When it comes to a man's physique, enlarged breasts can be quite embarrassing. This is a condition known as gynecomastia or men boobs or  enlarged breast in men and affects more men than you would imagine. It may affect one or both breasts. It can result in terrible embarrassment, teasing, and social trauma. Many will try to hide it with thick loose shirts, avoid bare chest activities like swimming, exercises etc and withdraw from public exposure.Though it does not pose a significant health risk, it can affect a man's psychological health and lower his self-confidence. The good news is that men suffering from this condition do not need to live with it. 

Male breast reduction surgery or gynecomastia surgery, aims at reconfiguring the contours of a man's chest by removing excess breast fat & if needed extra gland tissues. The only permanent solution to this condition is surgery. This is because fat tissues are not solely responsible for enlarged breasts. Often glandular tissue is present in excessive amounts as well. Patients need careful evaluation by Plastic Surgeon & sometimes if needed by endocrinologist to determine the source of their breast enlargement. 

Gynecomastia surgery is usually a daycare procedure. It is performed by Plastic Surgeons under local anesthesia with liposuction being the most preferred procedure. This procedure begins when the surgeon makes a small incision on each side of the chest. These incisions are usually placed along the natural contours of the body, around the edge of the areola or near the armpit so as to reduce the visibility of scars. Excess fat and glandular tissue are then sucked out of this incision. Simultaneously, the surgeon sculpts the other tissues in the chest to redefine chest contours. Patients are usually advised to wear a compression garment after the surgery to support the healing tissues and minimize swelling. 

Results of this procedure are visible almost immediately. Recovery from gynecomastia surgery is usually quick and many men find themselves back to their normal routine within a few days. However, vigorous exercising and heavy lifting should be avoided for a few weeks after the surgery. The patient may also experience slight soreness and minimal pain that can be relieved with over the counter pain killers. 

The results of this procedure are generally permanent if there are no hormonal abnormalities. It is important to maintain a healthy lifestyle and avoid drugs that influence your testosterone levels. Regular exercise can also help tone the chest muscles and maintain the achieved good shape of chest. It is really a very simple but rewarding surgery for the male & it definitely boosts his confidence, body image & self-respect.

Enlarged Breast In Men - Causes And Treatment 

Bedtime skin care to prevent acne

Skin repairs and rebuilds at night time while you rest, so it makes sense to follow good skin care routine before going to bed every night.

3 most effective bedtime skin care tips that rejuvenate your skin.

1. Cleanse and moisturize your skin: Your skin is exposed to kinds of pollutants, allergens, makeup during daytime. So cleanse your skin properly. Then apply vitamin E based moisturizer to keep your skin hydrated.

2. Use clean pillowcase: Many pathogens and oil may reintroduce to your skin if you use unwashed pillowcase. Thus make it a habit to use a clean pillowcase, preferably made of silk fiber, which keeps you away from the risks of pimples and other skin infections.

3. Don’t sleep with your phone: Your phone collects many bacteria and other microbes during daytime. Thus it is better to keep your phone away while sleeping to avoid any counter infections.



3 Highly Effective Bedtime Skin Regimen to Prevent Acne and Wrinkles

It is a common knowledge that beer has health benefits when used in masks, scrubs, as conditioners, etc. This reason is good enough for even non-drinkers to stock up their fridges with cans of beer. 
Here are a few ways by which we can use beer to make our skin and hair better:

Use beer as a conditioner - Beer happens to be an excellent conditioner. Mixing one cup warm beer with a teaspoon of jojoba oil makes a natural, non-greasy conditioner. Wash your hair with your regular shampoo and use this mix as a conditioner. The beer in it will give volume to your hair while jojoba oil will add shine and luster.
Use it for a face pack - Take two to three strawberries mash with a fork, add few drops of beer and make a paste. Rub this paste all over your face in a circular motion. Rinse after 15-20 minutes and apply moisturizer on your face.
Soak in beer laced water - Beer can be used in bubble bath too! Mix some soap with beer of your choice and add the mix to the running bath water. Soak in this water and feel your skin become soft and smooth.
Use beer as a hair-pack - Wash your hair with your usual shampoo. Now pour the mixture made of distilled water, beer, two teaspoon apple cider vinegar and few drops of essential oil (any scent), on your hair. Make sure it reaches the hair that is inside as well. Rinse this mixture with lukewarm water. You can do this once a month.
Get the beer glow - Take half a teaspoon of beer, one egg white and a drop of almond extract. Whisk them together and keep aside. On your washed and dried face, apply the mask and let it dry until your skin feels tight. Wash it off with lukewarm water.
From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over Whatsapp, Facebook and other media.

Do You Know What Beer Does To Your Hair & Skin?

Loss of hair from the scalp, one of the most common problems plaguing the world today, can be caused by a variety of factors such as genetics, disorders and environmental factors. There are a number of homeopathic treatments that are used to treat hair loss. These treatments focus on the cause of the disease rather than just treating the symptoms. 

Hair loss can be classified as: 
1. Telogen effluvium: This is a disorder of the hair growth cycle where the telogen phase (where the hair falls out) becomes dominant. 
2. Alopecia aorta: This is an autoimmune disorder where the immune cells of the body destroy the hair. Hair loss tends to occur in patches.
3. Androgenic alopecia: This type of disorder is caused by hormonal and genetic factors resulting in a receding hairline. 
The various homeopathic treatments for hair loss are: 
1. Silica: Silica is used to treat a number of diseases in homeopathy. Besides being an effective remedy for hair loss, it also treats symptoms of vitiligo, nail problems and eczema.
2. Phosphorus: Phosphorus is another homeopathic treatment that is used to treat hair loss. It promotes hair growth in spots where hair loss has occurred.
3. Kaliumcarbonicum: This treatment is used for brittle and thinning of hair, as it enhances hair growth. It is usually recommended for people with various forms of alopecia.
4. Lycopodium:This treatment is prescribed for people who suffer from premature balding. It is also recommended for pregnant women if they suffer from hair loss.
5. Natrummuriaticum: This homeopathic remedy is made from sodium chloride and is used to treat hair problems resulting from skin complications. It is also recommended for women who face hair loss from menstrual problems. It treats dandruff and hair disorders due to hormonal imbalances.
6. Sulfur: Sulfur is an excellent homeopathic remedy to treat hair loss as it promotes hair growth. It also eliminates dandruff from the scalp.

Homeopathy and Hair Loss

Lymphedema is a condition that typically affects the arms and legs. The most common cause of this condition is damage to the lymph nodes or their removal as part of a cancer treatment program. There is no known cure for this condition. However, surgeries such as Vascularized lymph node transfer surgery may help deal with it better.

Vascularized lymph node transfer surgery involves replacing the affected lymph nodes with healthy lymph nodes from other parts of the body. This allows blood to flow more easily and restores or augments the lymphatic drainage system. In most cases, the healthy lymph nodes are harvested from the patient s groin. This procedure is relatively new, and its limits are still being explored by doctors. In cases of breast cancer that causes lymphedema in the upper limbs, this procedure may be performed along with breast reconstruction.

To be a viable candidate for this procedure the patient must have maximized control over lymphedema through other forms of lymphedema therapy. This therapy will need to be restarted after the surgery to ensure good results. The lymphedema diagnosis should also be less than 5 years old such that the patient s lymphedema is in its early stages.

As with any other surgical procedure, there are certain risks associated with this procedure. These can include

Reaction to anesthesia
Bleeding
Infection
Scarring at the site and poor healing
Damage to adjacent blood vessels
Nerve damage that can cause a temporary loss of sensation
Muscle weakness
Numbness ta the sites from where healthy lymph nodes were harvested
Risk of Lymphedema in the area where the lymph nodes were harvested from
After the surgery, the patient will need to keep pressure off the site where the lymph nodes have been transferred. The surgery site may be bandaged but compression garments will not need to be worn. On being discharged the patient may resume normal activities such as driving and work. High-intensity exercises that involve the use of the operated limb should be avoided for at least a month after the surgery. Compression garments should not be used until recommended by the doctor or a minimum of 2 weeks post-surgery. They will also need to schedule review consultations with the doctor. The schedule followed usually involves check-ups after 2 weeks, 1 month, 3 months, 6 months, 9 months and 1 year. 

Lymphedema - Vascularized Lymph Node Transfer 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

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