Bhatia General Hospital, Mumbai

It is human nature to want to look good and feel good. A young, smiling face that greets you in the mirror can be one of the happiest moments on a given day. However, it is not always the case. With age, the image that looks back leaves a lot to be desired. The wrinkles, fine lines, dark spots, tanning spots, etc. seem to take away a lot of the beauty. However, with these concerns growing, the cosmetic industry has found out ways to mask these and keep that face in the mirror young and happy.

While earlier only celebrities could afford such treatments, now more and more people have access to simple but effective techniques to keep their youthful looks intact.

What is Botox?

It is a control use of a toxin to get desired paralysis the muscle according to three individual patient. In even extremely minor amounts, this toxin can relaxes muscles and this property of it is used to treat facial wrinkles and fine lines. This was accidentally discovered but is now one of the most widely used techniques in cosmetic surgery.

How does it work?

The nerves send messages to the muscles to contract or relax through neurotransmitters. Acetylcholine is one such neurotransmitter and sends signals to the skin from the nerves. Botox acts by preventing the release of this chemical. The result is that the muscle does not receive a signal to contract. The end result is reduced wrinkles and fine lines.

Uses: The forehead and corners of the eyes are the most common areas that are treated with Botox. The wrinkles are often lost and the skin looks younger and firmer. In addition, Botox is also medically approved for use in the following conditions.

1. Blepharospasm (spasm of the eyelids)
2. Lazy eye (strabismus)
3. Chronic migraine headaches
4. Chronic spasms in the neck
5. Overactive bladder (resulting in frequent urination)
6. Spasticity resulting from stroke
7. Excessive sweating
8. Esophageal motility disorders
9. Urinary incontinence
10. Bruxism (tooth grinding)
11. Crow’s feet (outer corner of the eyes)

With Botox gaining popularity, this list of indications is only set to get longer.

Precautions: This is a highly potent toxin and about 2 kg is sufficient to wipe out the entire human race. Therefore, it is very important to use this under the hands of a trained, experienced professional.

Side effects:

1. Mild pain or redness at the injection site
2. Temporary numbness
3. Allergic reaction to toxin (very rare)

These are very transient and disappear over a couple of days’ time, revealing the real benefits of Botox. Set realistic expectations with your surgeon and be ready to look at a younger, happier you.

The biggest organ of the body, skin can also be plagued with diseases and problems unheard of apart from common skin conditions.

Here are some of the rare skin conditions that you must know of:

• Argyria: This skin condition is characterized by blue or gray skin and develops due to ingestion or exposure to a large quantity of silver for a long period of time. This is a permanent skin problem without any known cure as of now. Causes for it can range from working in a sliver mine, developing photographs to consumption of silver supplements for curing a range of health problems such as diabetes, arthritis and so on. Apart from the toxicity caused by the exposure or ingestion of the element, a very common side effect of silver is a change in the color of your skin.
• Dermatographia: A rare skin condition, a person suffering from this tends to have skin that is exceedingly sensitive to light scratches and minor injuries. This happens due to the hypersensitivity of the body's immune system, which reveals itself in the skin. As a consequence it brings about the release of huge quantity of histamine, leading to the dilation of capillaries and formation of swellings when the surface of the skin gets scratched. 
• Harlequin Ichthyosis: Affecting newborns the most, the skin condition sees babies being born with hard and thick plates of skin all over their body. The condition renders newborns with the inability to control fluid and water loss, causing instances of severe dehydration. Newborns with this condition also experience trouble breathing, moving, controlling their body temperature as well as warding off infections. Many experts consider it to be a genetic disorder brought on by the mutation of the abca12 gene, leading to the improper development of the epidermis (outer layers of skin cells).
• Xeroderma Pigmentosum: Over here, the individual is said to be sensitive to uv light, which makes him or her avoid sunlight whether direct or indirect and even florescent illumination. In addition to blisters on the skin and sunburn, symptoms of the condition also include dark and light skin patches. It can also cause your skin to become thin, resulting in the appearance of blood vessels and spots. Development of skin cancer is the final outcome of this skin condition.
• Stevens-Johnson Syndrome: This skin condition brings about the shedding and falling off of not only your skin but even the lining of your internal organs. The skin problem is closely associated with another form of skin disease called toxic epidermal necrolysis (ten). It is usually identified through blisters and painful rashes that develop on the skin surface.

Corns and calluses are areas of stumpy skin caused by friction or pressure. They usually hurt when you wear shoes or walk.

Calluses generally develop on your feet or hands, and most of the time, don’t require treatment.

Corns have a hard or soft inner core. Soft corns are mostly found between the toes, while hard corns form on the top of the toes. Corns that are caused by ill-fitting shoes often reduce on wearing the right shoes.

Causes

Repeated friction or pressure causes corns and calluses on areas of skin. The pressure leads to the death of the skin, which develops a protective, hard surface. Soft corns develop in a similar fashion. Corns and calluses are not formed due to viruses and are not harmful. They can be formed due to:

1. Regular usage of any object that puts strain on the hands, such as sports equipment (badminton racquet) or tools (hammer or gardening hoe), usually leads to calluses on the hands.

2. Pressure from wearing the wrong footwear usually leads to corns and calluses on the feet. Calluses can also form by walking barefoot.

3. Abnormal structures on the foot, such as hammertoe or bone spurs, can cause calluses and corns.

4. Repeated pressure from playing certain sports can also cause calluses on the feet.

Symptoms

Corns and calluses on the feet are easy to spot. A callus is thick, hard and dry, and may appear yellowish or grey in colour. When touched, it will feel bumpy and more insensitive than the skin around it. A hard corn is thick and firm, while soft corns look like an exposed sore. The hard corn may have a grey centre with a light yellow ring around it.

Corns and calluses don’t hurt, but it does become painful when you are wearing shoes or walking. Fitting your feet into shoes gets more difficult due to them. Touching or squeezing the corn or callus can also be painful.

Treatment

Corns and calluses don’t require treatment normally, but if they hurt, here’s what you can do:

1. Wearing well-fitting shoes that are roomy with deep and wide toe boxes (the area covering the toe).

2. Protective paddings, such as moleskin, toe separator, toe sleeves, etc., can alleviate pain.

3. Soaking the corn or callus in hot water, and then gently wear down the dead skin by using a pumice stone.

4. Salicylic acid can be used to soften the corn or callus.

Melasma is a common skin problem where the skin becomes patchy brown, tan, or there is blue grey facial skin discoloration. It is also known as chloasma or mask of pregnancy. It occurs in women during the reproductive years and occurs rarely in men. It is primarily related to external sun exposure, external hormones like birth control pills and internal hormonal changes seen during pregnancy. Women with Melasma have a history of daily or intermittent sun exposure.

• Symptoms of Melasma: Melasma causes patches of discoloration, which are darker than typical skin colour. It occurs symmetrically with matching marks on both sides of face. It normally appears on the upper cheeks, upper lip, forehead and chin. It can also occur on the other areas of one's body which are often exposed to sun. Skin discoloration is not physically harmful, but it can affect the self-confidence of a person. Darker skinned individuals are more at risk as compared to fair skinned individuals. Melasma is associated with oestrogen and progesterone sensitivity, thus it can be triggered by birth control pills, pregnancy and hormone therapy. In few cases, stress and thyroid disease can also cause Melasma. Women taking hormone replacement therapy during menopause are also at high risk of getting Melasma
• Diagnosis of Melasma: A visual exam of the affected area is sufficient to diagnose Melasma. The doctor will perform the wood's lamp examination that uses ultraviolet (UV) light to look at the skin closely. However, the doctor may perform a biopsy to check for any serious skin conditions.
• Treatment of Melasma: When Melasma is caused by pregnancy or birth control pills, it disappears on its own. One can use creams containing hydroquinone or prescribed topical steroids, which can lighten the tone of the affected areas. Other options include chemical peels, dermabrasion and microdermabrasion which will remove the upper layers of skin and help lighten dark patches. In cases of severe Melasma, doctor may suggest laser treatments to remove the dark pigment.

It is quite possible that Melasma will clear up with treatment, there are things one must do to not to aggravate the condition and minimize appearance of the discoloration. These include usage of makeup to cover areas of discoloration, wearing sunscreen daily or wearing a hat with wide brim to provide shade to the face. The patients with Melasma are known to be at a lesser risk for Melanoma. Even if Melasma disappears, it can strike back especially if preventive measures regarding exposure to sun are not followed. Resolution with strict sun avoidance and topical bleaching creams can take sufficient time and patients should expect slow, but gradual lightening.