Saturday, 20 April 2013

Seven most frequently asked questions on Urticaria

Urticaria is one of the most common diagnoses made in my everyday clinical dermatology practice at Bangalore. Most of the patients are distressed and overwhelmed by the very enigmatic nature of this disease. I will be addressing frequently asked questions about this annoying mysterious entity.

Q 1 What is urticaria?
Ans – Spontaneous appearance of  pale red to pink skin swellings known as ‘hives’ is called as urticaria. It may last for less than six weeks (acute form) and chronic if lasting for more than six weeks. It may resolve in few minutes to hours only to reappear at a different site.

Q 2– What are the symptoms and signs of this disease?
Ans – Usually these hives itch or have a stinging sensation.  It may impart pain if the same swellings occur at a deeper level. Some patients may report dizziness, headache, nausea or diarrhea or even shortness of breath although the numbers are low.

Q3-What is the cause of Urticaria?
Ans- The’ Mast cell’ is central to the cause of this condition. It is a resident cell near the nerves and small blood vessels of the skin and releases a chemical known as ‘Histamine’ upon activation. In urticaria the number of these cells is believed to be more due to unknown cause or in some patients, It releases more amount of histamine. Histamine dilates the blood vessels in affected areas causing hives.

Q4- What triggers these cells to release histamine –Can I avoid that?
Ans – Mast cells normally get activated in response to foreign stimuli to the body like bacterial, viral or hepatitis infections, certain drugs , food items or in few chronic cases ‘auto-antibodies’. The latter are the immune cells which very weirdly start acting against own body’s cells. The patients who have increased auto-antibodies tend to have a longer course and sometimes it takes long to tailor their drug treatment.

Q5- How do I know whether I have autoimmune chronic urticaria?
Ans- Although this can only be confirmed by few tests like ASST which is available only in higher research centres , certain clues can be elicited in patient’s history . They may also have a personal or family history of other autoimmune diseases like thyroid, Diabetes mellitus type I or Rheumatoid arthritis. Premenstrual flare in women and exacerbation during menses can be commonly seen. A long course with no response to the conventional treatment therapies is another diagnostic clue.

Q6- What are the things I can avoid to prevent an attack?
Ans- Each patient should maintain a diary of events preceding an attack and it should be discussed at each visit to the doctor. It is difficult to generalize trigger food items but few of them are notorious like non vegetarian , seafood, mushrooms , yam  , jackfruit , avocadoes , cheese and peanuts. Certain infections like sore throat, diarrhea can also trigger along with long standing but yet undiagnosed conditions like thyroid disorders can also be incriminated. Even stress and intense physical exertion are known to be the triggers. But for most of the patients, despite a detailed investigation, we are not able to find the triggering cause.

Q7- In how much time will I get rid of this disease?
Ans – Urticaria is more of an annoying condition rather than a disease. It is difficult to predict the course of disease in all patients although acute urticaria generally resolves in 3 to 4 weeks in 99% of cases. Chronic cases take some time to resolve sometimes few months to years but adequate control can be achieved hence improving the quality of life. It is very important to keep a diary 

Thursday, 18 April 2013

8 Things you must know about sweat!

Come summers and most of the people complain of increased sweating and body odor. This goes without saying that it is not only socially embarrassing but an inconvenience too. Here are a few tips from your dermatologist on skin and hair solutions blog to control the sweat mania this summer.

1) HYDRATE !HYDRATE! HYDRATE! Quench the thirst soon!!  
Drink lots of water to detoxify and allow easy flushing of our body toxins. Our body produces more sweat if it senses less body fluids to keep our skin wet. Coconut water ,mango panna and lime water should replace aerated and frizzy drinks available in the market as the former are healthier and replenish many a lost vital body salts.

2) Why does it Sweat?                                                                                                                          Sweat is produced in human body to regulate the body temperature by its cooling effect via evaporation. Also it releases lot of toxic substances from the system.Most of the times it is not noticeable until the rate exceeds the rate of evaporation which can be affected by climate, stress and levels of activity.

3) What is the source of this sick odor?
Moist warm conditions in the underarms promote bacterial overgrowth which break down the fatty acids in the sweat and produce odor causing organisms. This process is accentuated if Hair are not removed as they cause more bacterial overgrowth.

4) Keep yourself squeaky clean!!!
The role of daily shower with a thorough toweling of the sweat prone areas cannot be overemphasized  Change your sweaty clothes out of your wardrobe and a fresh pair of fabric will definitely allow your skin to breathe.

5) Deodorants or antiperspirants ? Which one for me?                                                      Deodorants only serve to mask the odor while Antiperspirants  reduce odor and decrease sweat too. While the former can be applied to any body part and is classified as cosmetic , the latter are mainly used for underarms and are labelled as drugs.Antiperspirants have aluminium compounds  which react with the skin salts and form gel plugs the sweat glands. They exert a slight astringent effect causing pores to contract.

6)  Are there any side effects?                                                                                                   People with kidney problems and known allergy to preservatives should  definitely avoid the aluminum containing antiperspirants.There are alcohol free products available for people who get burning on application. These products should be of course used only if necessary and if lifestyle changes don't help as a little amount when used over a long time can definitely get absorbed through the skin into your system. Consult your dermatologist for the best product suited for you.

7)  Shall I make any changes in my diet?
Lots of food items especially garlic , onion, pepper and  spicy curries along with non vegetarian items like red meat should be completely avoided as they are removed from the body via sweat.  A plant based diet is AN INTERNAL DEODORIZER .. Chlorophyll and phytonutrients cleanse you from the inside out. Aromatic herbs like sage , rosemary , thyme ,oregano  and parsley , celery and mint are natural treasure of detoxifying agents.

Eat a healthy diet made of whole grains , green leafy vegetables , fresh fruits , soy products , raw nuts and plenty of healthy fluids will supercharge your system and body odor shall be a thing of past....

Monday, 15 April 2013

Hair loss approach explained in This week Bangalore

Dr Divya talks about a scientific approach to dealing with hairloss in the city based tabloid- "This week Bangalore" Sharing a snippet of the interview on skin and hair solutions blog, you can read the entire article by clicking on the following link:

Monday, 8 April 2013

Pityriasis alba- the pale white spots: FAQs

Pityriasis alba:

This condition literally means scaly ( pityriasis)  pale ( alba) patches. This condition presents as pale white patches on face, neck and upper arms. It may present initially with slightly red patches and sometimes have very fine scaling present over them. Most of the patients encountered daily in my practice belong to the age group of 2 to 13 years with males slightly outnumbering females. Frequently asked questions are as follows:

Q – Doctor, What is the cause of this condition?
Ans – This is a very mild form of eczema commonly presenting in growing age of children. Although the exact cause remains unknown, this is more apparent in summers when the surrounding skin tans making these white patches prominent.

Pale white spots of Pityriasis alba
 Q-   Doctor, My child has been suffering from these white patches for quite some time and they seem to migrate as if they disappear at one place only to appear at another?
Ans – These patches have a tendency to recur and hence it is perceived this way.

Q – Is it due to underlying calcium or any other deficiency?
Ans – No it is a form of mild eczema which is not affected by any dietary factors or anything in the external environment.

Q- Will it progress to ‘white patches‘ or leucoderma?
Distinct patches of leucoderma
Ans- Vitiligo or leucoderma is a close differential diagnosis but the patches are totally devoid of pigment or milky white as compared to pale white patches with slightly yellow tinge and mild scaling seen in Pityriasis alba. Also Vitiligo doesn’t disappear without treatment as compared to self healing nature of Pityriasis alba. Consult your dermatologist for confirmation of diagnosis and in case of any confusion. 

Q- Will the normal color return to these patches?
Ans- These patches will regain their normal color in some time , sometimes few months to over an year. They are not permanent in nature but take some time to disappear completely.

Thursday, 4 April 2013

Dandruff- are the flakes freaking you?

Dandruff is one of the most common complaints encountered daily in our clinical practice. People commonly misinterpret it as increased dryness of the scalp skin or increased flakiness which is not only a cause of social embarrassment but also leads to increased  hair loss.

Q What is Dandruff?
Ans  It is an inflammatory condition  of the skin which presents as erythema and greasy scaling in areas which are rich in Sebum( The ‘oil like ‘ thing appearing on face and hair if not washed. Its purpose is to prevent skin and hair from drying and making their surface waterproof)

Q What is the cause of dandruff?
Ans Excess of sebum  in some patients causes overgrowth of fungus known as Malassezia furfur  which is a part of the normal flora This fungus leads to breakdown of sebum into byproducts which activate immunity at the local site causing  flaking of the skin easily mistaken by folks as dryness of skin which is rather a weird reaction

Q What routine practices should we adopt to keep our scalp healthy ?
Ans  a) Keep the scalp  degreased and oil free which entails frequent shampooing and keeping the scalp oil free Regular use of Anti fungal shampoos with Ketoconazole 2% at-least twice or thrice a week is helpful
b) Make sure you apply the shampoo on the scalp skin and not on the hair. Keep the shampoo on for about five minutes and then rinse thoroughly.
It is very important to rinse the hair products thoroughly to prevent a build up which may aggravate the condition.
Do not apply hair oil which increases the fat content hence increasing the Fungal colonization and aggravating the condition . This is in contrary to the popular myth that Oiling will bring down the dryness But in reality It is the other way around.
d)  Dandruff is more of a tendency rather than a disease as it tends to come back if treatment is stopped midway and maintenance treatment is not followed properly.
e)Use of anti dandruff shampoos may  make the hair look dull and frizzy which is of temporary nature. Consult your dermatologist for supportive measures.
f) Consult your Dermatologist before taking up any Hair Spa measures which generally involve hair oil massages . As told above it may not be the best option for long term.
g) Consult your Dermatologist if it still doesn't respond to these measures a or else Dry scaly patches are seen on the face , behind the ears or middle of chest. This could be a severe form of dandruff known as Seborrheic Dermatitis

Images used in this blog have been randomly downloaded from the Web, I own no copyright on them

Wednesday, 3 April 2013

Skin healthy and skin wiser

Welcome to skin and hair solutions blog!

Skin is the largest organ of the body comprising of 12 -15% of our body weight. 
It apart from being the most intimate layer of clothing, advertises our health, individuality and identity. It is a unique canvas for self expression in many different ways today. But sadly it gets ignored in the daily humdrum of everyday affairs where the most basic protection of our body is ignored. We lose up-to 50,000 cells per minute and all this makes up 50% of the dust in our house.  

Through this blog together we delve deep into the journey of the evolution of three unique attributes of human skin: its naked sweatiness, its distinctive sepia rainbow of colors, and its remarkable range of decorations.

It isn't good to take for granted something as important as skin. Let this be a harbinger of our journey together to understand and explore this very essential fabric as I try to answer all your queries and put together knowledge sheets on commoner skin problems we face at one time or other. 

I appreciate genuinely any feedback and comments to constantly grow and improve together this endeavor to make people “skin healthy and skin wiser”.
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