Vitiligo Vulgaris

Vitiligo vulgaris is an acquired, non-contagious disorder. Patients with vitiligo vulgaris visit a dermatology clinic complaining of “loss of skin color”. However, white lesions are not always due to vitiligo vulgaris. This means that “loss of skin color” needs numerous differential diagnoses. The differential diagnoses included numerous diseases. In addition, we also analyzed the complications of patients with vitiligo vulgaris in view of the autoimmune diseases.

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Non Surgical Fat Removal

The ability to remove fat bulges safely and effectively without surgery is not science fiction. It is a reality!  Technology such as focused ultrasound and a process called cryolipolysis have made it possible to remove small amounts of fat without cutting the skin and with very little recovery time.  Both are FDA-cleared procedures that can, when used on appropriate candidates, spot reduce and smooth unwanted bulges.

Cryolipolysis works by cooling the unwanted fat bulge; this causes a percentage of the fat cells to self-destruct over several months, resulting in a smaller bulge and more pleasing body contour. Focused ultrasound destroys fat cells with targeted heat; over time, the body eliminates the damaged fat cells to shrink the unwanted bulge and improves the look of the area. To date, over 500,000 people around the world have been treated with these technologies with results to prove they work.

Since there is no cutting of the skin with either cryolipolysis or focused ultrasound, recovery time is minimal. In fact, the vast majority of people who have these procedures will return to normal activity immediately.

Although these treatments can deliver safe and effective results, they are not without limitations. Compared to liposuction, which is a surgical procedure that can remove up to 80% of fat in the treated area with dramatic results, cryolipolysis and focused ultrasound are targeting a much smaller percentage of fat cells per procedure and, therefore, yield more modest cosmetic improvement. For some, satisfactory cosmetic results may take several sessions to achieve.

Before and After Non Surgical Fat Removal: 

 

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Double Chin

A double chin is a layer of subcutaneous fat around the neck that sags down and creates a wrinkle, making the owner appear to have a second chin.

What causes Double Chin?

• Genetics - There is a chance that your double chin could be caused by hereditary factors. Just like the color of your eyes or hair, your double chin could be a result of your genetics. Take a look at the other members of your family and see if they also have double chins. If many of your family members have double chins then chances are that your condition is caused by genetics.  

• Age - If you're like many people then your double chin can also be a simple consequence of aging. Skin loosening and muscle loss are normal effects of aging. You were probably not unaware of it, but your chin has some muscles too. When these muscles begin to slacken, your risk of developing a double chin increases. The situation is worsened when your skin loses its tautness and elasticity.

• Excess Weight - Perhaps the most common cause of a double chin is simply excess weight or excess body fat. If you are overweight or obese, it's only natural to expect that you will develop a double chin as well. However, just because you are not extremely overweight doesn't mean you are completely safe from a double chin. When you continue to eat a fatty diet and lead a lifestyle that lacks exercise, your face or chin could be one of the first areas where your body will store fat. If your excess weight is the cause of your double chin, you can get rid of it by getting rid of your extra weight. 

 

Double Chin Removal Surgery: 

Patients with any combination of these features may be candidates for a double chin surgery. Double chin surgery is appropriate for younger patients under the age of 40 who don’t have any lower face or neck skin laxity. Patients over the age of 40 typically have lower face laxity that would render double chin surgery ineffective. Patients over the age of 40 who have a poor neck angle or double chin are typicall candidates for lower facelift for surgery.

Benefits of double chin removal surgery:

• Definition of the neck angle

• Reduction of double chin

• Reduced neck fullness 

 

Before and After Double Chin Removal Surgery: 

 

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Leucoderma

Leucoderma is a Latin synonym for white skin. It is a term used to express the white patch problem. Leucoderma or white skin, is the name given to a skin disease, wherein there is a gradual loss of the pigment, melanin, from the skin layers, resulting in the appearance of white patches. Leucoderma is a condition in which the skin layers experience loss of skin-pigment.

What causes Leucoderma?

The main causes for leucoderma are excessive mental worry and chronic or acute gastric disorders. Other causes involve impaired hepatic function such as jaundice, worms or other parasites in the alimentary canal, typhoid, a defective perspiratory mechanism and burn injuries. It can also be the result of hereditary reasons.

 

Leucoderma Symptoms:

The problem usually starts with a small white spot which later develops into white patches. These patches are pale in the beginning, but become whiter and whiter as time passes by due to loss of pigment. As the spots enlarge, they merge into each other and, in course of time, form a very broad patch. In some cases, most of the skin of the body may be covered with white patches.

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Alopecia Reduction

Alopecia Reduction also called scalp reduction is a surgical hair restoration procedure that surgically removes bald scalp and stretches hair-bearing scalp upward to replace bald scalp that has been removed.

Alopecia reduction can be a very successful approach to hair restoration. Is it right for you? A number of factors can bear upon that decision:

• Physical condition-the patient should be in good general health and have no medical conditions that would rule out a surgical procedure.
• The patient who undergoes alopecia reduction should be willing and able to have future alopecia reduction and/or hair transplantation and/or correction of surgical complications as the need arises.
• The rationale for alopecia reduction is that bald scalp can be surgically removed and hair-bearing scalp skin stretched up to cover the excised area.
• The patient's objectives-what do you, the patient, want hair restoration to accomplish? Your objectives, discussed thoroughly with the physician hair restoration specialist, will be a major factor in determining if alopecia reduction is a good option for you.

 

Alopecia Reduction and Hair Transplantation:

Alopecia reduction is often combined with hair transplantation. Hair transplantation may be combined with alopecia reduction to "fine tune" hair restoration in aesthetically sensitive areas, such as the frontal hairline that is not treated with alopecia reduction. Hair transplantation may be necessary in future years to keep pace with continued loss of hair. In younger patients, hair transplantation may be done first to restore the frontal one-third of the scalp, with alopecia reduction reserved for later years if hair loss progresses.

Alopecia Reduction Techniques:

A number of alopecia reduction techniques have been developed. No one technique is adaptable to all patients. Choice of technique is based upon considerations that may include degree of hair loss, scalp laxity, amount and quality of donor hair, and whether hair transplantation is to be a complementary procedure. Alopecia reduction technique is largely a matter of the pattern of scalp incision. The choice of technique and rationale for the choice should be discussed by patient and physician.

Before and After Alopecia Reduction:

Potential Complications and Side Effects:

• Complications are uncommon but there can be postoperative complications such as scarring at the suture lines, "stretch back" of scalp skin at the excised bald area, and a central midline scar called a slot deformity.
• Side effects of alopecia reduction surgery are temporary discomfort, swelling, and numbness in the operated area.

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Female Breast Reduction

Female Breast Reduction, also known as Reduction Mammoplasty, is an operation to reduce the weight and volume of the breasts.

Breast reduction removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body. Breast reduction surgery is also regularly performed to alleviate the discomfort associated with overly large breasts.

Breast size is determined by genes, hormones, body frame and weight. For most women, breast size is proportionate to the body, but for some women the breasts are particularly large.

Breast reduction surgery can help women who are unhappy with the shape, weight or droop of their breasts by making them smaller and more lifted. However, breast size alters with body weight, so your breasts may increase in size if you put on weight or become pregnant even after surgery.

Woman may be considered for a breast reduction operation, if she have physical discomfort from having large breasts, such as:

• Backache

• Neck pain

• Skin irritation

• Poor posture

• Excessive sweating, rashes and skin infections under the breasts

• Grooves on the shoulders from bra straps

• An inability to exercise or take part in sports

Large breasts can also cause psychological distress. Common complaints from woman with large breasts include not being able to wear fashionable clothes and finding it difficult to take part in active sports. Psychological distress may also include unwanted attention or harassment, self-consciousness and depression.

Breast reduction surgery can be include following risks:

• Scarring

• Unevenly shaped breasts or nipples

• Wound healing problems

• Loss of nipple sensation

• Being permanently unable to breastfeed

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Male Breast Reduction

Gynecomastia Surgery is the surgical correction of over-developed or enlarged breasts in men.

What is Gynecomastia?

Gynecomastia is a condition of over-developed or enlarged breasts in men that can occur at any age. The condition can be the result of hormonal changes, heredity, obesity, or the use of certain drugs.

Gynecomastia can cause emotional discomfort and impair your self confidence. Some men may even avoid certain physical activities and intimacy simply to hide their condition.

Gynecomastia is characterized by:

• Excess localized fat

• Excess glandular tissue development

• Sometimes excess breast skin

• Presence unilaterally or bilaterally

 

Gynecomastia Risk:

• Reactions to tape, suture materials, glues, topical preparations or injected agents

• Anesthesia risks

• Bleedin

• Blood clots

• Breast asymmetry

• Changes in nipple or breast sensation may be temporary or permanent

• Damage to deeper structures – such as nerves, blood vessels, muscles, and lungs – can occur and may be temporary or permanent

• Fatty tissue found in the breast might die

• Infection

• Persistent pain

• Poor wound healing

• Unfavorable scarring

Gynecomastia  Before-After:

 

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Female Pattern Baldness

Female Pattern Baldness is the most common type of hair loss in women.

 

Causes

Each strand of hair sits in a tiny hole in the skin called a follicle. In general, baldness occurs when the hair follicle shrinks over time, resulting in shorter and finer hair. Eventually, the follicle does not grow new hair. The follicles remain alive, which suggests that it is still possible to grow new hair.

The reason for female pattern baldness is not well understood, but may be related to:

• Aging

• Changes in the levels of androgens. For example, after reaching menopause, many women find that the hair on their head is thinner, while the hair on their face is coarser.

• Family history of male or female pattern baldness. 

Symptoms

Hair thinning is different from that of male pattern baldness. In female pattern baldness:

• Hair thins mainly on the top and crown of the scalp. It usually starts with a widening through the center hair part.

• The front hairline remains unaffected except for normal recession, which happens to everyone as time passes.

• The hair loss rarely progresses to total or near total baldness, as it may in men.

Itching or skin sores on the scalp are generally not seen.

Treatment

 

Hair loss in female pattern baldness is permanent, if not treated. In most cases, hair loss is mild to moderate. You do not need treatment if you are comfortable with your appearance.

Medication

The only medication approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness is minoxidil:

• It is applied to the scalp.

• For women, the 2% concentration is recommended.

• Minoxidil may help hair grow in about 1 in 4 or 5 of women. In most women, it may slow or stop hair loss.

• You must continue to use this medicine for a long time. Hair loss starts again when you stop using it.

If minoxidil does not work, your doctor may recommend other medicines, such as spironolactone, cimetidine, birth control pills, ketoconazole, among others. Your doctor can tell you more about these if needed.

Hair Transplant
During hair transplant, tiny plugs of hair are removed from areas where hair is thicker, and placed in areas that are balding. Minor scarring may occur where hair is removed. There is a slight risk of skin infection. You will likely need many transplants, which can be expensive. However, the results are often excellent and permanent.

Other Solutions
Hair weaving, hairpieces, or a change in hairstyle can help hide hair loss and improve your appearance. This is often the least expensive and safest way to deal with female pattern baldness.

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Male Pattern Baldness

Androgenic alopecia also known as androgenetic alopecia, alopecia androgenetica, or male pattern baldness is hair loss that occurs due to an underlying sensitivity of hair follicles to androgenic miniaturization.

Why Does Male Pattern Baldness Occurs?

Male pattern baldness is both genetic, and associated with the male sex hormones called androgens. Androgens have many functions, one of which is to regulate hair growth.

Each strand of your hair grows out of a little hole in your skin called a follicle. Normally, an individual strand of hair grows for two to six years, goes through a resting stage for several months, falls out, and is replaced by a new hair strand. With male pattern baldness, the hair follicle becomes smaller. It grows shorter and finer strands, and eventually stops growing hair altogether.

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Hair Transplantation Advantages and Disadvantages

 Advantages:

• Despite involving no threatening risk, it will be wise considering its pros and cons. Before opting for the surgical procedure costing a pretty penny it is important to analyze some of its advantageous aspects.
• With baldness playing a spoilsport and coming in the way of propriety - hair transplantation is pleasingly advantageous. With hair at your disposal, you can choose not having one out of place.
• Besides by means of this medically maneuvered technique, you need not bank on any other forms of treatment for hair growth. The hair implanted or grafted will continue with its growth.
  The fact that you yourself are the donor is also one of its pros.
• Unless you have opted for too many transplants, the process is by and large simple and desired result can be obtained in one go.
• Mostly little or no money is taken as consultation fee, so bearing in mind its everlasting effect the process is pretty much cost effective.
• Rather than going in for artificially driven mechanisms of hair systems, hair transplantation is far more cost effective.
• The operation is safe in the sense; you need not be brought under complete anesthesia. So in case you have fads and phobias about losing consciousness, the procedure can be managed by means of partial anesthesia.
• While the issues of pain may be duly addressed by localized sedation, you need not be anxious about total lapse of consciousness.
• One of the scientific advantages of hair transplantation relates to its uniformity of distribution. The technique is worked upon with optimization in such a way that your overall follicular distribution remains intact.

 Disadvantages:

• As one of its physiological disadvantages, it is worth bearing in mind that often sizeable proportion of the dermis has to be extracted for the purpose of implantation. The scalp provides protection to the follicle from trauma. Thus follicles tend to become more vulnerable in cases where a sizeable portion is removed.
• Cases involving dense packing tend to become more costly and time taking- calling for more than one session.
• Cases involving thick packing can lead to scarring and injuries.
• Due to injury and exposure to certain medications, graft planted may not survive resulting in the wastage of both time & money.

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Skin Whitening

Skin Whitening refers to the practice of using chemical substances in an attempt to lighten skin tone or provide an even skin complexion by lessening the concentration of melanin.

Several chemicals have been shown to be effective in skin whitening, while some have proven to be toxic or have questionable safety profiles, adding to the controversy surrounding their use and impacts on certain ethnic groups.

Uses:

Specific zones of abnormally high pigmentation such as moles and birthmarks may be depigmented to match to the surrounding skin. Conversely, in cases of vitiligo, unaffected skin may be lightened to achieve a more uniform appearance. Long term use of skin whiteners can lead to pigmentation increasing to the joints of the fingers, toes, buttocks and ears. The skin of the face can become thinned and the area around the eyes can have increased pigmentation causing a bleach panda effect.

Laser Treatments:

Both ablative and nonablative lasers can have a profound effect on melasma. However, the results are not always consistent, and problems have been reported. Laser treatments of this kind are more likely to result in problems for those with darker skin tones.

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Skin Tightening

Skin Tightening

As we age we lose volume in our face, primarily fat. As a result skin can hang down as gravity acts on it creating droopiness, wrinkles and bands. This can be thought of as excess skin and is similar in concept to a dress that becomes too large as its owner loses weight. In cases where you have a signficant amount of this loose skin, you may find no other solution than plastic surgery because the underlying muscles need to be addressed and repositioned.

Nonsurgical Skin Tightening:

• Dermal fillers like Juvederm, Restylane, or Radiesse can soften the shadowing that occurs around your nasolabial fold and facial creases, thus making the jowls and cheek folds appear less prominent.  Fillers act like inflating a beach ball to address the pockets and bulges. For example, by using a filler to restore volume to the cheeks, you can lessen the appearance of the jowls to some extent.
• There are a number of skin tightening devices or machines used in medical offices that may tighten skin such as Refirme, TITAN, or Thermage. Titan uses infrared light (IR) to tighten the skin, Thermage uses unipolar radiofrequency energy (RF), and Refirme uses IR and bipolar RF.
• A doctor may suggest you rejuvenate skin with laser skin resurfacing. The erbium laser with Profractional technology or the CO2 laser with Fraxel are additional options.

Skin Tighten with Cosmetic Surgery:

Many doctors believe a combination of treatments (surgical and nonsurgical) get the best tightening results.
Skin tightening from a combination of neck liposuction and thermage, MD After weight loss or a pregnancy, a person can be left with excess, loose skin. In most cases, excess skin will not go away with just diet and exercise. In such cases, a surgeon may recommend a procedure called a panniculectomy, which essentially remove excess skin.

For significant facial sagging, the Facelift or mini lift may be the appropriate solution. The goals of a facelift are to lift the jowls and clean up the neck.

Typically during a facelift the neck is sculpted by removing both the fat on top and underneath the muscle fibers that extend from the collarbone to the jaw. This muscle is tightened in the front of the neck and underneath the jaw-line to improve the jowl line. To lift the jowls, the facial superficial musculoaponeurotic system is also tightened.

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Skin Polishing

Skin Polishing

Skin polishing is one of the ways to enhance the beauty of skin. You can try skin polishing remedies by visiting skin care clinic.

Skin polishing in simple words is a special technique of exfoliating skin. The dead cells are removed which helps new and healthy cells to come in place of that and the skin looks clean and polished. So, if you want to give your skin a nice and fresh glow, you can go for skin polishing.

Why Skin Polishing?

Our skin is exposed to a variety of things like sun rays, dust, pollution and many more. This makes it lose the natural luster and shine. Well, we need to exfoliate our skin at regular intervals so that we can protect it from the adverse effects of these attacking elements.

Skin care has always been an important part of the routine for every man and woman. But, the amount of exposure and roughness that our skin faces these days, the time given to it in the hectic schedule is very less.

Skin Polishing Before and After: 

 

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Facial Skin Care

Facial Skin Care for Acne-Prone Skin

If you are prone to acne, choose a cleanser specially formulated for acne. These products often contain salicylic acid or benzoyl peroxide, which help to clear acne sores. Clean your face gently, as trauma to the acne breakouts may worsen the acne or cause scarring. Avoid harsh mechanical scrubbing of skin and picking lesions. If you need to use a moisturizer, use light, non-comedogenic moisturizers, which do not aggravate acne. Also, women should use an oil-free foundation, as heavy makeup or other cosmetic products that block pores may worsen acne.

Facial Skin Care for Mature Skin

Photoaging refers to the damage that is done to the skin from prolonged exposure to UV radiation, over a person's lifetime. Roughness, wrinkling, irregular pigmentation (coloration), inelasticity, enlarged sebaceous (oil) glands, precancerous and cancerous lesions are all examples of skin changes associated with photoaging. Sunscreens and sun protection are important to prevent further progression of photoaging. Furthermore, smoking has been shown to accelerate aging of skin, so stopping smoking is important for good skin health. In addition, a well-balanced diet allows the skin get the nutrition it needs to help repair ongoing damage from the sun and other environmental elements. Many topical non-prescription and prescription products are currently available for anti-aging purposes, including:

Tretinoin — Retin-A is a prescription medication initially developed to treat acne. In addition, it was discovered that it also improved skin texture and color when used over an extended period of time. Tretinoin exfoliates the skin (removes a dead layer of skin cells), helps even out pigmentation, and minimizes fine lines. Many people can benefit from using Tretinoin or related products at bedtime. Side effects of Tretinoin include redness, peeling, tightness, and swelling. You may be able to minimize these side effects by initially using Tretinoin every other night and then gradually increasing the frequency to nightly as tolerated. Tretinoin also makes the skin more sensitive to ultraviolet rays from the sun, and therefore we recommend the use of a broad-spectrum sunscreen each morning.

Alpha Hydroxy Acid — Alpha Hydroxy acids are found as ingredients of numerous skin products. In the United States alone, there are approximately 185 manufacturers of products containing AHAs. Creams and lotions with AHA may help with fine lines, irregular pigmentation, age spots, and may help decrease enlarged pores. Side effects of AHAs include mild irritation and sun sensitivity. For that reason, sunscreen should also be used every morning.

Beta Hydroxy Acid — Salicylic acid also has been studied for its effect on photoaged skin. It exfoliates skin, and can improve the texture and color of the skin. It penetrates oil-laden hair follicle openings and, as a result, also helps improve acne. There are many products available that contain salicylic acid. Some are available over-the-counter, and others require a doctor's prescription.

Hydroquinone — Hydroquinone is a bleaching agent that is used to remove hyper-pigmentation, such as age spots and dark spots related to pregnancy, hormone therapy, or excessive sun exposure.

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Dry Skin Care

Dry Skin Care

Dry skin is defined as flaking or scaling of the skin when there is no evidence of dermatitis. It is most prominent on the shins, hands, and sides of the abdomen, and can be associated with itching. It is more common during the winter months, when humidity is low, and improves in the summer time. Some people also have a genetic tendency to develop dry skin. In addition, elderly people tend to have more trouble with dry skin due to the natural changes in skin that occur with age.

Treatment is important because extensively dry skin can lead to dermatitis or eczema. Dry skin may be prevented or treated by:

• Taking lukewarm baths or showers 
• Limiting baths/showers to 5 to 10 minutes 
• Applying a moisturizer right after drying off from a shower or washing your hands 
• Using a moisturizing body soap and hand soap
• Using heavier creams or ointments during the winter months and lighter lotions in the summer.

If the above regimen does not improve the condition of the dry skin, it is possible that the flaking is a sign of underlying dermatitis. There are different types of dermatitis that may cause dry, itchy, flaking skin. They include:

• Seborrheic dermatitis — a red, scaly, mildly itchy rash on the scalp, eyebrows, and sides of the nose in areas that contain many oil glands.
• Allergic contact dermatitis — a rash that results when the skin comes in contact with a substance that causes an immune reaction, such as poison ivy. Allergic contact dermatitis of the hands often causes scaling on the palms or fingers.
• Atopic dermatitis — long-lasting type of dermatitis usually starting in childhood that tends to run in families. It also may cause excessively dry, itchy skin on the face and body. 
• Athlete's foot — dry flaking skin on the soles and/or sides of the feet and between toes caused by a fungus. 

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Melanin

Melanin

A dark brown to black pigment occurring in the hair, skin, and iris of the eye in people and animals is called Melanin. It is responsible for tanning of skin exposed to sunlight.

Melanin is found in several areas of the body including:

• Skin where it provides skin color
• Hair
• Pupils or irises of the eyes
• Stria vascularis of the inner ear
• Areas of the brain, the substantia nigra and locus coeruleus
• The medulla and zona reticularis of the adrenal gland

Types of melanin:

Some of the different types of melanin include eumelanin, pheomelanin and neuromelanin. Eumelanin is found in the hair, skin and dark areas around the nipples. It is particularly abundant among black populations and provides black and brown pigment to the hair, skin and eyes.

When eumelanin is present only in small amounts, hair may be blonde.

Pheomelanin is also found in the hair and skin. This type of melanin provides pink and red colors and is the main pigment found among red-haired individuals. This type of melanin is not as protective against UV- radiation induced cancer as eumelanin.

Neuromelanin is a form of melanin found in different areas of the brain and loss of this melanin may cause several neurological disorders.

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Radio Frequency Treatment

Radio Frequency Treatment

Radio Frequency Treatment is technology for non-surgical tightening of the early signs of loose or sagging skin; ideal for those people who either don’t want, or don’t believe they are old enough to have a surgical procedure.

Pure Radio Frequency Treatment is primarily used to treat skin laxity by facial tightening, and is best suited to patients with mild to moderate sagging of facial tissues, usually those in their mid 30s to 50s, with any skin colour. It is commonly used to treat the forehead, under the eyes, cheeks, mid-face, jaw line, and neck.

Based on current Radio Frequency technologies, most people should see at least a mild improvement in their skin tightness, with minimal risks and downtime compared to surgery.

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