Genital warts refer to small (sometimes invisible), cauliflower shaped bumps, which form around the genital region and severely affect the moist tissues around the concerned region. Genital warts are more common in sexually active people and are one of the most commonly transmitted sexual diseases. The virus responsible for the disease, Human Papillomavirus can also cause other serious disorders such as genital cancers.

Genital warts can occur in both the genders. The virus generally spreads through sexual intercourse. In men, warts appear around the scrotum, the tip of the penis or the anus. In women, warts might form around the vaginal walls, the cervix or around the anal canal. If you had any form of oral contact with the genitals of an already infected person, genital warts can form around your throat or mouth.

The symptoms of genital warts are as follows:
1. Severe itchy sensation and discomfort around the genital areas.
2. Bleeding during sexual intercourse
3. Formation of numerous small, grey bumps around the genital region
Genital warts are caused by genital HPV s, which are transmitted, primarily through sexual contact. In most of the cases, the immune system is able to combat the virus and makes you less susceptible to this disorder.

However, you might be at an increased risk of developing genital warts because of the following reasons:
1. Engaging in unprotected sex, that too with different partners.
2. Past history of other sexually transmitted infection
3. Being sexually active from an early age
4. Having unprotected sexual intercourse without being aware of one s medical history

The treatment for genital warts depends on the severity of the condition. If the warts are causing significant pain and discomfort for you, your doctor might opt for one of the following procedures to get rid of the same:
1. Application of Imiquimod creams around the affected area might help treat the condition.
2. A regulated application of  Trichloroacetic  acid on the affected areas might help to burn off the genital warts.
3. Application of a solution of  Podophyllin  on the affected areas might help destroying the soft tissues around the genital areas.
4. If your warts are significantly large in size or do not respond well to medications, you can also opt for surgical excision or laser therapies to get rid of them

What Can be the Possible Reasons of Gential Warts

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 

Warts are small fleshy growths on human skin, which can happen anywhere over the body and are usually harmless, although they could be unsightly and if growing in certain areas, may be painful. Genital warts belong to that variety. Most warts are caused by hpv or the human papilloma virus and genital warts are no different.

Causes of genital warts

Genital warts are usually contracted during sexual intercourse. During intercourse, tearing of skin and contact with an infected individual will pass of the virus to another person. This is how hpv is transmitted, which may result in genital warts. Other than being unsightly, genital warts can be painful if they are in position when they have friction against clothing and they may also obstruct the flow of urine requiring them to be removed expediently.

Treatment of genital warts in ayurveda

Ayurveda has some great remedies to cure this problem. Let us have a look at a few of them:

1. The onion and salt mixture remedy: this natural remedy has primarily two elements, which are onion and salt. To make this mixture you slice two onions, and sprinkle them with salt before leaving them overnight. In the morning, mash the onions into a thick paste and then pass it through a filter or sieve to extract juice. Apply this juice on the warts periodically for a few weeks until they either shrivel or fall off.

2. The garlic paste remedy: this is another easy remedy which if applied consistently can bring great results fairly quickly. In this method you need to take a few cloves of garlic, crush them to a paste, apply this paste on the warts, cover the affected area with a bandage and leave it for an hour. After an hour remove the bandage and wash of the area. Repeat this for a few weeks and you should see the results.

3. The potato remedy: this remedy would require you to follow the steps multiple times a day. Take a potato and cut it into slices. Use these slices to rub the affected area. This has to be followed up multiple times a day, preferable at least 3 or more times. Doing this for 2 to 3 weeks will bring results where the warts will either shrink up or fall off.

Natural Ayurveda Treatment for Genital Warts

Vitiligo is a skin disorder where white patches of depigmentation develop on the skin and keep enlarging. This disorder is long term and continuous in nature. The patches appear due to the death of melanocytes within the skin. Melanocytes are skin pigment producing cells, which produce melanin. Vitiligo can affect the skin of several areas, including the eyes, hair and the portion inside the mouth.

Causes
The causes of this disease are as follows:
1. Autoimmune disorders in which the immune system of a patient becomes over reactive and the melanocytes are destroyed.
2. This disease may also occur due to genetic oxidative stress imbalance.
3. Stressful events may also lead to vitiligo.
4. Harm or damage to the skin from sunburns or cuts also leads to vitiligo.
5. Exposure of the skin to several harmful chemicals may be a cause.
6. Neural disorders are also responsible for vitiligo.
7. Vitiligo may also happen from viral causes or may be hereditary and passed on from family members.

Symptoms
Vitiligo has only one major symptom. White, flat spots and patches develop on the surface of the skin. The earliest of these white patches appear on the parts of the body which are exposed to the sun continuously.
It starts off as a simple spot in the beginning and gradually, the spot starts getting pale and finally turns white. The patches have irregular shapes, and in some cases the edges get inflamed and are red in color. Itchiness is experienced in the affected areas. Symmetrical patches signify slow development of vitiligo.

The two major types of vitiligo are:
1. Non segmental vitiligo, which affects the back of the hand, the arms, knees, elbows, feet, mouth.
2. Segmental vitiligo, which is more stable than non segmental vitiligo, but spreads faster. It usually affects areas of the skin, which are attached to nerves.

Treatment
The different methods of treatment for vitiligo are:
1. Phototherapy with UVB and UVA light: Exposing the affected area of the skin to UVB lamps is a popular cure for vitiligo. This treatment can be performed easily at home. UVA treatment incorporates taking of a drug which makes the skin more sensitive to ultraviolet light and then the skin is exposed to high doses of UVA light.
2. Skin Camouflage: Cosmetic creams and makeup can be used to camouflage affected areas of the skin. These topical creams are waterproof.
3. Depigmentation: Depigmentation is used to treat widespread areas affected by vitiligo. The skin color of the unaffected areas is reduced in order to match the affected areas. It is done using topical ointments.
Vitiligo is a skin disease, the major causes of which are still to be discovered. Proper care and treatment should be taken for skin areas affected by vitiligo.

Vitiligo: Causes, Symptoms and Treatments

The first thing anyone notices about you is your face and often people find themselves wishing for things like a slimmer nose, fuller lips etc. This is where facial cosmetic surgery comes in. Facial cosmetic surgery can address areas like your eyebrows, nose, cheeks, chin etc to give you the facial structure you've dreamed of.

Take a look at some of the common types of facial cosmetic procedures:

Brow lift: Frown lines and creases that develop across the forehead, between the eyes and over the nose bridge can be addressed through this procedure. This surgery is performed mainly to combat signs of aging and involves raising eye brows that may be sagging over the eyelid.
Eyelid surgery: Puffiness in the upper eye lids may be caused by excessive fat deposits. When combined with sagging skin, it can disturb the contours of the eye and in some cases cause vision problems. Blepharoplasty or eye lid surgery removes this excess skin and corrects fine lines, wrinkles and bags under the eyes.
Nose: A rhinoplasty is used to reconstruct the nose. The nasal skin is separated from the tissue and cartilage structure underneath which is then reshaped as desired and then sutured together again. Rhinoplasty is of two types; open rhinoplasty and closed rhinoplasty.
Ears: An octoplasty is a facial cosmetic surgery aimed at correcting protruding ears or large outer ears and correcting ear deformities such as a lop ear, cupped ear or shell ear and torn ear lobes. This surgery is usually performed on children between the ages of 4 to 14.
Chin: Surgery on your chin can reshape it to make it look smaller or bigger as desired. This can be done by reshaping the jaw bone or inserting an implant. In some cases the procedure may be combined with liposuction.
Forehead: Signs of aging on the forehead, frown lines or heavy brows triggered by stress and hereditary furrowed lines above the nose can be addressed with a forehead lift. This procedure is often performed along with a facelift or eyelid surgery.
Facelift: As we grow older, our skin loses its elasticity. This triggers the development of wrinkles and deepens creases along the nose and cheek. Facelifts address these signs of aging by tightening skin and strengthening the muscles beneath it. Facial cosmetic surgery can also be used to correct congenital defects such as cleft lips and to treat scars.
Surgery to repair a cleft lip or cleft palate not only enhances appearances but also enhances the quality of life by improving functionality. Scar revision surgery involves the injecting or application of steroid medication to lighten the scar and make it less obvious. To treat burns that leave behind prominent scars, a procedure called Z plasty may be used.

Facial Cosmetic Surgery - Which Type is Suitable for You?

Introduction 

The common male problem in an Aesthetic clinic, Gyanecomastia, is truly Pseudogynaecomastia with only fatty tissue and minimal glandular tissue. The condition is a part of the co existing Obesity disorder and is rarely, a standalone entity. The treatment options shall include an approach to answer the issue of obesity as a whole, not rest contented with surgical removal of the enlarged breasts alone. What is seen and what is treated is just a tip of the iceberg. 

Gynaecomastia, an innocuous condition, that affects 35-70% of male population immediately after birth, during adolescence and old age is rarely brought to notice as the sufferer makes all attempts to hide it as the condition brings with it a sense of shame and pain in public places and mental suffering. Herein starts the search for the treatment. Medical and multifaceted surgical options evolved over centuries with the current opinion being fat removal by anyone form of liposuction and the gland removal by direct excision. Gynaecomastia, is increased breast tissue in males composed of glandular and fatty tissue. 

Physiological gynaecomastia of puberty that normally regresses with age tend to stay back being sustained by the modern lifestyle changes. Processed foods and environmental pollution of air and water, the cosmetics used on the body like deo odorants, perfumes and toiletries, synthetics and chemicals have contributed to explosions of generalised obesity. With this generalised obesity, the tendency to hold back excess fat in the breast developed. This clearly shows the reason for higher incidence of (pseudo) Gynaecomastia of late. Hormonal imbalance due to reasons stated above, aggravate the situation. Gynaecomastia is part of the generalised obesity and it is more fat and little gland. 
However, this condition does not have any harmful effect on the body, but it can cause distress emotionally. Men may lose their self-confidence and they can be psychologically affected by this.

What Causes Gynaecomastia?

It is a type of hormonal imbalance that results in the growth of the male breast tissues. The ratio of oestrogen v/s androgens gets altered and causes the enlargement of the breasts. For this condition to occur, the amount of oestrogen increase in the body, or the amount of testosterone drops. Sometimes it can be the combination of both.

There are certain diseases that may contribute to gynaecomastia and they are as follows:

Kidney diseases

Liver disease

Drop in testosterone levels

Certain medications such as methadone, medications for HIV or treating prostate cancer

Certain tumours caused in male sex organs such as cancer of the Leydig cells or the Sertoli cells resulting in deprivation of androgen levels

Conclusion: 
True Gynaecomastia that requires surgical treatment is not so uncommon. What is commonly believed to be gynaecomastia is truly Pseudo gynaecomastia with a co exiting clinical picture of obesity, high BMI, sedentary life and wrong lifestyle. Surgical treatment by laser liposuction under Tumescent Anaesthesia gives very good results with high patient satisfaction and negligible post operative complications. Gland fragmented with laser can be extricated thro  same entry point without sub areolar incision.

Gynaecomastia (Enlarged Breasts In Men): Causes and Treatments

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