Introduction 

The common male problem in an Aesthetic clinic, Gyanecomastia, is truly Pseudogynaecomastia with only fatty tissue and minimal glandular tissue. The condition is a part of the co existing Obesity disorder and is rarely, a standalone entity. The treatment options shall include an approach to answer the issue of obesity as a whole, not rest contented with surgical removal of the enlarged breasts alone. What is seen and what is treated is just a tip of the iceberg. 

Gynaecomastia, an innocuous condition, that affects 35-70% of male population immediately after birth, during adolescence and old age is rarely brought to notice as the sufferer makes all attempts to hide it as the condition brings with it a sense of shame and pain in public places and mental suffering. Herein starts the search for the treatment. Medical and multifaceted surgical options evolved over centuries with the current opinion being fat removal by anyone form of liposuction and the gland removal by direct excision. Gynaecomastia, is increased breast tissue in males composed of glandular and fatty tissue. 

Physiological gynaecomastia of puberty that normally regresses with age tend to stay back being sustained by the modern lifestyle changes. Processed foods and environmental pollution of air and water, the cosmetics used on the body like deo odorants, perfumes and toiletries, synthetics and chemicals have contributed to explosions of generalised obesity. With this generalised obesity, the tendency to hold back excess fat in the breast developed. This clearly shows the reason for higher incidence of (pseudo) Gynaecomastia of late. Hormonal imbalance due to reasons stated above, aggravate the situation. Gynaecomastia is part of the generalised obesity and it is more fat and little gland. 
However, this condition does not have any harmful effect on the body, but it can cause distress emotionally. Men may lose their self-confidence and they can be psychologically affected by this.

What Causes Gynaecomastia?

It is a type of hormonal imbalance that results in the growth of the male breast tissues. The ratio of oestrogen v/s androgens gets altered and causes the enlargement of the breasts. For this condition to occur, the amount of oestrogen increase in the body, or the amount of testosterone drops. Sometimes it can be the combination of both.

There are certain diseases that may contribute to gynaecomastia and they are as follows:

Kidney diseases

Liver disease

Drop in testosterone levels

Certain medications such as methadone, medications for HIV or treating prostate cancer

Certain tumours caused in male sex organs such as cancer of the Leydig cells or the Sertoli cells resulting in deprivation of androgen levels

Conclusion: 
True Gynaecomastia that requires surgical treatment is not so uncommon. What is commonly believed to be gynaecomastia is truly Pseudo gynaecomastia with a co exiting clinical picture of obesity, high BMI, sedentary life and wrong lifestyle. Surgical treatment by laser liposuction under Tumescent Anaesthesia gives very good results with high patient satisfaction and negligible post operative complications. Gland fragmented with laser can be extricated thro  same entry point without sub areolar incision.

Gynaecomastia (Enlarged Breasts In Men): Causes and Treatments

Corns are small circular patches of thick, hardened skin that generally develop on the toes or soles of feet. They may occur anywhere else on the body. They might be caused due to friction and pressure which may occur, if you wear poorly fitted shoes or as a symptom of some other conditions such as bunions (big toe bent towards other toes) or hammer toe (toe bent at the middle joint).

Corns, especially on feet will not get cured unless its root cause is treated. If left untreated, the skin becomes thicker and more painful. Cures for corns will depend on the cause or nature of the corn. Here are some effective ways to treat most types of corns.

1. Removal of hard skin: A dermatologist can help remove the thickened skin with a scalpel, which will relieve the pressure on the affected tissue.

2. Products that treat corns: Some foot care products are specially designed to allow your skin heal and to redistribute the excess pressure that is causing the corn. These may be prescribed by your dermatologist for quick healing of your corns. Some of these products include:
a. Rehydration creams that soften thickened skin
b. Soft padding or foam insoles that can be inserted into shoes
c. Corn plasters that provide protection
d. Small foam wedges which can be placed between toes to cure soft corns
e. Special silicone wedges that change the position of your toes and help in redistribution of pressure.

3. Salicylic acid: Salicyclic acid, contained in several over-the-counter products is helpful in softening the first layer of dead skin, thereby facilitating its removal. Products containing salicylic acid should not be used if you suffer from conditions that cause circulation problems, such as diabetes, peripheral neuropathy or arterial disease. If you have cracked or broken skin in the area of the corn or sensitive skin, salicyclic acid is not suitable for you either.

You can prevent corns by practising proper foot care, as your feet carry the weight of the entire body and are very susceptible to problems. Using a pumice stone regularly to rub away hard, dead skin is a good way to prevent corns and bacteria. Wearing properly fitted shoes is a must to prevent corns. If you wear heels very often, they may put excessive pressure on your feet. If you suffer from diabetes or other diseases causing circulation problems, do consult a doctor as corns and infections in the feet can lead to more severe infections.

How to Treat Corns on the Skin

There are mainly three kinds of burns. The degree of burns is determined by the extent of damage that the burn causes. First degree burns are minor while third degree ones are extremely severe. Variety of factors could lead to a burn. They may be chemical, electrical, fire and even sun induced. Boiling or scalding liquids might result in burns as well. The burn type isn t necessarily determined by what causes it. Scalding hot water might cause all the three types of burns; based on the duration of the skin being in contact with the water and how hot the water is. 

Electrical and chemical burns need immediate tending to by a doctor as it might affect the internal body without it being apparent as the damage to the skin is not much. There are also fourth-degree burns. This type of burn includes all of the symptoms of a third-degree burn and also extends beyond the skin into tendons and bones.

First-degree burns: These result in the least skin damage and are also known as  superficial burns  as they only affect the skin s outermost layer. Redness, pain, minor swelling and inflammation are all the symptoms of a first degree burn. As a first degree burn heals, dry skin and peeling takes place. As the skin peels, the symptoms and signs disappear as the burn only manifests on the top most skin layer. It usually takes a week or little more for a first degree burn to heal without any scarring. If the burnt area affects over three inches of skin, or is on the face, then a doctor should be consulted. Home care generally suffices for a first degree burn. Healing time accelerates with rapid treatment of the burn.
Second-degree burns: They are serious as the extent of damage is deeper than the topmost layer of the skin. The skin becomes extremely sore with the formation of red blisters. The blisters might pop open and as time passes, the wound may develop a scab. Proper bandaging is required to reduce chances of an infection. Home remedies should be avoided. The burns usually heal within three weeks.
Third-degree burns: They are the most severe. They extend through each layer of the skin. They might not cause any pain due to the severity of burn as the nerves might get damaged. There might be extreme scarring if corrective surgery isn t done.

Burns - Understanding Its Degrees!

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

Urticaria, also known as Hives and Nettle Rash. It is an allergic disorder. It is similar to the rashes that are caused due to touching a nettle plant. This allergic reaction can be caused due to a variety of reasons, thus increasing the difficulty in identifying the exact cause of the allergy. Homeopathic medication has proved to be very efficient in treating urticaria. Some of the best homeopathic remedies include:

1. Apis Mellifica: Described as one of the best solutions to urticaria, this medication is commonly prescribed with regard to treatment. The characterising symptoms of this medication is eruptions accompanied by inflammation and sting. It is similar to the sting of a bee where there is redness and swelling. Exposure to heat in any form is intolerable as the eruption are aggravated. The slightest of touch can cause burning or itching and the patient usually remains thirsty.

2. Dulcamara: This is a medication that is usually prescribed for Urticaria, caused due to cold air or wet weather or dampness. Consumption of sour food or indefinite diet can cause the eruptions. Even though the skin is often dry, there is redness and itching.

3. Natrum Mur: One of the frequently used medicines for urticaria, this medicine is prepared from common salt. It is used in cases where the eruptions are triggered by exposure to the sun, thereby resulting in intense itching. The skin has an oily or greasy feel. Most likely locations of occurrence include margins of hair or bends of joints.

4. Ledum Pal: This medication focuses on the eruptions that occur on the legs and feet. There is a possibility of the infection spreading from the lower to the upper regions at a later stage. Increase in itching can result from the warmth of bed or on scratching. Colder conditions provide a soothing sensation

5. Astacus Fluviatilis: This is an effective medication that be used to treat, both acute and chronic urticarial forms. Rashes are visible on the entire body and are at an increased sensitiveness to air. It is recommended for liver diseases and liver-related symptoms that are accompanied by urticaria.

Best Homeopathic Remedies for Urticaria

Gynecomastia is basically swelling of the breast tissues in boys and men. This is usually caused due to an imbalance of the hormones, estrogen, and testosterone. Gynecomastia can affect either one or both the breasts, sometimes in an uneven manner. Newborn babies, boys who go through puberty along with older men might develop this condition as a result of normal changes in the levels of the hormone.
It is not necessarily a serious problem but men might find it difficult to cope with this condition. This condition can go away on its own. In case, it persists, consultations with a cosmetic/plastic surgeon can be of great help.
Before looking at the tips from a cosmetic/plastic surgeon to come out of this problem, let us briefly talk about the symptoms and causes related to Gynecomastia.

Symptoms- 
There are certain signs and symptoms, which suggest that men could well be suffering from gynecomastia. They include the likes of:

Swelling of the breast gland tissue
Pain
Tenderness
Nipple getting discharged in either one or both the breasts
Causes -
Gynecomastia is usually triggered by a decrease in the amount of the hormone testosterone compared with estrogen. Different things can alter the hormonal balance like:

1. Natural hormonal changes

2. Several medicines including:

Anti-androgens used for treating enlarged prostate, prostate cancer
Anabolic steroids
Medicines for AIDS
Anti-anxiety medicines
Tricyclic antidepressants
Antibiotics
3. Consumption of alcohol
4. Heroin and other such drugs
5. Several health conditions like Hypogonadism, Hyperthyroidism, Kidney failure, Live cirrhosis, etc.

Tips From Cosmetic/Plastic Surgeon-
Consultation with Cosmetic/Plastic Surgeon can let men have useful tips as to the treatment as well as prevention of Gynecomastia. They include the following:

Liposuction Treatment can be an ideal way to get rid of this problem. It removes fat from the breast but leaves behind the breast gland tissue in its place. The treatment involves making two or more small incisions through narrow tubes get inserted into the chest region. The tube gets moved around gently to loosen up the excess fat tissue, which is then sucked out. The treatment involves less amount of scar.
Cosmetic/Plastic Surgeon can advise patients that there are iatrogenic causes behind this problem like side-effects from any medicine or health issues like an overactive thyroid or tumor.
Mastectomy can be another effective method of treatment. It is performed endoscopically and thus has a quicker recovery time. A patient can stay at the hospital for a few hours and go back. This involves less amount of scarring.
Cosmetic/Plastic Surgeons can also go for another extremely effective method in their hands to take care of this problem of Gynecomastia. It is the Excision Technique. This is recommended where glandular breast tissue or excess skin must be removed to cure this. The patterns of incision would vary depending on the specific conditions and patients  surgical preference.


All You Must Know About Gynecomastia!

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