Androgenic Alopecia

Alopecia

Alopecia: A Look at Abnormal Hair Loss
 
Our hair grows in cycles, and at any given time, a small percentage of our hair follicles are at a point in the growth cycle where the hair is shed in preparation for new hair to begin growing. Normal individuals lose some hair every single day. While previous estimates on what constitutes 'normal' hair loss have been quoted as high as 100 to 150 hairs a day, recent studies show that number to actually be closer to 35 to 40 hairs a day. This means that you will see evidence of some shedding of hairs as part of your normal grooming routine.

Androgenic Alopecia:
 
Androgenic alopecia, also called Androgenetic alopecia, is the most common form of alopecia and is the result of genetics, aging, and hormonal changes that combine to cause changes in the hair follicle. These changes result in the miniaturization of the terminal hair into vellus hair. The condition can found in individuals from their teens and upward in age. It is frequently seen by the age of forty.
 Female Pattern Baldness: 

In general, when women develop alopecia they typically have a diffuse thinning (less hair all over), in contrast to men who more frequently have a "patterned" type (hair loss that spares the back and sides of the head). Like men, women also suffer from androgenetic alopecia (genetic female balding), but unlike male pattern baldness women often maintain their frontal hairline. In contrast, men characteristically lose a significant amount of hair in the front part of their scalp from the very beginning. Androgenetic Alopecia is a common cause of female balding and the most likely reason for excessive hair loss.

There are a number of reasons to explain why hair loss in women presents differently than in men (although all of the factors are still not completely understood). The most important reason for difference in hair loss pattern is the difference in steroid metabolism; the metabolism of hormones, hormones which play an important role as the cause of hair loss both in women and men. It is because of this reason that the management, treatment and medication of androgenetic alopecia in women is different than for male pattern baldness.

Causes of Excessive Hair Loss:

Hair loss in women is most often very gradual, with the rate accelerating during pregnancy and at menopause. It is more often cyclical than in men, with seasonal changes that reverse themselves, and it is more easily affected by hormonal changes, medical conditions, and external factors. Hormone imbalance can also play some role in the manifestation of androgenetic alopecia and as the cause for excessive hair loss. Women after menopause may have a net drop in the androgen antagonist estrogen and are much more susceptible to the onset of pattern baldness or female balding. Other women who produce high levels of androgens are those who suffer from polycystic ovary syndrome (PCOS) which makes them more susceptible to hair loss.

With regards,

Dr Parmjit Walia

Consultant dermatosurgeon

Dr Walia skin & laser clinic

Scf-30, phase-3b2, Mohali.                     

0172-2221456, 09417015261

www.drwaliaskinclinic.com

      

Hair Transplantation

Hair Transplantation

Hair transplantation is a surgical technique that involves moving skin containing hair follicles from one part of the body (the donor site) to bald or balding parts (the recipient site). It is primarily used to treat male pattern baldness, whereby grafts containing hair follicles that are genetically resistant to balding are transplanted to bald scalp. However, it is also used to restore eyelashes, eyebrows, and beard hair, and to fill in scars caused by accidents or surgery such as face-lifts and previous hair transplants.

Follicular Unit Extraction (FUE) Hair Transplant

Follicular unit extraction or FUE is a hair transplant technique in which a small round punch is used to extract follicular units from a patient's bald resistant donor areas. These 1, 2, 3 and 4 hair follicular unit grafts are then transplanted into a patient's balding areas.
Given the time consuming and tedious nature of this procedure a physician is often limited to transplanting 500 to 800 follicular unit grafts in one day. The cost per graft of FUE is also typically twice the cost of the standard follicular unit hair transplant procedure in which a strip of donor tissue is removed from the back of the head and trimmed under magnification into individual follicular unit grafts.

How a FUE Hair Transplant is performed?

FUE hair transplant is a surgical procedure in which skin containing hair follicular unit (each unit has 1-5 hairs) are extracted from one part of the body (the donor side) to implant to bald area (the recipient side). The hair plantation here is done under local anesthesia; the patient remains conscious during the period of surgical procedure of hair transplantation. Hair transplant by FUE is done in sessions in one session patient can have 2-4 sittings in which he can get about 2000-3000 follicular grafts combined from scalp and body and even more if the patient desire so. FUE is today's most advance technique of hair transplant, which gives permanent and natural appearance to the person who undergoes hair transplant here from India as well as abroad. A person after transplantation can go back to his work within 24 hours and later on use any kind of shampoo & oil. Next session transplant surgery can be done after a period of 6-8 months.
Primarily this technique was used to restore male pattern baldness only but now days this Technique is used to restore moustache, beard, eyebrow hair plantation, eyelashes hair implant and restoration of hair in women as well. Hair of any part of the body can become donor and can be transplant to any part of the body. We have given hundreds of people back their looks by making their hair re-grow by transplantation using FUE and FUT.

With regards,

Dr Parmjit Walia

Consultant dermatosurgeon

Dr Walia skin & laser clinic

Scf-30, phase-3b2, Mohali.                     

0172-2221456, 09417015261

www.drwaliaskinclinic.com

Fraxel Re-Store Laser

Fraxel Re-Store Laser

1.   What is Fraxel Re-Store Laser?

Fraxel treatment is a revolutionary laser treatment that helps you to remove years from your appearance. The innovative Fraxel Laser is specially designed to alter only fractional volumes of the target tissue. The clinical effect of this treatment technique is to alter the appearance of aging and sun-damaged skin.

2.   How does Fraxel Re-Store treatment work?

Fraxel Re-Store laser treatment targets aging and sun-damaged skin with microscopic laser columns that penetrate deep into your skin to expedite your body’s remodeling of collagen. And since the laser treats only a fraction of tissue at a time, it leaves the surrounding tissue intact, which promotes very rapid healing. Fraxel Re-Store treatment resurfaces your skin by stimulating the growth of new, healthy skin cells from the inside out.

3.   What problem it treats?

Acne Scar

Surgical scars

Accidental Scar

Burn Scar

Chicken pox scar

Melasma (irregular patches of brown skin on the forehead, cheeks, upper lip and nose)

Dark circle

Fine wrinkles

Facial rejuvenation

Stretch marks

4.   How Fraxel Re-Store treatment is performed?

First, your skin will be cleansed. Then, about 60 minutes prior to treatment, a topical anesthetic ointment will be applied to the treatment area. The Fraxel Re-Store procedure takes 3 to 5 minutes for a full face rest it depends on the area.

5.   How many numbers of sittings are required?

3-5 sittings are recommended spaced about 21 to 30 days. The maximum effect comes in 15days. Redness & mild swelling can occur which goes off in 1-2 days. Your skin will naturally bronze over the next week and it will flake and exfoliate normally. Strictly avoid sun exposure. Put lot of sunscreen whenever go out and cover that particular area which is treated.

6.   What are the benefits of Fraxel Re-Store treatment?

Smoother, fresher, younger-looking looking skin

Improved tone and texture

Erasing of unwanted brown spots

Reduced fine lines and wrinkles around the eyes

Improved appearance of acne scars and surgical scars

Atopic Dermatitis

Atopic dermatitis

The skin of a patient with atopic dermatitis reacts abnormally and easily to irritants, food, and environmental and becomes red, flaky and very itchy. It also becomes vulnerable to surface infections caused by bacteria. The skin on the flexural surfaces of the joints (for example inner sides of elbows and knees) are the most commonly affected regions in people.

Atopic dermatitis most often begins in childhood before age 5 and may persist into adulthood. For some, it flares periodically and then subsides for a time, even up to several years.

Although atopic dermatitis can theoretically affect any part of the body, it tends to be more frequent on the hands and feet, on the ankles, wrists, face, neck and upper chest.

In most patients, the usual symptoms that occur with this type of dermatitis are aggravated by a, dry skin, stress, low humidity and sweating, dust or sand or cigarette smoke. Also, the condition can be worsened by having long and hot baths or showers, solvents, cleaners or detergents and wool fabrics or clothing.

 Symptoms

Approximately 50% of the patients who develop the condition display symptoms before the age of 1, and 80% display symptoms within the first 5 years of life.

The first sign of atopic dermatitis is the red to brownish-gray colored patches that are usually very itchy. Itching may become more intense during the night. The skin may present small and raised bumps which may be crusting or oozing if scratched, which will also worsen the itch. The skin tends to be more sensitive and may thicken, crack or scale.

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Prevention

Since there is no cure for atopic eczema, treatment should mainly involve discovering the triggers of allergic reactions and learning to avoid them.

Treatment

Maintaining the Skin Barrier

The primary treatment involves prevention, includes avoiding or minimizing contact with (or intake of) known allergens. Once that has been established, topical treatments can be used. Topical treatments focus on reducing both the dryness and inflammation of the skin.

To combat the severe dryness associated with atopic dermatitis, a high-quality, dermatologist-approved moisturizer should be used daily. Moisturizers are especially effective if applied 5–10 minutes after bathing.

Most commercial soaps wash away all the oils produced by the skin that normally serve to prevent drying. Using a soap substitute such as aqueous cream helps keep the skin moisturized. A non-soap cleanser can be purchased usually at a local drug store. Showers should be kept short and at a lukewarm/moderate temperature.

 Prescription Drugs

If moisturizers on their own don't help and the eczema is severe, a doctor may prescribe topical corticosteroid ointments, creams, or injections.Higher-potency steroid creams must not be used on the face or other areas where the skin is naturally thin; usually a lower-potency steroid is prescribed for sensitive areas. The use of the finger tip unit may be helpful in guiding how much topical cream is required to cover different areas.

Epidemiology

Atopic dermatitis is a common disease which tends to affect both males and females in the same proportion. Atopic dermatitis occurs most often in infants and children, and its onset decreases substantially with age, and it is highly unlikely to develop in patients who are older than 30 years.The condition appears to primarily affect individuals who live in urban areas and in climates with low humidity. However, specialists claim that there is a genetic factor which may play an important role in the development of atopic dermatitis.

Psoraisis

Psoriasis

What is psoriasis?

Psoriasis is a chronic, recurring skin disease. Its scope can vary considerably; from mild outbreaks, where the person may not even be aware they have psoriasis, to severe cases, which can be socially disabling and, in rare instances, life-threatening.

What causes psoriasis?

Psoriasis is a condition which runs in families, but the exact way in which the disease moves from generation to generation has not yet been established. Although the tendency to contract psoriasis is stored in a person's genes, it is by no means certain that it will ever develop.

However, exposure to certain stimuli (such as a streptococcal infection in the throat, alcohol, medicines and local irritation) or damage to the skin, may cause an outbreak of psoriasis in persons who have this genetic predisposition.

What are the symptoms of psoriasis vulgaris?

Psoriasis vulgaris is the most common form. The first signs of an outbreak are:

• Red spots or patches.
• The patches grow bigger and become scaly.
• The upper scales fall off in large quantities, while the lower layers of scales are firmly fixed.
• When the scales are scraped off, a number of small, bleeding points can be seen underneath.
• Psoriasis of the nail often manifests itself as small indentures in the nails. The outbreak can be so severe that the nail thickens and crumbles away.
• Flexural psoriasis occurs in skin folds (flexures). Red, itchy plaques appear in the armpits, under the breasts, on the stomach, in the groin or on the buttocks. The plaques are often infected by the yeast-like fungus candida albicans.
• Guttate psoriasis is a special variant which primarily occurs acutely in children and young people due to a streptococcal infection of the throat. Drop-like, scaly patches appear on the entire body. In many cases, the condition disappears by itself after a few weeks or months.

Psoriasis of the scalp can be difficult to distinguish from a severe case of cradle cap, and sometimes the two occur simultaneously. An outbreak of psoriasis often leads to lesions on the face.

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Who is most at risk?

People who have family members with psoriasis, especially if they are exposed to stress, alcoholism, infections, medical treatment, or events such as divorce, bereavement or moving house.

How is it diagnosed?

The diagnosis is usually made after a careful examination of the skin.

If there is any doubt about the diagnosis, the doctor will take a biopsy - a small portion of the skin which will be sent to a specialist for examination under a microscope.

What is the treatment?

The treatment, which should be carried out in close collaboration between the patient and the GP or the dermatologist, consists of various treatments used locally on the skin and taken by mouth. It depends on the patient's age, state of health and on the nature of the psoriasis.

Moisturisers are an important factor in treatment for psoriasis and may be all that is needed for mild psoriasis. They reduce dryness, cracking and scaling of the skin.

Specific local treatments include creams and ointments containing coal tar, dithranol, tazarotene (Zorac) or vitamin D-related compounds, eg  calcipotriol (Dovonex), calcitriol (Silkis) or tacalcitol (Curatoderm)).

Occasionally, corticosteroid-containing ointments are used for a short time. Combining a corticosteroid with another topical treatment, either as separate products used at different times of day, or as a combination product, eg Dovobet (calcipotriol and betamethasone) or Alphosyl HC (coal tar and hydrocortisone), may be beneficial for chronic psoriasis vulgaris.

Special lotions are available for scalp treatment. These often contain salicylic acid, coal tar, sulphur or corticosteroids.

Phototherapy (ultraviolet B, UVB) and photochemotherapy (psoralent ultraviolet A, PUVA) are both used in specialist dermatology centres for widespread psoriasis. Many patients find that natural sunlight also helps.

Oral treatment with immunosuppressants such as ciclosporin (Neoral) or methotrexate (eg Maxtrex) or the vitamin A derivative acitretin (Neotigason) may be used for patients with severe, widespread or unresponsive psoriasis.

Injections of the immunosuppressants etanercept (Enbrel), adalimumab (Humira) or infliximab (Remicade) may be used for people with severe plaque psoriasis that has failed to respond to ciclosporin, methotrexate or photochemotherapy, or for people who can't take or tolerate these treatments.

Intensive research is being carried out to find better treatments for psoriasis and new treatments are regularly introduced which improve the condition in some people.

Article on Warts

Article on Warts

  

Warts

Warts are small, skin-coloured, rough lumps on the skin that are benign (non-cancerous). They often appear on the hands and feet. Warts can look different depending on where they are on the body and how thick the skin is. Warts are caused by infection with a virus called the human papilloma virus (HPV). HPV causes keratin, a hard protein in the top layer of the skin (the epidermis), to grow too much, producing the rough hard texture of a wart.

Alternative Names of Warts are: Verruca vulgaris .

Rarely, treatment for warts can cause scarring and infection. It can be very difficult to treat warts in people with weak immune systems (for example, people with an illness such as AIDS or people who have had an organ transplant or treatment for cancer). In some cases, it may not be possible to clear the warts, even with treatment.  

Causes of Warts

You get warts through direct contact with the human papillomavirus (HPV). There are 100 or more types of HPV. Several types of HPV have been implicated in the cause of cancer of the cervix. Many more types tend to cause warts on your skin. Common warts usually occur on your hands, fingers or near your fingernails. Other types of HPV tend to cause warts in other places, such as on the soles of the feet, the genitals, or the face and legs.

Signs & Symptoms of Warts

Common warts are:

• Small, fleshy, grainy bumps
• Flesh-colored, white, pink or tan
• Rough to the touch
• Common warts usually occur:
• On your hands
• On your fingers
• Near your fingernails

Warts may occur singly or in multiples. They may bleed if picked or cut and often contain one or more tiny black dots, which are sometimes called wart "seeds" but are actually small, clotted blood vessels. Common warts are usually painless. Young adults and children appear to be affected most often.

Other locations for warts

other types of HPV tend to cause warts in other places:

• Plantar warts. These occur on the plantar surfaces, or soles, of your feet. They usually look like flesh-colored or light brown lumps with tiny black dots in them. These dots are small, clotted blood vessels. Plantar warts can be differentiated from corns by applying pressure tagentially as warts hurt more by tagential pressure.
• Genital warts. These are among the most common types of sexually transmitted diseases. They can appear on your genitals, in your pubic area or in your anal canal. In women, genital warts can also grow inside the vagina.
• Flat warts. These warts are smaller and smoother than other warts. They generally occur on your face or legs. They're more common in children and teens than in adults.

Diagnosis of Warts

The diagnosis is most often made on the basis of clinical appearance. Diagnostic clues include black dots within the warts and/or pinpoint bleeding after paring down the thickened skin. The wart also tends to disturb the natural skin lines and creates a disrupted surface. A biopsy can be used to confirm clinical suspicion, provide proper diagnosis, and help determine if progression to skin cancer, a rare complication, has occurred.

Treatments of Warts

A variety of creams, gels and medicated plasters for treating warts are available from pharmacies. Most of these contain salicylic acid as their active ingredient. Salicylic acid works by destroying the thickened skin that makes up the wart. The following are some tips for successful treatment.

• Salicylic acid and other wart treatments also affect healthy skin, so it's important to protect the surrounding area - use petroleum jelly or a corn plaster - and apply the product with care.
• Soak the wart in warm water for five minutes before applying the salicylic acid.
• Rub dead skin off once or twice a week with a pumice stone or emery board.
• Stop treatment and re-start in a few days if the skin becomes sore.
• Cover the wart with a plaster - this may help get rid of the wart.
• Persevere - you may need to continue applying

Prevention of Warts
To reduce the risk that you or your child will get or spread warts:

• Don't brush, clip, comb or shave areas that have warts, in order to avoid spreading the virus.
• Don't use the same file or nail clipper on your warts as you use on your healthy nails.
• Don't bite your fingernails if you have warts near your fingernails.
• Don't pick at warts. Picking may spread the virus. Consider covering your child's warts with an adhesive bandage to discourage picking.
• Keep your hands as dry as possible, because warts are more difficult to control in a moist environment.
• Wash your hands carefully after touching your warts.

When to seek Medical Advice

Prompt treatment by a doctor or dermatologist, however, may decrease the chance that the warts will spread to other areas of your body or to other people. See your doctor if your warts or your child's warts persist, despite home treatment. Also see your doctor if your warts are bothersome, painful or rapidly multiplying. Genital warts should be treated at the earliest to avoid spread to the partner. In females as these warts run the risk of turning into malignancy annual pap smear is recommended.
 

Alopecia Areata

Alopecia Areata

Alopecia areata (AA) is a condition affecting humans, in which hair is lost from some or all areas of the body, usually from the scalp. Because it causes bald spots on the scalp, especially in the first stages, it is sometimes called spot baldness. In 1%–2% of cases, the condition can spread to the entire scalp (Alopecia totalis) or to the entire epidermis (Alopecia universalis). Conditions resembling AA, and having a similar cause, occur also in other species.

Signs and symptoms

First symptoms are small, soft, bald patches which can take just about any shape but are most usually round. It most often affects the scalp and beard but may occur on any hair-bearing part of the body. There may be different skin areas with hair loss and regrowth in the same body at the same time. It may also go into remission for a time, or permanently.

The area of hair loss may tingle or be very slightly painful.

The hair tends to fall out over a short period of time, with the loss commonly occurring more on one side of the scalp than the other.

Causes

Alopecia areata is noncommunicable, or not contagious. It occurs more frequently in people who have affected family members, suggesting that heredity may be a factor. Strong evidence that genes may increase risk for alopecia areata was found by studying families with two or more affected members. This study identified at least four regions in the genome that are likely to contain alopecia areata genes. In addition, it is slightly more likely to occur in people who have relatives with autoimmune diseases.

Treatment

In cases where there is severe hair loss, there has been limited success treating alopecia areata with clobetasol or fluocinonide, steroid injections, or cream. Steroid injections are commonly used in sites where there are small areas of hair loss on the head or especially where eyebrow hair has been lost. Some other medications used are minoxidil, elocon ointment (steroid cream) irritants (anthralin or topical coal tar), and topical immunotherapy cyclosporine, each of which are sometimes used in different combinations.

For small patches on the beard or head it is possible to suppress with topical tacrolimus ointments like Protopic. Symptoms may remain suppressed until aggravated by stress or other factors.

Epidemiology

The condition affects 0.1%–0.2% of humans, occurring in both males and females. Alopecia areata occurs in people who are apparently healthy and have no skin disorder. Initial presentation most commonly occurs in the late teenage years, early childhood, or young adulthood, but can happen with people of all ages.  

       

With regards,

Dr Parmjit Walia

consultant dermatosurgeon

Dr walia skin & laser clinic

scf-30, phase-3b2, mohali.

0172-2221456, 09417015261

www.drwaliaskinclinic.com