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

Gynecomastia is a condition characterized by enlargement of the breast tissue in men. It occurs when there is an imbalance of the testosterone (male sex hormone) and estrogen (female sex hormone) in the body. It may a cause of embarrassment in men.
Causes:
The primary cause for this condition is increase in the level of estrogen in comparison with testosterone in the male body. Testosterone controls male characteristics such as body hair and muscle mass. Estrogen is responsible for controlling female characteristics such as breast enlargement. 
Men usually produce small quantities of estrogen in their body to maintain certain sexual functions. Complications occur when estrogen levels in the male body increase too much in proportion to testosterone.
The condition can be classified as follows:
1. Gynecomastia in infants:  Half of the infants are usually born with large breasts due to their mother's estrogen. The effect tends to wear of in a few weeks.
2. Gynecomastia during puberty: Gynecomastia occurs during puberty due to changes in hormones. The condition goes away without any treatment in six months to 1 year.
3. Gynecomastia in men: This condition may peak in men during the age of 50-80. Statistics show that at least 1 out of 4 men in this age group have this condition.

Some other causes for this condition in middle aged men are as follows:
1. Heart medications
2. Anti-anxiety drugs
3. Antibiotics
4. Chemotherapy
5. Medications that are used to treat heartburn
6. Smoking marijuana and drinking alcohol 

Treatments:
1.        If the cause of the condition is medications, then discontinuing the medicines should stop the effects. It can also be treated by taking medicines to reduce estrogen levels in the body. 
2.        Surgery is another option where an incision is made in the chest area and the extra breast tissues are removed from the area. This also requires repositioning of the nipple in the chest. 
3.        Post-surgery, you should stick to a proper and healthy lifestyle to retain the new shape of the chest area. Weight gain or taking steroids can cause the symptoms of this condition to reappear.


Causes and Treatment of Gynecomastia

The number of allergens are many and knowing what triggers your allergies can get complicated. The common triggers that are known to trigger allergic rhinitis are:

Moulds
Fungi
Pollen, the most common cause for allergies
Dust mites, and the faeces of dust mites that can cause severe allergic reactions
Cockroaches
Animal dander, which includes cat hair, dog fur, and may also include little flakes of skin
Avoiding the above mentioned triggers is more of a general guideline for the management of allergies. The lifestyle changes that you make to manage allergies:

Keep yourself hydrated at all times. Drink about eight to ten glasses of water every day. This will allow the mucous to be expelled with ease, if you experience any nose block.
During seasons like spring, when the amount of pollen in the air is at its maximum, limit your exposure. Try to stay indoors to avoid exposure to pollen or dust in the air.
Make it a point to take a shower before going to sleep as the residues of pollen and dust stuck to your skin are likely to make your symptoms worse.
Use fresh bedding and clothes every day. This will help to reduce your exposure to allergens.
Remove your carpets. Carpets are home to dust mites and pollen grains which become difficult to remove even with vacuum cleaners. Remove the carpets during the allergy season, and replace with hard flooring.
Keep windows and doors shut to avoid dust and pollen grains from entering the house and possibly causing allergies.
Avoid staying around pets. It that is not possible, then wash them at least once a week to reduce allergies.
Prevent inhaling cigarette smoke or smoking cigarettes. The smoke can be very harmful and can increase the risk of asthma in kids.
Avoid outdoor trips during seasons when the pollen count is high.

Allergies - Lifestyle Changes That Can Help Manage it!

Your child is fond of nuts and has eaten a chocolate with nuts but shortly after that develops a skin rash and starts to itch. The rash may even spread to the surrounding area. This is an indication of food allergy to nuts.

What happens is simple - the body's immune system recognizes specific proteins in the food as harmful (antigens) and produces antibodies which can combat them. This leads to an allergic reaction which can vary from something as simple as a skin rash to severe breathing issues.
Though any child can develop food allergies, in most cases, there is a strong hereditary linkage. If parents have had a history of allergy to certain foods, then there is a strong likelihood that the child could have that food allergy too.

Some of the common foods that can cause allergies are as follows:
1. Cow's milk
2. Eggs
3. Nuts (peanuts, walnuts, pecans, cashews or hazelnuts)
4. Soy
5. Wheat
6. Fish (salmon, cod and others)
7. Shellfish (lobsters, shrimps and others)
Of these, peanuts, seafood, and milk are the most common food stuffs that lead to allergies.

Because the child is yet to realize that he has eaten something that his system will not readily accept, the allergic reaction can be described in various ways, as below:
1. Scratching or itching on the tongue
2. Change in the voice - can become husky or hoarse
3. Burning of the tongue
4 tingling of the tongue
5. Funny feeling in the mouth
6. Feeling of something stuck in the throat
7. Itchy feeling or bugs in the ears
8. Throat going thick
9. Bump on the back of the tongue

These are some ways that a child can describe his allergic reaction. Some of the mild symptoms of a food allergy are as follows:
1. Hives (red, swollen, itchy areas on the skin)
2. Eczema of the skin (dry, itchy rash)
3. Nasal congestion
4. Sneezing
5. Itching of the tongue and the mouth
6. Nausea or vomiting
7. Stomach pain

Severe symptoms include:
1. Severe swelling of the lips and tongue that can block breathing
2. Inability to swallow
3. Difficulty breathing
4. Turning blue
5. Dropping of pulse
6. Drowsiness

As the parent identifies a similar reaction when eating the same food item, they can suspect allergic reactions and immediately reach out to the doctor. A detailed discussion will help establish the causative agent. Once that is known, then avoiding food allergies is quite easy. In fact, a well-informed child will know that avoiding certain foods is very beneficial. This will improve the quality of life of the child, help avoid missing school due to allergic reactions, and help avoid the child (and the parent) suffering.

How to Know if Your Child Suffers From Food Allergy

Food allergy is actually an abnormal response triggered by the immune system to food as if it is threatening. Food intolerance looks similar to food allergies. However, the difference lies in how each one of them affects an individual. Food allergy is extremely intrinsic and to an extent, affects the internal organs. 

On the other hand, food intolerance is less severe, mostly just affects the digestive system due to the inability to digest that particular food properly, leading to an upset stomach. Most of the people suffer from food intolerance only, but they confuse it with food allergy.

About ninety percent of all cases of food allergy are related to only eight types of food as per research statistics. These are milk, tree nuts, egg, peanut, soy, wheat, shellfish, and fish.

The Reaction:\

In order to understand how symptoms manifest, it is of utmost importance, in this case, to understand how an allergic reaction to food occurs. An allergic reaction is a bi-step process as discussed further.

Step1: On exposure to the food allergen for the first time, the body reacts abnormally and produces IgE antibodies against the perceived allergen. These circulate throughout the entire body with blood and attach themselves to basophils (found in blood) and mast cells (found in sites like the nose, lungs, throat, gastrointestinal tract, skin, etc.).

Step 2: The next time the body is exposed to a particular food allergen, it gets alert and alarms the tissue that releases histamine in large quantity. Depending on the site of release, allergy symptoms are caused, ranging from mild to severe to potentially life-threatening (for example, in anaphylaxis).

The time span for an allergic reaction manifesting into symptoms can vary between a few minutes to several hours post exposure to the food allergen. The site of mast cells for release of histamine greatly affects the location and timing of the reaction.

Who is at Higher Risk?

If a person has a family history of developing a food allergy, it creates even greater chances for him/ her to have the same or similar reactions. If both the parents have some kind of allergic reaction to food, it is very likely that the child would have that too.

Symptoms:

Symptoms of food allergies largely depend on the sites of mast cells that release histamines. It is possible that these sites are located in nose, ears, or throat leading to itching in mouth, having a trouble in swallowing and breathing, and swelling of lips and tongue. If the location is in the gastrointestinal tract, it may lead to vomiting, diarrhoea, and abdominal pain. If it is in the skin, it might lead to hives, itching, decolourization, pigmentation, worsened eczema, etc.

Cross Reactivity:

If a person has an allergy to a particular food, it is advisable to abstain from similar types of food. For example, if somebody is allergic to crab, he/ she should abstain from shrimp, crayfish, lobster, etc. too as they might also trigger the reaction. This is called cross reactivity.

Treatment:

It is always advisable to abstain from foods which cause an allergic reaction in an individual. However, in case it has already occurred, there are two major types of medication which help in relieving the symptoms. Antihistamines are used for treating mild to chronic reaction, whereas adrenalines are used for severe reaction like in anaphylaxis.

Take Away:

Food allergy is usually a condition for life and cannot be permanently treated. However, symptoms can be relieved. Therefore, it is advisable to avoid the allergy, causing group of food.

Food Allergy - Everything About It!

A rash on your child s body or their regular cough bouts can sometimes be triggered by an allergy. We can excuse it by calling it a common flu or a heat rash, but the reason behind it might be something you are not aware of. Your child might be allergic, and it is imperative for you to find out that exact thing your child is allergic to, it can be dust, nuts that you may think is beneficial for your child s health or even the fabric of the clothes you put on them. Allergies are caused when children come in contact with allergens, which can he inhaled, injected or even eaten unknowingly. If you see any of the symptoms of allergies, consult your doctor at the earliest and do not treat it lightly.

Some common triggers for allergies

These are divided into four groups

Foods: Certain foods like peanuts, eggs, milk and it products which you feed your child might be triggering their allergy.
Outdoors: When kids play outside pollens from trees or flowers might causes allergies. Even insect bites and stings are a major trigger
Indoors: Animal fur or hair and even dust mites and mold that exist in your house can trigger an allergy
Irritants: Common irritants like cigarette smoke, perfumes or even car exhaust should be watched out for.
Symptoms of common allergies

Nasal Congestion: It is referred to as stuffy nose, which is very common in kids. Allergies are the most common cause of chronic nasal congestion (a stuffy nose) in children. Sometimes a child s nose is congested to the point that he or she breathes through the mouth, especially while sleeping.
Allergic rhinitis (hay fever): It is also common and its symptoms include a runny or itchy nose and constant sneezing. A child with allergies may also have itchy, watery, red eyes and chronic ear problems. Even though it s commonly known as  hay fever,  allergic rhinitis isn t triggered by hay and doesn t cause fever.
If you suspect your child has an allergy, make an appointment to see a specialist. Start a diary before the appointment and keep track of what symptoms your child experiences and what you think causes them.

Common Allergies in Children - That You Need to Know!

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