HIRSUTISM

(Constitutional or male pattern hirsutism)

Hirsutism is the medical term for excessive hair, or hairness, particularly in women.
When a women grows hair on her face, trunk, and limbs that is similar to a man's, the condition is called male-pattern HIRSUTISM .
Humans appear to be fairly hairless, but in reality we have as many hair follicles as apes (monkeys). However most human follicles produce vellus hair, which is colorless and fine. Some vellus hair, though, is converted into the coarser, more visible terminal hair during puberty, when testosterone stimulates its growth.
Males produce more testosterone than females, thus men normally have more visible facial and body hair.
Excessive hair growth doesn't always signal a medical problem. it may be seen instead as constitutional hirsutism, or hair growth that is normal for person's age or racial and ethnic heritage.
Women of Mediterranean and near Eastern ancestry, for example, have more visible hair than their North European counterparts. Caucasians have more hair than Africans; and both Asians and Native Americans have less than other peoples.
Following menopause, women normally grow more facial hair, but the sudden development of male-pattern hirsutism in a younger women often indicates an imbalance of sex hormones, especially if there are other signs of virilization, such as a deepening of the voice and increased muscle growth.
Porphyria, a genetic disease marked by extreme sun sensitivity, can cause hirsutism, as can tumors of the ovaries or adrenal glands. If a cause cannot be identified the condition is called idiopathic hirsutism.

In both sexes, hirsutism may develop from certain medications; these include prednisone and other corticosteroids; phenytoin, an anti convulsant medication; and minoxidil, an anti hypertensive (used for high blood pressure) agent.

Medical Treatment:
When constitutional hirsutism is the problem, no medical treatment is required. Treatment of male pattern hirsutism depends upon the underlying cause. if there is excessive production of testosterone, spironolactone (Aldolactone) may be prescribed to block it.
Surgery may be necessary if a hormone producing tumor is present. When surgery is not possible, it may be destroyed by radiation therapy.

ALTERNATE THERAPIES
Electrolysis:
                 This is the only permanent method of hair removal. it is a time-consuming procedure that requires a skilled operator, known as the electrologist. Each hair is removed by the insertion of a fine probe into the hair follicle. An electrical current of low voltage passes through the probe and destroys the hair root.

Nutrition Therapy:
                               If obesity is contributing to a hormone imbalance that is causing excessive hair growth, a qualified nutritionist can devise a long term weight loss program.

Self Treatment:
There are numerous ways to remove unwanted hair temporarily or to make it less noticeable.

Bleaching:
                 This makes hair less visible . use a commercial product or make your own.
Method:

• One ounce of 6% hydrogen peroxide
• 10% of house hold Ammonia
• Enough baking soda to make a paste

Before using the mixture, do a small patch test on the inside of your wrist.

Depilatories:
These chemicals dissolve hair into a gelatinous mass that can be removed with a washcloth. Do a patch test and follow instructions carefully.

 Plucking:
This is a quick way to remove small amounts of body hair temporarily. Use care, however, as plucking can injure follicles and trigger infections, especially on the face.

Shaving:
This is the quickest way and most widely used method for removing hair from the underarms and legs. Although men regularly shave their faces, women hesitate to do so, as they mistakenly think that shaving will stimulate the growth of their hair. It only appears to, because all of the shaved hair grows back at the same time.

Waxing:
Warm melted wax is applied to the skin, allowed to cool, and then peeled off, taking with it any embedded hairs. Wax treatments are available in salons and there are also wax products for home use.

Other Causes Of Hairiness:
Thyroid disease, ovarian cysts, and pituitary tumors are among the endocrine disorders that can cause excessive hairiness.

Heat Rash (Miliaria; prickly heat)

Heat rash or prickly heat consists of clusters of tiny blisters filled with perspiration. It forms when pores become blocked and prevent the sweat glands from releasing perspiration, or when heat and humidity exceed the ability of the sweet glands to cool the body. The rash itches but doesn't become inflamed. It usually develops in the armpits and groin, and sometimes also on the chest, waist and back.

Babies are especially vulnerable because their ability to sweat is not fully developed, and because they often wear or lie on water proof materials, which intensify the effects of heat.
A similar rash, caused by sensitivity to ultraviolet light, may accompany prickly heat or occur independently. Referred to as a polymorphic light eruption, it produces itchy red spots within 24 to 48 hours of exposure to the sun. The rash appears mostly on the body, rarely on the face. Although children sometimes develop the rash, it is more common in young adults.

Medical Treatment:
A doctor may advise applying an over-the-counter cortisone lotion or cream 2-3 times daily. He may prescribe anti-histamines for severe itching or an anti-fungal medication containing cortisone, such as clotrimazole and betamethasone dipropionate (Lotrisone), if a secondary fungal infection has developed. A severe polymorphic light rash may require treatment with an oral steroid drug, such as prednisone.

Alternative Therapies:
Remedies that alleviate itching and cool the skin usually work well.

Herbal Medicines:
Herbalists often recommend adding thyme tea to bath water. Thyme contains thymol, an antiseptic substance that eases itching. 

Hydrotherapy:
Soaking in a cool bath is a soothing remedy. Don't apply soap to the rash. Instead, add 1 cup of oatmeal (Jo ka aata), cup of baking soda, 2 cups of apple cider vinegar, or 2 cups of laundry starch to the bath water. (A word of caution: Bathe a baby only in plain water). Soaking in a whirlpool bath of cool water is also helpful. alternatively, take one or two cool showers a day.
After bathing, gently pat the skin dry rather than rubbing it, then dust the affected areas lightly with cornstarch or baby powder. Don't apply moisturizing creams and lotions or use bath oil.
These products may further clog pores.

Self Treatment:
You can usually prevent heat rash by staying out of the sun and heat as much as possible, using air conditioning whenever available, and wearing light weight, loose-fitting, cotton garments. If a rash does develop, calamine lotion may ease the itching. Don't scratch.
Expose the effected areas to the air when you can. Avoid strenuous exercise or any activity that causing sweating.
When a baby has heat rash, change dipers as soon as they are wet; then pat the skin dry and apply a dusting of cornstarch. Avoid laying an infant on a plastic-covered mattress or pad; instead, use a cotton sheet or towel.

Chickenpox (Varicella)

Chickenpox is highly contagious childhood disease. About 95% of all children have been infected with it before adolescence, most commonly between ages 3 to 9.
This disease is caused by the varicella zoster virus, which is transmitted by direct contact with an infected patient. It is contagious a day or two before its characteristics itchy rashes appear, so a child may catch it from another before signs of infection are apparent. Clusters of small and bumps progress to blisters and scabs within 24hrs, but new clusters continue forming four hours or five days. The disease remains contagious until the final crop of blisters forms scabs.
The virus then becomes dormant in the body, but my reappear yrs later as shingles. A person who lacks immunity to the varicella virus can contract chickenpox if exposed to someone with a shingles rash.

Medical Treatments:
A pediatrician's care is usually not required, unless the patient has a weak immunity system or develops severe complications.

(to be continued)

TIPS TO REDUCE FOOT ODOR

• Wear shoes made up of natural materials, such as, leather and cotton canvas that allows air to circulate.
• Don't wear the same shoes, especially sneakers, everyday; give them a chance to air out. It also helps to dust them with deodorant or foot powder.
• In hot weather, choose open shoes which enables air to circulate.
• Wear white cotton socks with sneakers.
• After exercising, bathe feet with warm water and soap, dry them thoroughly, and change into dry socks and different shoes.

BRUISES

(Contusion; hematoma)
A bruise develops when blood escapes from damaged blood vessels into the surrounding tissue under the skin, usually as the result of a blow directly to the injured area. The expectaion is a black eye, which may result from a hit at the temple or forehead, as well as on the eye itself.
This happens because the blood follows a gravitational path. Bruised tissues under and around the eye are likely to swell, in some cases causing the eye to shut.
Although the skin over a bruise remains unbroken, it quickly becomes discolored, turning reddish initially, then black and blue or purple, and finally yellow or pale green, as damaged blood cells die and are reabsorbed into the blood stream.

The extent of a bruise is self-limiting, because nearby undamaged vessels contract and restrict any further blood flow to that area. Meanwhile, blood platelets collect and activate the clotting mechanism that closes off the break. Unless more serious injuries are present, most bruises will heal themselves in a week to 10 days.

TREATMENT:
there are no medical treatment for bruises as such, simple bruises are self healing. Other treatments are intake of Aspirin as it act as painkiller as well as known to disrupt the blood clotting mechanism.

HERBAL THERAPY:
Application of poultice made from the leaves of comfrey steeped in boiling water. This mixture should be cooled and applied between gauze layers to the bruises area. Key ingredient is Allantoin.
Others are, tincture of Arnica etc.

SUN BURN

Overexposure to the sun is by far the leading cause of skin damage, with consequences ranging from mild sunburn to premature aging and even skin cancer.

Most sunburns are classified as,
-First degree
-Second degree &
-Third degree

first degree are limited to the epidermis, second degree extends to the dermis and third degree will damage both layers of skin, underlying nerves and subcutaneous tissue, are rare.
They occur manly in babies and newly born. Damage depends upon intesity of ultra violet rays.

UV radiation has two components:
-The shorter UVB rays, which are responsible for most burns &
-Longer UVA rays, which are involved more in sun-tanning
both causes skin damage as well as promote skin cancer

over exposure to UV rays also encourages actinic keratoses; these are scaly lesions that may be pre-cancerous.

The tanning process is the body's way of protecting the skin from the sun's damage. Pigment producing cells send an increasing amount of melanin to the skin's surface to block the harmful incoming rays. Thus fair-skinned, blue eyed people who do not readily tan are the most vulnerable to sunburn.
Those with dark skin are also susceptible, but their heavier layer of melanin helps protect them against sunburn.

BALDNESS

Baldness involves the complete or partial loss of hair, usually from scalp, but sometimes other places as well. Normally, we shed 50 to 100 hairs per day as a part of natural growth, resting and renewal process. When a hair is in the resting stage, it loosens gradually from it's root and is shed. A few months later, a new hair begins to grow in its place.
With aging, it is normal for hair to thin in women and men. But many men experience more extensive hair loss due to hereditary condition called male pattern baldness, or androgenic alopecia, which can occur anytime after the teen years. Typically, it begins with a slow thinning of hair

TREATMENT:

Drug Therapy:
Hair loss due to male pattern baldness may be treated with MINOXIDIL, A reformulation of a blood pressure medication that causes excessive growth of a scalp, and body hair in side effect. It is now prescribed as a topical lotion which is applied daily on scalp.
It takes several months to show the results, and only about 1/3 of men experience significant hair re-growth. The new hair ll be finer and thinner than normal, and the drug must be used continously to show great results.
Alopecia areata can sometimes be halted by applying a topical STEROID or injecting it into the scalp to lower the immune system attack on hair follicles.

PLASTIC SURGERY:
Two procedures are now available. The oldest is HAIR TRANSPLANTATION, in which small circles, or plugs, of skin containing healthy hair follicles are transplanted from the back and sides of the head to the balding site. If plugs take, they continue to grow hair. Surgery is usually done in stages, but sometimes entire strips of skin with hair can be moved.
The second approach is scalp reduction, in which a surgeon removes an oval-shaped piece of scalp from the top of the head, then pulls the part of the scalp that still contains hair upward to fill in the missing piece.

HERBAL TREATMENT:
Balding process can be treated by rubbing an onion juice on the scalp and then exposing it under sun.


MEASURES FOR REDUCING BALDNESS:
Never brush your wet hair
comb gently by using a large tooth comb
always use a mild shampoo
use warm water, never hot
rinse with cool water
avoid gels, sprays
avoid perming, blow dry, colouring

OTHER CAUSES OF HAIR LOSS:
diseases that often produce hair loss include lupus, thyroid insufficiency, and scleroderma, a hardening of the skin.
A high fever, radiation exposure, and certain drugs, especially cancer chemotherapy, also produce hair loss.

RADIATIONS & BIRTH DEFECTS:

X-Ray and other forms of ionizing radiations are especially harmful to a developing fetus; they can cause severe birth defects or even fetal death. Any women who is pregnant, or who may be pregnant without knowing it, shouldn't be X-Rayed. If an X-Ray is absolutely necessary, a protective lead shield should be used to cover the fetus. Even before conception, radiation can cause birth defects by damaging the father's sperms or the mother's eggs. With time, a man's ability to produce a healthy sperm usually returns. But a women doesn't make new eggs; she is born with her lifetime supply. Fortunately, surgical techniques now allow the ovaries to be moved out of the field of exposure during radiation therapy, and later returned to their normal position.

DANDRUFF

DANDRUFF (Pityriasis simplex):
is a form of seborrheic dermatitis, an inflammatory condition in which dead scalp cells flake off, leaving telltale signs on the shoulder and clothing. More severe cases also effect the skin around the nose, behind the ears, or in the armpits or delicate areas.
The flaking is thought to be caused by scalp cells that are aging too rapidly. Normally, dead skin cells are shed from the scalp during routine hair care. But when the normal growth pattern is altered, and excessive dead cells reach the scalp's surface simultaneously, they stick together n fall off in flakes. However, some researchers dispute this view and argue that a yeast called PITYROSPORUM OVALE is responsible. Whatever the cause, dandruff doesn't lead to permanant hair loss/baldness.

TREATMENTS OF DANDRUFF:

Ordinary dandruff doesn't need medical treatment, but severe cases may require a medicated shampo (selsun blue by Abbott)
other therapies are,

Aromatherapy:
Practitionets recommend bathing the effected areas three times a week with a 2% essence of Geranium in a distilled water base. Another remedy calls for massaging a 10% sage essence in an olive oil base into the effected areas, then waiting 2hrs before washing out the mixture. This procedure should be followed twice a week.

Herbal Medicines:
Aloe vera has skin softening properties that can help alleviate dandruff. It is most effective when a freshly cut leaf is rubbed directly onto the affected area. Applying Eucalyptus oil to the scalp is advocated by some herbalists.

Massage:
Although this therapy cannot cure dandruff, its a time honored method for reducing the stress that may be an underlying cause. Reflexology, or foot massage, is alsi said to be effective.

Relaxation Therapies:
All forms of medication, including yoga, may help relieve a dandruff condition that is related to excessive stress. An increase in exercise may have a similar effect.

Self Treatment:
-If your hair is oily, treat dandruff by brushing thoroughly and then washing with a shampoo for oily hair. Follow this with a dandruff shampoo that contains sulfur, such as Sebulex, Sebutone or Selsun Blue to remove dead scalp cells and reduce the output of oil glands.
Next, apply a lemon rinse,
[METHOD: made with the strained juice of one lemon in a cup of warm water]
pour this on, work it through the scalp, n rinse with cool water. Do not use a conditioner, which may actually compound the oil problem.
Treat ur hair with this program twice a week until the condition is under control. If you shampoo more frequently, use a standard shampoo for oily hair followed by lemon rinse. Blow dry using a cool or warm setting, but avoid letting the hair dry naturally, because lying against the scalp allows wet hair to pick-up oil more quickly. If possible, avoid hair spray as it is a magnet for dirt and oil.

-While using an iron straightner, dryer or conditioner, always avoid reaching roots.

-Treat dry hair and dandruff first with a through brushing, then spread about 1/4 cup of hand and body lotion on the hair and work it into the scalp. Wrap the head with towel that has been soaked in very hot water and wrung out, and leave it in place about 20min. Next, wash the hair with mild dandruff shampoo, such as head & shoulder, clear or Zincon, that contains zinc pyrithione.

-If a dandruff persist then try a coal tar shampoo such as, Denorex or Polytar. After shampooing, always rinse the scalp throughly with warm water.

-If u have normal hair, treat dandruff by brushing, washing with simple shampoo and then applying an aspirin rinse, made by dissolving six aspirin tablets in a cup of warm water. The rinse should be poured over the hair, worked into the scalp, and left on for 15min before rinsing. Once the dandruff disappears, you can return to a normal program of hair care.
-For hair that has been bleached/permed, dandruff should be treated by first brushing, then shampooing with a protein, acid-balanced shampoo. Follow this with a mild dandruff shampoo that contains zinc pyrithione, and then rinse and apply a low-pH conditioner with protein.

ACNE VULGARIS

ACNE: (Acne vulgaris) our most common skin disorder, is characterized by whiteheads, blackheads, pimples, and cysts. Nearly everyone is afflicted at some time in life, but acne is particularly common in teenagers. The hormonal changes of puberty enlarge the skin's Sebaceous glands, increasing their output of an oily substance called sebum. A bulidup of sebum mixed with bacteria, dead skin cells, and other debris clogs pores, leading to one or more forms of acne. Birth control pills are sometime a triggering factor.

TREATMENTS: For mild to moderate acne, treatment typically starts with a 2.5% or 5% strength of BENZOYL PEROXIDE.
Dry agents such as SALICYCLIC ACID, ALCOHOL, & SODIUM THIOSULFATE, may be combined with it or used alone.
A topical antibiotic, ERYTHROMYCIN or CLINDAMYCIN cream is prescribed for persistent acne.
Others are,
TETRACYCLINE, [ TRETINOIN (RETIN-A), ISOTRETINOIN (ACCUTANE) vit-A derivatives]

HOW AN ACNE DEVELOPS:
-In a normal hair folicle, the sebaceous gland produces sebum, which reaches the skin surface through a pore
-An open comedone, or blackhead, forms when sebum combines with skin pigment (not dirt) to block the pore
-A closed comedone, or whitehead, appears when blockage develops below the surface of the skin. Bacteria thrive in this environment, helping to promote acne eruptions.
-As pressure builds, a large, infected cyst can form, resulting in the most severe type of acne.

SELF TREATMENT FOR ACNE:
Always avoid picking or squeezing pimples as this spreads the infection and can cause scarring.
Keep skin clean, but avoid harsh scrubbing and over washing, acne is not caused by dirty skin and you can't wash it away. Cleanse once or twice a day with a mild, unscented soap. If ur skin is very oily, try a drying soap that contains BENZOYL PEROXIDE. Use warm water and ur fingertips (not a wash cloth or scrub brush). Avoid the use of washing granules or other exfoliates, which can worsen acne by increasing skin irritation.
Periodically apply a facial masque of mud, clay (multani matti), basin to help remove oil. Use non-oily water-based makeup and sunscreen.
Diet doesn't cause acne, but in some ppl, certain foods such as those high in iodine may cause it worse (iodated salt). One at a time, eliminate foods you think affect ur acne to see if ur skin improves. Stress also doesn't cause acne but may worsen it; stress reduction techniques such as meditation may be helpfull.

STY (Hordeolum)

(Hordeolum)
A sty develops when a pimple like abscess forms in one or more of the specialized oil glands that line the eye-lid. The term sty (or Stye, as it is some times spelled) derives from the old English word "stigend", which means "to rise" Hordeolum, the medical term for a sty, is Latin for "a small grain of barley", which describes its appearance.
Most sties develop at the base of an eyelash on the outside of eyelid, but some, called internal hordeola, form on the inner edge. Regardless of where they appear, sties are usually caused by Staphylococcal bacteria, organisms that normally live on the skin n in the nasal passages without causing harm..

TREATMENTS: Most sites can be handled with self treatment, but medical care is warranted if a sty fails to rupture or doesn't drain spontaneously after it bursts.
When a sty doesn't burst or drain, it may be opened with a fine tipped lance, allowing a doc to express its contents. To prevent recurrence, an antibiotic ointment/cream may be applied.

Naevus of ota

NAEVUS OF OTA or NAEVUS OF ITO means a bluish grey pigmentation or a big scar of pigment of outer skin..
It's also known as "Congenital melanosis bulbi" "Nevus fuscoceruleus ophthalmomaxillaris" "Oculodermal melanocytosis" and "Oculomucodermal melanocytosis" is a blue or grey hyperpigmentation that occurs on the face.
It was first reported by Dr. M. T. Ota of Japan in 1939 (Wikipedia)
Women are nearly 5 times more likely to be affected than men, and it is rare among white people.
Nevus of Ota may not be congenital, and may appear during puberty.

It mainly appears on either or both cheeks, forehead, eye lids and similar pigmentation of sclera as well.
It is associated with melanomas of uvea orbit or glaucoma of the same eye..

The most common reason behind this defect is hormonal imbalance at the age of puberty (13-15yrz) mainly thyroid defect which cause increase melanin production at the specified spot..

Therapy is unknown yet.
Hydroquinone preparations can help out in this regard but complete therapy is laser till deep tissues.

Preparations Of Hydroquinone available in Pakistan:
Clariderm (2% and 4% in vanishing cream base)
By: Stifel

Dermopaque (2% and 4% in vanishing cream base)
Dermoquine (2% and 4% in vanishing cream base)
By: Wilson Pharma