Vitiligo or White patches is medically referred as Leucoderma. It is a disease that causes loss of skin colour resulting in white patches. It can affect the skin on any part of the human body. It occurs when the melanin-forming cells called melanocytes which produce melanin die or stop functioning. The condition is not life threatening or contagious, but it is stressful and makes one feel bad about oneself.

The main sign of vitiligo is loss of skin pigment which produces light or white patches on skin. The discoloration is first visible on sun exposed areas like the hands, feet, arms, face and lips. It can also be coupled with premature greying of hair below the age of mid-thirties, colour loss of retina and inner lining of the mouth.

Vitiligo has no cure, but homeopathic treatment help to stop or slow the process of colour loss and brings back some colour to skin. The failure of melanocytes can be attributed to disorder in which immune system attacks and destroys them. It can also be triggered by sunburn, stress or exposure to industrial chemicals. People with vitiligo are at risk of Social or psychological distress, loss of hearing, sunburn and skin cancer, inflammation of the iris and dry skin.

Homoeopathic treatment enhances the natural production of pigments and Vitiligo is considered as a manifestation of an inner disturbed state of the body. The patient is analysed on mental, physical and familial attributes. The medication is then based the results. Arsenic Sulph Falvus, Arsenic Album, Baryta Mur and Baryta Carb are known to give good results in Vitiligo. Vitiligo is a chronic disorder and it takes a long time even with the best of the homoeopathic treatment.

Calcarea Carb is prescribed to patients of Vitiligo with milky white spots on skin. It is prescribed to free perspiration over the head, neck and chest and persons with intolerance to cold weather.
Arsenic Album is useful remedy for vitiligo in persons prone to dry, rough skin. The skin complaint coupled with asthma is a strong contender for using homeopathic medicine Arsenic Album.
Sepia is prescribed for vitiligo in persons showing unresponsive attitude towards family and life
Silicea is prescribed for vitiligo in patients with pale and waxy skin, tendency to excessive perspiration. If the main mind symptom are timidity and an under-confident nature, then Silicea is a good choice. It is known to work on patients who seem under-confident, fear public speaking.
Sulphur is considered the best for vitiligo treatment as it goes deep inside the basic root cause to exterminate the disease. The persons requiring homeopathic medicine Sulphur show a mind constantly occupied with various theories and plans due to which they suffer from mental fatigue and absent mindedness.

Homeopathic Medicine for Vitiligo or White Patches Treatment

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

Plastic Surgery is a speciality that deals with reconstruction, alteration and restoration of certain parts in the human body. It improves a person's appearance and may also help in improving the functionality of various body parts. It can be classified as either re-constructive or cosmetic Surgery:

    Re-constructive Surgery: These type of surgeries are used to correct various defects in the body such as injuries as a result of trauma, physical birth defects, deformities in the ear and cleft lips.
    Cosmetic Surgery: Cosmetic Surgery is used to modify a part of the body for cosmetic reasons. The most common cosmetic surgery procedures are reconstructing the nose, removing fat from certain parts of the body and reshaping the breasts.

Outlined below are 5 facts about plastic surgery:

    Liposuction is popular among males: The most common plastic surgery among men is liposuction. So far, out of the 1 million plastic surgeries that men have undergone, most have been liposuction. The other popular cosmetic surgeries for men are face lifts and Rhinoplasty.
    35-50 year old undergo the maximum number of plastic surgeries. In 2014, over 4 million procedures were performed on people whose ages were in the range of 35-50 years. The most common concerns were sagging skin and fine lines. Liposuction was the most popular surgery in this age group.
    Most women opt for breast augmentation: Breast augmentation often requires correcting various issues such as post-op sagging and various other tweaks like modifying the size of the implants. The number of revisions in breast surgeries has actually gone up compared to the initial breast surgeries.
    Asian double eyelid surgery: A surgery where the eyelids are altered to make your eyes look bigger and attractive. It is a popular surgery among Asian women.

5 Facts You Never Knew About Plastic Surgery

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

All ayurvedic treatments have their roots in hundreds of years of research and thus are extensive. The philosophy followed by these treatments is that every human being in governed by three doshas of forces - vata (air), pitta (fire) and kapha (earth). Depending on the force that is in highest proportion in an individual, all his psychological and physical attributes are determined. Hair loss is attributed to the pitta dosha which is concentrates on metabolism and digestion. The various methods to treat premature loss of hair, according to ayurvedic principles are:


	Balancing the pitta dosha:&nbsp;pitta dosha can be managed by eating less salty, fried and spicy food, consuming limited amount of alcohol, coffee and meat and reducing smoking habits. Certain herbs can curb excess pitta like shatavari or asparagus and bitter vegetables.
	Ayurvedic oil and shampoo: an effective remedy is oil made by boiling a cup of neem (margosa) leaves in 4 cups of water. The mixture is then strained and stored. If applied at night and rinsed off in the morning, hair loss can be prevented and your hair gets healthier. An ayurvedic shampoo can be made at home by preparing a mixture of methi (fenugreek), green bean (mung dal), soapberries, lemon juice and curry leaves which need to grinded well together before applying on the scalp.
	Ayurvedic diet plan:&nbsp;ayurveda believes that a well-balanced diet is the preventive measure to most ailments, including hair loss. Consuming vegetables with high protein and iron content like cauliflower, kale, pumpkin leaves, spinach, salsify, lentils, beet greens, string beans, dandelion greens, raisins, soybeans etc. Proves to be helpful in this regard. This diet can also help to combat systemic diseases like alopecia which may causes loss of hair and sizeable bald spots.
	Ayurvedic medicines:&nbsp;four ayurvedic medicines are used extensively for the purpose of combatting hair loss. These are thikthakam kashayam, thikthakam grisham (regulates metabolism), chyavana prasam and narasimha rasayanam, which improves the strength and quality of hair).
	Combating other problems that cause hair loss:&nbsp;using herbs like brahmi (to manage stress), shilajita and jatamansi (for thyroid imbalance), cardamom (for chronic problems) and ashwagandha (for immune system disorders) can indirectly help when hair loss is a symptom or side effect of another disease.



Combating Hair Loss And Ayurveda

Vitiligo is a disease which results in the loss of skin colouring pigment and ultimately the person loose his or her skin colour in blotches. The rate and to what extent the colour loss will happen is always unpredictable. When the Melanocytes cells lose their ability or get destroyed completely, the human skin starts losing it's skin colour produced by these Melanocyte cells. Vitiligo can generally affect skin present of any body part. Vitiligo is a common disease and it affects almost one million people every year all over the world. The disease can affect a person of any age.

Causes of Vitiligo

There are different causes due to which Vitiligo is caused. Let us have a look :

Vitiligo can happen due to an autoimmune disorder, when the immune system becomes overactive and results in the destruction of the colour pigment-producing cells i.e. the Melanocytes.
Vitiligo is also believed to affect people because of genetic factors. The immune system can get affected by the genes and results in a loss of skin colouring melanocytes. It can be hereditary and gets passed on. However, it is not at all contagious and cannot be passed on to someone else.
Harmful exposure to UV rays can cause the body to loose melanocyte cells. Heavy sunburn is also a common cause of the disease.
A stressful life schedule or oxidative stress imbalance can easily make the melanocyte cells to go weak and eventually wither away.
A foreign virus or bacteria which may enter into the immune system and if not destroyed affects the melanocytes in different parts of the body.
Treatment for Vitiligo-

Vitiligo Treatment or White Patches Treatment is based on improving your skin s appearance by restoring its colour. Re-pigmentation treatment is most successful on face and trunk; hands, feet and areas with white hair respond poorly. Compared to long-standing patches, new ones are more likely to respond to medical therapy.

The treatment can be classified into

Medical

Medicines applied to the skin, such as:
Corticosteroid creams or ointments
Immunomodulator creams or ointments, such as Elidel & Protopic
Topical drugs such as methoxsalen (Oxsoralen)
Oral Medical treatment includes the use of immune-modulating drugs such as systemic corticosteroids, levamisole, cyclophosphamide, azathioprine, vitamin supplements (especially vitamin B12 and folic acid).
Phototherapy NBUVB full body   A medical procedure in which your skin is exposed to ultraviolet A (UVA) or ultraviolet B (UVB) light from a special lamp in full body chambers.
Excimer (Targeted Phototherapy)   Targeted phototherapy, also called concentrated phototherapy, focused phototherapy and microphototherapy, involves delivery of ultraviolet radiation directly focused on, or targeted at, the skin lesion through special delivery mechanisms.
Surgical Procedures

Surgical treatment   Normal skin is used as donor tissue and then grafts are surgically transplanted on areas of Vitiligo treatment. The new skin grafts start producing pigment. Patients who are candidates for this procedure must have stable Vitiligo, or Vitiligo that has not changed for at least one year. The criteria of stability is taken as (a) no new White patches, (b) no extension of existing White patches and (c) no loss of pigmentation of previously repigmened patches for at least 1 year. This procedure can be used for patients with limited areas of Vitiligo and also in those with more extensive disease.
Melanocyte cell transplantation   In this procedure, a skin graft is taken from the patients own thigh, this skin is then treated with an enzyme known as trypsin which separates all the layers of the skin and thus Melanocytes and Keratinocytes are concentrated. The Vitiligo (Skin White Spot) skin is then removed with the use of diamond burs or Lasers and the cells are transplanted. The advantage of this procedure is that cell culture is not needed and that skin harvesting from the donor area, preparation of cell separation and application of Melanocytes can all be undertaken in a single 3-h procedure.
Blister Grafting   In this procedure, blisters are created on your pigmented skin primarily by using suction. The tops of the blisters are then cut out and transplanted to a depigmented skin area where a blister of equal size has been created and removed.
Punch grafting  Punch grafting is the simplest and the least expensive of all the grafting procedures in Vitiligo. The procedure involves the transfer of circular pieces or punches of skin tissue from the donor area into similar shaped pits that are made on the recipient skin. The size of these punches can range from 1 mm to 2 mm and they are spaced 5-10 mm apart on the recipient skin.
De-pigmentation  Depigmentation involves fading the rest of the skin on your body to match the already-white areas. If you have vitiligo on more than 50 percent of your body, depigmentation may be the best treatment option. In this procedure, the drug monobenzone (Benoquin) is applied twice a day to the pigmented areas of your skin until they match the already-depigmented areas. Some patients who are resistant to depigmentation with drug monobenzone (Benoquin) will need Q Switch NDYAG Laser to destroy the pigment cells. Depigmentation in most patients is a permanent technique in which the whole body is gradually turned white.
Color (Camouflage)   Camouflage used to treat vitiligo can be classified into two- temporary and permanent. 
Temporary colouring is the method which intends to blend the white patches with the rest of the body s colour. The method is done using coloured creams to the affected skin. Those creams will have the same shade as that of the natural skin. Applying the creams make the patches less noticeable.
Tattooing (permanent coloring)   Tattooing is injecting artificial pigment into the depigmented area. After selecting the pigment shade which matches the surrounding skin color, the pigment granules are implanted into the depigmented patch either with a manual or electrically driven needles. Though the patch resembles the surrounding normal skin, it may permanently fade or acquire a bluish hue after 1   2 years which is distinctly noticeable and may become unacceptable. Hence, tattooing is usually not advised unless the patch is in an inoperable site.

Best Vitiligo Treatment  - Medical & Surgical Methods

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