It is hard to escape the harsh rays of the sun during summers. Staying outdoors for too long will lead to tanned skin, which is a sign of skin damage. Sometimes skin damage can get severe and lead to diseases like skin cancer. To prevent your skin from damaging and keep it healthy, here are seven pro tips:

1. Aever skip the sunscreen: sunscreen with spf 15 or more will help in protecting your skin from harmful uv rays. Even if you are going to be out in the sun for more than 15 minutes, make sure to apply sunscreen generously. Remember, the higher the spf, the better is the protection.

2. Always wear sunglasses: sun damage can lead to premature signs of aging; especially wrinkles around the eyes since the skin around your eyes are very thin. Wider lenses that can block out 99% of sun rays are recommended to protect your eyes.

3. Your lips need protection too: just like your eyes, the skin is much more delicate and thinner on your lips. Your lips are susceptible to tanning as well, along with the risk of fine lines around the mouth if not well protected. Always apply a lip protection balm when going out.

4. Upf clothing: garment with special upf (ultraviolet protection factor) coating can shield you from harmful uva and uvb rays. Like spf, the higher the upf, they better it will protect you. Regular clothes can protect you as well, provided they are woven tightly and are of a darker color.

5. Keeping a close look at the time: uv rays are the strongest and mostly harmful from 10 a. M. To 4 p. M. If you are out during these hours, do not forget the sunscreen, umbrella and sunglasses.

6. Don't forget to protect your head: a hat with a brim of 2 to 3 inches all around shield the skin of your neck, face and ears and protects you from skin damage.

7. Apply religiously: even if your sunscreen promises that it is sweat proof, waterproof or rub proof, it never completely is, as no product works the same for everybody. So apply your sunscreen throughout the day.

How to Prevent Our Skin From Sun Damage

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

While injuries of any form can be painful, burn injuries are one of the worst to suffer from. While cuts and bruises can be temporarily assuaged with a proper dressing, burns are quite different in this regard. With burns, the damaged tissues will stay on the body and may cause continuous pain. Thus, burn injuries are difficult to treat and they require different strategies for pain management as well.

Treatment methods available for treating pain arising due to burn injuries

Apply an anesthetic cream or aloevera gel to soothe the burnt skin. Avoid exposing the skin to air as that will cause painful sensations.
Loose gauze or antibiotic ointment must be used to protect the influenced area.
Soak the burnt area wound in cold water for about five minutes or more.
If the burn escalates or affects a widespread area, seek medical attention immediately.
Pain management factors for burn injuries:

Relaxation: During the phase of recovery, burn injuries put immense stress on your body and continue for a long period. Muscle tension is caused by stress that increases pain. Some relaxation techniques are proven to be beneficial to reduce the stress on body.
Coping with your pain: Different people have different ways to cope with physical discomfort. Look out for situational aspects which are currently under your control and take it positively. The  what ifs  or wishing that the burn didn t occur in the first place will not help with your current situation. You should focus on things what you can control like self-rehabilitation, doing your daily exercises, physical therapy treatment or following a doctor s suggestion of pain management strategies. This will help you cope with your pain to a greater extent.
Sleep medications: If your normal sleep routine is hampered, consult your physician for safe sleep medications. Proper sleep is very important for the healing process and even more so in the case of burn related injuries.
Antidepressants: Some people may not be suffering from depression, but they might still need antidepressants for relief and sound sleep. A health care provider might prescribe antidepressants as a way to deal with acute pain from burn injuries.
Increase the pace of your activities: If you want to rebuild your health and stamina and get back in form soon, focus on the regular physical and mental activities. Exercise regularly, but don t push yourself too much. Increase your physical activities gradually over time. Unless and until you are fully comfortable, don t strain yourself too much. Occupational and physical therapists can help you with an appropriate activity program.

Burn Injuries - 5 Ways to Manage Its Pain

Athlete's foot is a common form of a fungal infection. It most commonly occurs between the toes and is medically known as tinea pedis. The most common cause are sweaty feet which when enclosed inside a tight-fitting shoe for a prolong time leads to this condition. The most common symptom of athlete's foot is a scaly rash which causes itching and burning on your foot. It is a contagious disease and is most commonly spread through towels or clothing of people who have that disease. It can also be spread through the floors which people with athlete's foot walk on. Here is everything you need to know about athlete's foot.

Causes
1. Dirty wet socks inside covered shoes
As mentioned earlier, athlete's foot is a contagious disease which originates from wearing dirty wet socks inside covered shoes. 
2. Infection
You may also get it by coming into contact with an infected person or their towels and/or clothing. Even walking on the same floor as they walk on may cause an infection.

Symptoms
1. Scaly red rash
There is usually a scaly red rash in between the toes when you have athlete's foot.
2. Itching
There will be severe itching throughout the persistence of this disease especially when you first take off your shoes.
3. Blisters and ulcers
This is not a very common symptom of athlete's foot. However, blisters and ulcers do occur on certain types of athlete's foot.
4. Chronic dryness and scaling
This occurs on the soles of the feet and then slowly starts spreading upwards. These symptoms only occur on the type of athlete's foot known as moccasin. Due to this, athlete's foot is often mistaken for eczema and sometimes even dry skin.
5. Spreading to the hand
Athlete's foot always starts in your legs and in some cases spread to your hands as well. The likelihood of athlete's foot spreading to your hand is increased if you scratch or pick at the areas of the foot infected.

Treatment
There are three stages of treatment and these depend on the severity of the infection.
1. Over-the-counter medicines
In the first stage of treatment, the doctor will simply prescribe over-the-counter antifungal ointments, sprays or powders.
2. Prescription medications
In the next stage of treatment, prescription medications need to be applied to your feet.
3. Antifungal pills
If nothing else works, only then should antifungal pills be prescribed.

All About Athlete's Foot

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

Rhinoplasty, more commonly known as Nose-Job, is a cosmetic procedure designed to change the shape and size of the nose. 

A Rhinoplasty can effectively change the size and shape of the nose to complement the facial balance. It also helps improve nasal symmetry efficiently enhancing your facial features.

How is the surgery performed?

We prefer General Anaesthesia for the surgery to make patient pain free and most comfortable. It s a Day-care procedure or may need overnight stay.

The operation involves an incision which is made for easy access to the cartilage and bones of the nose. These incisions are generally placed inside the nose, so that they do not appear as scar marks after the surgery is done. Moulding, removal or replacement of the bone or cartilage depends on the demands of the restructuring of the nose. Once the reshaping of the nose is done, the nose tissue is put back into place and a splint is temporarily placed to support the new structure of the nose. The splint is removed at 5-7 days. 

Precautions to take after a nose surgery

After a nose surgery, the area around your nose will stay swollen and bruised for around 10-15 days. Thus you have to ensure that-

You get adequate period of rest.

Use cold compresses over the swollen face, this will reduce the swelling and ease the pain.

Do not indulge in relatively vigorous physical activity for 15 days. 

Take you medicines regularly.

Risks of nose surgery

Every surgery or medical procedure involves certain risks, and so does Rhinoplasty. Along with some puffiness and bruising around the eye and nose region, you may also experience-

Some amount of bleeding 

Injury to the septum area

Irritation of the skin and skin problems 

Infections 

Nasal blockage due to swelling in the inner nasal area 

Complications resulting from anaesthesia 

Although there are certain risks to Rhinoplasty, the surgery is considerably safe if done by a qualified expert plastic surgeon and the results are quite permanent.

Rhinoplasty - Things You Must Know!! 

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