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

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?

Warts are benign growths on the skin. They are hard in nature and are caused due to virus infection. Warts usually infect the upper layer of the skin. This virus is generally passed through a cut in the skin or a damaged skin. If a person with a cut or a damaged skin comes in contact with another infected person, then the virus may spread rapidly. There are different kinds of warts depending on the areas they grow on.

Below mentioned are eight remedies to get rid of warts:

1. Try to be hygienic: warts may pass from one body part to another. So do not touch the infected parts of your skin several times. Make sure to wash your hands with clean water every time you touch the infected areas.
2. Eat healthy: make sure to eat healthy, exercise and sleep well as this will help you to develop a strong immune system. A strong immune system can help you to get rid of warts.
3. Garlic: a paste made of garlic can be very useful for treating warts.
4. Lemon juice: lemon juice has great healing powers for treating warts. It contains vitamin c which can destroy the viruses causing warts.
5. Using lukewarm water: soaking the infected parts of your body in lukewarm water will soften the warts and help you to get rid of them too.
6. Laser therapy: laser therapy can also help you to get rid of warts. In some cases, it might require anesthesia.
7. Oils: applying essential oils on the affected areas can also prove to be very helpful. You can use oils like tea tree oil or bergamot oil.
8. Acetic acid: acetic acid can also help you to get rid of your warts, especially from the areas of your feet or hand.
Apart from the remedies mentioned above, you can also consider special surgeries for removing warts after consulting a dermatologist.

8 Remedies to Get Rid of Warts

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?

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

If you see continual and long-term white patches of depigmentation on your skin, it could be vitiligo. Vitiligo is a condition that appears when melanocytes in your skin are no more alive. This bunch of cells is responsible for producing the melanin pigment that endows the skin with its colour as well as protects it from the harmful UV rays. The area which may be affected by this dermatological disease varies from person to person, and it can also affect the hair, mouth and eyes as well. In most cases, the vitiligo affected area stays discoloured for the rest of the patient s life.

Various types of vitiligo and their symptoms
Scientists have classified vitiligo into two types: segmental and non-segmental. The non-segmental vitiligo is the most common variant and 90 percent of vitiligo affected patients suffer from this kind of disorder. In this disease, the patches take place with little symmetry on both sides of the body. It can be further broken down into 5 sub-divisions.

Generalised vitiligo: It can occur at any part of the body without any rules, and this is by far the most common type.
Acrofacial vitiligo: It is mostly seen on the toes and fingers.
Mucosal vitiligo: In this condition, the discolouration normally takes place around the lips and mucous membranes.
Universal vitiligo: This is the rarest type of vitiligo where the whole body is covered in white patches.
Focal vitiligo: This is most commonly found in children. The children have white and scattered patches across the body.
Possible treatments for vitiligo

Though there are no treatments possible that will re-pigment your skin to its original colour, there are several remedies that aid in decreasing the visibility of white patches on the affected areas of the skin. Some of them include:

Phototherapy with UVB radiation: This is a common form of treatment where the affected area is exposed to UVB radiation and can be performed at home too. If you have large white spots across the body, it is important to have the treatment performed by an expert at any healthcare centre.
Phototherapy with UVA radiation: In this treatment, a drug is first administered for increasing skin s sensitivity to this radiation. Then the affected area of the skin is exposed to high doses of UVA radiation.
Skin camouflage: In mild cases of vitiligo, cosmetic creams and make-up can be used to camouflage the affected area. It can last for about 12- 18 hours when applied in proper techniques.
In case you are suffering from vitiligo, it is crucial to speak with an expert and opt for the best means to curb down the impact of vitiligo.

Vitiligo - Signs You Are Suffering From It!

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