When an injury happens, the normal tendency of the skin is to repair itself from inside out, until it is completely closed and healed. However, in some cases, due to various reasons, excessively large scars can form. These hypertrophic scars are known as keloids. Here is everything you would like to know about keloids:

Features of keloids:

Benign, fibrous, smooth, hard growths that form over a healed wound
Can be bigger than the original wound
Most commonly found on chest, ear lobes, cheeks, and abdomen
Pregnant women are usually at the risk of developing keloids
Though they do not develop into malignant lesions, they are a cosmetic issue, especially when the visible portions of skin are affected
They are localized, flesh-colored and red in color
They are raised from the surrounding tissue and are prone to repeat injury
It continues to grow with time
Could cause discomfort and irritation when it comes in contact with clothing
Sun exposure or tanning can worsen it and cause tenderness
Common injuries that can lead to keloid formation include burns, surgical incisions, skin piercings, chicken pox scars, tattoos, etc.
Treatment for keloids may not always be effective and need repeat treatments
Treatment options: If the keloid is not in a visible area and does not cause any problem, it is best to leave it untreated and observe for any changes. The following changes could indicate the need for treatment.

Change in color from pale pink to red (indicating inflammation)
Severe increase in pain/tenderness
Sudden increase in size, which could indicate malignancy (keloids are an area where benign growth can turn cancerous)
A biopsy can be done to identify if treatment is necessary. This involves removing a small part of the tissue by injection and sending it for laboratory examination.
Treatment options include both nonsurgical and surgical. Nonsurgical methods are tried first before resorting to surgery.

Steroid injections into the keloid to control growth and inflammation
Moisturization to keep it soft and avoid dryness and cracking and bleeding
Freezing the tissue (cryotherapy) to freeze the growth can help in further increase in the size of the tissue
Laser to remove the tissue, especially if it is small. Alternately, this could be used as a secondary measure after the keloid is excised to prevent further growth
Radiation therapy to shrink the growth
Surgical excision, where the keloid is quite visible or large. This could be followed by radiation or laser to prevent further growth.
Also, in people who are prone to develop keloids, surgical incisions can be treated for a longer time with pressure dressings and silicone pads.

Keloids - Know About Its Treatment!

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

What are Stretch Marks? - Stretch marks are the off-coloured stripes or streaks formed on the skin as a result of swift stretching of skin or weight changes. They mainly appear on abdomen due to pregnancy or obesity. They are formed due to hormonal changes related to pregnancy, puberty, hormone replacement therapy, etc. Stretch marks can be commonly seen on waist, thighs, lower backs, hips, breasts, arms, and buttocks.

How are these stretch marks formed? - The skin of the human body consists of three main layers ? 1) Epidermis (the outer layer), 2) Dermis (the middle layer), and 3) Hypodermic (the deepest and third layer)

When the connective tissue is stretched due to the expansion and contraction of skin, the stretch marks starts developing on the dermis or the middle layer of the skin. With the stretch in skin, the collagen gets weak, and the elastin fibres start tearing. Due to this, its normal production cycle gets damaged or interrupted. This results in the formation of fine scars under the epidermis or the top layer of the skin. Initially, they appear red or pink, but gradually, they turned into thin silvery line.

Causes - Stretch marks are not a disease, which infects the human body, but are the scars formed due to contraction and expansion of skin. They are basically caused by stretching of the skin. Their appearance depends on the type of skin. These ugly stretch marks are caused due to:

- The physical stretching of the skin at the end of pregnancy.
- Extraordinary weight gain, specially on arms, thighs, etc.
- Use of certain medications, including lotions, pills, Corticosteroid creams, and steroids.
- Genetic disorders
- Muscle building
- Hormonal changes during puberty
- Heredity 

Symptoms - What are the signs of stretch marks? No one would ever like to have stretch marks on their skin. They commonly appear on the places where a large amount of fats is deposited. Some of the symptoms which help to recognize the development of stretch marks are as follows:

- The skin becomes pink, flattened and thin before the development of stretch marks.
- Development of red, pink, or purple lines on the skin.
- Affected area becomes soft in touch.
- At the initial phase, these lines appear wrinkly and somewhat raised.
- With the passage of time, these lines convert into silver or white in colour.
- They may also appear in patches of parallel lines.
- They appear as scar. 

Home Remedies for Stretch Marks - It is natural that every woman will develop stretch marks at some point of time in her life. Although they are natural, but have truly ugly looks. Here are some quick home remedies for stretch marks, which will undoubtedly reduce or remove the scars from the affected area.

1) Honey - Honey is the best natural moisturizer. Skin gets extra hydrated and supple when honey is used as a lotion.

2) Lemon Juice - Lemon juice is other easy treatment for stretch marks. The acid present in lemon juice helps in reducing stretch marks, acne, skin injuries, and scars. Take out juice from some lemons. Massage it gently for 10 minutes in a circular motion on the stretch marks. Clean the affected area with warm water.

3) Carrot Puree - Mash some soft steamed carrots and make a paste, apply to stretch marks and let it sit for as long as possible then rinse with lukewarm water. (Caution: In lighter skin tones it may temporarily turn you orange)

4) Aloe Vera - Aloe vera is considered to be the most effective homeopathic remedy for stretch marks and various other skin problems. It is known for its healing and soothing properties. Apply aloe vera directly on the stretch marks. After a few minutes, clean it with lukewarm water.

5) Egg Whites - To get rid of stretch marks, egg whites are beneficial as they are rich in proteins and amino acid. Extract whites of two eggs. Whip it with the help of a fork. After washing the affected area with clean water, apply a thick layer of egg whites with the help of a brush. Let it dry completely and wash it off with cold water. After this, apply some olive oil to moisturize the skin. For two weeks, continue the process daily for better results.

6) Essential Oils - They contain moisturizing properties because of their viscosity. Oregano oil, grape seed oil, and sage oil have amazing antioxidant properties. Castor oil and jojoba oil can lighten dark spots.

If you have any more questions on this topic, click on consult privately to ask me.

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.

6 Most Effective Home Remedies To Fight Stretch Marks

If sunburn is taking the mickey out of your fun time in the sun or your summer vacation, then you may want to read this article or pin it up where you can see it every day. Sunburn is something that does not show up immediately. It can happen when you have been in the sun for too long a time, and without the protection of proper clothing, hats, glares and sunscreen lotions. So what can you do when you feel that first sting of sunburn? here's our list!

Swift action: you will need to act fast towards cooling down the onset of a sunburn. Taking a quick dip in a pool or a lake if you are near one can help in soothing the area so that the sunburn is not too bad. Also, you can then cover yourself up and step indoors immediately, where you will be properly shaded from the sun. You can continue with the cool treatment by using a cold or ice compress to press around the area that is burning or has been most affected. Remember to stay away from the exact spot as it may lead to inflammation.

Avoid drying: do not let the area become too dry. Take frequent showers but stay away from harsh soaps as they may make the area dry which leads to chapping and pain.

Breathe: allow the skin to breathe. Do not obstruct the area with too many items of clothing and wear cotton fabric or other light weight clothing that will protect the area and let the skin breathe. Stay away from tight clothes as this may lead to chafing of the skin and the sunburns.

Moisturise: one good way of getting rid of sunburns quickly is to moisturise as soon as you have had a bath or a shower. This will help in locking in moisture which is not really possible when you moisturise the surface later. Use a gentle lotion or cream based moisturiser and stay away from products that contain petroleum gel as this may irritate the skin further and clog the area instead of getting absorbed into the skin.

Inflammation: tackle inflammation by taking corticosteroids or other anti inflammatory drugs. These should be prescribed by a doctor. Aloe vera can also be used to soothe the inflammation.

Hydrate: drink plenty of fluids for fast regeneration of the skin cells and so that the burns do not draw the fluid from the surface if the skin.

Take all the necessary precautions before you step out for some fun in the sun with proper sunscreen and protective clothing as well!

Feeling the Sting of Sunburn? These Tips Can Help!

"While the reasons of those embarassing whilte flakes on your shirt range from dry weather, hormonal imbalance, imperfect diet to stress or health conditions. Here are some handpicked methods that work best, to get rid of Danduff-
1. Regular hair wash, preferebly with an antidandruff shampoo with gentle head massage and cold water
2. Adopt diet rich in Zinc and Vitamin B. Try cold-water fish, flax seeds, walnuts, eggs and leafy green vegies.
3. Easy home remedies like tea tree oil, lemon, green tea, curd etc help immensely in the treatment of dandruff.
4. Hair styling products can aggravate the problem of dandruff. Avoid use of hair styling gel or spray.
"

5 ways to dust off Dandruff

A little bit of sun is always good for you and you do need sunlight for your body to process vitamin D, which is necessary for bone health. At the same time, the ultraviolet rays from the sun can be detrimental for your health. While being in the sun is not a bad thing, how long you stay in the sun and how well you are protecting yourself count. Prolonged and unprotected sun exposure harms your skin and can decrease the immunity function of the skin.

Some effects of sun exposure include:

Development of cancerous and non-cancerous skin lesions
Benign tumours
Coarse and fine wrinkles
Freckles
Mottled pigmentation (Skin discoloration in certain areas)
Sallowness (The colour of the skin turns yellow)
Telangiectasia (Expansion of blood vessels under your skin)
Elastosis (Destruction of the collagen and elastic tissue)

The most harmful effect of sun exposure is definitely skin cancer. It is the uncontrolled development of anomalous skin cells is skin cancer. This accelerated development leads to formation of tumours, which are either malignant (cancerous) or benign (noncancerous). Skin cancer is mainly of 3 types: basal cell carcinoma, melanoma and squamous cell carcinoma. Among these, squamous cell and basal cell carcinoma are less critical; while melanoma is very serious. When melanoma is left untreated, it can affect the other organs and get difficult to treat. UV rays are the major causes of skin cancer. Sun exposure over the years leads to squamous cell and basal cell carcinoma, while severe sun damage episodes before the age of 18 cause melanoma.

Here are some tips to prevent sun damage:

Always apply sunscreen 20 minutes before you go out, even if it is cloudy. A sunscreen with SPF of 30 or more, and zinc oxide is advisable if you want optimum sun protection. Also, you should reapply sunscreen every 2 hours, especially if you are swimming or sweating.
Select cosmetic products, contact lenses and clothing that offer protection from UV rays.
Choose sunglasses that offer total protection from UV rays. Also, wear a hat with a wide brim to shade your neck and face.
Avoid direct exposure during harsh hours like between 10.00 and 3.00PM.

Prolonged Sun Exposure - How It Can Damage Your Skin?

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