Dr. Ajit Singh

Cutaneous vascular lesions are the most common birthmarks found in children. Flat vascular lesions have a tendency to persist, but raised vascular lesions, called hemangiomas may involute gradually. They are the result of several or huge vessels that are formed underneath the skin and can lead to complications like pain, bleeding, cosmesis or disfigurement. It is necessary to seek treatment for both medical and cosmetic reasons.

Cutaneous vascular malformations are best treated by laser surgery and it is effective sometimes for cosmetic reasons. Hemangiomas may need surgery for residual lesions after involution of the lesion. Use of laser surgery, successfully can help in eliminating certain targets (chromophores) within your skin by putting into use the beam of requisite wavelength, energy setting and pulse duration. Initially these caused serious side-effects like scarring of the skin or permanent dyspigmentation but after the development of photothermolysis technique, the side effects were less seen.

Things to keep in mind before lesion treatment:
The main forms of treatment include laser therapy. Surgery is less used at present as it poses the risk for hemorrhage. The patient should be aware of a few things before going through the treatment procedures.

1. Cutaneous vascular malformations are best treated by laser surgery can be effective sometimes for cosmetic reasons hemangiomas may need surgery for residual lesions after involution of the lesion.
2. Laser therapy can treat vascular lesions, such as telangiectasias or spider veins, port wine stain, birthmarks and strawberry hemangiomas. The laser is safer and more effective because it proves to be useful in treating the blood vessels of a lesion without affecting the surrounding tissues.
3. The patient may experience temporary discoloration of the skin surrounding the treatment site. This blue green discoloration is known as purpura and it usually fades within a week.
4. The laser therapy is more effective in case of people who have a lighter skin color. In case of heavily tanned or deeply pigmented skin, the laser light may not be able to reach the surface of the lesion.
5. A topical antibiotic in the form of an ointment or cream may be required by some patients after the treatment.

Premature ejaculation or early ejaculation is the expelling of semen with minimum sexual stimulation, almost immediately after (or sometimes before) sexual penetration. This is a common sexual problem for men below the age of 45 in addition to erectile dysfunction. Premature ejaculation can be a result of several physical and psychological factors.
 
If the root cause is not serious, the problem can be solved by a few simple techniques, such as: 

1. Breathing exercises: Relaxation techniques like breathing exercises and meditative practices can help you to concentrate. It also moderates the tension and stress levels which are directly related to arousal. Avoid short and rapid breaths as they can put undue pressure on the heart and increase the pulse rate. This often results in early ejaculation. On the other hand, if you take deep breaths and practice holding them in for three to five seconds, you can also use the technique during arousal.
2. Kegel exercises: Kegel exercises can help both men and women with their sexual problems. In men, these help to strengthen the pubococcygeus muscle by repeated contraction and relaxation. The pubococcygeus muscle helps to control urination too. If you use the same technique when you are close to an orgasm, you can delay your ejaculation. 
3. Squeeze technique: This technique is used to reduce excessive and rapid rate of arousal. When you are close to orgasm, you can squeeze the base of the penis to curb the erection somewhat so that it can build up again. This will automatically delay ejaculation. It is a good idea to practice this technique on your own first and then try it with your partner.
4. Stop and start exercise: This exercise was perfected by the Masters and Johnson team of sexual research. This technique is also to be practiced individually for the first few times. You can masturbate alone and stop just before reaching the climax. You can practice this again and again by bringing yourself closer to ejaculation every time until the point you cannot control or regulate the process any more. This will help you to know the limit till which you can stop and regulate the ejaculation process. You can then use this technique during sexual activity with your partner. 
5. Reduce stress: The stress hormones in your body prevent the secretion of testosterone which is responsible for your sex drive. Alcohol, tobacco or nicotine and other illegal drugs used to combat stress can also have an adverse effect on your sexual arousal and cause premature ejaculation.