Burning your skin is a very traumatic experience and can leave behind scars that remind one of the traumatic incident. Scarring caused by burns may fade a little with time but are usually permanent. Apart from affecting your appearance severe burns can also affect the functioning of the body. Burns can make a person withdraw socially by making him or her afraid of how people will accept them with their scars as well as make them depressed about their appearance.

Burn repair surgery can be categorised under two headings: Acute and Reconstructive

Acute repair surgery happens immediately after the burn and deals with large burns and burns that affect critical areas. The focus here is to close the skin in case of open burns and help the skin heal.
Reconstructive burn surgery addresses the skin after the initial burn wounds have healed. The goal here is to improve the appearance of the scars and ensure no lasting loss of functioning. Reconstructive burn surgery has a high success rate.
There are many types of reconstructive surgeries for burns and the type of surgery best suited to a patient is based on the location of the scar, the extent of scarring and the patient s personal goals.

Skin grafts: This involves the removal of healthy skin tissues from one part of the body and transplanting it to the burn site. This skin graft may include only a few outer layers of skin or may involve the entire dermis. This is used in cases of severe burns where a large section of the dermis is affected.
Microsurgery: This is a procedure where the surgeon reattaches or reconstructs severed fingers, toes, ears etc by sewing together blood vessels and nerves. This is often used alongside other surgical procedures.
Free flap procedure: In this procedure, muscle, bone or skin is transferred from one part of the body to another to reconstruct the area. This type of surgery is often accompanied by microsurgery.
Tissue expansion: This involves the insertion of a balloon expander under the skin near the burn site. As the balloon is filled with saline, the skin stretches and grows. Once the skin has stretched enough, the expander is removed and the skin can then be used to repair burn scars.
This procedure has many advantages as the skin colour and texture are a near perfect match thus reducing scarring to a large extent. However, it is a very slow procedure and can take a few months.

Burn Repair Surgery - How Effective It Is?

Men also suffer from breast enlargement, medically called gynecomastia. This usually happens when the levels of female sex hormones, in the affected male, overshadow the male sex hormone levels.

Gynecomastia is different from fat accumulation in the male upper chest. It is typically characterised by an increase in the glandular tissue, which can produce milk.

Lots of adolescent boys suffer from male breast enlargement due to the adolescent hormonal surge, though, the condition can present in men at any age. Adolescents lose the breast enlargement typically in periods ranging from 6 months to a year. Beyond this period, a man with enlarged breasts has to seek medical intervention for treatment.

Typically, gynecomastia occurs due to certain medications like for renal failure and hypertension. It can also be caused due to conditions like hyperthyroidism or kidney failure, liver cirrhosis or problems with testes which causes changes in hormones in the male body.

Treatments-

Whatever be the reason, gynecomastia is a deeply distressing condition for men of all ages. Treatments are available, both surgical and medicinal and they help especially surgery.

Male Breast Reduction Surgery- Facts

Surgery for male breast reduction can be performed safely and successfully on teenagers and adult men alike.

In male breast reduction surgery, the surgeon makes an incision around the nipple and removes the excess glandular tissue and fats causing the appearance of the breast. This is the only effective treatment for gynecomastia that has long-lasting, if not permanent, results. Male breasts may also appear due to excess fat in the upper chest. Liposuction is generally very effective in treating this. The surgeon removes fats and some glandular tissue and then sculpts a new chest contour that looks natural for your body.

More severe cases of gynecomastia may require more than this. The surgeon has to then go for something called  surgical tissue excision  to achieve optimal results. Older males with gynecomastia with sagging skin also require tissue excision. This technique allows the surgeon to remove a major chunk of glandular tissue and/or skin that cannot be successfully removed by mere liposuction.

If you are planning to go for breast reduction surgery, find the best cosmetic surgeon. This will go a long way in you getting the best results and minimise scars.

Also be prepared for the after-effects of the surgery. Even though it is typically performed as an outpatient procedure using general anaesthesia or local anaesthesia with sedation, you must be prepared for soreness and swelling. Recovery time is usually a week and a patient is often given a compression garment to wear for the first few weeks after surgery to support the healing breast tissue. Also, be prepared to be off exercise for a month or so after surgery.

Can Surgery Help Reduce Enlarged Breasts In Men?

Gynecomastia is a hormonal condition that causes swelling of the breast tissues in men and boys. This condition usually arises as a result of hormonal imbalance. Breasts do not form in the same pattern in males as they do in females but all males are naturally born with tiny quantities of the breast tissues. The male body produces the testosterone hormone, which plays an important role for growth during the stage of puberty. However, they also make the hormone estrogen that is instrumental for developing sexual growth in females.

When a male passing through the stage of puberty makes lesser amounts of testosterone then there is an imbalance of the hormones. As a result of the higher amount of estrogen present in men leads to swelling of the breast tissues.

Cause of imbalance-

Aside from the common reason which is the lesser production of testosterone, there are a few other reasons that can put into effect this imbalance. They are-

  Injury to the testicles that are responsible for producing testosterone
  Obesity which leads to greater production of estrogen
  Taking illegal drugs
  Liver disorder
  Failure of the kidney
  Thyroid problems that result in throwing off your hormonal balance
  Medications that you might be taking for illnesses such as cancer, depression, heart disorders and ulcers

Treatment of Gynecomastia

The treatment of gynecomastia involves a general surgery which reduces the size of breasts by flattening and enhancing the contours of the chest. If in very severe cases the weight of the breast tissue has sagged and stretched the areola region, then the areola size can be improved surgically by reducing the excess skin.

  Mammaplasty

Plastic surgery, known as Mammaplasty, is also sometimes put into effect in order to treat the condition of gynecomastia.

  Liposuction

In the case of liposuction, the procedure of the treatment first starts with a set of medications that need to be consumed. These medications help to reduce pain during the surgery. There are two ways of taking this medication, either through intravenous sedation or via general anaesthesia. The liposuction technique involves the insertion of a hollow tube with the help of several incisions. Liposuction technique is generally prescribed if the cause of gynecomastia is excess of fatty tissues. During the procedure, the cannula or the tube will be moved back and forth in order to loosen up the excess fat. This fat is then removed via vacuum suction.

  Excision Technique

The excision technique is prescribed when the glandular breast tissue needs to be removed in order to rectify gynecomastia. In this procedure, the nipple will either be repositioned to a manlier contour or the areola size will either be lessened. In some other cases, the general surgery of gynecomastia can also involve a combination of both the excision technique as well as the liposuction technique.

Gynecomastia is a condition that can severely damage the emotional balance of a man and lessen their self-confidence. It has been also seen that many men suffering from this condition tend to avoid physical intimacy or sexual activities as a result of body-image issues. Therefore, treatment is highly recommended for those suffering from gynecomastia.

Gynecomastia - Knowing The Causes & Treatment Of It!

Psoriasis is a chronic dermatosis characterised by an unpredictable course of remissionn & relapse. It is an non-infectious skin disaease chracterised by scaly, silvery patches mainly on the scalp and extensior surface of the body. Its exact cause is unkown. In ayurveda, it is closely resembles with ekakushta. The features of ekakushta explains in ayurveda classics resembles with the symptoms of psoriasis. Psoriasis is the challenge for modern science. There is no definite treatment for psoriasis in modern science till today. The drug available in the market use to treat psoriasis are not very effective and have local and systemic effects.

In ayurveda, vata pitta and kapha dosha is the main contributory factor for the disease. Due to vitiation of three dosha, the disease manifest and main line of treatment for psoriasis is panchkarma and internal medicine. It is considering the best approach for skin disorder in ayurveda. A case report of 42-year old male, presented with well demarcated red scaly, silvery patches mainly on both legs, hands, scalp, chest and back with itching, and also nail and joint involvement has been presented in this article.

Etiology of Psoriasis: 

Unknown but many factors have been associated-

Genetic: may be autosomal dominant

Triggers: physical trauma ,infection and drugs.

Biochemical change: like increase level of arachidonic acid and Cgmp.

Immunological factors: helper T cells PLAY A KEY ROLE.

Epidemiology: 

Roughly, 1% of population is affected. Can occur at any age and affected both sex. Most patients as worse in winters.around 7 million people are affected in developed country.

Histopathogenesis:

Increased epidermal cell proliferation.

Retention of nuclei in stratum corneum.

Proliferation of fibroblast.

Dilated and tortous capillary loops.

Shortened epidermal turnover time from normal of 60 to 10 days.

Clinical features: Usually chronic indolent lesions which persist for month. Lesions are mildly papule or plaque.erthematous plaque lesions with characteristic slivery, large, loose scales. The patients of psoriasis may also suffer from depression and low self-esteem.

In a patients with psoriasis always check for nail and joint involvement.

Nail: 10 to 15% of the patients have nail involvement. Pitting, nail plate thickening, subungual debris, discolouration of nail plate and oil spot seen in the nails.

Joints: 10% patients have joint involvement.

Sites: Scalp, pressor points & extensor. Sometimes generalised.

Chronic recurrent psoriasis is difficult to treat. Modern science treat with PUVA and corticosteroids but these drugs having local and systemic side effects like liver and kidney failure etc. So, it is the time to find out the effective and safe treatment for Psoriasis. Medicines which are used in ayurveda are safe and practised since many years. A huge numbers of drugs are prescribed in ayurveda for the treatment of kushta.

Case details: A 42-year old male patient, hindu brahman by religion, presented on 10 april 2016 with well demarcated raised red scaly, silvery patches on chest, back and both legs and hands. He complained of itching all over the body and on scraping, white powder like substances fall down and leaves a bleedy surface. On history, patients had complaints since 20 years and diagnosis of psoriasis by allopathic physician. Since 20 years he has been taking allopathy and homoepathy patients from various practioners of U.P and delhi. He is brahman and lives in well known temple of delhi and visit homes of peoples for religious ceremony. He is afraid that if the disease is spreading continously, then he is unable to work as priest because people neglect him due to disease. The disease is spreading all over his body and also involves nail and joint. Destruction of nail plates of hand and legs was also developed. For this, patients took allopathic treatment for such a long time but do not get relief.

The patients visit our clinic for the first time. He told use that his problem not solves since 20 years and spreading continuously. So, he is unable to trust us. So, we first give him counselling because reassurance and emotional support are invaluable. Physical and mental rest enhance the effects of the treatment. It is also important to tell him that the disease is not contagious and is benign.

SYMPTOMS OF THE PATIENTS :

Itching all over body

Silvery patches, especially, on legs ,chest ,back but now spreading in his hand and scalp.

Destruction on nail plates

Swelling and pain in left middle fingers and flexor deformity in proximal interphalangeal joint

Swelling in right middle metatarso phangeal joint and pain

Some blood test of the patients were done like CBC, LFT, KFT, SR, URIC ACID to assess outcome.

His general health was good and both physical and all blood test were within the normal limts.we advise patients for panchkarma and oral medication but patients refuse for panchkarma so we start his oral or internal medication. 

Investigation Done :

CBC(Complete Blood Count)

LFT(Liver Function Test)

KFT(Kidney function Test)

Sr. Uric Acid

Investigation was done to rule out any other pathology. Investigation were within normal limit.

Internal Medication :

Medication are given into two phase. In First Phase, we are given panchsakara churna - one spoon two times daily for anulomana and pachan, Panchnimba churna- one spoon two times daily with luke water, panchtikta ghrita gugulu - two tab two times daily, and one oil for local application containing jyotishmati,bakuchi, and chakramad for five days. We told patient to apply the oil firstly only on legs for 5 days. Patient taking the same for 5 days and come on 5th day, we see the fabulous result, the rashes which are developed within 4 to 5 months just disappear and other rashes are also subsiding.

After 5 days, in second phase, we continue the same treatment and also added haridra khand - one spoon two times daily, gugulu tiktam kashaya - three spoon two times daily (one hour before food for 15 days). The patient came back on 20th day, with great result, the rashes were almost 60 % subsiding and pain and swelling in finger and ankle also reduce to great extent. Now, patient is not taking any pain killer for pain. Patient also get improvement in nails of legs.

We prescribe the same medicine for one month that time and ask him to do some physiotherapy additional for finger deformity. After that patient came with 70 to 75 % relief in symptoms and patients also tell that during the treatment, he will not develop any additional rashes.

During the treatment, we also told the patients to follow some dietary changes and live according to the rules of Ayurveda.

Result: Psoriasis is a disease with unkown etiology and triggered by many factors. In modern science, treatment of psoriasis is a challenge. They do not have any safe and proper medicine for psoriasis. But, ayurveda treatment gives satisfactory results as well as the quality life to the patients. Ayurveda removes toxin out of the body and corrects the formation of aama. Ayurveda gives the prevention as well as the treatment. So, by following the dietary and lifestyle change we prevent the reoccurrence of the disease.

Ayurveda For Psoriasis 

Psoriasis can be defined as a skin condition, which is caused due to autoimmune disorders within the body. This is a condition where the skin on the body develops raised and dry areas which are reddish in colour while also being bordered by silvery scales. 

Treatment of psoriasis in ayurveda
Ayurveda has a different slant to conventional medicine with regards to the treatment of psoriasis. According to ayurveda, it is the impurities in the blood, which cause the immune system to react adversely and cause this condition. Ayurveda concentrates on treating the underlying problems through the combination of changes in diet, home remedies and certain medications to treat this disorder. Some of them are mentioned below:

Changes in diet which will help purify the symptoms: 
Some advice that is usually given to patients to clean up their diet and include certain other items are as follows:
1. Avoid spicy food and try to eat food, which can be easily broken down within the digestive system
2. Inclusion of more fruits and fruit juices in your diet
3. Also include vegetables and also have a mix of boiled vegetables daily.
4. It is better to avoid animal products such as animal fats, eggs, canned and processed foods from your diet.
5. Regular consumption of butter milk and curd are known to be very good in blood purification and thus should be consumed in large quantities. 

Some ayurvedic tips and ingredients, which can help treat psoriasis: 
Other tips that can be implemented as skin applications to treat psoriasis are as follows: 
1. Use avocado oil to rub on the affected areas as it is known to be an effective treatment when applied long term.
2. Ensure that the skin is always moisturized by applying a soft, cream or gel.
3. Periodic baths in sea water if possible is also good for lessening the symptoms of psoriasis.
4. Aloe vera cream applied specifically on the patches is known to also lessen them overtime.

Few other tips to follow
1. Get into deep breathing and meditation to ensure that your body and mind are relaxed as this is very important during the healing process
2. Expose the affected areas of your skin to mild sunlight for about half an hour daily as it is known to improve symptoms. 


Ayurveda and Psoriasis

Psoriasis is a long lasting disease characterized by patches of scaly, itchy and red skin. It can be restricted to a small areas or can even spread to the whole of your body. When the underlying infection reaches the surface of your skin, the healthy cells die. This causes red and itchy plaque covered with white scales. It mostly occurs on the elbows, knees and scalp. Sometimes these scales itch and also bleed. In severe cases the red skin grows and merges with another patch.

Conditions of psoriasis:
1. Finger nails get discolored and pitting is noticed. The nails begin to crumble and in severe cases detach from the nail bed.
2. Scales and crust start to develop on the scalp.

Types of psoriasis:
1. Guttate psoriasis- It is characterized by small red spots which occur on the torso and limbs. It usually starts in young childhood or adulthood. It triggers respiratory infection, tonsillitis and strep throat.
2. Inverse psoriasis- In this condition bright red and shiny abrasion occurs in the groin area, in the armpits and under your breasts.
3. Erythrodermic psoriasis- It is characterized by periodic redness of the skin and shedding of the skin. It also causes severe sunburn and infection.

Cause of psoriasis:
Many factors can cause psoriasis. Factors such as, trauma, infection or emotional stress can trigger this condition. Some abnormalities in the system also cause psoriasis. People who have a flare up of psoriasis are usually affected by emotional stress or some trauma like the death of a loved one or loss of a new job. These tensions may intensify because of problems in your internal system.

Ayurvedic treatments for psoriasis:
1. Consuming medicated ghee.
2. Herbal medicines or herbal concoctions can also be consumed.
3. Basthies are medical and herbal enemas which should be taken for 8days.
4. You should avoid having meat and only consume vegetarian dishes to reduce psoriasis. Also avoid yogurt, black gram, salty food products and chilies.
5. You can also remove impurities from your body by means of vomiting and purging.
6. You can also cure psoriasis by covering your entire body in a paste of mud.
7. Consume turmeric and Neem daily to treat psoriasis.

Some medicine like arogya vardhini vati, kutaki, ras manikya, Giloy ghan vati must be taken after consulting an Ayurvedic expert.

7 Best Ayurvedic Medicine for Psoriasis Treatment

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