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

Vitiligo is a condition in which white patches appear on the skin. It can affect any part of the body. It can affect the inside of the mouth and the hair as well. It happens when the skin cells (melanocytes) that make or produce pigment (colour) of the skin die or stop functioning. This disease is not contagious or life-threatening, it cannot be caught from another person having vitiligo. All types of skin can be affected by vitiligo but it may be more evident in people with darker skin. It develops between the ages 10 to 30 and it often appears before the age of 40.

Causes

The main cause of this disorder is still not clear, why the cells die or fail. For some reason, the colour or pigment-forming cells called melanocytes dies. However, these are the following reasons that can cause this problem:

An autoimmune disorder, where the defences of the body turn on their own cells instead of attacking the germs that destroyed the melanocytes

A trigger or stressful events such as exposure to industrial chemicals, stress, or sunburn

Family history (heredity)

A neural cause

A virus

A genetic oxidative stress imbalance

Symptoms

The one and only symptom of this condition is the appearance of white patches or flat white spots on the skin. Those white patches are irregular in shape. They may stay the same for a while but may get bigger with time on different parts of the body. It generally affects body folds such as armpits, around body openings, or around moles. It can also affect hair and eyelids. It does not cause any irritation, dryness, discomfort, or soreness in the skin.

Treatment

There is no known way to cure or prevent the condition but the appearance of the affected skin can be improved with corticosteroid creams and cosmetics. The doctor can recommend melanocyte transplant surgery which includes a new needling micro-grafting technique. The surgery includes a split-thickness skin graft that is taken from the normal area. Later, it is cut into very small pieces in diameter ranging from 0.1 mm-0.3 mm. The local anesthesia is given to the recipient area to implant the micro-grafts into the dermis by using the needling technique. This new method of treating this condition delivers satisfactory and rapid pigmentation.

Takeaway

Vitiligo is a disorder in which flat white spots or patches appear and can affect any area of the body. It happens when the melanocytes die or stop functioning. The condition can be managed by cosmetics, corticosteroid creams, therapies, and surgeries. Out of all these methods, melanocyte transplant surgery is a new and effective technique to manage this disease. However, it is always advisable to consult a doctor before opting for any of these methods. 

Vitiligo - Its Causes, Symptoms And Treatments!

Spending a day out at the beach or going up on a hike is something most people love to do. What they, however, do not want is the after effects of being out in the sun the sunburn. While sunscreen lotions do help to a large extent, being in the sea can wash off the sunscreen, leaving the skin exposed to the imminent damage. Also, the effect of most sunscreens wears off with time, thereby, invariably producing some damage to the skin. However, there are simple ways to reduce the damage and in some cases even reverse the damage done by the sunburn.

Listed below simple ways with which you can treat a sunburn:

The minute you realize sunburn has set in, reduce further damage by getting out of the sun.
If you were out in the beach, rinse off with regular water as early as possible to clear the chlorine and sand and salt water. The salt water irritates the skin and aggravate the damage further.
Take a pain-killer which will reduce the inflammation and control the overall effect of swelling and pain. This can also help the mild headache that can develop because of being out in the sun.
The sun dries the skin and therefore, make sure you make an extra effort and moisturize your skin. Use creams that contain aloe vera, glycerin or hyaluronic acid. Keeping them in the fridge for a while produces an extra-refreshing effect.
Make a compress containing egg white or green tea and skimmed milk. The green tea will reduce inflammation and the egg white will supply the necessary proteins for the skin to recover.
Not just the skin, the sunburn also leaves you dehydrated overall. Ensure the water intake is increased and consume water rich food like watermelon, grapes, and cucumber.
If there are sun blisters as a result of the sunburn, do not touch them. Peeling them can produce scars, which can be permanent.
On spots that are painful after the sunburn, slices of potatoes or cucumber can be used to rub the area. This will produce a cooling effect and also reduce swelling.
Vinegar contains acetic acid and reduces pain, swelling, and inflammation that happens subsequent to a sunburn. Towel soaked in vinegar can be used to wipe the area or vinegar can be added to the water for a bath.
Mint is another wonderful agent to manage sunburn. Include it in tea or add peppermint oil to lukewarm water for that healing drink.
These are some tips to treat a sunburn and reduce the damage (sometimes permanent) that can happen as a result.

10 Easy Ways to Treat a Sunburn

The skin is the largest organ in the body and is one of the five sense organs, helping us with  touch.  The first outer layer is called the epidermis and the underlying layer is called the dermis. The skin has a protein known as keratin, which protects it from various external toxins and infections.

In some people, due to unknown reasons, there could be pile up of this protein in the deeper layers, producing small bumps, which feel like sandpaper. Literally, the term keratosis pilaris (KP) refers to piling up of keratin pigment. It can block the hair follicle that would normally open into the skin. When there are multiple blocks in the same area, there could be a sandpaper-like rough feeling to the touch. This gives this condition other names including goosebumps, chicken skin or chicken bumps. Though it is a cosmetic issue, it is medically a benign and very common condition.

Cause

KP, as it is popularly known as, is believed to be a genetic disorder with faulty genes leading to excessive accumulation of keratin. These appear as red, small bumps that are usually seen on the hands, arms, thighs, buttocks, and rarely on the face. The surrounding skin may be inflamed if there is a buildup of skin under the pile of keratin.

The onset of KP is usually in the first decade of life, worsens during puberty, and reduces during adulthood. There are, however, instances where the onset happens during adulthood. Twins and people with atopic dermatitis are more likely to have KP.

KP is more common in people with dry skin as oily skin seems to offer some protection.

There are also studies that give it a correlation with weather, with winter seeing more of this condition than summer. This is because our skin tends to dry more in winter than in summer. There could be some people who are completely normal during the summer months but will develop these bumps during the winter, which again subsides with the season.

Signs and Symptoms

As noted above, KP is a medically benign condition. There is a cosmetic concern if it is in the visible areas like arms and hands. Also, the area could feel rough and dry, but the affected person may not experience any itching or other harm. People with atopic dermatitis and eczema are more likely to develop KP; hence these other skin conditions require proper management.

Management

Patient education is the most important. This disease does not require any treatment and is usually self-limiting. It is very rare for KP to affect the whole body. Creams containing alpha hydroxy acid, salicylic acid, lactic acid, or vitamin A may be required to remove dead skin cells and to prevent clogged follicles from the bodies of the affected people.

Keratosis Pilaris: Signs, Causes, Treatment, and Prevention

One of the most important functions of the skin is protection. During this process, it comes in contact with various substances including chemicals, pollen, dust, and other pollutants. While it does protect the overall body from all these, there is some damage that is inevitably done to the skin through these exposures. Different skin and different bodies react differently to these, and while some may have no reaction, others develop allergies. This is also defined by how strong the person s immunity is.

Hives is one of the most common skin allergy responses. While it is not easy to pinpoint what causes the allergy or the hives, the causative agent can be nailed by observing patterns and excluding out some of the causative agents. There are a set of regular household and surrounding items that could lead to urticaria, and working around these can help pin down the source.

Origin: When the body encounters a foreign body, it produces what are known as histamines. When they are produced, the plasma in the cell leaks out, producing a red and swollen appearance. Hives are red, itchy, raised patches on the skin. They are seen in about 20% of the population. Hives are usually allergic in nature, implying that they occur when there is a foreign substance that induces an allergic reaction. Hives can appear either due to coming in touch with some substance or due to eating some allergy-inducing substance.

Hives can be acute or chronic. Acute is when the hives appear in response to an allergic reaction. These usually disappear in a matter of days to a week at the maximum. In some people, they could be chronic and can last for months together.

Treatment: Given that they are allergic in nature, managing hives includes a combination of immediate treatment as well as preventive measures. While most are topically managed, others might require systemic intervention also.

Once the hives have developed, the following can help in the relief of symptoms and prevent from spreading further. The redness and swelling will take some time to disappear.

Avoid tight-fitting clothes
Use cool compresses on the hives
Avoid warm or hot shower
Stay in a cooler room
Avoid itching the hives
Use topical moisturizer to prevent dryness
Use topical steroid cream to manage the inflammation
Take a systemic antihistamine or an injection of epinephrine if required.
While these help in managing the hives which have occurred, preventing is via the following.

Avoid the source once identified
If the source is not yet known, record when the hives are occurring
Manage stress and see hives appear much less
Increase moisturizer use
Keep an antihistamine handy so you can take it immediately in case of suspected hives. 

Urticaria (Hives) - The Best Way It Can Be Treated!

Exposure to the sun for a long period of time can result in several skin problems. They occur on the basis of heat, humidity and the rays of the sun. Here are the most common skin problems caused due to sun exposure:

Sunburn: Sunburns occur as a result of overexposure of the skin to the harmful ultraviolet rays of the sun. Melanin in the skin protects it from the sun s rays, but in case of overexposure, melanin fails to work and sunburn is caused. The symptoms of sunburn include the skin turning red, burning in the affected areas, skin tightness and a sensation of itching. Severe symptoms are blisters, chills, fever and fatigue.
Age spots: Age spots are caused due to overexposure to the sun. They are brown marks, which appear on the surface of the skin, especially in the arms, hands and other body parts. Age spots get more prevalent with ageing. Symptoms of this condition include brown and gray pigmentation on the skin surface. The pigmentation occurs in a circular shape and is flat on the skin.
Photosensitivity: This condition is also known as sun allergy. People with photosensitivity are likely to get burned from sun exposure very easily, and symptoms of sunburn are observed. Symptoms include red and pink skin rashes accompanied by itching and burning. The area gets scaly and blistered.
Moles: Moles occur commonly due to sun exposure. They may appear on any part of the body. Moles may vary from being harmless to cancerous. Common symptoms include raised skin and the skin tone changing into reddish brown or black. Moles are round in shape, and some moles are painful.
Solar elastosis: This condition is commonly known wrinkles and occurs when the elastic tissues of the skin get deteriorated due to sun exposure. The skin turns limp on account of no strength of the tissues and collagen. Wrinkles appear, and the skin seems loose and sagging. Deep lines are formed on the skin.
Skin cancer: Skin cancer accounts for being the most severe and fatal result of prolonged exposure to the sun without any kind of protection. There are many forms of skin cancer. The most primary skin cancers include Melanoma, basal cell carcinoma and squamous cell carcinoma.
Polymorphous light eruption: This condition, known as PMLE in short, affects women between the age group of twenty to forty. It also occurs in light sensitive people who spend more time under the sun. Symptoms include a red or pink, bumpy rash and raised areas on the skin surface. Itchiness and dry patches are indicated.
A large number of skin problems occur due to long hours of sun exposure. Some of these are chronic problems, which require proper treatment.

Skin Problems Caused due to Sun Exposure

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