If you see continual and long-term white patches of depigmentation on your skin, it could be vitiligo. Vitiligo is a condition that appears when melanocytes in your skin are no more alive. This bunch of cells is responsible for producing the melanin pigment that endows the skin with its colour as well as protects it from the harmful UV rays. The area which may be affected by this dermatological disease varies from person to person, and it can also affect the hair, mouth and eyes as well. In most cases, the vitiligo affected area stays discoloured for the rest of the patient s life.

Various types of vitiligo and their symptoms
Scientists have classified vitiligo into two types: segmental and non-segmental. The non-segmental vitiligo is the most common variant and 90 percent of vitiligo affected patients suffer from this kind of disorder. In this disease, the patches take place with little symmetry on both sides of the body. It can be further broken down into 5 sub-divisions.

Generalised vitiligo: It can occur at any part of the body without any rules, and this is by far the most common type.
Acrofacial vitiligo: It is mostly seen on the toes and fingers.
Mucosal vitiligo: In this condition, the discolouration normally takes place around the lips and mucous membranes.
Universal vitiligo: This is the rarest type of vitiligo where the whole body is covered in white patches.
Focal vitiligo: This is most commonly found in children. The children have white and scattered patches across the body.
Possible treatments for vitiligo

Though there are no treatments possible that will re-pigment your skin to its original colour, there are several remedies that aid in decreasing the visibility of white patches on the affected areas of the skin. Some of them include:

Phototherapy with UVB radiation: This is a common form of treatment where the affected area is exposed to UVB radiation and can be performed at home too. If you have large white spots across the body, it is important to have the treatment performed by an expert at any healthcare centre.
Phototherapy with UVA radiation: In this treatment, a drug is first administered for increasing skin s sensitivity to this radiation. Then the affected area of the skin is exposed to high doses of UVA radiation.
Skin camouflage: In mild cases of vitiligo, cosmetic creams and make-up can be used to camouflage the affected area. It can last for about 12- 18 hours when applied in proper techniques.
In case you are suffering from vitiligo, it is crucial to speak with an expert and opt for the best means to curb down the impact of vitiligo.

Vitiligo - Signs You Are Suffering From It!

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?

Corns are small circular patches of thick, hardened skin that generally develop on the toes or soles of feet. They may occur anywhere else on the body. They might be caused due to friction and pressure which may occur, if you wear poorly fitted shoes or as a symptom of some other conditions such as bunions (big toe bent towards other toes) or hammer toe (toe bent at the middle joint).

Corns, especially on feet will not get cured unless its root cause is treated. If left untreated, the skin becomes thicker and more painful. Cures for corns will depend on the cause or nature of the corn. Here are some effective ways to treat most types of corns.

1. Removal of hard skin: A dermatologist can help remove the thickened skin with a scalpel, which will relieve the pressure on the affected tissue.

2. Products that treat corns: Some foot care products are specially designed to allow your skin heal and to redistribute the excess pressure that is causing the corn. These may be prescribed by your dermatologist for quick healing of your corns. Some of these products include:
a. Rehydration creams that soften thickened skin
b. Soft padding or foam insoles that can be inserted into shoes
c. Corn plasters that provide protection
d. Small foam wedges which can be placed between toes to cure soft corns
e. Special silicone wedges that change the position of your toes and help in redistribution of pressure.

3. Salicylic acid: Salicyclic acid, contained in several over-the-counter products is helpful in softening the first layer of dead skin, thereby facilitating its removal. Products containing salicylic acid should not be used if you suffer from conditions that cause circulation problems, such as diabetes, peripheral neuropathy or arterial disease. If you have cracked or broken skin in the area of the corn or sensitive skin, salicyclic acid is not suitable for you either.

You can prevent corns by practising proper foot care, as your feet carry the weight of the entire body and are very susceptible to problems. Using a pumice stone regularly to rub away hard, dead skin is a good way to prevent corns and bacteria. Wearing properly fitted shoes is a must to prevent corns. If you wear heels very often, they may put excessive pressure on your feet. If you suffer from diabetes or other diseases causing circulation problems, do consult a doctor as corns and infections in the feet can lead to more severe infections.

How to Treat Corns on the Skin

Eczema is a skin condition which is characterized by rough, cracked, red, itchy and inflamed skin. Sometimes it can also cause blisters. Eczema is also known as atopic dermatitis. It is a severe condition which starts during infancy and can go on throughout childhood. While some people may outgrow this condition, the rest might have it till adulthood.

Causes of Eczema:
1. Irritants- Certain irritants found in vegetables, meats, juices extracted from fresh fruits, disinfectants, shampoos, detergents and soaps can cause eczema.
2. Allergens- Dandruff, mold, pollens, pets and dust mites can also contribute to Eczema.
3. Microbes- Certain bacteria such as Staphylococcus Aureus, fungi and viruses can also cause eczema
4. Food products- Many people are allergic to food products such as wheat, soy products, seeds, nuts, eggs and dairy products. This might contribute to Eczema.
5. Stress- This doesn t cause eczema but can aggravate the symptoms of it.
6. Hormones- Women usually experience worsening of Eczema during certain stages of their menstrual cycle or during pregnancy.

Symptoms of eczema in infants and children:
1. Rashes appearing on the cheeks and scalp
2. Rashes which bubble up before fluid discharge
3. Rashes which cause itchiness and lead to disturbed sleeping; continuous scratching and rubbing can result in skin infections
4. Rashes which can appear behind the creases of the knees and the elbows; these rashes are also common on the legs, creases of the buttocks, ankles, wrists and neck.

Symptoms of Eczema in adults:
1. Rashes on the nape of the neck
2. Rashes on the eyes, face and neck
3. Rashes that can cause extremely dry skin
4. Extreme discomfort caused due to itching
5. Scaly skin caused due to rashes
6. Rashes which can result in skin infections
7. Lichenification, a condition wherein the rashes thicken and develop knots, is also a possibility.

How is Eczema treated?
1. Topical ointments and corticosteroid creams- These are anti-inflammatory medications which relieve symptoms of eczema such as itchiness and skin inflammation.
2. Antibiotics- These are usually prescribed if there is any underlying bacterial skin infection.
3. Antihistamines- These mainly reduce scratching at night. In some cases, it can also cause drowsiness.
4. Topical calcineurin inhibitors- This is a drug that suppresses activities of the immune system. It helps to prevent flare-ups and decrease inflammation.
5. Barrier repair moisturizers- These types of moisturizers repair the skin and reduce water loss from the skin.

Eczema - 5 Ways It Can Be Treated!

How To Get Rid Of Pimples Using Home Remedies

Pimples are very annoying, especially when they are on your cheeks because then they do twice the damage - hurt your skin and at the same time they also steal away the charm of your looks. Although there are many lotions and creams in the markets that guarantee the removal of this skin inflammation, they are chemicals that eventually start showing its side-effects on your skin. For this reason, a few home remedies with some simple pimple-combating tools work the best and here are some of them:

Use ice cubes and crushed ice to reduce the redness and the heat in the inflammation. Applying ice over the pimples eventually makes them reduce in size and disappear altogether.

Soak a little piece of cotton or rag in fresh lemon juice and apply it over a pimple. Lemon helps a pimple dry up faster.

Soak a rag of cotton in tea tree oil and put it over a pimple. It has anti-bacterial properties which help fight against acne pimples. For even better results, you can also try mixing tea tree oil in aloe vera gel. You can put this mixture on your acne pimples and rinse it after 20 minutes for effective healing.

White toothpaste can work wonderfully with a pimple and reduce it to nothing in a very little time.

Steaming is another foolproof way to get rid of the pimples in the most natural manner. If you expose the pimples to steam, the steam works its way through the pimples and cleans out all the bacteria. It thus helps your skin to breathe and get in contact with oxygen. This ultimately makes a pimple ripen quickly and thus leads to its deterioration.

Use garlic to get rid of pimples. How? Garlic is an antiviral, antifungal, antiseptic and antioxidant agent which is why it is a very good remedy for pimples. Cut a small piece of garlic and rub it over your pimples. After several minutes wash your face with lukewarm water.

Honey is another natural antibiotic that can accelerate the removal of pimples by effective healing. The catch here is to apply honey directly over the affected area. Keep it for several minutes and then wash it off with lukewarm water. Mixing honey and cinnamon and applying its paste on the affected area is also a very dead-sure manner of getting rid of pimples.

Grind a cucumber to make a face mask and allow it to dry. Then wash your face after several minutes. This cleans up the dirt and bacteria in the pimples.

Next time you get those unwanted pimples, you know what to do!

Natural Home Remedies to Get Rid of Pimples Overnight Fast!

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.

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