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

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 

A common form of skin inflammation brought about by the fungal infection is called as Athlete's Foot and is most commonly seen among the athletes. In medical terms, this condition is called "tinea pedis". This generally starts in between the toes and gradually moves towards the toe nails, if left untreated. In the later stages, this infection has the tendency to move towards the palm region of the hands and other body surfaces, if left unchecked. Most often, this condition is referred to as the ringworm of the moccasin feet. 

Statistics have shown that about 15% of the population is affected by this condition. It is important to note that men have a higher chance of contracting this contagious condition than women. Young adults or old children are most likely to take the hit for this condition.

After a serious research, the National Health Service has come out with the finding that, Athlete's foot can be transmitted from one person to another either by direct or indirect contact. Any environment that is warm and moist serves as the perfect breeding place for the fungal species to cause this condition.

Getting them treated before the condition spreads to other parts of the body is a very important step that has to be taken by the person who has been diagnosed with this disease. Instead of worrying about the condition after it has set in, a few remedial precautions can be taken to prevent the onset of this disease. 

Some preventive measures are:

1.  Clean shoes and socks: The socks have to be changed at least twice a day and these must be able to absorb the sweat from the feet.

2.  Using a medicated powder: Normal talcum powder or an anti-fungal powder can be applied to the skin where the irritation prevails and this kills the fungi that might form on the surface.

3. Precaution after swimming and going for walk: The region between the toes has to be wiped clean after swimming, bathing or going for a long walk. The basic idea is to remove the excessive moisture from the skin.

4.  Using socks and sandals: The sandals must allow some breathing space for the skin on the legs and when at home, socks without shoes can be worn. 

Preventive measures help a great deal in avoiding the complications that arise out of this Athlete's foot.

Athlete's Foot - How To Prevent It?

Have you been noticing bumps on your skin surface? Does the top of this growth resemble a cauliflower and feel bumpy or smooth when you touch it? These are the symptoms of a disease known as warts, which is caused by HPV or human papillomavirus. Generally, warts are not very dangerous, but they are ugly, contagious and may cause pain as well. Warts may be caused by more than 100 types of HPV viruses. A certain type of HPV causes warts around the genitals. In women, these are called genital warts and it is a severe disease.

Treatment
All warts do not require treatment and disappear on their own. This is because over time, the body s immune system can destroy the HPV virus which causes warts. A wart needs to be treated when it is painful, embarrassing, gets irritating easily, spreads to other parts of the body or spreads to other people. The goal of the treatment is to eliminate or remove the wart, avoiding a scar tissue. Creating a scar tissue would cause more pain than the wart. The treatment of warts depends upon the type, location and specific symptoms of the disease.

Self-treatment
Warts can be treated at home using salicylic acid and duct tape. Most warts do not require treatment, but in case the symptoms worsen and do not go away on their own, you require proper care.
Medical treatment

The medical treatment for warts prescribed by a doctor includes the following:

Cryotherapy
Certain medicated creams and ointments
Surgical methods such as electrosurgery or laser surgery
Chemical peels with certain acids
Excision or cutting of the warts
Before going for a treatment, it is important to detect the exact type of wart. Treatment for some types of warts may be quite painful with the chances of a scar tissue. Warts which lie beneath the skin are difficult to treat and the doctor might need to make an incision on the skin over the wart to let the medicine penetrate through it.

An HPV vaccine can be taken to protect men and women from the common warts caused by HPV viruses. This vaccine can be taken up to the age of 26. The vaccine should be taken before getting sexually active and is more effective when taken before being exposed to the HPV virus. In order to prevent transmission of the HPV virus, having protected sex is recommended. In case of any severe symptoms of warts, you must consult a doctor immediately.

Warts - Dermatological Treatments For It!

Vitiligo is a medical condition, which causes the loss of skin color due to loss of pigmentation. This usually occurs in blotches and looks very unsightly. Vitiligo is very unpredictable and can affect any part of your body. In some cases it also affects the inside of the mouth, eyes, and hair. Vitiligo is more noticeable on people with darker skin tone.

Symptoms of Vitiligo:

Premature graying or whitening of the hair in your eyebrows, eyelashes, scalp, and beard. This usually occurs before the age of 35.
Skin discoloration can also occur from other parts of the body such as hands, feet, abdomen, neck and other areas.
Change or loss of the color of the retina (inner layer on the eyeball).
Discolored patches on and around the navel, rectum and genitals.
What causes vitiligo?

A medical disorder where your immune system destroys and attacks the melanin forming pigments in your skin. This is known as an autoimmune disorder and by far is the most common cause behind vitiligo. An event such as sudden or prolonged stress, sunburn, or being exposed to industrial chemicals. A history of family members or relatives having vitiligo in the past.

Ayurvedic Treatments for Vitiligo:

Mustard and Turmeric Oil: A paste made with mustard and turmeric oil can be applied on the affected area. This is also good for the skin and reduces vitiligo. Do this at least 2 times a day to reduce the patches considerably.
Duckweed: This is a type of water plant and is very rich in a mineral called lignin. It is considered a natural treatment for skin disorders and vitiligo. It will also help to restore your natural skin color.
Sun screen: If you already have vitiligo, exposure in the sun can make it worse, so applying a sunscreen with SPF 30 or above (or an appropriate level of sunscreen protection) can protect your skin from further damage.
Papaya: This fruit is great for restoring and reviving melanin (responsible for skin pigmentation). Drinking papaya juice or rubbing papaya on the affected area can reduce vitiligo to some extent.

Vitiligo - 4 Ayurvedic Preparations for Treating it 

Do birth control pills help in controlling acne?

An outbreak of a pimple is perceived as a cause of embarrassment and concern as it gives rise to skin damage. Coming to the cause of acne, it generally occurs due to excess oil (sebum) production. The oil on your skin combined with dead skin cells, blocks your skin pores, thereby promoting bacteria growth and causing acne breakouts. 
The use of birth control pills to cure acne is usually recommended when topical medications and oral antibiotics don’t help in clearing up the problem. 
Here’s how they work on acne. 

Possessing properties that can regulate your hormone production, birth control pills contain the two hormones that your body naturally makes – oestrogen and progesterone. Present in different amounts in the pills, they act by lowering the amount of androgens (male sex hormones, which give rise to excessive sebum production) produced by your body. As a result, with a reduction in sebum production, there is also a decrease in the breakout of acne on your skin. However, you shouldn’t expect instant results from their use. 

Many a times, birth control pills can cause a flare-up of the problem before it can be contained. This can result in your acne getting worse before getting better. 
Although birth control pills can help to control acne, it’s still important to maintain a proper skincare routine comprising of washing, toning and moisturising for a healthy and glowing skin. 

If you would like to consult with me privately, please click on 'Consult'.

Do Birth Control Pills Help in Controlling Acne?

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