HAIR TRANSPLANTATION

HAIR RESTORATION TREATMENT
Hair restoration treatment is the redistribution/rearrangement of the existing hair follicles in a particular techniques so as to cover the bald areas of alopecia and give a goo cosmetic camouflage.
The concept of Donor Dominance heralded the modern era of hair transplantation.
INDICATIONS:
1) Male Pattern Alopecia(Androgenetic Alopecia)
2) Female Androgenetic Alopecia
3) Cicatricial Alopecia
4) Reconstruction of Eyebrows & Eyelashes

TECHNIQUES OF HAIR RESTORATION SURGERY:
1) Punch Grafting
2) Single Hair grafting
3) Follicular Unit Grafting
4) Strip Grafting
5) Alopecia Reduction
6) Alopecia Reduction with Tissue Expansion
7) Transposition of Scalp flaps
8) Combination of the above techniques
9) Synthetic Hair Grafting

Depending on classification of Androgenetic Alopecia & patient selection criteria, an appropriate treatment modality is chosen which gives best possible result to the patient.

At C POINT, Hair restoration surgery is done electively by team of doctors specialized in treatment after thorough assessment of patient.
FAQ’s ABOUT HAIR RESTORATION SURGERY:

Why I need hair transplant i.e. surgery, when medication and other non-surgical means are available?

Medications:

Medication can thicken and lengthen (regrowth) hair in some and not in all who take them.
Medication is effective at the back (Vertex) and middle (Mid scalp) but almost ineffective in the front (esp. Hair line) where one needs the hair most.
Medication can work only until you keep taking if you stop taking medication the benefits achieved by medication soon start disappearing (because the hormones once again start working their ill effects). Medication although reasonably safe should be taken for lifetime –the idea normally puts off many.
Medications although fairly safe are not without any side effects.

Other Non- Surgical Means:

Wigs and Concealers are other possible solutions to baldness. Concealers are temporary hair cosmetics, good for thinning hair and as temporary solution such as before going to party. They require regular care and expense. They are not cheap either.

As for the wigs: 10 reasons why people don't choose wig!

· It gives constant feeling of weight and discomfort in hot days.
Sweat cannot be cleaned properly and bad hygiene can lead to skin problems.
· It’s fixing methods like weaving, bonding, pinning etc. can pull on the natural remaining hair and add to your hair loss and can even lead to scarring.
· It gives same look all the time that looks and feels artificial and unnatural. You have fixed style all hours of use.
· Its high level of detectability becomes a butt of jokes and teasing by the friends, colleagues and media.
· It’s cost run from few hundred dollars to many thousand dollars depending upon quality.
· You need regular maintenance every few weeks for the rest of your life.
· Attachment may become loose- constant state of low-level paranoia and anxiety about his public discovery.
· Long-term financial investment because of regular maintenance may be more than that of hair transplant. With life time maintenance & few monthly replacement & frequent visits to wig maker- it becomes very expensive
· You need to change it every few months.
· Not done by doctors.

Surgery by Follicular hair Transplant is better in many respects:

· Transplanted Hair Looks and feels natural unlike wig and concealer.
· Transplanted hair remain undetectable among the other hair.
· Transplanted hair grows and keeps growing permanently unlike the hair of wig and the regrown hair by medication.
· Do not require extra maintenance or care unlike wig, which require lifetime care.
· The Transplanted hair can be cut, colored and styled as well.
· Transplantation normally has one time expense unlike medication or wig which require lifetime expense.
· It is a One day Procedure performed by numbing your skin so you can talk with doctor, watch TV, listen to music, read, take a nap, have lunch and juice and even go to toilet.
· No bandages at the end.
· You can take shoulder bath from same day and can shampoo your hair from 3rd day.
· You can even do light office work from second day.

What is the guarantee that the implanted hair will grow? Why don't they too fall under the effect of hormones like other hair?

The Common Baldness or Pattern baldness in males and females is programmed by heredity or genes i.e. the hair in the top middle part of scalp become susceptible to the effect of the hormones and the fringe of hair at the side and back remain genetically immune to the effect of hormones. These hairs grow permanently or at least till late age and they also maintain their quality unlike the susceptible hair of middle, which shorten and thin out in caliber as well. These hairs are called permanent hair. If we remove the roots from permanent area and graft them in front or any other part of scalp or body they keep growing like they used to do in their native area. The hormones even in new area don't affect them. Over 90% of the implanted are destined to survive with modern techniques of transplanting.

Do I have to wait till all my hair fall out or can I under go the procedure to increase my density?

Like any medical problem, one should not wait till the last stage of manifestation of deformity of baldness. As the density of hairs gets down, one can safely plant the follicles in-between existing hairs, to compensate for the loss, without looking bald.

Can girls and women have this procedure?

Yes, girls and women can take benefit of this procedure for the correct indications.

Can it be done if there is no hair on head?

Usually the procedure is refused if there is no hair on the scalp. Body hair transplant can be an inferior possibility.

Can it be done for eyebrow, moustache, eyelashes or other body areas?

Thinning, total or partial loss of eyebrow, eyelashes, moustache or beard or sideburns since birth or due to other causes like injury or burns can be corrected cosmetically by Hair Transplant .

At what age one can have Hair Transplantation? Can a child undergo Hair Transplantation? Can a 70 years old person undergo Hair Transplantation?

Age is no bar for Scarring baldness. For pattern baldness unusually surgery is refused before 20 years and if the quality of donor hair is good even at late age transplant can be done .

Do I have to undergo tests before the procedure?

Yes usually they are 1. Complete blood count 2. HbSAg (Australian Antigen) 3. P.T & APTT 4. Blood Sugar (Fasting and Post prandial) 5. H.I.V.

What care do I take before Hair Transplantation?

Pre operative Care Before Procedure:

In order for us to provide you with the highest quality medical care; the following instructions are important for you to follow:
Medications: Do not take aspirin & other blood thinning agents, Betablockers (for Blood Pressure), anti-inflammatory (like Ibuprofen, etc), Tricyclic Anti depressants & MAO inhibitors, multivitamins including vitamin B, a week prior to your procedure.
Avoid Alcohol for a days prior, & tea or coffee on the day of operation- that may increase bleeding
Don't smoke at least 24 hours prior to operation –that will reduce healing
The morning of your procedure take a bath or shower and wash your hair thoroughly using regular shampoo. After shampooing, please rinse thoroughly and use a fresh clean towel to dry your hair. Do not apply sprays or gels to your hair. If you wear a wig, please make sure it is removed prior to your morning shower and not replaced before your procedure. Wear cap after shampoo to keep the hair free of dust.
Eat light breakfast the morning of your procedure
Wear comfortable clothing the day of your procedure avoid T shirt or thermal. Wear simple shirt.
You may be receiving medications during the procedure that can make you drowsy. Because of this we strongly recommend not to drive home the day of your procedure.


Can HT be done if I am Diabetic or if I have Blood Pressure or other medical problems?

Medical problems under good control by medication do not stop you from undergoing the procedure.

What are the side effects and complications?

It is one of the safest procedures devised by medical science and leaves you with hardly any long-term problems. Discomfort, swelling of forehead, numbness at the back trouble you only for a while. Serious complication in competent hand is unheard of.

Can hair from other parts of my body be transplanted?

Technically that is possible but hair follicle from the other parts of the body when planted on the head, does maintain its genetic characteristics, and hence it does not look, feel and grow as good as scalp hair.

How many follicles will I require?

Number of follicles required is based on factors that vary among individuals.

Degree & Progress of hair loss
Hair characteristics
Area where coverage is desired
Expectation by patient
The total number of hair on the head remains the same as before or after Hair Transplantation. The hair root from ‘permanent hair growing area” from the back and side of the head (medically known as Hair Bank or Donor Area) is transferred to the front and /or top of the head. In Hair Transplantation no new hair is grown. Only the transplanted hair roots are arranged in such a way that head looks fuller with hair.
We have approximately 1,00,000 hair on head. In the last stage of baldness i.e. Stage 7 baldness; he is left with almost 25,000 hair on the back and side of his head (medically known as Hair Bank or Donor Area). From this area, we can harvest up to 60 % or 15000 hairs, without looking obvious. One sq. cm of Donor Area contains 100 follicles, but each follicle (Root) may have either 1.2.3 or 4 number of hair. If you have more follicles containing 3 or 4 hair, you will have more density than one having 1 or 2 hair in each follicles. On an average each hair follicle contains 1.5-to2 hairs. So, on an average 100 follicles will contain up to 200 hairs. 15,000 hair means up to about 7 500 follicles are available for transplant from your donor site. These follicles are planted in such an artistic and Staggered pattern to create what is called an Organized Disorder Pattern over the bald area that head looks full of hair. It is the combination of Art and Science both, which gives most natural result.
Normally, you have density of 100 -follicles/sq cm on the head. We do not see the bald skin until we lose up to 60% of hair in the area. So in view of the limited availability of longer lasting follicles in the bank, we should aim for the maximum density of up to 40% plus /Sq.cm esp. in vital areas like frontal forelock. You do not get the same density all over, as before but you can make it look like near normal density.

What density will I get?

Hair Density (mass or fullness) is more with
Length of each hair
Thickness of hair
Number of hairs per sq.cm. (Density)
Acuteness of angle of exit of hair from the skin. This factor depend on the artistic ability of surgeon
More perpendicular (coronal) direction of hair to the hole while inserting hair follicle. This factor depend on the artistic ability of surgeon
Number of Hair per follicle like, 3-4 hair per follicle give more density
Curliness of hair
Low Contrast between color of hair and color of scalp
Time: Hair starts growing after about 8 to 12 weeks from plantation and continues to grow at the rate of 1 cm per month. So, only with the passage of time, the hair mass will increase.
Normally, you have density of 100 -follicles/sq cm on the head. We do not see the bald skin until we lose up to 60% of hair in the area. So in view of the limited availability of longer lasting follicles in the bank, we should aim for the maximum density of up to 40% plus /Sq.cm esp. in vital areas like frontal forelock. You do not get the same density all over, as before but you can make it look like near normal density.

What time it takes?

Only a day that you have to spare. It takes 2-8 hours usually depending upon the number of the follicles to be implanted

Will there be any effect on my mind?

This is one of the safest surgeries devised and it limits itself to the skin your brain remains much deep beneath and safely protected in the natural helmet of your skull.

How do you implant the hair? Do I have cuts and stitches?

There are micro punctures done but there are no big cuts or stitches taken at the site of grafting.

What is the after care of Hair Transplantation?
Post-operative instructions

You will leave the clinic on the same day with no bandages on - but you should wear a cap for a week to protect grafted from dust, sun & heat
Take medications as directed. (Avoid Aspirin for 2 weeks)
Sleep in the position in which you’re most comfortable but sleep with the head on 2-3 pillows for a few nights.
Place wrapped ice pack on your forehead & eyes but not on the graft sites for 48 hours to avoid swelling. Swelling will go away in few days. These days swelling is uncommon due to medications taken post operatively.
After 6 hours of the procedure shampoo the graft site & donor site gently without rubbing and wash the head with shower. Blow dry or dry without rubbing the graft site until all scabs fall out.
If bleeding occurs apply a light & steady pressure for 20-30 minutes with a clean cloth at the site of bleeding
Sutures in the donor area gets dissolved & need not be removed
Avoid Alcohol for 48 hours
Avoid smoking for as long as you can
No swimming in chlorinated water for 2 weeks
Rest for 1 day
Light work for a week
Heavy work, exercise or sex after 2 weeks
Visit your hair dresser for hair cut after 3 weeks & for hair styling after 6 weeks
Diet: Healthy nutritious diet with more proteins is beneficial. A diet that contains high quantities of animal fat can lead to an increase concentration of testosterone in the blood stream, increasing your risk of hair loss. High protein diet in pulses, milk, and white of egg, red meet and fish are good. Green vegetables and fruits are good source of minerals and antioxidants. A lot of water keeps your hair texture good.

How will it look?

Advantage of Follicular Hair Transplant is that the result is not only natural looking and natural feeling but it remains undetectable.

What time it takes to grow hair after Hair Transplantation?

The hair start sprouting by average 3-4 months and it takes 8-18 months for the hairs to grow in length and thickness.

What care will I have to take for the newly grown hair?

You don't need any special care for the newly grown hair after transplant, at least not more than your other hair.

What if the implanted hair falls?

Implanted hair fall within first month of transplant. The transplanted root form new hair in 3-4 months time. They become of combable length by 6-9 months and grow like any normal hair i.e. in cycle. So they may cyclically fall and in few weeks also start re-growth. The final result is achieved by 1 to 1 and a half year when the texture and thickness of transplanted hair becomes fully mature.

When can have my haircut? When can I shampoo, style, and colour my hair?

Haircut is possible after 3 weeks and colour and styling after 6 weeks of transplant.

Will I have bandages or dressing?

You leave the clinic with no bandage. But it would be wise to use baseball cape when outdoors, to protect from sun, dust and pollution for 2weeks
When can I work?

Usually from next day for the light work but heavy work is avoided for 7-10 days.
BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
DERMATOLOGIST & COSMETOLOGIST
SHRADDHA SKIN & COSMETIC CENTER,
"DOCTOR HOUSE",2nd FLOOR,INDIRA CIRCLE CHOWK,
RAJKOT-360005
http://www.drlalseta.blogspot.com/
chetanlalseta@gmail.com
09825199585

Sponsored by the business degree web page.

SWINE FLU---------TAKE CARE

Air Travel Guidelines are Needed to Prevent Flu's Spread.

India needs to announce flu prevention guidelines for airline travel. American Medical association has already framed their guideline on June 16 at its annual meeting held from June 13 to 17 in Chicago.
Suggested points
1. The confined nature of air travel raises the risk of influenza's spread.
2. It supports efforts to develop airline travel guidelines to help keep the flu -- including H1N1 swine flu -- from spreading.
3. If you must travel to an area that has reported cases of H1N1 flu (swine flu), stay informed. Follow local public health guidelines, including any movement restrictions and prevention recommendations.
4. Be aware that India is checking all exiting airline passengers for signs of H1N1 flu (swine flu). Exit screening may cause significant delays at airports.
5. The country should adopt policy of entry check also. As it?s the entry which causes the spread of illness to the fellow passengers.
6. Do not illegally import swine flu in the country by consuming drugs to help stop flu symptoms for a few hours. Drugs like anti allergics, steroids, pain killers, anti fever drugs, nasal anti allergic drops and anti cough syrups can all cover the symptoms for a few hours.
7. Antiviral medications for the prevention of H1N1 flu (swine flu) should be considered for travelers going to Mexico who are at high risk of severe illness from influenza. This would include persons with certain chronic medical conditions, persons aged 65 or older, children younger than 5 years old, and pregnant women. The recommended antiviral drugs for H1N1 flu (swine flu) are oseltamivir (brand name Tamiflu) nd zanamivir (brand name Relenza). Both are prescription drugs that fight against H1N1 flu (swine flu) by keeping it from reproducing in the body. These drugs can prevent infection if taken as a preventative.
8. Check if your health insurance plan will cover you abroad including for the swine flu. Consider purchasing additional insurance that covers medical evacuation in case you become sick.
9. The Indian embassies, consulates and military facilities may not have the legal authority, capability, and resources to evacuate or to give medications, vaccines or medical care to private Indian citizens overseas.

Practice healthy habits to help stop the spread of H1N1 flu (swine flu)
Wash your hands often with soap and water. This removes germs from your skin and helps prevent diseases from spreading.
Use waterless alcohol-based hand gels (containing at least 60% alcohol) when soap is not available and hands are not visibly dirty.
Cover your mouth and nose with a tissue when you cough or sneeze and put your used tissue in a wastebasket.
If you don't have a tissue, cough or sneeze into your upper sleeve, not your hands.
Wash your hands after coughing or sneezing, using soap and water or an alcohol-based hand cleaner (with at least 60% alcohol) when soap and water are not available.
Avoid touching your eyes, nose, or mouth. Germs spread that way.
Try to avoid close contact with sick people (within 6 feet). Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
It is important to follow the advice of local health and government authorities. You may be asked to restrict your movement and stay in your home or hotel to contain the spread of H1N1 flu (swine flu).
BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-360005

http://www.cpoint.in/
http://www.mcspl.in/
http://www.drlalseta.blogspot.com/
chetanlalseta@gmail.com

Sponsored by the business degree web page.

09825199585

SKIN MARKERS OF MALIGNANCY

SKIN MARKERS OF MALIGNANT DISEASE
Some skin disorders are precipitated by an underlying malignancy and others almost always indicative a visceral neoplasm. Early recognition may assist detection of the underlying neoplastic disease.

Disorders with a strong association with underlying malignancy:
1) NECROLYTIC MIGRATORY ERYTHEMA:

This is usually caused by a tumour of the pancreatic islet alpha cells that secrete glucagon, but it is sometimes caused by hyperplasia or benign adenomatosis of these cells. Rarely no underlying abnormality can be found. Areas of erythema, which becomes eroded and crusted, develop around the groins, on the lower trunk, around the flexures and at the sides of the mouth. They may temporarily remit at one site, to appear elsewhere. The skin disorder responds to removal of the underlying tumour, but usually complete removal is not possible.
Characteristically, there is degenerative change in the upper dermis. Blood tests reveal increased circulating glucagon, hyperglycemia and hypoaminoacidaemia and it is the last of these that may be responsible for this curious skin disorder.

2) ACANTHOSIS NIGRICANS:

Acanthosis nigricans may occur in association with endocrine disease and also, rarely, accompanies lipodystrophies. An identical clinical picture accompanies obesity and is then known as pseudo acanthosis nigricans.When the condition occurs in an adult unaccompanied by obesity or endocrine disease, an underlying neoplasm is usually the cause. The neoplasm involved is often a gastrointestinal adenocarcinoma.
There is a velvety thickening and increased rugosity of the skin of the flexures- the axilla and groin in particular. The sides and back of the neck and the sides of the mouth are also affected.
The thickened areas are also pigmented and bear skin tags and seborrhoeic warts. There may also be some generalized increase in pigmentation, as well as thickening and increased rugosity of the buccal mucosa and the palmar skin.
There is overall hypertrophy of all components of the skin of the affected areas. Insulin- like growth factors may be involved.

3) ERYTHEMA GYRATUM REPENS:

This is probably the rarest of the specific markers of visceral malignancy. This odd disorder is almost always a marker of a neoplasm, often carcinoma of the bronchus.

Large rings composed of reddened polycyclic bands are seen; the rings contain concentric rings; giving a wood-grain effect. The rings gradually enlarge and change shape. Rarely, other dramatic types of annular erythema may be signs of an internal malignancy.

4) SKIN METASTASES:

Carcinomas of the breast, bronchus, stomach, kidney and prostate are the most common visceral neoplasms to metastasize to the skin. Secondary deposits on the skin may be the first sign of the underlying visceral cancer. The lesion themselves are usually smooth nodules, which are pink or smooth colored, but may be pigmented in deposits of melanoma.

5) ACQUIRED ICHTHYOSIS:

When generally scaling without erythema begins in adult life, it is quite likely that there is an underlying neoplasm, particularly in reticulosis. This has to be distinguished from mild dryness of the skin and the slight irritation seen in many chronic disorders, known as xeroderma.
Other causes of acquired ichthyosis include AIDS, sarcoidosis and leprosy, but if these can be excluded, a neoplastic cause is the most likely explanation.

Disorders that are sometimes associated with underlying malignancy:

1) BULLOUS PEMPHIGOID:

This subepidermal blistering disorder occurs mainly in those over 60 years of age, who are anyway more likely to be affected by a neoplasm. Nonetheless,there are a few patients with pemphigoid in whom the skin disorder is provoked by the malignancy and remits after the neoplasm has been removed.

2) DERMATOMYOSITIS:

Women over the age of 40 years with dermatomyositis may have 50% chance of malignant tumour of the genitourinary tract, but infants with the disease have no greater risk than a control group. Overall, even in adults, the association is not common and most cases of dermatomyositis occur without an identifiable cause. There is an impression that dermatomyositis provoked by malignant disease is more severe.

3) FIGURATE ERYTHEMA:

Rarely, annular erythema and erythema multiforme seem to be caused by underlying malignant disease.

BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-360005

http://www.cpoint.in/
http://www.mcspl.in/
http://www.drlalseta.blogspot.com/
chetanlalseta@gmail.com
09825199585

Sponsored by the business degree web page.

SURGERY IN VITILIGO

VITILIGO SURGERY

INTRODUCTION:
In India, Vitiligo is considered a social stigma and the affected patient & family ostracized, hence it is important to treat and cure patient fully with all available modalities. Often we come across vitiligo patients who have stop responding to all possible medical therapies or who are responding very slowly to the same. Also, sometimes patient with clinically inactive lesions present for correction of their cosmetic deformity.
Apart from these, smaller group of secondary leucodermas (following thermal or chemical burns,etc) also need correction of the depigmented lesions.When inactive lesions occur on the unexposed, cosmetically unimportant areas, patients are ready to accept those lesions and hence can be left alone. However, frequently such hidden lesions also necessitate treatment, along with those occurring on the exposed sites. In such situations, camouflaging creams for daily application can be advised, but may not be acceptable to all, due to time consuming application, color mismatch, temporary action and cost factors. In such situation, one can think of surgical management of vitiligo.
Since 1964, various surgical techniques and modifications have been reported to treat recalcitrant but stable vitiligo with permanent and complete repigmentation.
Depigmentation in Vitiligo and secondary leucoderma results due to depletion of local melanocytes following their destruction by underlying disease. The various surgical procedures are designed with either of the following 4 aims;
1) Introduction of the artificial pigments into the lesions for permanent camouflage e.g. tattooing.
2) Removal of the depigmented areas forever e.g. Excision with primary closure.
3) Repopulation of the depleted melanocytes by various grafts e.g. Thierch’s grafts, ultra thin grafts, suction blister and miniature punch grafts, non cultured epidermal suspension or transplantation, epidermal and melanocyte cultures.
4) Therapeutically wounding the lesion so as to stimulate the melanocyte from the periphery and the black hair follicles to the proliferate, migrate and repigment the lesion e.g. therapeutic dermabrasion, laser ablation, cryosurgery, needling, local application of phenol or TCA.

SURGICAL MODALITIES FOR VITILIGO:

1) Cosmetic Tattooing
2) Excision & closure
3) Thin Thierch’s graft
4) Suction blister technique.
5) Miniature punch grafting.
6) Therapeutic wounding—Dermabrasion, Laser ablation,needling,cryosurgery,etc
7) Ultra thin grafting.
8) Grafting of non-cultured epidermal suspension.
9) Skin cultures—autologous, allologous or foetal; either epidermal containing both keratinocytes and melanocytes, or pure melanocytes only.
10) Others—Trypsinised autograft injection, single hair transplant homologous grafting, etc.

However, certain patient selection criteria should be strictly adhered to before taking any patient for surgical intervention.

PATIENT SELECTION CRITERIA:
1) Patient should have realistic expectations. Avoid psychologically unstable patients.
2) Patient not responding adequately to medical line of treatment.
3) Vitiligo lesions should be strictly stable for last two years i.e. existing lesions should not be expanding and no new lesion should have appeared in the interim.
4) The stability of the lesion should be confirmed by first doing trial grafting in a small vitiliginous area, 1-2 months before undertaking surgery of the entire lesion.

SUMMARY:

Good cosmetic end results will be obtained by strictly following the patient selection criteria and choosing appropriate surgical techniques depending on each individual case.
BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-360005

http://www.cpoint.in/
http://www.mcspl.in/
http://www.drlalseta.blogspot.com/
chetanlalseta@gmail.com
09825199585

Sponsored by the business degree web page.

MICRODERMABRASION

MICRODERMABRASION: (SKIN POLISHING)
Microdermabrasion is an anti-aging and skin rejuvenating cosmetic procedure.It is widely used for a variety of cosmetic objectives ,including the improvement of Fine lines,Wrinkles,Photoaging,Acne,Scars and Stretch marks.
HOW MICRODERMABRASION WORKS?
In this method, a controlled flow of Aluminium oxide crystals is used to gently exfoliate the uppermost superficial dead layers of the skin It is a very effective skin polishing treatment using fine crystals that are directed on the skin through a vacuum tube and thus allowing a radiant translucent skin to emerge. This treatment removes dead surface skin cells to improve texture, softness, and brightness. It also stimulates cell and collagen production and reduces the appearance of large pores. Various defects in the surface of the skin can thus be addressed to reveal fresher, clearer skin in an effective and painless manner. Special Diamond tip Microdermabrasion is helpful in superficial to mediun depth scarring.This treatment or procedure can be done with other facial treatments to optimize results.
FAQ ABOUT MICRODERMABRASION:(SKIN POLISHING)
Why does one need Microdermabrasion or Skin Polishing? At what age can one start this service?

MICRODERMABRASION(SKIN POLISHING) is recommended for every one since at some point in time we are subjected to stress & increasing levels of environmental pollution. These factors cause our skin to get dull and pigmented. Due to over exposure to the sun, our skin gets damaged and one shows early signs of ageing. Such skin concerns need to get addressed and this is done with visible results through our service called C POINT Skin Polishing treatment.Practically in post pubertal age group,in both males & females, this treatment can be done safely & effectively
How is Microdermabrasion or Skin polishing different from facials?
The CPOINT Skin Polishing procedure has some advantages over facials;
It is useful in a wide range of skin problems like acne prone skin,fine wrinkles,photodamaged skin and superficial and medium depth acne scarring safely and effectively.
Removal of dead cells is uniform and is done very effectively and the service remains to be non-invasive
What is the procedure involved in MICRODERMABRSION or SKIN POLISHING?
Crystal Sensitivity Check: on your forearm.
Cleansing the face is then cleansed with the Cleansing gel.
Skin Polishing & Brightening: The dead, superficial skin cells on the uppermost layer of the skin are removed through a controlled flow of crystals.
Application of CPOINT products: After the procedure, a combination of products, which brighten the skin and improve skin tone are applied to your face. These products also have moisturizing & sun protection properties.

What is the chief skin concerns that CPOINT Microdermabrasion or Skin Polishing addresses?

CPOINT Skin Polishing & brightening addresses skin concerns such as dull skin,superficial & medium depth acne scars, fine lines and wrinkles & Sun damaged skin. This service can also be undertaken as part of your regular skin care and enhancement regime

Is the treatment for Microdermabrasion or Skin Polishing Safe?Yes,Microdermabrasion or Skin Polishing is an extremely safe procedure and is recommended for all skin types. At C POINT as an added precaution a crystal sensitivity check is done to rule out a rare case of sensitivity.

Are there any side effects whilst doing a Microdermabrasion or Skin Polishing?

C POINT skin polishing is absolutely safe,painless & non-invasive procedure and there are no side effects of it. However, very sensitive skin may become red due to the exfoliation action. However, this effect is transient. A cold compress is recommended in such a rare case.

What are the body parts for Microdermabrasion or Skin Polishing?

Most commonly employed body parts are face,neck,forearm & back,however in indicated person it can be done practically at any body parts.

How long does each session take?

The duration for Microdermabrasion or Skin Polishing usually lasts about 30 minutes per session.

Can I return to regular activities immediately after a session of Microdermabrasion or Skin Polishing?

C POINT Skin polishing requires no post procedure care. You can resume normal activities immediately. However in some cases of sensitive skin, direct sun exposure to excessive sunlight should be avoided and a sunscreen with a minimum SPF of 15 should be used regularly.

How many sessions are required to see best results?

Our skin is a dynamic organ. Excessive exposure to years of dust, pollution and harmful UV rays occurs continuously. Everyone has different skin and skin tones, with different levels of skin concerns. However at least 4 sessions are required to see visible results.Depending on indications, number of sessions and duration between session may vary accordingly.

Does this service have to be continued to maintain the results achieved?

To maintain the look achieved one monthly session is recommended.

Can I undertake C POINT Microdermabrasion or Skin Polishing just before a special occasion such as a party?

Due to the exfoliation action, the immediate effect can be reddening of the skin, which subsides within hours. In extra sensitive skin, the effect lasts a day. Therefore Ideally you should get C POINT skin polishing procedure 2 to 3 days prior to occasion.

PHOTOGRAPHS OF PRE AND POST TREATMENTS.











BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
CONSULTANT DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-360005
http://www.cpoint.in/
http://www.mcspl.in/
http://www.drlalseta.blogspot.com/
chetanlalseta@gmail.com

Sponsored by the business degree web page.

09825199585

MYTHS & REALITIES ABOUT DERMATO-COSMETOLOGY

MYTHS AND REALITIES IN DERMATOLOGY

INTRODUCTION

Quite often, we read or hear some cosmetic information which we may not always be able to substantiate by restoring to standard textbooks of dermatology. Hence, a compilation of common myths prevalent in our society are discussed here to provide scientific knowledge to those patients seeking cosmetic counseling.

MYTHS RELATED TO SKIN, HAIR AND NAIL CARE :

1) Soaps or shampoos which produce more lather have better cleansing action.

Reality : Lather productiom is dependent on addition of foam boosters to soaps or while cleansing is related to their detergent content. Hence, amount of lather produced is not proportional to cleansing activity of either soaps or shampoos, foam baths or bubble baths.

2) Foreign cosmetics are better than local ones.

Reality : The efficacy of these products depend on their basic contents and vary for individual. The fact that it is produced abroad with multiple additives does not certify any cosmetic to be better than it’s Indian counterpart.

3) Household cosmetics are harmless.

Reality : Home remedies can also irritate or sensitise the skin or have comedogenic potential and should be used with care.

4) Skin creams and moisturizers with vitamin A, E and other plant extracts prevent aging and skin wrinkling.

Reality : Most of these substances are not absorbed topically and hence, carry no added advantage over a plain moisturizer. Some of them are humectants and thus act as moisturizers and temporarily improve wrinkles due to their plumping action.

5) Oil massage before bath gives a glowing skin.

Reality : Although, any massage improves the local circulation, the best results of oil application are obtained when applied on slightly moist skin, as during or after bath especially in those with dry skin. The regular use of oil massage in infants can produce folliculitis, especially if persons with poor hygiene are employed for this purpose.

6) Cleansing milks, facial packs and facials are more effective ways to clean the deep pores.

Reality : Soaps are equally effective for facial cleaning and above products, offer no significant advantage except for placebo effect.

7) Oily foods precipitate or aggravate acne.

Reality : Dietary factors are not involved in pathogenesis of acne and hence, food restrictions are unnecessary.

8) Regular steaming is good for skin.

Reality : Although, steaming hydrates the blocked pilosebaceous ducts so that comedone extraction become easier, it’s regular use in normal people can cause large, open pores. Even in acne patients, it should be used only for 1 – 2 minutes every 7 – 8 days. More frequent usage can result in damage to elastic fibres in long run causing premature aging.

9) Regular hair oil application prevents premature canities and prevents hairfall and give luxuriant hair growth.

Reality : Premature hair greying is genetically determined, it’s expression dependent on environmental factors, other than oil application. The only purposed served is probably improvement in local circulation, if massage is done after application, with improvement in hair growth.

10) Shaving the scalp or cutting hair improves growth in diffuse alopecia.

Reality : The rate of hair growth remains the same after these procedures. Also, no new hair follicles are formed by shaving or cutting the preexisting hair.

11). Shampoos with additives like pro-vitamin B5, keratin etc. are more effective in damaged hair.

Reality : Damaged hair due to abuse of hair styling techniques and hair products need a mild detergent shampoo with conditioner containing protein like hydrolysed animal protein are beneficial as they penetrates hair shaft and restores damaged hair protein structures. Various other additives only enhance commercial appeal, since they are not absorbed in scalp and hair shaft is dead cutaneous appendage.

12). Application of kajal improves eyesight and eyelashes growth.

Reality : Kajal contains carbon and apart from it’s cosmetic purpose of enhancing eye appeal, it serves no beneficial action. On the contrary, it’s application can cause contact dermatitis and conjunctivitis.

13).Use of castor oil increases growth of eyelashes and eyebrow hairs.

Reality : Application of any oil does not affect rate of hair growth; except for possible effects of ensuing massage action.

14).Trimming of cuticle is an essential part of nail care.

Reality : Cuticle is designed to protect underlying nail matrix from getting invaded by pathogens and irritant and allergen substances. The habit of trimming or pushing it back during manicure can damage the cuticle with resultant complication like acute and chronic paronychia.

15).Medicated soaps are better cleansing agents and good for diseased skin.

Reality : The normal skin flora acts as a defence against the pathogenic species and prevents their inhabitation of skin surface through bacterial interference. Medicated soaps with germ fighters destroy this beneficial flora; thereby allowing pathogenic bacterial invasion of the skin. Usually they also produce excessive dryness/irritation of the skin due to additional contents and hence should not be recommended excepts for recurrent skin infections/acne vulgaris.

16).The regular use of pumice stone and scrubbers cleans the skin better and reduces hyperpigmentation.

Reality : Bare hands and nails are enough to cleanse the skin along with a soap on daily basis. If pumice stone / scrubber are used vigorously they may dry the skin excessively. Also, bathing brush dermatitis with bilaterally symmetrical hyperpigmentation on bony prominence can follow years of usage of such products.

17).Costly branded cosmetics are more effective and cannot produce side effects.

Reality : The effectivity /adverse reaction of any cosmetic depends on it’s compounds eg. PPD in hair dyes and hence is present in both cheap and costly OTC products. Sometimes, costly product or branded cosmetics may contain additives like fragrances or preservatives to which side effects can develop.


SUMMARY
These are certain points which clarify wrong beliefs common in our society so that correct cosmetic usage and adoption of scientific techniques be followed by the patients.









BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
CONSULTANT DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-360005
http://www.cpoint.in/
http://www.mcspl.in/
http://www.drlalseta.blogspot.com/
chetanlalseta@gmail.com
09825199585

Sponsored by the business degree web page.

dr chetan lalseta: CANDIDIASIS

dr chetan lalseta: CANDIDIASIS

CANDIDIASIS

CANDIDIASIS
Candidiasis is an acute or chronic,superficial or disseminated mycotic infection caused by the fungus candida albicans and occasionally by other species of candida.It commonly involves skin & the mucous membranes and sometimes the viscera.
FACTORS PREDISPOSING TO CANDIDIASIS
1) Local factors:
Tissue damage, moisture, warmth, maceration, Topical corticosteroids, prolonged catheterization, etc.
2) Physiological states:
Infancy, pregnancy, old age
3) Metabolic & endocrinal factors:
Iron deficiency, Diabetes mellitus, Obesity, Cushing’s syndrome
4) Immuno compromised status:
• Primary or secondary to malignancy, AIDS, prolonged administration of antibiotics, systemic corticosteroids, oral contraceptive pills, cytotoxic drugs,etc
• Development of candidiasis in an HIV infected patient indicates deterioration of his immune status.

CLASSIFICATION OF CANDIDIASIS
Based on the anatomical site involved,candidiasis is classified into the following clinical syndromes:
CANDIDIASIS
MUCOSAL CUTANEOUS SYSTEMIC

Acute pseudomembranous Paronychia Gastrointestinal
Chronic hyperplastic Intertrigo Bronchopulmonary
Angular chelitis Diaper candidiasis Renal
Denture stomatitis Nodular Joints
Vaginitis & Balinitis Candidiasis Heart,Meningeal

CLINICAL SYNDROMES:
The clinical features of candidiasis vary depending upon whether the infection involves skin or mucous membrane. On keratinized surface of skin, the infection causes well marginated, erythematous, scaling pustules, whereas on the mucous membrane, the infection produces white, cheesy deposits surrounded by erythema.
Candidial Paronychia:
Candidial paronychia is a chronic inflammation of one or more nail folds.It is characterized by redness and swelling of the affected nail fold.The initial event is injury to the cuticle followed by detachment of the nail fold from the dorsal surface of the nail plate.This leads to the formation of pocket which then collects within it food debris etc. and facilitates growth of bacteria as well as fungi.The affected nail folds are sometimes painful and tender.Often,there is concomitant bacterial infection and beads of pus are exuded on pressing the affected nail fold. Subsequently, the nail becomes dystrophic, often ridged and develops green or brown colour.
This condition is usually found in housewives,washerwomen,people practicing manicure & pedicure,in those whose hands are constantly immersed in water for prolonged periods.
Nodular Candidiasis of Napkin Area:
This condition is a atypical reaction to the candida infection, manifesting as bluish-brown nodules or cutaneous horn like lesions.It involves the napkin area over the buttocks,genitalia,upper thighs and pubis.
Topical application of steroids is an important aetiological factor.
Chronic Mucocutaneous Candidiasis:
It is a distinct syndrome characterized by persistent,superficial candidial infection of the skin,nails and mucous membrane of the mouth and genitals, refractory to conventional topical therapy. It is not a single disease entity but is a manifestation of various underlying primary defects in cell mediated immune responses.
Systemic Candidiasis:
Under conditions leading to immunocompromisation, candida may cause systemic disease and involve the lungs,oesophagus,intestines or urinary tract. Candidemia may occur following prolonged use of indwelling catheters for intravenous infusions or in intravenous drug abusers,Rarely,hematogenous spread of candida may lead to meningitis, bone and joint lesions.
The underlying disease and iatrogenic factors predisposing to infection must always be sought and treated in all forms of systemic candidiasis.
Candidial Intertrigo:
Candidial intertrigo is characterized by erythema,moist exudation with an irregular ,fringed margin and subcorneal pustules in the affected area.Satellite pustules may develop and rupture leaving erosions and peeling skin.In case of interdigital space involvement,there is marked maceration.
It involves intertriginous areas of skin like interdigital spaces, genitocrural, perianal. Inframammary and axillary folds. It most commonly occurs in obese and diabetic individuals.
Candidial intertrigo should be differentiated from tinea,seborrhoeic dermatitis,bacterial intertrigo and flexural psoriasis.
Oral Thrush:
Oral thrush usually involves buccal mucosa,tongue,gums or palate and in severe cases in pharynx too pseudomembrane is formed by fungal mycelia,desquamated epithelial cells,fibrin,leucocytes and food debris attaching to inflamed epithelium.It is loosely attached to the inflamed mucosa and when removed,leaves behind erosions and bleeding.The lesions are often painful and interfere with eating.
The condition commonly occurs in premature babies,neonates and in old people with poor resistance. In neonates it can be acquired from the birthcanal of the mother.
Angular Cheilitis:(Perleche)
Basically,perleche is a form of intertrigo which may be caused by different factors, of which candida is the commonest.Riboflavin deficiency,presence of moisture due to persistent salivation or licking of the lips,depth of the fold and malocclusion of teeth are some other factors which predispose to infection.
Denture stomatitis:
This condition is characterized by bright red or dusky erythema of the affected mucous membrane, sharply defined at the margin of the denture.The epithelium is often shiny,atrophic,oedematous and eroded.
Balanoposthitis:
Candidial balanoposthitis involves skin of the glans penis and prepuce,causing inflammation of fissuring.In mild cases, tiny papules develop on the glans a few hours after sexual intercourse, grow into vesicles,pustules and rupture leaving a scaly edge. The patient complains of soreness and pain while passing urine.
The status where both sexual partners have symptomatic genital candidiasis is known as ‘Conjugal Candidiasis’.
In either of the above case,the sexual partner of the patient should be simultaneously treated , even if asymptomatic. In persistent or recurrent cases, the patient and sexual partner should be investigated for Diabetes mellitus.
Vulvovaginitis:
Candidial vulvovaginitis is characterized by beefy red erythema of the affected vulvar skin and vaginal mucosa accompanied by creamy white, thick curdy flecks of vaginal discharge. In some cases,it may extend to cause intertrigo of groins and natal cleft.In severe cases,subcorneal pustules may be seen peripherally.Patient usually complains of soreness,pruritus and dyspareunia.
It most often occurs in diabetics because of high concentration of sugar in urine, in women during pre-menstrual period, during pregnancy, in women taking oral contraceptive pills and in patients with AIDS.
It should be differentiated from Trichomonas infection,bacterial vulvovaginitis, physiological leucorrhoea during pregnancy and dermatoses affecting the vulva.
INVESTIGATIONS FOR CANDIDIASIS:
1) Direct examination under the microscope:
Lesions are scraped with blunt end of a scalpel and the material is mounted in 2-3 drops of 10% KOH solution.When viewed directly under a microscope, it reveals gram positive yeasts and pseudohyphae, often associated with inflammatory cells.
The presence of pseudohyphae suggests candida as a pathogen.Blastophores and pseudohyphae can be demonstrated by H & E stain.
2) Culture of the selective material on Sabouraud’s Dextrose Agar:
Candida albicans forms white,creamy colonies on Sabouraud’s dextrose agar in 2-3 days. The species is identified by rounded, refractile, double walled chlamydospores,produced by subcultures on corn-meal agar for 24-96 hours at room temperature and by germ tube formation.

TREATMENT FOR CANDIDIASIS:
Treatment can be classified into two ways:
Topical and Systemic:
Topical:
1) Imidazoles:
Miconazole 2% gel/lotion/cream/powder twice daily
Clotrimazole 1% cream/gel/lotion/powder
100 mg vaginal tablet once daily for 6 days
Or 500mg single dose vaginal tablet.
Econazole 1% ointment, 150 mg vaginal tablet twice daily
Newer molecules like eberconazole,sertaconazole are also available.
2) Ethanolamine derivative:
Ciclopirox olamine 1% cream twice daily
3) Polyne antibiotics:
Nystatin 1 Lac units vaginal tablets BID for 2 weeks
Natamycin 2% cream or 25 mg vaginal tablets for 1 week.

Systemic:
1) Polyne antibiotics:
Amphoterecin B 0.3-.7mg/kg per day IV over 4-8 hrs in
systemic disease
Nystatin 5 lacs units thrice daily in Intestinal
Candidiasis.
2) Azoles:
Ketoconazole 200 mg orally OD or BID for 2 weeks in
Mucocutaneous candidiasis.
Fluconazole 150 mg single dose orally for vaginitis &
Balanitis.
150 mg once weekly for three weeks for
recurrent vaginal candidiasis.
Itraconazole 200mg/day for 3 days for vaginitis and
Balanitis.
200 mg on first day of menstrual cycle for
three months for recurrent vaginal candidiasis.

PREVENTIVE MEASURES AGAINST CANDIDIASIS:

Avoid:
• Prolonged warking in water.
• Tight fitting clothes,synthetic or woolen undergarments and socks.
• Closed and tight footwears.

Advised:
• Maintain good personal hygiene
• Use gloves and cotton liners while working in water.
• Use loose clothing and absorbent cotton undergarments and socks.
• Use open footwear.
• Thoroughly dry the intertriginous areas and apply simple talcum or an antifungal powder.
• Simultaneously treat the sexual partner, even if asymptomatic, in case of balanitis and vaginitis.

BY:
DR CHETAN LALSETA
M.D.(Skin & V .D)
CONSULTANT DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-360005
www.cpoint.in
www.mcspl.in
www.drlalseta.blogspot.com
chetanlalseta@gmail.com
09825199585

Sponsored by the business degree web page.

BALANCE SHEET OF LIFE

Our Birth is our Opening Balance !

Our Death is our Closing Balance!
Our Prejudiced Views are our Liabilities

Our Creative Ideas are our Assets

Heart is our Current Asset

Soul is our Fixed Asset

Brain is our Fixed Deposit

Thinking is our Current Account

Achievements are our Capital

Character & Morals, our Stock-in-Trade

Friends are our General Reserves

Values & Behaviour are our Goodwill

Patience is our Interest Earned

Love is our Dividend

Children are our Bonus Issues

Education is Brands / Patents

Knowledge is our Investment

Experience is our Premium Account

The Aim is to Tally the Balance Sheet Accurately.

The Goal is to get the Best Presented Accounts Award.


Some very Good and Very bad things...

The most destructive habit....... ......... ......Worry

The greatest Joy......... ......... ......... ....Giving

The greatest loss........ ........Loss of self-respect

The most satisfying work........ .......Helping others

The ugliest personality trait........ ......Selfishnes s

The most endangered species..... ....Dedicated leaders

Our greatest natural resource.... ......... ..Our youth

The greatest "shot in the arm"........ ..Encouragement

The greatest problem to overcome.... ......... ....Fear

The most effective sleeping pill........ Peace of mind

The most crippling failure disease..... .......Excuses

The most powerful force in life......... ......... .Love

The most dangerous pariah...... ......... ...A gossiper

The world's most incredible computer.... ....The brain

The worst thing to be without..... ......... ..... Hope
The deadliest weapon...... ......... ........The tongue

The two most power-filled words....... ........" I Can"

The greatest asset........ ......... ......... .....Faith

The most worthless emotion..... ......... ....Self- pity

The most beautiful attire...... ......... .......SMILE!

The most prized possession.. ......... .....Integrity

The most powerful channel of communication. ....Prayer

The most contagious spirit...... ......... ..Enthusiasm

The most important thing in life........ ......... .GOD

DR CHETAN LALSETA
CONSULTANT DERMATOLOGIST
SHRADDHA HOSPITAL
INDIRA CIRCLE CHOWK
RAJKOT
GUJARAT,INDIA
09825199585
chetanlalseta@gmail.com
www.cpoint.in,
www.mcspl.in
www.drlalseta.blogspot.com

HOW TO OVERCOME OBESITY

HOW TO OVERCOME OBESITY

FACTS ON OBESITY:
• Globally, there are more than 1 billion overweight adults, atleast 300 million of them are obese.
• Obesity and overweight is a major risk to Type 2 diabetes, cardiovascular disease,hypertension and stroke and certain forms of cancer.
• The key factors are increased consumption of energy dense foods high in saturated fats and sugars and physical inactivity.
• As a rule,women have more body fat than men.Most healthcare professionals agree that men with more than 25% body fat and women with more than 30% body fat are obese.
OBESITY:
“Obesity” refers to an excessive amount of body fat.
“Overweight” refers to an excessive amount of body weight that includes muscle,bone,fat & water.
MEASUREMENT OF OBESITY:
Body Mass Index:
The BMI is a tool used to assess overweight and obesity and monitor changes in body weight.It is calculated by dividing a person’s weight in pounds by height in inches squared.
WEIGHT CATEGORY BMI SCORE
Underweight Below 18.5
Healthy weight 18.5 to 24.9
Overweight 25 to 29.9
Obese 30 and above
CAUSES OF OBESITY:
The balance between caloric intake and energy expenditure determines a person’s weight.Some contributing factors for obesity are:
• Genetics: A person is more likely to develop obesity if one or both parents are obese.
• Overeating: Overeating leads to weight gain.especially if the diet is high in fat.
• Slow metabolism: Women have less muscle mass than men.Muscle burns more calories than other tissues.As a result, women have slower metabolism than men, and hence have a tendency to put on more weight than men,and weight loss is more difficult in women.
• Physical inactivity: The National Health & Examination Survey showed that physical inactivity is strongly correlated with weight gain in both sexes.
• Medications: Medications associated with weight gain includes Steroids,Antidepressants and anticonvulsants.
• Psychological factors: Emotions influences eating habits in some persons,specially during boredom,sadness,stress or anger.
• Lack of sleep may also contribute to obesity.

CONSEQUENCES OF OBESITY:

Health risks:
• Gallbladder diseases & gall stones.
• Fatty liver diseases.
• Gastroesophageal reflux.
• Osteoarthritis and Gout.
• Pulmonary problems including sleep apnea.
• Reproductive problems in women including menstrual irregularities and infertility.
Psychological and Social Effects:
Emotional suffering may be one of the most painful parts of obesity.Feelings of rejection,shame or depression may occur.

MANAGEMENT OF OBESITY:
Doctors generally agree that people who have BMI of 30 or more can improve their health through weight loss.
Preventing additional weight gain is recommendedif one has BMI between 25 and 29.9.
Treatment of Obesity:
The method of treatment depends on level of obesity,overall health condition & readiness t lose weight.Treatment may include a combination of diet,exercise,behavior modification,weight loss drugs and Bariatric surgery.
Following steps are important to work towards a healthier weight.
1) Establish a reasonable target weight:
• Discuss the BMI score with ur expert doctor & let them assess the related risk factors for disease and health problems.
• Depending on person’s circumstances,a reasonable target goal may be a weight loss of 10% of body weight over six months.
• In some case, minimum goal may be to prevent further weight gain.
• It is best to lose weight gradually—keep in mind that small amount of weight loss can have positive health impact.
2) Best Health Diet Tips:
• Drink plenty of water or other calorie free beverages.
• Think about what you can add to diet, not what you should take away.
• Consider whether you are really hungry.
• Be choosy about nighttime snacks.
• Enjoy your favourite foods.
• Eat several mini-meals during the day.
• Eat protein at every meal.
• Order children’s portion at restaurants.
• Use non-food alternative to cope with stress.
• Have oily free food and also avoid junk foods like pizzas,burgers,etc.
• Avoid to have food while watching television.
3) Be as active as possible:
• Any kind of physical activity is beneficial.Not only can it assist with weight loss & maintenance,it also improves health in many ways.
• Work towards a long term goal of atleast 30 minutes of a moderate physical activity on most days of the week.
• It is best to start any new physical activity gradually,taking special care to prevent injury.
4) Choose Aerobic activities that are fun:
People are more likely to remain active if they like what they are doing.Choose activities accordingly:
• Brisk walking or jogging
• Bicycling
• Swimming
• Aerobic exercise classes
• Dancing
• Playing basketball or soccer
5) Be Good to yourself:
Try some of this ideas to help relieve stress and stay on track with your fitness and nutrition goals.
• Get plenty of sleep.
• Practise deep breathing and relaxing muscles one at a time.
• Take a breath and go for a walk.
• Take short stretch breaks throughout the day.
• Try taking yoga class to energize yourself and reduce stress.
• Try a new hobby,like a pottery class.
• Surround yourself with company of enjoyable people.
• Laughter is one of the most relaxing thing.
• Think of activities that will give your spirit a little lift.
6) Weigh every week & keep records:
• People who weigh once a week tends to be more successful at maintaining a weight loss.
• Keeping records is helpful in assessing overall progress in weight.
• Keeping a record of food consumed each day can help maintain the focus on diet plan and provide additional information related to progress.
• Keeping an activity chart can help in keeping track of whether physical activity goals are being met.
• Keep realistic fitness goals.
7) Role of medication in the treatment of Obesity:
Medication treatment of obesity should be used only in patients who have health risks related to obesity—such as Diabetes,Hypertension,etc.
Like diet and exercise, the goal of medication treatment should be realistic.With successful medication treatment, one can expect an initial weight loss of at least 5 pounds during 1-3 months of treatment and a total weight loss of 10-15% of the initial body weight.
8) Surgery for Obesity:
For those severely obese patients and associated all risk factors of obesity, Bariatric surgery offers good option not only to reduce weight but also relief in risk factors.

BY:
DR CHETAN LALSETA
M.D.(Skin & V.D.)
CONSULTANT DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL COMPANY
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-04
9825199585
chetanlalseta@gmail.com
www.cpoint.com
www.drlalsetablogspot.com

Sponsored by the business degree web page.

SKIN CHANGES DURING PREGNANCY

COMMON DERMATOLOGICAL MANIFESTATIONS DURING PREGNANCY
Pregnancy is a physiological event and skin being a dynamic organ, variety of skin changes can be seen during pregnancy.Some of the commonest one,usually harmless, are mentioned here and how one can help to overcome them.
SKIN CHANGES DURING PREGNANCY INCLUDES:
1) Stretch marks(Striae)
2) Skin tags
3) Changes in hair growth
4) Acne vulgaris
5) Pregnancy glow
6) Generalised hyperpigmentation
7) Accentuation of moles & freckles

1) What are stretch marks(striae)?
Stretch marks are linear lesions that most often develop over the breasts,hips,abdomen & thighs. They begin as reddish purple lines and with time,they become white atrophic(cigarette paper like wrinkled) scars.Stretch marks are common in pregnancy and it occurs in 50 to 90% of pregnant women.
Do stretch marks cause any symptoms?
Most of the times they are aymptomatic but rarely may cause burning and itching.
What causes stretch marks in pregnancy and who gets them?
The exact mechanism of development of stretch marks is still not fully understood.It is commonly thought to be caused by rapid weight gain and subsequent overstretching of the skin;though not proven.
Stretch marks are often seen in more than one family member.A personal history(e.g.appearance of striae during teens),race(more common in Africans compared to Caucasians)and other genetic factors play part in the development of stretch marks.They are more frequently seen in young women who are overweight and have large babies.
When do stretch marks appear during pregnancy?
Usually stretch marks begin to appear around 25th week of pregnancy,although some women may develop even earlier.
Is there any health risk if stretch marks are present?
No there are no risks associated with stretch marks. However they may look cosmetically unpleasant and may cause emotional distress.
What happens to stretch marks after delivery?
Most of the stretch marks fade of its own after delivery.
Can stretch marks be treated or prevented?
There are no good and satisfactory proven treatments to treat or prevent stretch marks.Many therapies are done empirically and may offer some benefit in few cases.
Olive oil massage,castor oil,cocoa butter soothing,glycolic or fruit acids,homeopathic creams and/or oils are used with little effects.Many expensive and painful treatments are often tried without any outcome and hence is not recommended.
Daily massage of the skin with simple moisturizer may be tried
Post pregnancy retinoids can be used as they help to fade stretch marks-however they are absolutely contraindicated during pregnancy because of their potential harmful effect on foetus. LASER treatment (585 nm flashlamy-pulsed dye laser) may be effective in some cases.

2) SKIN TAGS(ACROCORDON):
Skin tags are very small 1-5 mm,loose,polyp like,skin coloured growths of skin that usually appear in underarms,neck or breasts.The increased incidence of skin tags during pregnancy is hormonally induced at areas exposed to mechanical irritation.They may disappear after delivery.However if they persists, can easily be removed by electrocautery,radiofrequency or CO2 LASER.
3) CHANGES IN HAIR GROWTH:
During pregnancy more hair goes into the resting phase,a particular part of the normal hair cycle.This causes diminished shedding of the hair and is perceived as hair thickening by patient.Three months after delivery the hair cycle normalizes causing temporarily more hair loss in many women.This is known as Telogen Effluvium.This process is usually completed in 6-12 months after delivery.Thereafter the hair will usually be the same as before pregnancy.
Pregnant women may sometimes experience male pattern hair growth like in beard region.This phenomenon is also related to hormonal change.It tends to disappear in few months after delivery.
4) ACNE VULGARIS:
The increased levels of female hormones during pregnancy usually improves acne. But there may be worsening of acne in some patients.
5) PREGNANCY GLOW:
During pregnancy the blood circulation of the skin is significantly increased which causes face to be brighter.The increased production of hormones may stimulate glands that produce sebum resulting in shiny face.”Pregnancy glow” is an old fashioned phrase to describe this phenomenon.
If patient feels skin too oily,an oil free cleanser or a mild alcoholic (50-70%) solution containing salicylic acid(1-3%) for cleansing the face can be used.Cold and warm water may also be used.
6) GENERALISED HYPERPIGMENTATION:
Increased skin pigmentation is common during pregnancy particularly in dark skinned women in whom up to 90% may be affected.There is darkening of nipples,genitalia and linea alba will develop.In some women recent scars will darken.The unsightly and sometimes distressing facial pigmentation called melasma or chloasma also known as ‘Mask of pregnancy’affects many women.It gets worse with sunlight and can be reduced by the use of High Sun Protective Factor UVB & UVA sunscreens.It usually disappears after pregnancy by itself,if not it may be treated by Dermatologists.



BY:
DR CHETAN LALSETA
M.D.(Skin & V.D.)
CONSULTANT DERMATOLOGIST & COSMETOLOGIST
“C POINT”—A UNIT OF MCSPL COMPANY
SHRADDHA HOSPITAL,INDIRA CIRCLE CHOWK,
RAJKOT-04
9825199585
chetanlalseta@gmail.com
www.cpoint.com
www.drlalseta.blogspot.com

Mirror skin polishing & brightening treatment

Introduction
Our skin tends to get affected by external & internal factors like stress, hectic lifestyles & increasing levels of environmental pollution. As a result skin is dull, dry, dehydrated with reduced elasticity. There are many procedures available today that help to rejuvenate skin. MIRROR Skin Polishing & Brightening or ‘Microdermabrasion’ as it is commonly known is one of the most effective yet safe technologies available. This regime is a breakthrough in skin treatment. If your skin needs to regain its natural radiance and skin clarity, this is the perfect treatment for it.

MICRODERMABRASION.

It is a skin procedure done at MIRROR to enhance the quality of the skin. It is a machine- based manually controlled abrasion of the superficial layer of skin. In this method, a controlled flow of Aluminium oxide crystals is used to gently exfoliate the uppermost superficial dead layers of the skin It is a very effective skin polishing treatment using fine crystals that are directed on the skin through a vacuum tube and thus allowing a radiant translucent skin to emerge. This treatment removes dead surface skin cells to improve texture, softness, and brightness. It also stimulates cell and collagen production and reduces the appearance of large pores. Various defects in the surface of the skin can thus be addressed to reveal fresher, clearer skin in an effective and painless manner. Special Diamond tip microdermabrasion is helpful in superficial to mediun depth scarring.This treatment or procedure can be done with other facial treatments to optimize results.

FAQ’S ABOUT MIRROR SKIN POLISHING & BRIGHTENING TREATMENT

Why does one need Skin Polishing & Brightening? At what age can one start this service?

MIRROR Skin Polishing & Brightening is recommended for every one since at some point in time we are subjected to stress & increasing levels of environmental pollution. These factors cause our skin to get dull and pigmented. Due to over exposure to the sun, our skin gets damaged and one shows early signs of ageing. Such skin concerns need to get addressed and this is done with visible results through our service called MIRROR Skin Polishing & Brightening.Practically in post pubertal age group,in both males & females, this treatment can be done safely & effectively.

How is Skin Polishing & Brightening different from facials?
The MIRROR Skin Polishing & Brightening procedure has some advantages over facials
It is useful in a wide range of skin problems like acne prone skin,fine wrinkles,photodamaged skin and superficial and medium depth acne scarring safely and effectively.
Removal of dead cells is uniform and is done very effectively and the service remains to be non-invasive.
It can be used synergistically with chemical peels when better results are expected.


What is the procedure involved in MIRROR Skin Polishing and Brightening?
Crystal Sensitivity Check: on your forearm
Cleansing the face is then cleansed with the MIRROR Cleansing gel
Skin Polishing & Brightening: The dead, superficial skin cells on the uppermost layer of the skin are removed through a controlled flow of crystals.
Application of MIRROR products: After the procedure, a combination of products, which brighten the skin and improve skin tone are applied to your face. These products also have moisturizing & sun protection properties.



MIRROR Skin Polishing & brightening addresses skin concerns such as dull skin,superficial & medium depth acne scars, fine lines and wrinkles & Sun damaged skin. This service can also be undertaken as part of your regular skin care and enhancement regime.
Is the treatment for MIRROR Skin Polishing and Brightening Safe?
Yes,MIRROR Skin Polishing & Brightening is an extremely safe procedure and is recommended for all skin types. At MIRROR as an added precaution a crystal sensitivity check is done to rule out a rare case of sensitivity.
Are there any side effects whilst doing a MIRROR Skin Polishing and Brightening treatment?
MIRROR skin polishing & Brightening is absolutely safe,painless & non-invasive procedure and there are no side effects of it. However, very sensitive skin may become red due to the exfoliation action. However, this effect is transient. A cold compress is recommended in such a rare case.

What are the body parts for MIRROR Skin Polishing & Brightening?
Most commonly employed body parts are face,neck,forearm & back,however in indicated person it can be done practically at any body parts.
How long does each session take?
The duration of MIIRROR Skin Polishing and Brightening usually lasts about 30 minutes per session.

Can I return to regular activities immediately after a session of MIRROR Skin Polishing & Brightening?
MIRROR Skin polishing and Brightening requires no post procedure care. You can resume normal activities immediately. However in some cases of sensitive skin, direct sun exposure to excessive sunlight should be avoided and a sunscreen with a minimum SPF of 15 should be used regularly.

How many sessions are required to see best results?
Our skin is a dynamic organ. Excessive exposure to years of dust, pollution and harmful UV rays occurs continuously. Everyone has different skin and skin tones, with different levels of skin concerns. However at least 4 sessions are required to see visible results.Depending on indications, number of sessions and duration between session may vary accordingly

Does this service have to be continued to maintain the results achieved?
To maintain the look achieved one monthly session is recommended.Can I undertake MIRROR Skin Polishing & Brightening just before a special occasion such as a party?Due to the exfoliation action, the immediate effect can be reddening of the skin, which subsides within hours. In extra sensitive skin, the effect lasts a day. Therefore Ideally you should get MIRROR skin lightening & brightening procedure 2 to 3 prior to occasion.
FOR QUERIES OR COMMENT,CONTACT;
DR CHETAN LALSETA
M.D.(SKIN & V.D.)
CONSULTANT DERMATOLOGIST & COSMETOLOGIST
MIRROR LASER & COSMETIC CENTRE,
( A UNIT OF MCSPL COMPANY)
SHRADDHA HOSPITAL,
INDIRA CIRCLE CHOWK,
RAJKOT-04
CONTACT NO: 98251 99585
Chetanlalseta@gmail.com

HAIR DISORDERS

HAIR DISORDERS

Hair disorders are amongst the common skin problems affecting all class of population at one or another time. Commonest of them are briefly mentioned here.
1) ALOPECIA AREATA:
Definition and clinical features
A non-scarring auto immune disorder affecting any hair-bearing area. Typically, there is a sudden onset of solitary or multiple circular or oval bald areas,usually affecting the scalp.The residual hair follicles are visible confirming a lack of scarring.Diagnostic exclamation mark hairs may be visible at the margins of the lesion. The affected scalp is usually normal in color but may be erythematous.Hairs at the edge of the patch may be easily removed on slight traction. Spontaneous regrowth frequently occurs but the areas may spread peripherally and may eventually involve the whole scalp( Alopecia Totalis) and sometimes even facial & body hairs( Alopecia Universalis).
Rarely, a diffuse alopecia may be seen without discrete bald patches.Nail changes may also occur as fine regular pitting or a roughened sand paper appearance(Trachyonychia).
Epidemiology
A common disorder affecting all races and either sex equally. It occurs at any age,with maximum incidence between 10-30 years.
Differential Diagnosis
Fungal infection of scalp—may be confirmed by Wood’s light and mycological examination.Trichotillomania—shows broken hairs of varying length.Telogen effluvium also causes diffuse non-scarring alopecia.
Investigations
An autoimmune basis is suggested.Organ specific antibodies may be demonstrated. A family history of alopecia areata occurs in 20-50% of patients. Scalp biopsy is supportive.
Management
Spontaneous regrowth may occur in localized disease.Topical,intralesional & systemic corticosteroids can produce temporary regrowth.Contact sensitization therapy using irritants or allergens & PUVA are also used. The more extensive the hair loss, the less likely the prospect of regrowth.Extensive involvement, atopy, other autoimmune diseases, nail involvement and onset in childhood are poor prognostic factors.

2) TELOGEN EFFLUVIUM:
Definition and clinical features
Sudden extensive hair loss occurring 4-8 weeks following the precipitating event. Several hundred hairs may be lost per day, producing an alopecia diffusely affecting the entire scalp.Pre-existing androgenetic alopecia may become more evident, the scalp appears normal and duration is variable(recovery is usually complete within 6 months).
Epidemiology
Occurs at any age but most frequently in young adults.Female:Male ratio is 2:1.
Differential Diagnosis
Diffuse scalp alopecia can also occur with alopecia areata, hypothyroidism,iron deficiency,anaemia,and may be caused by drugs.
Investigations
Trichogram (plucked scalp hairs) will show an increase in the number of telogen hairs and reduction in anagen hairs.
Special points
Acute precipitating factors include childbirth,pyrexia, haemorrhage,changing or discontinuing hormonal therapy(including oral contraceptive pills),eating disorders,strict dieting and nutritional deficiencies.
3) ANDROGENETIC ALOPECIA(MALE PATTERN BALDNESS):
Definition and clinical features
Miniaturisation of hair follicle through successive cycles affecting the fronto-vertex and crown of the scalp, producing a gradual conversion of terminal to villus hairs. The scalp hair loss begins with recession at the temples and the frontal hairline in men(Hamilton pattern) and thinning over the crown and vertex. This slowly progresses over years, in severe cases hair remains at the occiput and sides of the scalp alone.Vellus hair may remain on the vertex.In women(Ludwig pattern) the frontal hairline is frequently kept but a difuse thinning occurs over the top of the scalp.In women, associated hirsutism,acne vulgaris,obesity and irregular menses may suggest an underlying polycystic ovarian syndrome.
Epidemiology
Affects all races world wide, occurring physiologically from the late teens to the 50s.In women, occurs usually post menopausally.The condition requires genetic predisposition and normal amounts of circulating plasma androgens.
Differential Diagnosis
Telogen effluvium may produce diffuse alopecia but usually affects the back and sides of the scalp as well as the fronto-vertex.Hair styles producing traction may cause recession of the anterior hair margin.
Investigations
In women,hormone profile and ovarian ultrasound scan may confirm underlying polycystic ovarian syndrome.
Management
Treatment includes topical measures such as Minoxidil lotion, systemic antiandrogens in women or scalp reduction or hair transplantation surgery.
4) TRICHOTILLOMANIA:
Definition and clinical features
Self-induced alopecia produced by deliberate trauma to the hair. A diffuse area of thinned hair with a poorly defined margin.Scalp skin is normal.Affected hairs show breakage of varying lengths.The area may be solitary or multiple. A normal,long haired margin often remains.The scalp is usually affected but hair loss may also occur in the eyebrows, eyelashes or body hair.
Epidemiology
Trichotillomaia occurs more frequently in females than males(3:1) but may occur at any age.Most frequently it occurs between the ages of ages of 5 & 10 years developing as a habit tic.In older women it may be a sign of underlying psychiatric disorder.Anxiety & emotional stress are precipitating factors.
Differential Diagnosis
Alopecia areata produces more discrete,completely bald areas of patches.Tinea capitis can produce broken hairs,scaling and inflammation may be present.
Investigations
Hair microscopy will reveal broken hairs of varying lengths.
Management
Occlusion of the area often allows recovery.Children frequently outgrow the habit tic,whilst in adults psychiatric therapy may be required.



BY:
DR CHETAN LALSETA
M.D.(SKIN & V.D.)
CONSULTANT DERMATOLOGIST & COSMETOLOGIST
MIRROR LASER & COSMETIC CENTRE,
SHRADDHA HOSPITAL,
INDIRA CIRCLE CHOWK,
RAJKOT-04
CONTACT NO: 98251 99585
Chetanlalseta@gmail.com

HAIR DISORDERS

HAIR DISORDERS

Hair disorders are amongst the common skin problems affecting all class of population at one or another time. Commonest of them are briefly mentioned here.
1) ALOPECIA AREATA:
Definition and clinical features
A non-scarring auto immune disorder affecting any hair-bearing area. Typically, there is a sudden onset of solitary or multiple circular or oval bald areas,usually affecting the scalp.The residual hair follicles are visible confirming a lack of scarring.Diagnostic exclamation mark hairs may be visible at the margins of the lesion. The affected scalp is usually normal in color but may be erythematous.Hairs at the edge of the patch may be easily removed on slight traction. Spontaneous regrowth frequently occurs but the areas may spread peripherally and may eventually involve the whole scalp( Alopecia Totalis) and sometimes even facial & body hairs( Alopecia Universalis).
Rarely, a diffuse alopecia may be seen without discrete bald patches.Nail changes may also occur as fine regular pitting or a roughened sand paper appearance(Trachyonychia).
Epidemiology
A common disorder affecting all races and either sex equally. It occurs at any age,with maximum incidence between 10-30 years.
Differential Diagnosis
Fungal infection of scalp—may be confirmed by Wood’s light and mycological examination.Trichotillomania—shows broken hairs of varying length.Telogen effluvium also causes diffuse non-scarring alopecia.
Investigations
An autoimmune basis is suggested.Organ specific antibodies may be demonstrated. A family history of alopecia areata occurs in 20-50% of patients. Scalp biopsy is supportive.
Management
Spontaneous regrowth may occur in localized disease.Topical,intralesional & systemic corticosteroids can produce temporary regrowth.Contact sensitization therapy using irritants or allergens & PUVA are also used. The more extensive the hair loss, the less likely the prospect of regrowth.Extensive involvement, atopy, other autoimmune diseases, nail involvement and onset in childhood are poor prognostic factors.

2) TELOGEN EFFLUVIUM:
Definition and clinical features
Sudden extensive hair loss occurring 4-8 weeks following the precipitating event. Several hundred hairs may be lost per day, producing an alopecia diffusely affecting the entire scalp.Pre-existing androgenetic alopecia may become more evident, the scalp appears normal and duration is variable(recovery is usually complete within 6 months).
Epidemiology
Occurs at any age but most frequently in young adults.Female:Male ratio is 2:1.
Differential Diagnosis
Diffuse scalp alopecia can also occur with alopecia areata, hypothyroidism,iron deficiency,anaemia,and may be caused by drugs.
Investigations
Trichogram (plucked scalp hairs) will show an increase in the number of telogen hairs and reduction in anagen hairs.
Special points
Acute precipitating factors include childbirth,pyrexia, haemorrhage,changing or discontinuing hormonal therapy(including oral contraceptive pills),eating disorders,strict dieting and nutritional deficiencies.
3) ANDROGENETIC ALOPECIA(MALE PATTERN BALDNESS):
Definition and clinical features
Miniaturisation of hair follicle through successive cycles affecting the fronto-vertex and crown of the scalp, producing a gradual conversion of terminal to villus hairs. The scalp hair loss begins with recession at the temples and the frontal hairline in men(Hamilton pattern) and thinning over the crown and vertex. This slowly progresses over years, in severe cases hair remains at the occiput and sides of the scalp alone.Vellus hair may remain on the vertex.In women(Ludwig pattern) the frontal hairline is frequently kept but a difuse thinning occurs over the top of the scalp.In women, associated hirsutism,acne vulgaris,obesity and irregular menses may suggest an underlying polycystic ovarian syndrome.
Epidemiology
Affects all races world wide, occurring physiologically from the late teens to the 50s.In women, occurs usually post menopausally.The condition requires genetic predisposition and normal amounts of circulating plasma androgens.
Differential Diagnosis
Telogen effluvium may produce diffuse alopecia but usually affects the back and sides of the scalp as well as the fronto-vertex.Hair styles producing traction may cause recession of the anterior hair margin.
Investigations
In women,hormone profile and ovarian ultrasound scan may confirm underlying polycystic ovarian syndrome.
Management
Treatment includes topical measures such as Minoxidil lotion, systemic antiandrogens in women or scalp reduction or hair transplantation surgery.
4) TRICHOTILLOMANIA:
Definition and clinical features
Self-induced alopecia produced by deliberate trauma to the hair. A diffuse area of thinned hair with a poorly defined margin.Scalp skin is normal.Affected hairs show breakage of varying lengths.The area may be solitary or multiple. A normal,long haired margin often remains.The scalp is usually affected but hair loss may also occur in the eyebrows, eyelashes or body hair.
Epidemiology
Trichotillomaia occurs more frequently in females than males(3:1) but may occur at any age.Most frequently it occurs between the ages of ages of 5 & 10 years developing as a habit tic.In older women it may be a sign of underlying psychiatric disorder.Anxiety & emotional stress are precipitating factors.
Differential Diagnosis
Alopecia areata produces more discrete,completely bald areas of patches.Tinea capitis can produce broken hairs,scaling and inflammation may be present.
Investigations
Hair microscopy will reveal broken hairs of varying lengths.
Management
Occlusion of the area often allows recovery.Children frequently outgrow the habit tic,whilst in adults psychiatric therapy may be required.



BY:
DR CHETAN LALSETA
M.D.(SKIN & V.D.)
CONSULTANT DERMATOLOGIST & COSMETOLOGIST
MIRROR LASER & COSMETIC CENTRE,
SHRADDHA HOSPITAL,
INDIRA CIRCLE CHOWK,
RAJKOT-04
CONTACT NO: 98251 99585
Chetanlalseta@gmail.com