary and passed on from family members.

Symptoms
Vitiligo has only one major symptom. White, flat spots and patches develop on the surface of the skin. The earliest of these white patches appear on the parts of the body which are exposed to the sun continuously.
It starts off as a simple spot in the beginning and gradually, the spot starts getting pale and finally turns white. The patches have irregular shapes, and in some cases the edges get inflamed and are red in color. Itchiness is experienced in the affected areas. Symmetrical patches signify slow development of vitiligo.

The two major types of vitiligo are:
1. Non segmental vitiligo, which affects the back of the hand, the arms, knees, elbows, feet, mouth.
2. Segmental vitiligo, which is more stable than non segmental vitiligo, but spreads faster. It usually affects areas of the skin, which are attached to nerves.

Treatment
The different methods of treatment for vitiligo are:
1. Phototherapy with UVB and UVA light: Exposing the affected area of the skin to UVB lamps is a popular cure for vitiligo. This treatment can be performed easily at home. UVA treatment incorporates taking of a drug which makes the skin more sensitive to ultraviolet light and then the skin is exposed to high doses of UVA light.
2. Skin Camouflage: Cosmetic creams and makeup can be used to camouflage affected areas of the skin. These topical creams are waterproof.
3. Depigmentation: Depigmentation is used to treat widespread areas affected by vitiligo. The skin color of the unaffected areas is reduced in order to match the affected areas. It is done using topical ointments.
Vitiligo is a skin disease, the major causes of which are still to be discovered. Proper care and treatment should be taken for skin areas affected by vitiligo.

Vitiligo: Causes, Symptoms and Treatments

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

Do birth control pills help in controlling acne?

An outbreak of a pimple is perceived as a cause of embarrassment and concern as it gives rise to skin damage. Coming to the cause of acne, it generally occurs due to excess oil (sebum) production. The oil on your skin combined with dead skin cells, blocks your skin pores, thereby promoting bacteria growth and causing acne breakouts. 
The use of birth control pills to cure acne is usually recommended when topical medications and oral antibiotics don’t help in clearing up the problem. 
Here’s how they work on acne. 

Possessing properties that can regulate your hormone production, birth control pills contain the two hormones that your body naturally makes – oestrogen and progesterone. Present in different amounts in the pills, they act by lowering the amount of androgens (male sex hormones, which give rise to excessive sebum production) produced by your body. As a result, with a reduction in sebum production, there is also a decrease in the breakout of acne on your skin. However, you shouldn’t expect instant results from their use. 

Many a times, birth control pills can cause a flare-up of the problem before it can be contained. This can result in your acne getting worse before getting better. 
Although birth control pills can help to control acne, it’s still important to maintain a proper skincare routine comprising of washing, toning and moisturising for a healthy and glowing skin. 

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

Do Birth Control Pills Help in Controlling Acne?

Dermatology is a very vast subject and many times it crosses the medical field to the cosmetology sector, where beautiful skin maintenance is concerned. The case of mole removal, for example, is handled by dermatologists. However, while examining the moles they first confirm that they do not, in any way, pose the risk of melanoma, a type of skin cancer. In fact, it has been reported that a dermatologist in Christchurch, New Zealand is offering free checkups during weekends for melanoma. Her plight is that she lost her brother to melanoma and many people make the mistake of ignoring moles on their skin and pay the heavy price.

A Professional Way Better than Trying at Home
For exactly the reason mentioned above, if you find moles on your skin, you should have the area examined by a dermatologist. The doctor would have the right instruments to identify and check whether they are only moles and then advise the appropriate removal. If the advice from the doctor itself indicates a simple procedure at home, then you can do this. There are over the counter products, such as peels available which can be used and then the moles can be removed. For other cases, you will need to subject yourself to a proper mole removal procedure.

Simple Methods For Surgeries
Chemical peels and burning away the extra growth using Cantharidin are some of the options available to dermatologists to remove moles from your skin. They may either have their own proprietary peels made or use the ones available in the market. Either way, the dermatologist will know how to prepare the skin before applying the remedy and also after treatment care. Skin is a very sensitive part of the body and no risk can be taken. If the mole removal has to be carried out only through a surgical procedure, the dermatologist will make that decision and do it as soon as you are ready.

Again, within the surgical method of removing moles, the doctor may use very simple procedures such as a scalpel to cut and remove the mole as well as a small amount of skin and dress it up. In the next level, the doctor may have to make a proper incision and then stitch up the area around the cut portion. Care will be taken regarding the scar on the skin.

Take Care of Your Skin
Depending on which part of the world you live in, there are steps you must take to protect your skin from getting damaged. In particular, the areas, like the face, neck, shoulders and hands which are exposed to the sun or cold winds or other vagaries that pose risks to the surface of the skin. The moment you observe signs of any abnormality in the skin, consult a good dermatologist to get healthy skin.

Mole Removal - What To Know?

Eczema refers to any kind of superficial inflammatory process that primarily involves the epidermis, and is characterised by itching, redness, vesicles and sometimes crusting and oozing. Another term for eczema is atopic dermatitis. This kind of skin infection can start during infancy and continue until many years. Though there are some people who outgrow the condition, others may have it all their lives.

Causes:

The factors that play a role in causing eczema are:

Genetics is one of the factors that may affect the proper functioning of your skin as a barrier against harmful substances. Therefore, if either one of the parent or both suffers from the condition, it is very likely that their children too will suffer from it.
Abnormal functioning of your body's immune system can also lead to this skin condition. This is because it's your body's immune system that fights off infections as well as harmful intruders.
Dry skin brings down your skin's ability to fend off irritants as well as allergy causing substances from entering your skin, resulting in an inflammatory condition.
The presence of the bacteria called Staphylococcus aureus, which brings about sweat buildup, inflames the skin considerably, leading to this condition.
Even environmental factors like pollen, cigarette smoke lead to the flaring of eczema.
What are the symptoms of eczema?

Atopic dermatitis is commonly seen as dry patches appearing on the skin and sometimes these patches are extremely itchy and cause discomfort. In the case of infants, the rashes appear on the scalp and cheeks and often bubble up before the liquid oozes out. Rashes commonly appear on the backside of the creases of the elbows and knees in the case of kids above two years, and other places on the body may also be affected. In adults, the rashes can make the skin dry and cover maximum area of the body. It may also lead to further skin infections, skin irritation, and may also cause eye problems.

How can eczema be treated?
Though there is no overall cure for eczema, but the treatments can heal the affected skin as well as prevent flaring of the symptoms. Doctors often suggest a plan of treatment on the basis of the age of the patient, symptoms, and the present state of health. You can opt to take warm baths on a regular basis and apply moisturiser within three minutes. You will have to avoid harsh soaps and instead use the mild soap or non-soap cleansers while washing. It is important to keep your fingernails short so that you don t scratch the affected area which would further aggravate it.
If you are unable to keep eczema under control with all these preventive tips, then it would be best to consult a dermatologist for curing it.

How can you prevent an eczema outbreak?

It is very common for this skin condition to flare-up from time to time. But you can avoid such outbreaks or reduce their severity by following these very simple ways:

Sudden changes in temperature can cause the skin condition to break out. So, when the weather is hot, keep yourself cool but during cold weather, use a humidifier to prevent the skin from drying out.
Keep sweating in check as it can cause an outbreak very easily
Keep your skin well-moisturized so that it doesn't dry out causing further irritation.
Avoid the use of harsh detergents and soaps, woolen materials as well as the consumption of foods that may lead to flare-ups. 

Eczema - Causes, Symptoms and Treatments

Vitiligo is a type of skin disorder. It is an autoimmune disease in which the melanin cell stops functioning or starts dying, and forms blotches on the skin. It can affect any part of the skin. It may also affect the inside of the mouth and hair.

There are many treatments available to restore the pigmentation of the skin. However, one of the most trusted and reliable treatments is described in Ayurveda. According to Ayurveda, there are tons of ways available in the house. By using these remedies, one can easily and adequately treat Vitiligo without any side effects. In Ayurveda, Mustard oil is one of the most significant remedies. Mustard oil is very beneficial to heal this type of skin disease.

Know More About Mustard Oil:

Mustard oil is extracted from the mustard seed by the process of steam distillation. The connotations of this oil may vary depending upon the part of the world the mustard seed is coming from. In some countries, mustard oil is only used for massage purposes. However, in many countries, it is considered edible. In both cases, mustard oil has millions of medicinal values and health benefits.  

Nutritional Value of Mustard Oil:

Mustard oil is packed with all the nutrients of the mustard seed. In 1 litre of mustard oil, there are 844 calories. Mustard oil has a total fat content of 100 grams which includes 21 grams of polyunsaturated fat, 12 grams of saturated fat, and 59 grams monounsaturated fat. It has zero content of sodium, carbohydrates, and protein. It also contains some important fatty acids such as  linoleic, oleic, and erucic acid along with some important substance called Allyl isothiocyanate, that has several health benefits.

Benefits of Mustard Oil:

There are many health and medicinal benefits of mustard oil. Some of them are:

Mustard essential oil improves blood circulation.

Mustard oil helps in digestion by keeping the digestive system intact.

Mustard oil boosts appetite and makes a person feel full.

Mustard essential oils fight bacterial infections.

Mustard essential oils prevent fungal infections.

Mustard oil repels insects.

Mustard oil is good for hair.

It is also beneficial for many orthopaedic problems like arthritis, lumbar pain, cervical pain, vertigo, etc.

Mustard is also used for the treatment of Vitiligo.

How Is Mustard Oil Used To Treat Vitiligo?

Mustard oil is one of the most popular home remedies used to heal Vitiligo. It helps in producing intense melanoid pigments and one can observe pigment initiation within 10 days. Regular use of mustard oil in food, massaging, or in the form paste will help to treat this skin disorder.

According to a recent study, mustard or mustard oil has enormous therapeutic potential for treating Vitiligo. Paste of mustard oil and turmeric will help intensify the pigments of the skin.  

Take Away:

There are many home remedies available used to cure Vitiligo and mustard oil is one such ingredient. It is the most popular and scientifically proven method for the treatment of Vitiligo. However, it is best to consult a dermatologist or physician before opting for any of these remedies. Everyone s skin and internal function is different and hence it is better to always go for the options which are prescribed for better and safe result.

How Is Mustard Oil Beneficial In Vitiligo Treatment?

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